- Digestion
Diabetes mellitus is a prevalent disorder that affects the way the body processes and uses carbohydrates, fats and proteins. The most obvious sign of diabetes is a high level of blood glucose (blood sugar). Because blood sugar level is regulated by insulin, a hormone produced by the pancreas, the development of diabetes is related to both the body's level of insulin and how efficiently body tissues respond to insulin.

There are two different types of diabetes: Type 1 and Type 2. Only about 5% of people with diabetes have Type 1, also called "juvenile diabetes" or "insulin-dependent diabetes." This type of diabetes happens because the pancreas can no longer  produce insulin, and it usually starts in childhood or adolescence. The majority of people with diabetes have type 2 diabetes, also called adult-onset diabetes or non-insulin-dependent diabetes.

A poor response of body tissues to the actions of insulin is a prominent feature of type 2 diabetes. It usually begins after age 40 and is commonly caused by obesity, which frequently leads to the insulin resistance syndrome. The insulin resistance syndrome, includes the following problems: increased blood levels of insulin (hyperinsulinemia), high blood pressure, elevated levels of triglycerides, low levels of protective high-density lipoprotein cholesterol and an increased incidence of arteriosclerosis.

In patients with Type 2 Diabetes, the pancreas initially puts out large amounts of insulin to overcome the insulin resistance of body tissues, Eventually, however, the pancreas cannot keep up with the demand, and diabetes develops. Development of type 2 diabetes tends to run in families.

Diabetes Symptoms - The initial symptoms of diabetes are related to high blood glucose levels.

Islet cells in the Pancreas (green) produce insulin.

These symptoms include excessive urination, thirst and hunger; weight loss; and increased susceptibility to infections, especially infections of the skin and vagina. Extremely high blood sugar levels may lead to a dangerous complication called hyperosmolar coma. Hyperosmolar coma can complicate a severe acute illness, such as a stroke; it can also happen when poor fluid intake triggers dehydration. In some cases, hyperosmolar coma is the first sign that a patient has type 2 diabetes.

When patients with type 2 diabetes take either insulin or sulfonylurea drugs to reduce blood sugar, sugar levels can drop too far and cause hypoglycemia (low blood sugar). Symptoms of hypoglycemia may include sweating, trembling, dizziness, hunger, confusion, seizures and loss of consciousness.

What Blood sugar level is too high?                                - mg/dL

Diabetics who have had high blood sugar levels for long periods of time can develop late complications of diabetes, including damage to the eyes (retinopathy), nerves (neuropathy) and kidneys (nephropathy). Diabetic retinopathy can lead to blindness, whereas neuropathy can cause numbness, tingling and pain in the legs and arms. Diabetic nephropathy can result in kidney failure and can cause many symptoms related to the accumulation of waste products.

People with diabetes are also at increased risk of cardiovascular disease caused by arteriosclerosis. Arteriosclerosis can involve the heart (coronary heart disease), brain (cerebrovascular disease) or arteries supplying the legs (peripheral vascular disease).

Symptoms of arteriosclerosis include chest pain (angina), heart attacks, or heart failure caused by CHD; stroke caused by cerebrovascular disease; and intermittent claudication (leg pain on walking or exercising that stops quickly with rest) caused by PVD. Diabetics who have peripheral neuropathy, combined with the poor circulation associated with PVD, can eventually develop foot ulcers and infections, which can lead to gangrene and amputations.

- Diabetes Self-Diagnosis Quiz

Individuals who are middle-aged and are overweight, especially around the middle, and don't exercise are the most likely candidates for type 2 diabetes. Take a self-diagnosis quiz to find out if you are at risk. (Adapted from the American Diabetes Association ).

What your Doctor might look for - Your doctor looks for obesity, especially abdominal obesity (waist circumferences greater than 40 inches in men or 35 inches in women); high blood pressure; signs of retinopathy on eye examination; decreased sensation and reflexes in the legs;poor pulses in the feet; blisters, ulcers or infections of the feet; and abnormal heart rhythm.

Diabetes Drugs

Many types of drugs are used to treat with type 2 diabetes. Each helps lower blood sugar in a different way. These are the actual chemical names for the drugs, they usually have different names in pill form. Sulfonylureas - Stimulate your pancreas to make more insulin. Biguanides - Decrease the amount of sugar made by your liver. Alpha-glucosidase inhibitors - Slow the absorption of the starches you eat. Thiazolidinediones - Make you more sensitive to insulin. Meglitinides - Stimulate your pancreas to make more insulin.

Laboratory tests include measuring fasting glucose; hemoglobin A1c (which measures average blood glucose over the preceding two months); blood creatinine and urine microalbumin for evidence of kidney disease; and lipid profile (cholesterol, triglycerides, high-density lipoprotein and low-density lipoprotein cholesterol) to evaluate the risk of arteriosclerosis.

Diagnosis - Your doctor makes the diagnosis of diabetes when your fasting blood glucose is 126 milligrams per deciliter or higher on more than one blood test.

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