Diabetes
Sometimes referred to as: diabetes mellitus, type 1 diabetes, type 2 diabetes
Interview between:
Nora Lansen, MD
Jamila Schwartz, MD
Diabetes is a disorder of the endocrine system that is primarily divided into type 1, type 2, and gestational diabetes. In all forms of diabetes, the body loses its ability to properly process blood glucose.
Cases Per Year (US)
1.5 million Americans are diagnosed with diabetes every year.
General Frequency
As of 2015, 30.3 million Americans had diabetes. This equates to 9.4% of the U.S. population. An additional 84.1 million Americans, or one in three US adults, had “prediabetes,” which if not treated will often lead to diabetes within five years.
Risk
Diabetes was the seventh leading cause of death in the U.S. in 2015.
Symptoms
How does diabetes affect the body?
To properly process the carbohydrates in food, the body breaks them down into glucose (“blood sugar”) to use for energy. Then, the pancreas produces insulin to move the glucose from the bloodstream into cells.
In type 1 diabetes, the body does not properly make insulin. This type is thought to be caused by a combination of genetics and environmental factors and is generally first diagnosed among youths. However, there are also adult-onset cases of type 1 diabetes.
As for type 2 diabetes, the body does not respond properly to the insulin that it makes. This is called insulin resistance. Early in the disease, the body makes more insulin to compensate. But, over time, the body cannot keep up, and insulin deficiency develops as type 2 diabetes progresses.
With gestational diabetes, a pregnant woman develops diabetes during her pregnancy even though she has never had it before.
What are the long term complications of diabetes?
There are a multitude of long-term complications of diabetes that are caused by elevated blood glucose levels over time. These include heart disease, stroke, high blood pressure, kidney nephropathy (disease) possibly leading to kidney failure requiring dialysis, poor circulation and foot ulcers potentially leading to limb amputations, peripheral neuropathy (nerve damage causing pain), autonomic neuropathy (causing erectile dysfunction, gastroparesis, etc), other neuropathy (such as Charcot neuropathic arthropathy), vision loss (due to diabetic retinopathy, glaucoma, or cataracts), skin infections or other problems. Diabetics have nearly double the risk of heart attack or stroke compared to people without diabetes.
Are those complications only the result of blood sugar or are there other factors involved?
There are certainly genetic and environmental risk factors for cardiovascular disease, high cholesterol, kidney disease, and vision impairment or loss that are distinct from the presence of diabetes.
However, diabetics are more likely to develop these diseases or conditions than people without diabetes. For all complications of diabetes, improved blood glucose control will decrease the risk of developing them, as will controlling blood pressure and quitting smoking.
Causes
Prevention
Treatment
Diet
Lifestyle Factors
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Nora Lansen, MD and Jamila Schwartz, MD are both members of the Galileo Clinical Team. Connect with one of our physicians about Diabetes or any of the many other conditions we treat.
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