Jump up ^ Ahlqvist, Emma; Storm, Petter; Käräjämäki, Annemari; Martinell, Mats; Dorkhan, Mozhgan; Carlsson, Annelie; Vikman, Petter; Prasad, Rashmi B; Aly, Dina Mansour (2018). "Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables". The Lancet Diabetes & Endocrinology. 0 (5): 361–369. doi:10.1016/S2213-8587(18)30051-2. ISSN 2213-8587. PMID 29503172.
Diet management is very important in people with both types of diabetes mellitus. Doctors recommend a healthy, balanced diet and efforts to maintain a healthy weight. People with diabetes can benefit from meeting with a dietitian or a diabetes educator to develop an optimal eating plan. Such a plan includes avoiding simple sugars and processed foods, increasing dietary fiber, limiting portions of carbohydrate-rich, and fatty foods (especially saturated fats). People who are taking insulin should avoid long periods between meals to prevent hypoglycemia. Although protein and fat in the diet contribute to the number of calories a person eats, only the number of carbohydrates has a direct effect on blood glucose levels. The American Diabetes Association has many helpful tips on diet, including recipes. Even when people follow a proper diet, cholesterol-lowering drugs are needed to decrease the risk of heart disease (see recommendations).

2.Retinopathy - Diabetes may cause blood vessels in the retina (the light sensitive lining of the eye) to become leaky, blocked, or grow abnormally [Figure 1]. Retinopathy is rare before the age of 10 and the risk increases with the length of time a person has diabetes. Treatments such as laser, injections in the eye, or other procedures may be helpful to prevent visual loss or restore sight. The longer a patient has diabetes, the greater chance of developing an eye problem.  All patients with diabetes are at risk for developing retinopathy, but the risk is higher for patients with worse blood sugar control.  Early retinopathy may have no symptoms, but early treatment is essential to prevent any loss of vision.

There are other factors that also fall into the category of environmental (as opposed to genetic) causes of diabetes. Certain injuries to the pancreas, from physical trauma or from drugs, can harm beta cells, leading to diabetes. Studies have also found that people who live in polluted areas are prone to type 2, perhaps because of inflammation. And an alternate theory of insulin resistance places the blame on damage caused by inflammation. Age also factors into type 2; beta cells can wear out over time and become less capable of producing enough insulin to overcome insulin resistance, which is why older people are at greater risk of type 2.


In 2013, of the estimated 382 million people with diabetes globally, more than 80 per cent lived in LMIC. It was estimated that India had 65.1 million adults with diabetes in 2013, and had the 2nd position among the top 10 countries with the largest number of diabetes. This number is predicted to increase to 109 million by 2035 unless steps are taken to prevent new cases of diabetes1. Primary prevention of diabetes is feasible and strategies such as lifestyle modification are shown to be effective in populations of varied ethnicity2,3. However, for implementation of the strategies at the population level, national programmes which are culturally and socially acceptable and practical have to be formulated which are currently lacking in most of the developed and developing countries. Early diagnosis and institution of appropriate therapeutic measures yield the desired glycaemic outcomes and prevent the vascular complications4.


a chronic metabolic disorder in which the use of carbohydrate is impaired and that of lipid and protein is enhanced. It is caused by an absolute or relative deficiency of insulin and is characterized, in more severe cases, by chronic hyperglycemia, glycosuria, water and electrolyte loss, ketoacidosis, and coma. Long-term complications include neuropathy, retinopathy, nephropathy, generalized degenerative changes in large and small blood vessels, and increased susceptibility to infection.
Prediabetes is a condition in which blood glucose levels are higher than normal, but a person does not yet have diabetes. Prediabetes and high blood glucose levels are a risk factor for developing diabetes, heart disease, and other health problems. Other warning signs prediabetes may include increased urination, feeling you need to urinate more often, and/or increased thirst.
The tuberculosis skin test is based on the fact that infection with M. tuberculosis produces a delayed-type hypersensitivity skin reaction to certain components of the bacterium. The standard recommended tuberculin test is administered by injecting 0.1mL of 5 TU (tuberculin units) PPD into the top layers of skin of the forearm. "Reading" the skin test means detecting a raised, thickened local area of skin reaction, referred to as induration. The area of induration (palpable, raised, hardened area) around the site of injection is the reaction to tuberculin.
a chronic metabolic disorder in which the use of carbohydrate is impaired and that of lipid and protein is enhanced. It is caused by an absolute or relative deficiency of insulin and is characterized, in more severe cases, by chronic hyperglycemia, glycosuria, water and electrolyte loss, ketoacidosis, and coma. Long-term complications include neuropathy, retinopathy, nephropathy, generalized degenerative changes in large and small blood vessels, and increased susceptibility to infection.
Other studies have focused, not on sugar overall but specifically on sodas and other sugar-sweetened beverages. Many have found no significant relationship, apart from sugar’s extra calories that lead to weight gain. For example, the Women’s Health Study,8 the Atherosclerosis Risk in Communities Study,9 the Black Women’s Health Study,10 and the Multi-Ethnic Study of Atherosclerosis found no significant associations between sugar consumption and diabetes risk after adjustment for measures of body weight. Some studies have had mixed results, exonerating sucrose, but indicting glucose and fructose.12,13 And some studies have shown associations between sugar-sweetened beverages and diabetes that persist after adjustment for body weight.14,15
Type 2 diabetes is different. A person with type 2 diabetes still produces insulin but the body doesn't respond to it normally. Glucose is less able to enter the cells and do its job of supplying energy (a problem called insulin resistance). This raises the blood sugar level, so the pancreas works hard to make even more insulin. Eventually, this strain can make the pancreas unable to produce enough insulin to keep blood sugar levels normal.
Family or personal history. Your risk increases if you have prediabetes — a precursor to type 2 diabetes — or if a close family member, such as a parent or sibling, has type 2 diabetes. You're also at greater risk if you had gestational diabetes during a previous pregnancy, if you delivered a very large baby or if you had an unexplained stillbirth.
You have a higher risk of type 2 diabetes if you are older, have obesity, have a family history of diabetes, or do not exercise. Having prediabetes also increases your risk. Prediabetes means that your blood sugar is higher than normal but not high enough to be called diabetes. If you are at risk for type 2 diabetes, you may be able to delay or prevent developing it by making some lifestyle changes.
On behalf of the millions of Americans who live with or are at risk for diabetes, we are committed to helping you understand this chronic disease. Help us set the record straight and educate the world about diabetes and its risk factors by sharing the common questions and answers below. If you're new to type 2 diabetes, join our Living With Type 2 Diabetes program to get more facts.
You should expect your dentist to inquire about how you monitor your blood sugar and your current status (e.g. most recent HbA1c, medication profile). For most routine dental procedures (e.g. examinations, simple fillings, routine cleanings), no special alterations in the delivery of dental care are necessary. However, more involved procedures, such as extensive surgery or treatment of serious infection, may interfere with your normal diabetes management. For such cases, your dentist will work with your physician to ensure the most appropriate approach to care is undertaken. For example, if you need a surgical procedure that will temporarily interfere with your ability to eat, special modifications regarding your nutrition and medication dosing may be prescribed. Finally, if you notice any unusual changes in your mouth (e.g. swelling, pain, red areas) you should see your dentist as soon as possible. These changes may indicate the presence of an infection that may compromise your normal blood sugar control and lead to a worsening of your ability to fight infection. As a result, your infection could become more difficult to treat.
Diabetes mellitus is a chronic disease, for which there is no known cure except in very specific situations.[75] Management concentrates on keeping blood sugar levels as close to normal, without causing low blood sugar. This can usually be accomplished with a healthy diet, exercise, weight loss, and use of appropriate medications (insulin in the case of type 1 diabetes; oral medications, as well as possibly insulin, in type 2 diabetes).[medical citation needed]
Dietary factors also influence the risk of developing type 2 DM. Consumption of sugar-sweetened drinks in excess is associated with an increased risk.[46][47] The type of fats in the diet is also important, with saturated fat and trans fats increasing the risk and polyunsaturated and monounsaturated fat decreasing the risk.[45] Eating lots of white rice, and other starches, also may increase the risk of diabetes.[48] A lack of physical activity is believed to cause 7% of cases.[49]
Diabetes mellitus is a public health problem around the world. In 1980, 108 million adults worldwide had diabetes (4.7% of the global population). By 2014 this had risen to 422 million adults (8.5% of the global population). By 2040, the number is expected to be 642 million adults. In the UK, there is estimated to be between 3 and 4 million people with diabetes. Type 2 diabetes accounts for more than 90% of all patients with diabetes. 

Q. My 7yr has Diabetes. She been Diabetic for about 5 weeks and we can't get numbers at a good spot. she aether way to low (30- 60 scary when she gets like this) and to high (300 - 400) We been looking at what she eating calling the physician. he been play with here shots but nothing working. Its when she at school is were the nuber are mostly going up an down. we been trying to work with the school but she the only one in the hole school that has Diabetes. what to do ?
observations The onset of type 1 diabetes mellitus is sudden in children. Type 2 diabetes often begins insidiously. Characteristically the course is progressive and includes polyuria, polydipsia, weight loss, polyphagia, hyperglycemia, and glycosuria. The eyes, kidneys, nervous system, skin, and circulatory system may be affected by the long-term complications of either type of diabetes; infections are common; and atherosclerosis often develops. In type 1 diabetes mellitus, when no endogenous insulin is being secreted, ketoacidosis is a constant danger. The diagnosis is confirmed by fasting plasma glucose and history.
A study by Chan et al indicated that in pediatric patients with type 1 diabetes, the presence of hypoglycemia is a sign of decreased insulin sensitivity, while hyperglycemia in these patients, especially overnight, signals improved sensitivity to insulin. In contrast, the investigators found evidence that in pediatric patients with type 2 diabetes, markers of metabolic syndrome and hyperglycemia are associated with reduced insulin sensitivity. Patients in the study were between ages 12 and 19 years. [23]
At present, the American Diabetes Association does not recommend general screening of the population for type 1 diabetes, though screening of high risk individuals, such as those with a first degree relative (sibling or parent) with type 1 diabetes should be encouraged. Type 1 diabetes tends to occur in young, lean individuals, usually before 30 years of age; however, older patients do present with this form of diabetes on occasion. This subgroup is referred to as latent autoimmune diabetes in adults (LADA). LADA is a slow, progressive form of type 1 diabetes. Of all the people with diabetes, only approximately 10% have type 1 diabetes and the remaining 90% have type 2 diabetes.
Often people don't experience symptoms of diabetes until their blood sugars are very high. Symptoms of diabetes include: increased thirst, increased urination, increased hunger, extreme fatigues, numbness and tingling in the extremities (hands and feet), cuts and wounds that are slow to heal, and blurred vision. Some people also experience other less common symptoms including weight loss, dry itchy skin, increased yeast infections, erectile dysfunction, and acanthosis nigricans (thick, "velvety" patches found in the folds or creases of skin, such as the neck, that is indicative of insulin resistance).
Polyuria is defined as an increase in the frequency of urination. When you have abnormally high levels of sugar in your blood, your kidneys draw in water from your tissues to dilute that sugar, so that your body can get rid of it through the urine. The cells are also pumping water into the bloodstream to help flush out sugar, and the kidneys are unable to reabsorb this fluid during filtering, which results in excess urination.
Excessive hunger goes hand-in-hand with fatigue and cell starvation. Because the cells are resistant to the body's insulin, glucose remains in the blood. The cells are then unable to gain access to glucose, which can trigger hunger hormones that tell the brain that you are hungry. Excessive eating can complicate things further by causing blood sugars to increase.

No single environmental trigger has been identified as causing diabetes mellitus, however both infectious agents and dietary factors are thought to be important. Various viruses have been implicated in the development of type I DM. They may act by initiating or modifying the autoimmune process. In particular, the rubella virus and coxsackie viruses have been closely studied. In particular, congenital rubella infection has shown direct relationships with the development of type 1 diabetes mellitus. This is presumably due to the virus (or antibodies against it) damaging the beta cells of the pancreas. Some research has looked at dietary factors that may be associated with type 1 diabetes. In particular, cow’s milk proteins (such as bovine serum albumin) which may have some similarities to pancreatic islet cell markers may be able to trigger the autoimmune process. Other chemicals including nitrosamines have been identified as causes of diabetes mellitus in animal models, but not in humans.
Another area of pathologic changes associated with diabetes mellitus is the nervous system (diabetic neuropathy), particularly in the peripheral nerves of the lower extremities. The patient typically experiences a “stocking-type” anesthesia beginning about 10 years after the onset of the disease. There may eventually be almost total anesthesia of the affected part with the potential for serious injury to the part without the patient being aware of it. In contrast, some patients experience debilitating pain and hyperesthesia, with loss of deep tendon reflexes.

The United Kingdom Prospective Diabetes Study (UKPDS) was a clinical study conducted by Z that was published in The Lancet in 1998. Around 3,800 people with type 2 diabetes were followed for an average of ten years, and were treated with tight glucose control or the standard of care, and again the treatment arm had far better outcomes. This confirmed the importance of tight glucose control, as well as blood pressure control, for people with this condition.[86][132][133]


Insulin is the hormone responsible for reducing blood sugar. In order for insulin to work, our tissues have to be sensitive to its action; otherwise, tissues become resistant and insulin struggles to clear out sugar from the blood. As insulin resistance sets in, the first organ to stop responding to insulin is the liver, followed by the muscles and eventually fat. How does insulin resistance begin? The root of the problem is our diet.
According to the Mayo Clinic, doctors may use other tests to diagnose diabetes. For example, they may conduct a fasting blood glucose test, which is a blood glucose test done after a night of fasting. While a fasting blood sugar level of less than 100 milligrams per deciliter (mg/dL) is normal, one that is between 100 to 125 mg/dL signals prediabetes, and a reading that reaches 126 mg/dL on two separate occasions means you have diabetes.
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