Diabetes info:
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Life Gestational Diabetes
Gestational Diabetes, or diabetes that occurs in pregnancy and resolves at birth, occurs in approximately three to eight pregnancies of every 100 in America1.
Risk factors for developing gestational diabetes include:
A family history of diabetes
Being overweight
Having
prediabetesHaving given birth previously to a child weighing 9 pounds or more
Gestational diabetes mellitus, or GDM, is diabetes that first appears in pregnancy and resolves at birth. An estimated 200,000 American women, approximately 5% of total pregnancies, are diagnosed with GDM annually. Women who develop gestational diabetes have problems metabolizing glucose. Their pancreas produces plenty of insulin (the hormone responsible for "unlocking" cells so that glucose can enter them and provide energy), but a condition known as
insulin resistance prevents them from using it effectively. When insulin doesn't work properly, blood glucose (or blood sugar) builds up in the bloodstream, and gestational diabetes is the result.
Gestational diabetes requires treatment with
dietary changes and
exercise and/or
insulin injections to keep maternal blood glucose levels as close to normal as possible and to prevent
complications in both mother and baby. Women with GDM are also encouraged to
self-test their blood glucose levels often.
A fetus of a woman with GDM may become large for date as it stores the excess glucose it is receiving from mom as fat, a condition known as macrosomia. A large infant may have a more difficult time descending down the birth canal. Other potential risks for baby include
hypoglycemia (low blood sugar) and jaundice. A pediatrician or a neonatolgist, a physician that specializes in high risk infant care, is often present at the births of GDM babies to handle any potential complications.
Gestational Diabetes: Causes And Risk FactorsThe hormones produced by the placenta in pregnancy—including estrogen, cortisol, and human placental lactogen (HPL)—are what trigger the
insulin resistance in women predisposed to the condition. As pregnancy progresses and the placenta grows larger, hormone production also increases and so does the level of insulin resistance. This process usually starts between 20 and 24 weeks of pregnancy. At birth, when the placenta is delivered, the hormone production stops and so does the GDM.
Assessing Your Risk
Risk factors for developing gestational diabetes include:
Being of
African American,
American Indian/Alaskan Native,
Asian American,
Pacific Islander or
Latino descent
Being an
overweight or obese woman (i.e., BMI of 25 or higher)
Having a first degree family history of type 2 diabetes,
prediabetes or a previous history of gestational diabetes
Being older than 25
Having a still birth or a large baby (i.e., 9 pounds or more) in a previous pregnancy
presence of glycosuria (detection of glucose in the urine despite nomal blood sugar level)
diagnosis of PCOS (PolysCystic Ovarian Syndrome)
If you have 2 or more of these risk factors you are at HIGH RISK for gestational diabetes.
If you have ONLY ONE of these risk factors you are at AVERAGE RISK for gestational diabetes. If you have none of these risk factors you are at LOW RISK for gestational diabetes.
PrediabetesPrediabetes, also called impaired glucose tolerance (IGT), is a precursor condition to
type 2 diabetes characterized by higher than normal blood glucose levels and
insulin resistance. It's also called impaired glucose tolerance (IGT) or impaired fasting glucose (IFG),
depending on the test used to diagnose it with. The U.S. Department of Health and Human Services (DHHS) and the American Diabetes Association (ADA) estimate that 41 million Americans between the ages of 40 to 74 are living with prediabetes, and most remain unaware of their condition.1 Without intervention and appropriate treatment, people with prediabetes are at
risk for developing type 2 diabetes within 10 years.
Prediabetes is a relatively new clinical diagnosis. The term was first introduced in 2002 by the DHHS and ADA. One of the reasons for renaming prediabetes from its former clinical name of impaired glucose tolerance was to highlight the seriousness of the condition and to motivate people to get appropriate treatment. With early intervention and lifestyle adjustments, prediabetes can be slowed, stopped, and even reversed.
SOURCE:1 - Centers for Disease Control. National Diabetes Fact Sheet United States, 2005. (PDF accessed 2/8/08).2 - The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. "Follow-Up Report on the Diagnosis of Diabetes Mellitus." Diabetes Care 26:3160-3167, 2003.
Last Modified Date: March 26, 2008
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Type 1 DiabetesAlso known as: juvenile diabetes, insulin-dependent diabetes mellitus (IDDM), childhood diabetes, and ketosis prone diabetes (Note: some of these terms are now outdated). Type 1 diabetes accounts for between 5 and 10% of all diagnosed diabetes in the United States.
Although type 1 diabetes develops most often in
children and young adults (one in every 400-600 children has type 1 diabetes)1, the disease can be diagnosed at any age throughout the lifespan, and is equally distributed among males and females. Unlike
type 2 diabetes, type 1 diabetes is more common in Caucasians than in those of
Latino,
African-American, or other non-Caucasian backgrounds.
Type 1 diabetes is an autoimmune disease that occurs when the insulin-producing beta cells within the pancreas are gradually destroyed and eventually fail to produce insulin.
Insulin is a hormone that helps the body's cells use glucose for energy. Blood glucose (or blood sugar) is manufactured from the food we eat (primarily carbohydrates) and by the liver. If glucose can't be absorbed by the cells, it builds up in the bloodstream instead, and high blood sugar is the result. Over time, the high blood glucose levels of uncontrolled diabetes can be toxic to virtually every system of the body.
Because type 1 diabetes is frequently diagnosed in childhood, it is sometimes referred to as juvenile diabetes. However, it can develop at any age throughout adulthood. Effective management is important to prevent some of the more serious
complications of diabetes, which include heart disease, blindness, stroke, nerve damage, and kidney failure. In addition to following an
exercise and
healthy eating plan, individuals with type 1 diabetes must receive insulin by
injection or pump.
The causes of type 1 diabetes are complex and still not completely understood. People with type 1 diabetes are thought to have an inherited, or genetic, predisposition to the disease. Researchers believe that this genetic predisposition may remain dormant until it is activated by an environmental trigger or triggers such as a virus or a chemical. This starts an attack of the immune system that results in the eventual destruction of the beta cells of the pancreas.
There are several subtypes of type 1 diabetes, including type 1A diabetes, idiopathic diabetes (type 1B), and latent autoimmune diabetes of adulthood (LADA). The basic treatment (i.e.,
insulin injections) is the same for all.
Type 1 Diabetes: Symptoms
Many of the symptoms of type 1 diabetes are nonspecific—that is, they may be indications of any one of a number of different medical problems. If you're experiencing any of these diabetes symptoms, please contact your healthcare provider immediately for medical evaluation.
Diabetes may include
one or more of the following:
Excessive thirst
Frequent urination
Extreme hunger
Unexplained weight loss
Fatigue, or a feeling of being "run down" and tired
Rapid breathing
Blurred
visionDry, itchy skin
Headache
Tingling or burning pain in the feet, legs, hands, or other parts of the body
High blood pressureMood swings
Irritability,
depressionFrequent or recurring infections, such as
urinary tract infections,
yeast infections, and skin infections
Slow healing of cuts and bruises
Type 1 Diabetes: Causes and Risk Factors
What causes diabetes? Researchers have identified several genes associated with the development of type 1 diabetes. The prevailing belief about the etiology, or cause, of type 1 diabetes is that although someone may have a genetic predisposition for developing type 1 diabetes, it takes an environmental trigger or series of triggers (e.g., virus, toxin, drug) to set the autoimmune process in motion that destroys insulin-producing pancreatic beta cells and causes type 1 diabetes.
Risk factors for developing type 1 diabetes may include:
Family history.
A child that has a parent or sibling with type 1 diabetes has a 2 to 6% risk of developing the disease (the risk is higher if both a parent and sibling or an identical twin have type 1 diabetes). Although family history is important, 80% of people with type 1 diabetes do not ave another relative with type 1 diabetes.
Autoimmune diseases.
The presence of other autoimmune disorders, such as thyroid disease and celiac disease, raises the risk of type 1 diabetes.
Early cessation of breastfeeding and/or exposure to cow's milk.
Clinical research indicates that breastfeeding at least three months decreases the risk of type 1 diabetes. Some studies have also found that exposure to cow's milk or cow's milk-based formula before one year of age may increase diabetes risk3-6, although other studies have not borne out the link.
Ethnicity.
Viruses that have been associated with type 1 diabetes as environmental triggers include coxsackie B, enteroviruses, adenovirus, rubella, cytomegalovirus, and Epstein-Barr virus.
Type 2 Diabetes
Also known as: adult-onset diabetes and non-insulin dependent diabetes mellitus (NIDDM) (Note: These terms are now outdated).
Type 2 diabetes is more common in
adults aged 50 and older, although it can occur in children and adolescents as well.1 Being
overweight or obese and leading a sedentary (i.e., nonactive) lifestyle are major risk factors for developing type 2 diabetes, as is having a family history of the disease. People of
African-American,
American Indian,
Asian American,
Latino, and
Pacific Islander background are more likely to develop type 2 diabetes.
Type 2 diabetes is the most prevalent form of the disease, accounting for 90 to 95% of all diabetes cases in America.2 Unlike
type 1 diabetes, where destruction of the pancreas reduces and eventually stops the supply of the hormone insulin, most people with type 2 diabetes are still able to produce insulin at diagnosis. However, the insulin they produce is unable to perform its primary job, which is helping the body's cells use glucose for energy. Usually this is due to a problem with the body's insulin receptors, the location ..s where insulin binds so that glucose can enter (although less frequently there may be a problem with the chemical makeup of the insulin itself). This condition is called
insulin resistance.
If glucose can't be absorbed by the cells, it builds up in the bloodstream instead, and high blood sugar is the result. The pancreas keeps increasing insulin production in an effort to keep up with rising blood sugar levels, and high circulating levels of insulin (known as hyperinsulinemia) develop. Hyperinsulinemia increases the risk of
cardiovascular disease and other health problems.Over time, the high blood glucose levels from uncontrolled diabetes can cause serious long-term health problems with virtually every system in your body. Eventually, they may cause damage to the insulin-producing beta cells of the pancreas, reducing insulin output. An early diagnosis is important to prevent some of the other more serious
complications of diabetes, which include heart disease, high blood pressure, nerve damage, and kidney failure. Fortunately, in many cases type 2 diabetes can be adequately controlled through a combination of proper
nutrition,
exercise, and
metformin - which your doctor may prescribe - which is usually the first line of treatment. However, some people with type 2 diabetes do require
oral medications or
insulin injections.
Although the vast majority of individuals with type 2 diabetes are
adults,
children and adolescents are increasingly at risk for the disease due to growing childhood weight problems and sedentary lifestyles.
Not everyone with type 2 diabetes has symptoms, particularly in the early stages of the disease. In fact, one-third of the over 18 million Americans with type 2 diabetes are unaware that they have the disease.
Type 2 diabetes symptoms may include one or more of the following:
Excessive thirst
Frequent urination
Extreme hunger
Unexplained weight loss
Fatigue, or a feeling of being "run down" and tired
Rapid breathing
Blurred vision
Dry, itchy skin
Headache
Tingling or burning pain in the feet, legs, hands, or other parts of the body
High blood pressure
Mood swings
Irritability, depression
Frequent or recurring infections, such as
urinary tract infections,
yeast infections, and skin infections
Slow healing of cuts and bruises
Unlike
type 1 diabetes, which frequently has a sudden onset of symptoms and reaches a crisis point before diagnosis is made, the signs of type 2 diabetes may be gradual and more insidious. Often, the first symptoms that people with undiagnosed type 2 diabetes experience are those from complications of the disease, such as blurry vision (retinopathy) or foot pain (neuropathy).
Type 2 Diabetes: Causes and Risk Factors
The exact causes of
type 2 diabetes aren't completely understood, but it is known that the disease has a strong hereditary component. Individuals who have a parent or sibling with type 2 diabetes have 10 to 15% chance of developing the disease (the risk is much higher if the sibling is an identical twin). Environmental factors like an inactive lifestyle or poor diet may act as a trigger for someone with a genetic tendency towards type 2 diabetes. Other potential causes of type 2 include chronic stress, low birth weight (and associated fetal malnourishment), and gene mutations.
Diabetes risk factors for developing type 2 diabetes include:Overweight or obesity.
Having a body mass index (BMI) of 25 or more
Heredity.
Having a parent or sibling with type 2 diabetes
Gestational diabetesA history of gestational diabetes, or having at least one baby weighing more than 9 pounds at birth
Hypertension.
High blood pressure of 140/90 mm Hg or higher
Poor cholesterol profile.
HDL cholesterol ("good" cholesterol) levels of 35 or lower and/or triglyceride levels of 250 or higher
Inactivity.
Living a sedentary lifestyle (i.e.,exercising less than three times a week)
Being an older adult.
Approximately 18.4% of Americans over age 65 have type 2 diabetes
According to the National Institutes of Health, an estimated 80% of people with type 2 diabetes are overweight or obese (i.e., a BMI of 25 or higher).
Here's why excess fat increases insulin resistance:
Fat cells have fewer insulin receptors (the place where insulin binds to open the cell to glucose) than muscle cells.
Fat cells release free fatty acids, and free fatty acids interfere with glucose metabolism.
Excess glucose that can't be used by the cells for energy is stored as body fat, increasing the cellular mass that the pancreas is trying to "feed" via insulin. In overweight people, insulin production is increased to meet.
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