Diabetes

What is diabetes?

Diabetes, or diabetes mellitus, is a condition where blood glucose (blood sugar) levels are too high. Glucose is the body’s main source of energy, coming from food and produced internally. Insulin, made by the pancreas, helps move glucose into cells for energy. With diabetes, the body either does not make insulin or does not use it effectively, or both. This causes glucose to remain in the bloodstream, which, over time, can lead to serious health problems.

Types of diabetes

• Type 1 diabetes: An autoimmune condition where the body makes little or no insulin.
• Type 2 diabetes: The most common form, where the body makes insulin but cells don’t respond properly.
• Gestational diabetes: Develops during pregnancy when the body cannot produce the extra insulin needed.

Causes of diabetes

• Type 1: Likely linked to genetics and environmental triggers.
• Type 2: Caused by a combination of genes, lifestyle factors such as inactivity, and excess weight.
• Gestational diabetes: Triggered by pregnancy-related hormonal changes along with genetic and lifestyle influences.

Who is at risk?

• Type 1: Can occur at any age, often beginning in childhood. Risk increases with a family history.
• Type 2: Higher risk if overweight, inactive, over age 35, have prediabetes, have had past gestational diabetes, gave birth to a baby weighing over 9 lbs, or belong to African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander groups. Certain conditions, such as high blood pressure or PCOS, also raise risk.
• Gestational: More likely in women who are overweight, have PCOS, a family history of diabetes, or prior gestational diabetes.

Symptoms of diabetes

• Excessive thirst and hunger
• Frequent urination, especially at night
• Fatigue
• Blurred vision
• Numbness or tingling in hands or feet
• Slow-healing sores
• Unexplained weight loss

Note: Symptoms differ by type — type 1 often appears suddenly and severely, type 2 develops gradually and may go unnoticed, and gestational diabetes often has no obvious symptoms.

Diagnosis

Health care providers use blood glucose tests, including the A1C test, to diagnose diabetes.

Treatment

• Type 1: Daily insulin by injection or pump, sometimes with additional medicines.
• Type 2: Lifestyle changes (healthy diet, physical activity, weight management) and often medications; in some cases, type 2 diabetes can be reversed.
• Gestational: Healthy eating and exercise, sometimes with medication. The condition usually resolves after birth, though it increases the risk of later type 2 diabetes.

Regular blood glucose monitoring is a key part of treatment for all types.

Prevention

• Type 1: Cannot be prevented.
• Type 2: May be delayed or prevented with a healthy diet, weight control, and regular exercise.
• Gestational: Similar lifestyle changes may reduce risk during pregnancy.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

What is type 1 diabetes?

Type 1 diabetes occurs when the pancreas produces little or no insulin. Insulin is the hormone that helps glucose move from the bloodstream into cells for energy. Without insulin, glucose builds up in the blood, leading to high blood sugar. Over time, this can cause complications with the heart, kidneys, nerves, eyes, and even gums and teeth.

Who can develop it?

Type 1 diabetes often begins in childhood or young adulthood, but it can appear at any age.

Common symptoms

• Excessive thirst
• Frequent urination
• Feeling very hungry or unusually tired
• Unexplained weight loss
• Sores that heal slowly
• Dry, itchy skin
• Tingling or numbness in the feet
• Blurry vision

Diagnosis

A blood test can confirm type 1 diabetes. The A1C test is also used to measure average blood glucose over several months and track how well the condition is being managed.

Treatment

People with type 1 diabetes must take insulin for life, either through injections or an insulin pump. Managing the condition also involves regular monitoring of blood glucose, healthy eating, and physical activity.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

What is type 2 diabetes?

Type 2 diabetes occurs when blood glucose (blood sugar) levels become too high. Normally, insulin helps glucose move from the bloodstream into cells for energy. In type 2 diabetes, the body does not make enough insulin or does not use it well, leaving too much glucose in the blood. Over time, this can lead to serious health problems.

Causes of type 2 diabetes

Type 2 diabetes often develops due to a combination of:

• Excess body weight or obesity
• Lack of physical activity
• Family history or genetics

The condition usually begins with insulin resistance, where cells no longer respond normally to insulin. At first, the body makes more insulin to compensate, but eventually it cannot produce enough, causing blood sugar levels to rise.

Who is at risk?

You are more likely to develop type 2 diabetes if you:

• Are over age 45 (though it can occur in children and young adults)
• Have prediabetes
• Experienced gestational diabetes or gave birth to a baby over 9 pounds
• Are overweight or have obesity
• Have a family history of diabetes
• Belong to certain groups: African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander
• Are physically inactive
• Have other conditions such as high blood pressure, heart disease, PCOS, depression, or high cholesterol
• Show signs of acanthosis nigricans (dark, thickened skin on the neck or armpits)

Symptoms

Type 2 diabetes may develop gradually with few noticeable signs. Common symptoms include:

• Excessive thirst and urination
• Increased hunger
• Fatigue
• Blurred vision
• Numbness or tingling in hands or feet
• Sores that heal slowly
• Unexplained weight loss

Diagnosis

Health care providers may use one or more blood tests:

• A1C test – measures average blood glucose over 3 months
• Fasting plasma glucose (FPG) – requires fasting at least 8 hours before the test
• Random plasma glucose (RPG) – measures blood glucose without fasting, often used if symptoms are present

Treatment

Managing type 2 diabetes focuses on controlling blood glucose and reducing complications:

• Healthy lifestyle changes: balanced eating, regular exercise, weight management
• Medicines: oral medications, insulin, or other injectables (sometimes in combination)
• Routine blood glucose checks as directed by your provider
• Monitoring and managing blood pressure and cholesterol
• Regular health screenings

Prevention

Type 2 diabetes can often be delayed or prevented by:

• Losing weight if overweight
• Eating fewer calories and choosing nutrient-rich foods
• Staying physically active
• Managing related health conditions such as high blood pressure or PCOS

NIH: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

What is diabetes?

Diabetes occurs when blood glucose (blood sugar) levels are too high. Normally, insulin helps move glucose from the bloodstream into cells for energy. In type 1 diabetes, the body does not make insulin. In type 2 diabetes, the body does not make or use insulin well. Without enough insulin, glucose stays in the blood.

What is gestational diabetes?

Gestational diabetes develops during pregnancy, usually around the 24th week. It happens when the body cannot produce the extra insulin needed. Researchers believe it is linked to hormonal changes during pregnancy, along with genetic and lifestyle factors.

Who is at risk?

Anyone who is pregnant can develop gestational diabetes, but the risk is higher if you:

• Are you overweight or have obesity
• Have a family history of diabetes
• Had gestational diabetes in a previous pregnancy
• Gave birth to a baby weighing 9 pounds or more
• Have polycystic ovary syndrome (PCOS)
• Are you African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander

How is it diagnosed?

Gestational diabetes often has no symptoms. If present, they may include increased thirst or frequent urination. Most people are screened between 24–28 weeks of pregnancy, though those at higher risk may be tested earlier. Tests include:

• Glucose challenge test
• Oral glucose tolerance test (OGTT)

Both involve drinking a sugary liquid followed by blood tests at specific times.

How can diabetes affect pregnancy?

Diabetes during pregnancy may increase risks for both the parent and baby:

For the parent:

• Higher chance of preeclampsia (sudden high blood pressure)
• Increased likelihood of cesarean delivery
• Need for adjustments in meal plan, physical activity, or medication
• Possible worsening of existing diabetes-related health problems

For the baby:

• Increased risk of birth defects if blood glucose is high early in pregnancy
• Greater chance of obesity and type 2 diabetes later in life
• Higher risk of preterm birth, breathing issues, or low blood sugar after birth
• Increased chance of miscarriage or stillbirth

Management before, during, and after pregnancy

• Before pregnancy: Control blood glucose early to reduce risks to the developing baby. Discuss with your provider which diet, activity, and medicines are safe.
• During pregnancy: Follow a healthy eating plan, stay physically active, and take medicines if needed. Continue prenatal care, take vitamins, and avoid harmful substances such as alcohol, tobacco, and drugs.
• After pregnancy:
  • If you had gestational diabetes, test for type 2 diabetes within 4–12 weeks after delivery and continue testing every 1–3 years.
  • If you had diabetes before pregnancy, work with your provider to adjust your care plan as your body changes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Overview

For many years, the most common type of diabetes in children and teens was type 1 diabetes, also known as juvenile diabetes. In type 1, the pancreas does not produce insulin, the hormone that moves glucose (sugar) into cells for energy. Without insulin, glucose builds up in the blood.

Now, type 2 diabetes is also appearing more often in children and teens. Once called “adult-onset diabetes,” type 2 is linked to rising obesity rates in young people. In type 2, the body does not make enough insulin or does not use it effectively.

Risk factors in children

Children are more likely to develop type 2 diabetes if they:

• Are you overweight or have obesity
• Have a family history of diabetes
• Are physically inactive
• Belong to higher-risk groups: African American, Hispanic, Native American/Alaska Native, Asian American, or Pacific Islander

Prevention strategies

Parents and caregivers can help reduce risk by encouraging children to:

• Maintain a healthy weight
• Stay physically active
• Eat smaller portions of balanced, healthy foods
• Limit time spent on TV, computers, and video games

Management

• Children with type 1 diabetes usually need daily insulin.
• Children with type 2 diabetes may manage the condition through diet and exercise. Some may require oral medicines or insulin if lifestyle changes are not enough.
• An A1C test helps track long-term blood glucose control.