Although urine can also be tested for the presence of glucose, checking urine is not a good way to monitor treatment or adjust therapy. Urine testing can be misleading because the amount of glucose in the urine may not reflect the current level of glucose in the blood. Blood glucose levels can get very low or reasonably high without any change in the glucose levels in the urine.
Diabetes mellitus type 2 (also known as type 2 diabetes) is a long-term metabolic disorder that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urination, and unexplained weight loss. Symptoms may also include increased hunger, feeling tired, and sores that do not heal. Often symptoms come on slowly. Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations. The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon.
Although many of the symptoms of type 1 and type 2 diabetes are similar, they present in very different ways. Many people with type 2 diabetes won’t have symptoms for many years. Then often the symptoms of type 2 diabetes develop slowly over the course of time. Some people with type 2 diabetes have no symptoms at all and don’t discover their condition until complications develop.
The causes of diabetes mellitus are unclear, however, there seem to be both hereditary (genetic factors passed on in families) and environmental factors involved. Research has shown that some people who develop diabetes have common genetic markers. In Type I diabetes, the immune system, the body's defense system against infection, is believed to be triggered by a virus or another microorganism that destroys cells in the pancreas that produce insulin. In Type II diabetes, age, obesity, and family history of diabetes play a role.
The body’s immune system is responsible for fighting off foreign invaders, like harmful viruses and bacteria. In people with type 1 diabetes, the immune system mistakes the body’s own healthy cells for foreign invaders. The immune system attacks and destroys the insulin-producing beta cells in the pancreas. After these beta cells are destroyed, the body is unable to produce insulin.
When diabetes occurs in women during pregnancy, it is called gestational diabetes. It usually is diagnosed between the 24th and 28th weeks of pregnancy. Like in type 1 and type 2 diabetes, blood sugar levels become too high. When women are pregnant, more glucose is needed to nourish the developing baby. The body needs more insulin, which is produced by the pancreas. In some women, the body does not produce enough insulin to meet this need, and blood sugar levels rise, resulting in gestational diabetes.
Know Your Numbers: Knowing your ABCs—A1c, blood pressure, and cholesterol—are important in reducing your risk for diabetes and keeping your diabetes in good control. If you are someone with diabetes who has elevated blood pressure or cholesterol, you are increasing your risk of heart attack and stroke. Your physician will give you your A1c, blood pressure, and cholesterol targets. Make sure you pay attention to them and understand what they mean and why they are important.
A growing number of people in the U.S. and throughout the world are overweight and more prone to develop Type 2 diabetes, particularly if they have the genetics for it. "Type 2 diabetes can be caused by genetic inheritance, but by far the obesity epidemic has created massive increases in the occurrence of Type 2 diabetes. This is due to the major insulin resistance that is created by obesity," Gage says.
Patients who suffer from diabetes have a lifelong struggle to attain and maintain blood glucose levels as close to the normal range as possible. With appropriate blood sugar control, the risk of both microvascular (small blood vessel) and neuropathic (nerve) complications is decreased markedly. Additionally, if hypertension (high blood pressure) and hyperlipidemia (high cholesterol) are treated promptly and aggressively, the risk of cardiovascular complications should decrease as well.
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Insulin, a hormone released from the pancreas (an organ behind the stomach that also produces digestive enzymes), controls the amount of glucose in the blood. Glucose in the bloodstream stimulates the pancreas to produce insulin. Insulin helps glucose to move from the blood into the cells. Once inside the cells, glucose is converted to energy, which is used immediately, or the glucose is stored as fat or glycogen until it is needed.
Lose Weight: If you are overweight, losing weight can help your body use insulin. In fact, the American Diabetes Association recommends that people with diabetes lose about 7 percent of their body weight, which should improve the way your body uses insulin and reduces insulin resistance. In addition, weight loss can help lower blood pressure, reduce joint pain, increase energy, and reduce sleep apnea and cholesterol. It can also reduce your risk of other diseases, including heart disease.
Hyperglycemia (ie, random blood glucose concentration of more than 200 mg/dL or 11 mmol/L) results when insulin deficiency leads to uninhibited gluconeogenesis and prevents the use and storage of circulating glucose. The kidneys cannot reabsorb the excess glucose load, causing glycosuria, osmotic diuresis, thirst, and dehydration. Increased fat and protein breakdown leads to ketone production and weight loss. Without insulin, a child with type 1 diabetes mellitus wastes away and eventually dies due to DKA. The effects of insulin deficiency are shown in the image below.
a complex disorder of carbohydrate, fat, and protein metabolism that is primarily a result of a deficiency or complete lack of insulin secretion by the beta cells of the pancreas or resistance to insulin. The disease is often familial but may be acquired, as in Cushing's syndrome, as a result of the administration of excessive glucocorticoid. The various forms of diabetes have been organized into categories developed by the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus of the American Diabetes Association. Type 1 diabetes mellitus in this classification scheme includes patients with diabetes caused by an autoimmune process, dependent on insulin to prevent ketosis. This group was previously called type I, insulin-dependent diabetes mellitus, juvenile-onset diabetes, brittle diabetes, or ketosis-prone diabetes. Patients with type 2 diabetes mellitus are those previously designated as having type II, non-insulin-dependent diabetes mellitus, maturity-onset diabetes, adult-onset diabetes, ketosis-resistant diabetes, or stable diabetes. Those with gestational diabetes mellitus are women in whom glucose intolerance develops during pregnancy. Other types of diabetes are associated with a pancreatic disease, hormonal changes, adverse effects of drugs, or genetic or other anomalies. A fourth subclass, the impaired glucose tolerance group, also called prediabetes, includes persons whose blood glucose levels are abnormal although not sufficiently above the normal range to be diagnosed as having diabetes. Approximately 95% of the 18 million diabetes patients in the United States are classified as type 2, and more than 70% of those patients are obese. About 1.3 million new cases of diabetes mellitus are diagnosed in the United States each year. Contributing factors to the development of diabetes are heredity; obesity; sedentary life-style; high-fat, low-fiber diets; hypertension; and aging. See also impaired glucose tolerance, potential abnormality of glucose tolerance, previous abnormality of glucose tolerance.
Part of a treatment plan for diabetes will involve learning about diabetes, how to manage it, and how to prevent complications. Your doctor, diabetes educator, or other health care professional will help you learn what you need to know so you are able to manage your diabetes as effectively as possible. Keep in mind that learning about diabetes and its treatment will take time. Involving family members or other people who are significant in your life can also help you manage your diabetes.
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.