Diabetes mellitus has become an epidemic in the United States with about 1 million people over age 20 diagnosed with the condition each year. About 17 million people, or 6 percent of the U.S. population, have diabetes mellitus, a disease in which the body doesn't produce or properly use insulin, a hormone produced in the pancreas that converts sugar into energy.
Diabetes, the sixth leading cause of death in the United States, can cause serious health complications such as blindness, kidney failure, nerve damage and the need for lower-extremity amputations. In addition, diabetes is a major risk factor for cardiovascular disease, dramatically increasing the risk for heart disease and stroke.
There are three main types of diabetes:
Type 1 Diabetes: About 5 to 10 percent of those with diabetes have type 1 diabetes. It's an autoimmune disease, meaning the body's own immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. Patients with type 1 diabetes have very little or no insulin, and must take insulin everyday. Although the condition can appear at any age, typically it's diagnosed in children and young adults, which is why it was previously called juvenile diabetes.
Type 2 Diabetes: Accounting for 90 to 95 percent of those with diabetes, type 2 is the most common form. Usually, it's diagnosed in adults over age 40 and 80 percent of those with type 2 diabetes are overweight. Because of the increase in obesity, type 2 diabetes is being diagnosed at younger ages, including in children. Initially in type 2 diabetes, insulin is produced, but the insulin doesn't function properly, leading to a condition called insulin resistance. Eventually, most people with type 2 diabetes suffer from decreased insulin production.
Your doctor will first ask about your medical history and perform a physical examination to check for symptoms of diabetes and high blood sugar. Diabetes usually is diagnosed with the following tests that measure the glucose levels in your blood:
Fasting Plasma Glucose Test: This is the standard test for diagnosing type 1 and type 2 diabetes. You must not eat or drink anything for at least eight hours prior to this simple test in which blood is drawn to check your sugar levels. A diagnosis of diabetes will be made if you have a fasting blood sugar level of 126 milligrams per deciliter or higher on two separate days.
Other Tests: Diabetes also may be diagnosed based on a random high glucose level of 200mg/dl and symptoms of the disease. Your doctor may wish to perform an oral glucose tolerance test, which is the traditional test for diabetes mellitus.
The goal of diabetes management is to keep blood glucose levels as close to normal as safely possible. Since diabetes may greatly increase risk for heart disease and peripheral artery disease, measures to control blood pressure and cholesterol levels are an essential part of diabetes treatment as well.
People with diabetes must take responsibility for their day-to-day care. This includes monitoring blood glucose levels, dietary management, maintaining physical activity, keeping weight and stress under control, monitoring oral medications and, if required, insulin use via injections or pump. To help patients achieve this, UCSF's Diabetes Teaching Center offers self-management educational programs that emphasize individualized diabetes care. The program enables patients to make more consistent and appropriate adjustments in their therapy and lifestyle.
Reviewed by health care specialists at UCSF Medical Center.