Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both.
To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested:
A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body.
An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel.
People with diabetes have high blood sugar. This is because:
Their pancreas does not make enough insulin
Their muscle, fat, and liver cells do not respond to insulin normally
Both of the above
There are three major types of diabetes:
Type 1 diabetes is usually diagnosed in childhood. Many patients are diagnosed when they are older than age 20. In this disease, the body makes little or no insulin. Daily injections of insulin are needed. The exact cause is unknown. Genetics, viruses, and autoimmune problems may play a role.
Type 2 diabetes (11 images)
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Type 2 diabetes is a chronic (lifelong) disease marked by high levels of sugar in the blood. It begins when the body does not respond correctly to insulin, a hormone released by the pancreas. Type 2 diabetes is the most common form of diabetes. See also: Diabetes; Gestational diabetes; Type 1 diabetes. Reviewer: A.D.A.M. Editorial Team: David Zieve, MD, MHA, Greg Juhn, MTPW, David R. Eltz. Previously reviewed by Elizabeth H. Holt, MD, PhD, Assistant Professor of Medicine, Section of Endocrinology and Metabolism, Yale University. Review provided by VeriMed Healthcare Network (6/17/2008).Date: 12/12/2008
Type 1 diabetes (5 images)
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Type 1 diabetes is a chronic (lifelong) disease that occurs when the pancreas does not produce enough insulin to properly control blood sugar levels. See also: Diabetes; Gestational diabetes; Type 2 diabetes. Reviewer: Elizabeth H. Holt, MD, PhD, Assistant Professor of Medicine, Section of Endocrinology and Metabolism, Yale University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. Date: 06/17/2008
Gestational diabetes (2 images)(Doctor-Reviewed information)
Gestational diabetes is high blood sugar (diabetes) that starts or is first diagnosed during pregnancy. Reviewer: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. Date: 10/28/2008
Diabetes insipidus (1 image)(Doctor-Reviewed information)
Diabetes insipidus is a condition in which the kidneys are unable to conserve water. Reviewer: Elizabeth H. Holt, MD, PhD, Assistant Professor of Medicine, Section of Endocrinology and Metabolism, Yale University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 03/18/2008
Glucose test - blood (1 image)(Doctor-Reviewed information)
A blood glucose test measures the amount of sugar (glucose) in a sample of your blood. See also: Glucose test - CSF; Glucose test - urine; Home blood glucose monitoring. Reviewer: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 05/12/2009
Hypoglycemia (1 image)
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Hypoglycemia is a condition that occurs when your blood sugar (glucose) is too low. Reviewer: Elizabeth H. Holt, MD, PhD, Assistant Professor of Medicine, Section of Endocrinology and Metabolism, Yale University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 06/17/2008
Diabetes diet (1 image)
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Specific diabetic dietary guidelines have been developed by the American Diabetes Association and the American Dietetic Association to improve the management of diabetes. Key principles are to: Achieve weight control through reducing calories; Individualize guidelines for carbohydrates based on the type of diabetes you have and the control of your blood sugar levels; Reduce intake of dietary fat (specifically saturated fat. Reviewer: Patrika Tsai, MD, MPH, Assistant Clinical Professor, Pediatric Gastroenterology, Hepatology and Nutrition, University of California, San Francisco, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 06/23/2008
Diabetes foot care (2 images)(Doctor-Reviewed information)
If you have diabetes you are more likely to have to foot problems. Diabetes can damage your nerves (See: Diabetic neuropathy. This, in turn, may make you less able to feel an injury or pressure on the skin of your foot. You may not notice a foot injury until severe damage or infection develops. Diabetes changes your body's ability to fight infections. Damage to blood vessels because of diabetes results in less blood and oxygen getting to your feet. Because of this, small sores or breaks in the skin may become deeper skin ulcers. The affected limb may need to be amputated when these skin ulcers do not improve, get larger, or go deeper into the skin. If you have diabetes, you should: Improve control of your blood sugar; Stop smoking; Get a foot exam by your health care provider at least twice a year and learn whether you have nerve damage; Check and care for your feet EVERY DAY, especially if you already have known nerve or blood vessel damage or current foot problems. Follow the instructions below. DAILY CARE ROUTINE Check your feet every day. Look carefully at the top, sides, soles, heels, and between the toes. Wash your feet every day with lukewarm water and mild soap. Strong soaps may damage the skin. Test the temperature of the water with your fingers or elbows before putting your feet in warm or hot water. Because of your diabetes, you may not be able to sense if the water is too hot. Burns can easily occur; Gently and thoroughly dry your feet, particularly between your toes. Infections can develop in moist areas; Your feet may become very dry and may crack, possibly causing an infection. After bathing your feet, soften dry skin with lotion, petroleum jelly, lanolin, or oil. Do not put lotion between your toes. Ask your health care provider if it is okay for you to trim your nails. If it is, ask your health care provider to show you the safest way. If your toenails are not trimmed correctly, you may get a foot sore or ulcer. Soak your feet in lukewarm water to soften your nails before trimming; Cut the nail straight across, because curved nails are more likely to become ingrown. Avoid sitting with legs crossed or standing in one position for long periods of time. If you smoke, stop. It decreases blood flow to the feet. TIPS ON SHOES AND SOCKS Wear shoes at all times to protect your feet from injury. Otherwise, if you have poor vision and less ability to feel pain, you may not notice minor cuts or bumps. Check the inside of your shoes for rough areas or torn pieces that can cause irritation; Change your shoes after 5 hours of wearing them during the day. This changes the pressure points during the course of the day. The type of shoes you wear when you have diabetes is important: Wear comfortable, well-fitting shoes that have plenty of room in them. Never buy shoes that do not fit properly, hoping the shoes will stretch with time. Nerve damage may prevent you from being able to sense pressure from improperly fitting shoes.You may need a special shoe made to fit your foot; Wear shoes made out of canvas, leather, or suede. Do not wear shoes made out of plastic, or another material that does not breathe. Do not wear thong sandals; Wear shoes you can easily adjust. They should have laces, Velcro, or buckles; Do not wear shoes with pointed or open toes, such as high heels, flip-flops, or sandals. Socks may provide an extra layer of protection between your shoe and your foot. Wear clean dry socks or non-binding panty hose every day; DO NOT wear stockings with seams that can cause pressure points; Wear socks to bed if your feet are cold. In cold weather, wear warm socks and limit your exposure to the cold to prevent frostbite. MORE HELPFUL TIPS DO NOT use antiseptic solutions on your feet because these can burn and injure skin; DO NOT Reviewer: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 05/02/2009
Diabetic ketoacidosis (1 image)(Doctor-Reviewed information)
Diabetic ketoacidosis is a complication of diabetes that occurs when sugar (glucose) is not available as a fuel source by the body and fat is used instead. Byproducts of fat breakdown, called ketones, build up in the body. Reviewer: Elizabeth H. Holt, MD, PhD, Assistant Professor of Medicine, Section of Endocrinology and Metabolism, Yale University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 06/17/2008
Diabetes risk factors (1 image)(Doctor-Reviewed information)
You have a higher risk for diabetes if you have any of the following: Age greater than 45 years; Diabetes during a previous pregnancy; Excess body weight (especially around the waist; Family history of diabetes; Given birth to a baby weighing more than 9 pounds; HDL cholesterol under 35; High blood levels of triglycerides, a type of fat molecule (250 mg/dL or more; High blood pressure (greater than or equal to 140/90 mmHg; Impaired glucose tolerance; Low activity level; Poor diet. Persons from certian ethnic groups, including African Americans, Hispanic Americans, and Native Americans, all have high rates of diabetes Everyone over 45 should have their blood glucose checked at least every 3 years. Regular testing of random blood glucose should begin at a younger age, and be performed more often if you are at higher risk for diabetes. See: Diabetes Reviewer: Elizabeth H. Holt, MD, PhD, Assistant Professor of Medicine, Section of Endocrinology and Metabolism, Yale University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 06/17/2008
Diabetes insipidus - central (1 image)(Doctor-Reviewed information)
Central diabetes insipidus is a rare condition that involves extreme thirst and excessive urination. See also: Diabetes insipidus - nephrogenic Reviewer: Robert Cooper, MD, Endocinology Specialist and Chief of Medicine, Holyoke Medical Center, Assistant Professor of Medicine, Tufts University School of Medicine, Boston MA Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 07/28/2008
Congenital nephrogenic diabetes insipidus (1 image)(Doctor-Reviewed information)
Congenital nephrogenic diabetes insipidus is a condition in which the kidneys can't conserve water, leading to excessive water loss. See also: Diabetes insipidus - nephrogenic Reviewer: Charles Silberberg, DO, Private Practice specializing in Nephrology, Affiliated with NY Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network.Date: 08/14/2007
Diabetes insipidus - nephrogenic (1 image)(Doctor-Reviewed information)
Nephrogenic diabetes insipidus is a disorder in which a defect in the small tubes (tubules) in the kidneys causes a person to pass a large amount of urine. The tubules allow water to be removed from the body or reabsorbed. See also: Diabetes insipidus - central Reviewer: Parul Patel, MD, Private Practice specializing in Nephrology and Kidney and Pancreas Transplantation, Affiliated with California Pacific Medical Center, Department of Transplantation, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 04/14/2008
Diabetes - resources (1 image)(Doctor-Reviewed information)
The following sites provide further information on diabetes: American Diabetes Association - www.diabetes.org; Juvenile Diabetes Research Foundation International - www.jdrf.org; National Center for Chronic Disease Prevention and Health Promotion - www.cdc.gov/diabetes; National Diabetes Education Program - http/ndep.nih.gov; National Diabetes Information Clearinghouse - www.diabetes.niddk.nih.gov. See the following for information on diabetes-related complications: Blindness resources; Kidney disease resources. Reviewer: Jennifer K. Mannheim, CRNP, private practice, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 04/02/2009
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