Diabetes Overview

Diabetes Mellitus, often called “sugar diabetes” by non-medical people,  is a syndrome in which the amount of glucose in the blood is too high. Type 1 diabetes which was called “juvenile diabetes” is a problem with insulin production from the pancreas. Type 2 diabetes is a problem with insulin resistance. Insulin is the protein that is responsible for removing glucose from the blood stream.

Type 1 diabetes is usually diagnosed in childhood or early adulthood. It is a problem with the cells of the pancreas not being able to produce insulin, With no insulin around the blood glucose (blood sugar) becomes too high. Type 1 Diabetes is almost always treated with insulin injections. Type 2 diabetes is usually diagnosed in adults. Type 2 diabetic patients usually are overweight and may have a family history of diabetes.  Type 2 diabetes can aften be treated with diet and exercise but may require oral medications or even Insulin infections to get the blood sugars under good control.

Type 1 diabetes may present with symptoms of weight loss, extreme thirst, increased urination, or fatigue. Type 2 diabetes usually does not have symptoms and is discovered on routine screening. There are different ways diabetes can be screened for. One is to check a fasting blood sugar, that is a blood test to look at the amount of glucose in the blood first thing in the morning prior to eating. Another way is to check a Hemoglobin A1C . The Hemoglobin A1C is a protein that gives an average of the blood sugars over the past 3 months. If this is elevated, diabetes can be diagnosed. The Hemoglobin A1C is also useful for following diabetes to see how well it is being controlled. A 2 hour glucose tolerance test can also be used to diagnose diabetes. In this test the patient comes to the lab fasting. A measured amount of glucose solution is given for the patient to drink. A blood glucose level is checked 2 hours after the drink is consumed. If the value is high this demonstrates that the glucose is not being removed from the blood appropriately and diagnosis diabetes. Finally, a random blood sugar can be checked. If the patient has symptoms, an elevated random blood sugar confirms diabetes.

The majority of people with Diabetes have type 2 diabetes. It is estimated that about 1/4 of people with diabetes have not been diagnosed. People that are 45 or older that have a body mass index (BMI) of 25 or higher should be screened for diabetes every 3 years. If there is a strong family history of diabtes or there are symptoms, screening may need to done earlier and more often.