Type 1 diabetes, originally referred to as juvenile-onset diabetes because it so often occurs in children or young adults, can strike people of any age. It is usually caused by an autoimmune reaction in which the body’s defense system attacks its own insulin-producing cells. Little is known about why the reaction occurs, but type 1 diabetics produce little or no insulin. Only 5% of diabetics have type 1 diabetes. To control the levels of glucose in their blood, type 1 diabetics need to be on insulin therapy.
Type 1 Diabetes
Type 2 Diabetes
Over 90% of diabetics are Type 2. It is often associated with being overweight or obese, which can cause insulin resistance and lead to high blood glucose levels. For those with type 2 diabetes, the body does not produce enough insulin, or the cells ignore the insulin, and glucose builds up in the blood instead of reaching the cells. Diabetes complications include nerve damage, stroke, kidney disease, high blood pressure, eye problems, and ketoacidosis. Although type 2 diabetics can initially manage their condition through exercise and diet, over time most people will require oral drugs and/or insulin.
Gestational Diabetes
Gestational diabetes (GDM) is a form of diabetes that involves high blood glucose levels during pregnancy. It develops in one in 25 pregnancies worldwide and is associated with complications to both mother and baby. While GDM usually disappears after pregnancy, women with GDM and their children are at an increased risk of developing type 2 diabetes later in life: about half of women with a history of GDM go on to develop type 2 diabetes within 5–10 years after delivery.
Treatment Methods
Treatment for diabetes falls into three key areas: behavioral, drug therapy, and insulin therapy. Type 1 diabetes is primarily treated with insulin while type 2 diabetes often involves a combination of all three approaches, depending on the severity of the condition. Diabetics seek to avoid or minimize chronic diabetic complications, as well as to avoid acute problems of hyperglycemia or hypoglycemia.
Behavioral Changes
Behavioral changes can help type 2 diabetics lose weight and thereby increase insulin sensitivity. Treatment includes increased physical activity, eliminating saturated fat and reducing sugar and carbohydrate intake. Even modest weight loss (for example, 5 kg or 10–15 lbs lost) can restore insulin sensitivity, especially when weight loss occurs in abdominal fat
deposits. Diets low in saturated fats may even help reverse insulin resistance.
Medication
Drug treatment of diabetes usually involves hypoglycemic treatment using either oral hypoglycemics and/or insulin therapy. There are several classes of anti-diabetic medications available. Metformin is generally recommended as a first-line treatment because there is some evidence that it decreases mortality. If metformin is insufficient, a second oral agent may be used. Injections of insulin may either be added to oral medication or used alone. Managing diabetes requires patients to be educated about their disease and in compliance with their treatment plan.
Insulin
Beta cells in the pancreas produce the insulin hormone and release it with each meal to help the body use or store the glucose derived from food. In people with type 1 diabetes, the beta cells have been destroyed and the pancreas no longer makes insulin, which is why they require insulin treatment to survive. Some people with type 2 diabetes need diabetes pills or insulin injections to help their bodies use glucose for energy. Insulin must be injected into subcutaneous fat in order to reach the bloodstream.
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