What is Diabetes?

Type 1 diabetes is usually diagnosed in kids and young adults, and used to be called juvenile diabetes. Only 5% of people with diabetes have this form of the disease. In type 1 diabetes, the body does not produce insulin. The body breaks down the sugars and starches you eat into a simple sugar called glucose, which it uses for energy.

Insulin is a hormone produced in the pancreas that the body needs to move glucose from the bloodstream into the cells of the body. With the help of insulin shots and other treatments, even young children can learn to manage their condition and live long, healthy lives. 

Type 2 diabetes is often linked to being overweight and less active. The amount of insulin produced by your pancreas has already decreased by 80% at the time you are diagnosed. Your body still makes some insulin, but your cells have become resistant to insulin (insulin resistance).

Symptoms

Symptoms of high blood sugar include:

• Increased thirst
• Increased urination
• Increased urination during the night
• Weight loss (This weight loss may be rapid)
• Frequent infections
• Tiredness
• Weakness
• Vision changes, such as blurred vision.
• Fruity smell to your breath.
• Stomach pain.

Diagnosis

Diabetes is diagnosed when blood sugar levels are too high. Your blood sugar level may be checked by one or more of the following blood tests:

• A fasting blood glucose test: greater than 126 mg/dL. You will not be allowed to eat for at least 8 hours before a blood sample is taken.
• A random blood glucose test: greater than 200 mg/dL. Your blood glucose is checked at any time of the day no matter when you last ate.
• A hemoglobin A1c blood glucose test: greater than 6.5%. A hemoglobin A1c test provides information about blood glucose control over the previous 3 months.
• An oral glucose tolerance test (OGTT): greater than 200 mg/dL (commonly used during pregnancy). Your blood glucose is measured at least 1-3 hours after you have last eaten and then after you drink a glucose-containing beverage. Since the hormones that cause insulin resistance are highest at about 24-28 weeks of a pregnancy, an OGTT is usually done during that time. If you are at risk for gestational diabetes, your doctor may test you for gestational diabetes earlier than 24 weeks of pregnancy.

What is Prediabetes?

Prediabetes is a serious health problem that increases the risk of having type 2 diabetes, heart problems, and stroke. Prediabetes means that your blood sugar is high, but not so high that that it is considered to be diabetes.

A blood sugar checked first thing in the morning before you have eaten is called a fasting blood sugar. A normal fasting blood sugar is less than 100. A fasting blood sugar between 100 and 125 is considered prediabetic or the doctor may say you have impaired fasting glucose.

Risk Factors for Prediabetes and Type II Diabetes:

• Over 45 years of age
• Overweight
• Have a parent, sister, or brother with diabetes.
• Race: African-American, Hispanic/Latino, American-Indian, Asian-American, or Pacific-Islander.
• Gestational diabetes or gave birth to a baby weighing 9 pounds or more.
• Physically active less than three times a week.

It is important to screen early for prediabetes and type 2 diabetes, because early treatment can prevent serious problems that diabetes can cause, such as blindness, nerve damage or kidney damage.

Diagnosis

If you or your doctor suspect high blood sugars, your doctor may suggest a test called an oral glucose tolerance test. For this test you drink a sweet liquid and have blood drawn to check your blood sugar 2 hours after drinking the liquid. If your 2-hour blood sugar level is between 140 and 199, you are prediabetic. The doctor may say you have impaired glucose tolerance.

• A lab value called a hemoglobin A1C is considered normal if it is less than 5.7%.
• An A1C 5.7 to 6.4% is considered prediabetic.
• A1C 6.5% or higher is considered to be diabetic.

Next Steps

Without lifestyle changes to improve health, 15% to 30% of people with prediabetes will end up with type 2 diabetes within 5 years.

Losing 5-7% (10-20 lbs.) of body weight and regular exercise can help prevent or delay type 2 diabetes by up to 58% in people with prediabetes. Getting at least 30 minutes of exercise 5 days a week, such as brisk walking, is important for overall health.

The Centers for Disease Control and Prevention (CDC) estimates that one in every three adults has prediabetes. That is 88 million people!

What is Gestational Diabetes?

Pregnant women who did not have diabetes before they became pregnant, but who have high blood sugars during pregnancy, have gestational diabetes. Gestational diabetes is like type 2 diabetes- the pancreas does not make enough insulin and/or the cells are less responsive to the insulin that is made (insulin resistance). As a result, high blood sugar develops. High sugar levels can cause problems for the unborn baby. About 2% to 5% of pregnant women develop gestational diabetes. Testing for gestational diabetes is done between the 24th and 28th weeks of pregnancy. Women with gestational diabetes have a three to seven times higher risk of getting type 2 diabetes within five to 10 years. Your baby also has a greater risk of getting type 2 diabetes.

Risk Factors

You have higher chance of getting gestational diabetes if you have a family history of diabetes and/or also have one or more of the following risk factors:

• You are obese (body mass index (BMI) greater than 30).
• You had a prior pregnancy with gestational diabetes.
• You are pregnant at an older age
• Previous baby weighed more than 9 lbs.
History of polycystic ovary syndrome (PCOS)

If blood sugar levels are kept in the normal range during pregnancy, women can have a healthy pregnancy. If your blood sugar levels are not well controlled, there may be risks to you, your unborn baby, your labor and delivery, or your newborn baby. The good news is that 70-85% of women with gestational diabetes are able to control it with lifestyle changes alone.

Current guidelines from the American Diabetes Association recommend that women with gestational diabetes have blood sugar testing done 4 to 12 weeks after the baby is born and every one to three years thereafter depending on risk factors.

All women with a history of gestational diabetes should exercise, eat healthy and work toward a normal body weight to prevent type 2 diabetes.