What Diabetes Is

Chapter 1 of 6

Diabetes means that your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn't good for your health.

On this page:

• How do you get high blood glucose?
  
• What is pre-diabetes?
  
• What are the signs of diabetes?
  
• What kind of diabetes do you have?
  
• Why do you need to take care of your diabetes?
  
• What's a desirable blood glucose level?
  

How do you get high blood glucose?

Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. If your body doesn't make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes.

What is pre-diabetes?

Pre-diabetes is a condition in which blood glucose levels are higher than normal but are not high enough for a diagnosis of diabetes. People with pre-diabetes are at increased risk for developing type 2 diabetes and for heart disease and stroke. The good news is if you have pre-diabetes, you can reduce your risk of getting diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes and even return to normal glucose levels.

What are the signs of diabetes?

The signs of diabetes are

• being very thirsty
• urinating often
• feeling very hungry or tired
• losing weight without trying
• having sores that heal slowly
• having dry, itchy skin
• losing the feeling in your feet or having tingling in your feet
• having blurry eyesight

You may have had one or more of these signs before you found out you had diabetes. Or you may have had no signs at all. A blood test to check your glucose levels will show if you have pre-diabetes or diabetes.

What kind of diabetes do you have?

People can get diabetes at any age. There are three main kinds. Type 1 diabetes, formerly called juvenile diabetes or insulin-dependent diabetes, is usually first diagnosed in children, teenagers, or young adults. In this form of diabetes, the beta cells of the pancreas no longer make insulin because the body's immune system has attacked and destroyed them. Treatment for type 1 diabetes includes taking insulin shots or using an insulin pump, making wise food choices, being physically active, taking aspirin daily (for some), and controlling blood pressure and cholesterol.

Type 2 diabetes, formerly called adult-onset diabetes or noninsulin-dependent diabetes, is the most common form of diabetes. People can develop type 2 diabetes at any age—even during childhood. This form of diabetes usually begins with insulin resistance, a condition in which fat, muscle, and liver cells do not use insulin properly. At first, the pancreas keeps up with the added demand by producing more insulin. In time, however, it loses the ability to secrete enough insulin in response to meals. Being overweight and inactive increases the chances of developing type 2 diabetes. Treatment includes using diabetes medicines, making wise food choices, being physically active, taking aspirin daily, and controlling blood pressure and cholesterol.

Some women develop gestational diabetes during the late stages of pregnancy. Although this form of diabetes usually goes away after the baby is born, a woman who has had it is more likely to develop type 2 diabetes later in life. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin.

Diabetes can start at any age.

This guide is for people who have either type 1 diabetes or type 2 diabetes.

• If you use insulin, look at the white boxes for "Action Steps."
  
• If you don't use insulin, look at the gray boxes for "Action Steps."

Why do you need to take care of your diabetes?

After many years, diabetes can lead to serious problems in your eyes, kidneys, nerves, and gums and teeth. But the most serious problem caused by diabetes is heart disease. When you have diabetes, you are more than twice as likely as people without diabetes to have heart disease or a stroke.

If you have diabetes, your risk of a heart attack is the same as someone who has already had a heart attack. Both women and men with diabetes are at risk. You may not even have the typical signs of a heart attack.

You can reduce your risk of developing heart disease by controlling your blood pressure and blood fat levels. If you smoke, talk with your doctor about quitting. Remember that every step toward your goals helps!

Later in this guide, we'll tell you how you can try to prevent or delay long-term problems. The best way to take care of your health is to work with your health care team to keep your blood glucose, blood pressure, and cholesterol in your target range.

What's a desirable blood glucose level?

Everyone's blood has some glucose in it. In people who don't have diabetes, the normal range is about 70 to 120. Blood glucose goes up after eating, but returns to the normal range 1 or 2 hours later.

Ask your health care team when you should check your blood glucose with a meter. Talk about whether the blood glucose targets listed below are best for you. Then write in your own targets.

What You Need to Know About High Blood Glucose

If your blood glucose stays over 180, it may be too high. It means you don't have enough insulin in your body. High blood glucose can happen if you miss taking your diabetes medicine, eat too much, or don't get enough exercise. Sometimes, the medicines you take for other problems cause high blood glucose. Be sure to tell your doctor about other medicines you take.

Having an infection or being sick or under stress can also make your blood glucose too high. That's why it's very important to check your blood glucose and keep taking your insulin or diabetes pills when you're sick.

If you're very thirsty and tired, have blurry vision, and have to go to the bathroom often, your blood glucose may be too high. Very high blood glucose may also make you feel sick to your stomach.

If your blood glucose is high much of the time or if you have symptoms of high blood glucose, call your doctor. You may need a change in your insulin or diabetes pills, or a change in your meal plan.

What You Need to Know About Low Blood Glucose (Hypoglycemia)

Hypoglycemia happens if your blood glucose drops too low. It can come on fast. It's caused by taking too much diabetes medicine, missing a meal, delaying a meal, exercising more than usual, or drinking alcoholic beverages. Sometimes, medicines you take for other health problems can cause blood glucose to drop.

Hypoglycemia can make you feel weak, confused, irritable, hungry, or tired. You may sweat a lot or get a headache. You may feel shaky. If your blood glucose drops lower, you could pass out or have a seizure.

If you have any of these symptoms, check your blood glucose. If the level is 70 or below, have one of the following right away:

• 2 or 3 glucose tablets
• 1/2 cup (4 ounces) of any fruit juice
• a piece of fruit or a small box of raisins
• 1 cup (8 ounces) of milk
• 1/2 cup (4 ounces) of a regular (not diet) soft drink
• 5 or 6 pieces of hard candy
• 1 or 2 teaspoons of sugar or honey

Have one of these "quick fix" foods when your blood glucose is low.

After 15 minutes, check your blood glucose again to make sure your level is 70 or above. Repeat these steps as needed. Once your blood glucose is stable, if it will be at least an hour before your next meal, have a snack.

If you take insulin or a diabetes pill that can cause hypoglycemia, always carry food for emergencies. It's a good idea also to wear a medical identification bracelet or necklace.

If you take insulin, keep a glucagon kit at home and also at a few other places where you go often. Glucagon is given as an injection with a syringe and quickly raises blood glucose. Show your family, friends, and co-workers how to give you a glucagon injection if you pass out because of hypoglycemia.

You can prevent hypoglycemia by eating regular meals, taking your diabetes medicine, and checking your blood glucose often. Checking will tell you whether your glucose level is going down. You can then take steps, like drinking fruit juice, to raise your blood glucose.

When you have hypoglycemia, have a snack to bring your blood glucose back to normal.