Diabetes overview.Almost every one of us knows someone who has diabetes. An estimated 16 million people in the United States have diabetes mellitus--a serious, lifelong condition. About half of these people do not know they have diabetes and are not under care for the disorder. Each year, about 650,000 people are diagnosed with diabetes. Although diabetes occurs most often in older adults, it is one of the most common chronic disorders in children in the United States. About 127,000 children and teenagers age 19 and younger have diabetes. What Is Diabetes? Diabetes is a disorder of metabolism--the way our bodies use digested food for growth and energy. Most of the food we eat is broken down by the digestive juices into a simple sugar called glucose. Glucose is the main source of fuel for the body. After digestion, the glucose passes into our bloodstream where it is available for body cells to use for growth and energy. For the glucose to get into the cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach. When we eat, the pancreas is supposed to automatically produce the right amount of insulin to move the glucose from our blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the body cells do not respond to the insulin that is produced. As a result, glucose builds up in the blood, overflows into the urine, and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose. What Are the Different Types of Diabetes? The three main types of diabetes are: * Insulin-dependent diabetes mellitus insulin-dependent diabetes mellitus n. Abbr. IDDM See diabetes mellitus. (IDDM IDDM abbr. insulin-dependent diabetes mellitus IDDM insulin-dependent diabetes mellitus. IDDM Insulin-dependent diabetes mellitus; now known as type 1 diabetes mellitus ) or Type I diabetes Type I diabetes Also called juvenile diabetes. Type I diabetes typically begins early in life. Affected individuals have a primary insulin deficiency and must take insulin injections. Mentioned in: Diabetic Ketoacidosis * Noninsulin-dependent diabetes mellitus diabetes mellitus Disorder of insufficient production of or reduced sensitivity to insulin. Insulin, synthesized in the islets of Langerhans (see Langerhans, islets of), is necessary to metabolize glucose. In diabetes, blood sugar levels increase (hyperglycemia). (NIDDM NIDDM abbr. non-insulin-dependent diabetes mellitus NIDDM non-insulin-dependent diabetes mellitus. NIDDM Non-insulin-dependent diabetes mellitus. See Type 2 diabetes mellitus. ) or Type II diabetes Type II diabetes Type II diabetes is the most common form of diabetes and usually appears in middle aged adults. It is often associated with obesity and may be delayed or controlled with diet and exercise. Mentioned in: Diabetic Ketoacidosis * Gestational diabetes Gestational Diabetes Definition Gestational diabetes is a condition that occurs during pregnancy. Like other forms of diabetes, gestational diabetes involves a defect in the way the body processes and uses sugars (glucose) in the diet. . Insulin-Dependent Diabetes Insulin-dependent diabetes is considered an autoimmune disease autoimmune disease, any of a number of abnormal conditions caused when the body produces antibodies to its own substances. In rheumatoid arthritis, a group of antibody molecules called collectively RF, or rheumatoid factor, is complexed to the individual's own gamma . An autoimmune disease results when the body's system for fighting infection (the immune system immune system Cells, cell products, organs, and structures of the body involved in the detection and destruction of foreign invaders, such as bacteria, viruses, and cancer cells. Immunity is based on the system's ability to launch a defense against such invaders. ) turns against a part of the body. In diabetes, the immune system attacks the insulin-producing beta cells beta cells, n See cells, beta. in the pancreas and destroys them. The pancreas then produces little or no insulin. Someone with IDDM needs daily injections of insulin to live. At present, scientists do not know exactly what causes the body's immune system to attack the beta cells, but they believe that both genetic factors and viruses are involved. IDDM accounts for about 5 to 10 percent of diagnosed diabetes in the United States. IDDM develops most often in children and young adults, but the disorder can appear at any age. Symptoms of IDDM usually develop over a short period, although beta cell beta cell n. 1. Any of the basophilic chromophil cells located in the anterior lobe of the pituitary gland. 2. Any of the insulin-producing cells of the islets of Langerhans in the pancreas. Also called B cell. destruction can begin months, even years, earlier. Symptoms include increased thirst and urination urination Process of excreting urine from the bladder (see urinary system). Nerve centres in the spinal cord, brain stem, and cerebral cortex control it through involuntary and voluntary muscles. The need to void is felt when the bladder holds 3. , constant hunger, weight loss, blurred vision, and extreme tiredness. If not diagnosed and treated with insulin, a person can lapse into a life-threatening coma. Noninsulin-Dependent Diabetes The most common form of diabetes is noninsulin-dependent diabetes. About 90 to 95 percent of people with diabetes have NIDDM. This form of diabetes usually develops in adults over the age of 40 and is most common among adults over age 55. About 80 percent of people with NIDDM are overweight. In NIDDM, the pancreas usually produces insulin, but for some reason, the body cannot use the insulin effectively. The end result is the same as for IDDM--an unhealthy buildup of glucose in the blood and an inability of the body to make efficient use of its main source of fuel. The symptoms of NIDDM develop gradually and are not as noticeable as in IDDM. Symptoms include feeling tired or ill, frequent urination (especially at night), unusual thirst, weight loss, blurred vision, frequent infections, and slow healing of sores. Gestational Diabetes Gestational diabetes develops or is discovered during pregnancy. This type usually disappears when the pregnancy is over, but women who have had gestational diabetes have a greater risk of developing NIDDM later in their lives. What Is the Scope and Impact of Diabetes? Diabetes is widely recognized as one of the leading causes of death and disability in the United States. According to death certificate data, diabetes contributed to the deaths of more than 169,000 persons in 1992. Diabetes is associated with long-term complications that affect almost every major part of the body. It contributes to blindness, heart disease, strokes, kidney failure kidney failure or renal failure Partial or complete loss of kidney function. Acute failure causes reduced urine output and blood chemical imbalance, including uremia. Most patients recover within six weeks. , amputations, and nerve damage. Uncontrolled diabetes can complicate pregnancy, and birth defects birth defects, abnormalities in physical or mental structure or function that are present at birth. They range from minor to seriously deforming or life-threatening. A major defect of some type occurs in approximately 3% of all births. are more common in babies born to women with diabetes. Diabetes cost the United States $92 billion in 1992. Indirect costs, including disability payments, time lost from work, and premature death, totaled $47 billion; medical costs for diabetes care, including hospitalizations, medical care, and treatment supplies, totaled $45 billion. Who Gets Diabetes? Diabetes is not contagious. People cannot "catch" it from each other. However, certain factors can increase one's risk of developing diabetes. People who have family members with diabetes (especially NIDDM), who are overweight, or who are African American African American Multiculture A person having origins in any of the black racial groups of Africa. See Race. , Hispanic, or Native American are all at greater risk of developing diabetes. IDDM occurs equally among males and females, but is more common in whites than in nonwhites. Data from the World Health Organization's Multinational Project for Childhood Diabetes indicate that IDDM is rare in most Asian, African, and Native American populations. On the other hand, some northern European countries, including Finland and Sweden, have high rates of IDDM. The reasons for these differences are not known. NIDDM is more common in older people, especially older women who are overweight, and occurs more often among African Americans, Hispanics, and Native Americans. Compared with non-Hispanic whites, diabetes rates are about 60 percent higher in African Americans and 110 to 120 percent higher in Mexican Americans and Puerto Ricans. Native Americans have the highest rates of diabetes in the world. Among Pima Indians living in the United States, for example, half of all adults have NIDDM. The prevalence of diabetes is likely to increase because older people, Hispanics, and other minority groups make up the fastest growing segments of the U.S. population. How Is Diabetes Managed? Before the discovery of insulin in 1921, all people with IDDM died within a few years after the appearance of the disease. Although insulin is not considered a cure for diabetes, its discovery was the first major breakthrough in diabetes treatment. Today, daily injections of insulin are the basic therapy for IDDM. Insulin injections must be balanced with meals and daily activities, and glucose levels must be closely monitored through frequent blood sugar testing. Diet, exercise, and blood testing for glucose are also the basis for management of NIDDM. In addition, some people with NIDDM take oral drugs or insulin to lower their blood glucose levels. People with diabetes must take responsibility for their day-to-day care. Much of the daily care involves trying to keep blood sugar levels from going too low or too high. When blood sugar levels drop too low--a condition known as hypoglycemia--a person can become nervous, shaky, and confused. Judgment can be impaired. Eventually, the person could pass out. The treatment for low blood sugar is to eat or drink something with sugar in it. On the other hand, a person can become very ill if blood sugar levels rise too high, a condition known as hyperglycemia hyperglycemia: see diabetes. . Hypoglycemia hypoglycemia: see diabetes. hypoglycemia Below-normal levels of blood glucose, quickly reversed by administration of oral or intravenous glucose. Even brief episodes can produce severe brain dysfunction. and hyperglycemia, which can occur in people with IDDM or NIDDM, are both potentially life-threatening emergencies. People with diabetes should be treated by a doctor who monitors their diabetes control and checks for complications. Doctors who specialize in diabetes are called endocrinologists or diabetologists. In addition, people with diabetes often see ophthalmologists for eye examinations, podiatrists for routine foot care, dietitians for help in planning meals, and diabetes educators for instruction in day-to-day care. The goal of diabetes management is to keep blood glucose levels as close to the normal (nondiabetic) range as safely possible. A recent Government study, sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases About NIDDK The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), of the U.S. National Institutes of Health, conducts and supports research on many of the most serious diseases affecting public health. (NIDDK NIDDK National Institute of Diabetes and Digestive and Kidney Diseases ), proved that keeping blood sugar levels as close to normal as safely possible reduces the risk of developing major complications of diabetes. The 10-year study, called the Diabetes Control and Complications Trial The Diabetes Control and Complications Trial, or DCCT, was the largest, most comprehensive diabetes study ever conducted at the time. The U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) conducted this clinical study of 1,441 volunteers (DCCT DCCT Diabetes Control and Complications Trial (NIDDK) DCCT Distributed Computing and Communications Technology ), was completed in 1993 and included 1,441 people with IDDM. The study compared the effect of two treatment approaches--intensive management and standard management--on the development and progression of eye, kidney, and nerve complications of diabetes. Researchers found that study participants who maintained lower levels of blood glucose blood glucose Diabetology The principal sugar produced by the body from food–especially carbohydrates, but also from proteins and fats; glucose is the body's major source of energy, is transported to cells via the circulation and used by cells in the presence through intensive management had significantly lower rates of these complications. Researchers believe that DCCT findings have important implications for the treatment of NIDDM, as well as IDDM. What Is the Status of Diabetes Research? NIDDK supports basic and clinical research in its own laboratories and in research centers and hospitals throughout the United States. It also gathers and analyzes statistics about diabetes. Other institutes at the National Institutes of Health also carry out research on diabetes-related eye diseases, heart and vascular complications, pregnancy, and dental problems. Other Government agencies that sponsor diabetes programs are the Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center. , the Indian Health Service The Indian Health Service (IHS) is an Operating Division (OPDIV) within the U.S. Department of Health and Human Services responsible for providing federal health services to American Indians and Alaska Natives. , the Health Resources and Services Administration The Health Resources and Services Administration (HRSA) is an agency within the United States Department of Health and Human Services whose goal is to improve access to health care for those without insurance. , the Bureau of Veterans Affairs, and the Department of Defense. Many organizations outside of the Government support diabetes research and education activities. These organizations include the American Diabetes Association The American Diabetes Association, or the ADA, is an American health organization providing diabetes research, information and advocacy. Founded in 1940, the American Diabetes Association conducts programs in all 50 states and the District of Columbia, reaching hundreds of , the Juvenile Diabetes juvenile diabetes n. Insulin-dependent diabetes. Foundation International, and the American Association of Diabetes Educators. In recent years, advances in diabetes research have led to better ways to manage diabetes and treat its complications. Major advances include: * New forms of purified insulin, such as human insulin human insulin n. A protein that has the normal structure of insulin produced by the human pancreas but that is prepared by recombinant DNA techniques and by semisynthetic processes. produced through genetic engineering * Better ways for doctors to monitor blood glucose levels and for people with diabetes to test their own blood glucose levels at home * Development of external and implantable insulin pumps that deliver appropriate amounts of insulin, replacing daily injections * Laser treatment for diabetic eye disease, reducing the risk of blindness * Successful transplantation of kidneys in people whose own kidneys fail because of diabetes * Better ways of managing diabetic pregnancies, improving chances of successful outcomes * New drugs to treat NIDDM and better ways to manage this form of diabetes through weight control * Evidence that intensive management of blood glucose reduces and may prevent development of microvascular complications of diabetes * Demonstration that antihypertensive drugs Antihypertensive Drugs Definition Antihypertensive drugs are medicines that help lower blood pressure. Purpose The overall class of antihypertensive agents lowers blood pressure, although the mechanisms of action vary greatly. called ACE-inhibitors prevent or delay kidney failure in people with diabetes. What Will the Future Bring? In the future, it may be possible to administer insulin through nasal sprays or in the form of a pill or patch. Devices that can "read" blood glucose levels without having to prick a finger to get a blood sample are also being developed. Researchers continue to search for the cause or causes of diabetes and ways to prevent and cure the disorder. Scientists are looking for Looking for In the context of general equities, this describing a buy interest in which a dealer is asked to offer stock, often involving a capital commitment. Antithesis of in touch with. genes that may be involved in NIDDM and IDDM. Some genetic markers for IDDM have been identified, and it is now possible to screen relatives of people with IDDM to see if they are at risk for diabetes. The new Diabetes Prevention Trial--Type I, sponsored by NIDDK, identifies relatives at risk for developing IDDM and treats them with low doses of insulin or with oral insulin-like agents in the hope of preventing IDDM. Similar research is carried out at other medical centers throughout the world. Transplantation of the pancreas or insulin-producing beta cells offers the best hope of cure for people with IDDM. Some pancreas transplants have been successful. However, people who have transplants must take powerful drugs to prevent rejection of the transplanted organ. These drugs are costly and may eventually cause serious health problems. Scientists are working to develop less harmful drugs and better methods of transplanting pancreatic tissue to prevent rejection by the body. Using techniques of bioengineering, researchers are also trying to create artificial islet cells that secrete secrete /se·crete/ (se-kret´) to elaborate and release a secretion. se·crete v. To generate and separate a substance from cells or bodily fluids. insulin in response to increased sugar levels in the blood. For NIDDM, the focus is on ways to prevent diabetes. Preventive approaches include identifying people at high risk for the disorder and encouraging them to lose weight, exercise more, and follow a healthy diet. The Diabetes Prevention Program, another new NIDDK project, will focus on preventing the disorder in high-risk populations. Points to Remember What Is Diabetes? * A disorder of metabolism-the way the body digests food for energy and growth. What Are the Different Types of Diabetes? * Insulin-dependent diabetes (IDDM) * Noninsulin-dependent diabetes (NIDDM) * Gestational diabetes. What Is the Scope and Impact of Diabetes? * Affects 16 million people * A leading cause of death and disability * Costs $92 billion per year. Who Gets Diabetes? * People of any age * More common in older people, African Americans, Hispanics, and Native Americans. Where Is More Information Available? For more information about IDDM, NIDDM, and gestational diabetes, as well as diabetes research, statistics, and education, contact: National Diabetes Information Clearinghouse The National Diabetes Information Clearinghouse(NDIC) is an information dissemination service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health, which is part of the U.S. 1 Information Way Bethesda, MD 20892-3560 (301) 654-3327. The following organizations also distribute materials and support programs for people with diabetes and their families and friends: American Association of Diabetes Educators 444 North Michigan Avenue, Suite 1240 Chicago, IL 60611 (800) 832-6874 (312) 644-2233 American Diabetes Association ADA Ada, city, United States Ada (ā`ə), city (1990 pop. 15,820), seat of Pontotoc co., S central Okla.; inc. 1904. It is a large cattle market and the center of a rich oil and ranch area. National Service Center 1660 Duke Street Alexandria, VA 22314 (800) 232-3472 (703) 549-1500 Juvenile Diabetes Foundation International 120 Wall Street 19th Floor New York New York, state, United States New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of , NY 10005 (800) 223-1138 (212) 785-9500. National Diabetes Information Clearinghouse 1 Information Way Bethesda, MD 20892-3560 (301) 654-3327 The National Diabetes Information Clearinghouse (NDIC NDIC National Drug Intelligence Center NDIC National Diabetes Information Clearinghouse NDIC Nigeria Deposit Insurance Corporation NDIC National Defence Industries Council (UK defense) ) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health, under the U.S. Public Health Service. The clearinghouse, authorized by Congress in 1978, provides information about diabetes to people with diabetes and their families, health care professionals, and the public. NDIC answers inquiries; develops, reviews, and distributes publications; and works closely with professional and patient organizations and government agencies to coordinate resources about diabetes. Publications produced by the clearinghouse are reviewed carefully for scientific accuracy, content, and readability. Materials produced by other sources are also reviewed for scientific accuracy and are used, along with clearinghouse publications, to answer inquiries. |
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