After a meal, a portion of the food a person eats is broken down into sugar (glucose). The sugar then passes into the bloodstream and to the body's cells via a hormone (called insulin) that is produced by the pancreas. Normally, the pancreas produces the right amount of insulin to accommodate the quantity of sugar. However, if the person has diabetes, either the pancreas produces little or no insulin or the cells do not respond normally to the insulin. Sugar builds up in the blood, overflows into the urine and then passes from the body unused. Over time, high blood sugar levels can damage:

Eyes - leading to diabetic retinopathy and possible blindness
Blood vessels - increasing risk of heart attack, stroke and peripheral artery obstruction
-Nerves - leading to diabetic neuropathy, foot sores and possible amputation, possible paralysis of the stomach, chronic diarrhea
- Kidneys - leading to kidney failure
-Diabetes has also been linked to impotence and digestive problems. It is important to note that controlling blood pressure and blood glucose levels, plus regular screenings and check-ups, can help reduce risks of these complications.
-There are two main types of diabetes, Type I and Type II:
-Type I diabetes or insulin-dependent diabetes (formerly called juvenile-onset diabetes, because it tends to affect persons before the age of 20) affects about 10 percent of people with diabetes. With this type of diabetes, the pancreas makes almost no insulin.

Type II diabetes or non-insulin-dependent diabetes. This was previously called "adult-onset diabetes" because in the past it was usually discovered after age 40. However, with increasing levels of obesity and sedentary lifestyle, this disease is now being found more and more in adolescents - and sometimes even in children under 10 - and the term "adult onset" is no longer used.

Type II diabetes comprises about 90 percent of all cases of diabetes. With this type of diabetes, either the pancreas produces a reduced amount of insulin, the cells do not respond to the insulin, or both.

There are three less common types of diabetes called gestational diabetes, secondary diabetes and impaired glucose tolerance (IGT): Gestational diabetes occurs during pregnancy and causes a higher than normal glucose level reading.

Secondary diabetes is caused by damage to the pancreas from chemicals, certain medications, diseases of the pancreas (such as cancer) or other glands.

Impaired glucose tolerance (IGT) is a condition in which the person's glucose levels are higher than normal.

Causes and Risk Factors of Diabetes
The cause of Type I diabetes is genetically based, coupled with an abnormal immune response.
The cause of Type II diabetes is unknown. Medical experts believe that Type II diabetes has a genetic component, but that other factors also put people at risk for the disease. These factors include:

Sedentary lifestyle
Obesity (weighing 20 percent above a healthy body weight)
- Advanced age
- Unhealthy diet
- Family history of diabetes
- Improper functioning of the pancreas
-Minority race (higher risk in Black, Hispanic, American Indian, westernized Asian and native Hawaiian populations)
-Medication (cortisone and some high blood pressure drugs)
-Women having given birth to a baby weighing more than 9 lbs.
- Previously diagnosed gestational diabetes
- Previously diagnosed IGT

Symptoms of Diabetes Usually, the symptoms of Type I diabetes are obvious. That is not true for Type II. Many people with Type II do not discover they have diabetes until they are treated for a complication such as heart disease, blood vessel disease (atherosclerosis), stroke, blindness, skin ulcers, kidney problems, nerve trouble or impotence.

The warning signs and symptoms for both types are:

Type I: Frequent urination, increased thirst, extreme hunger, unexplained weight loss, extreme fatigue, blurred vision, irritability, nausea and vomiting.

Type II: Any Type I symptom, plus: unexplained weight gain, pain, cramping, tingling or numbness in your feet, unusual drowsiness, frequent vaginal or skin infections, dry, itchy skin and slow healing sores.

Note: If a person is experiencing these symptoms, they should see a doctor immediately. Diagnosis of Diabetes

Besides a complete history and physical examination, the doctors will perform a battery of laboratory tests. There are numerous tests available to diagnose diabetes, such as a urine test, blood test, glucose-tolerance test, fasting blood sugar and the glycohemoglobin (HbA1c) test.

A urine sample will be tested for glucose and ketones (acids that collect in the blood and urine when the body uses fat instead of glucose for energy).

A blood test is used to measure the amount of glucose in the bloodstream.
A glucose-tolerance test checks the body's ability to process glucose. During this test, sugar levels in the blood and urine are monitored for three hours after drinking a large dose of sugar solution.
The fasting blood sugar test involves fasting overnight and blood being drawn the next morning.
The glycohemoglobin test reflects an average of all blood sugar levels for the preceding two months.
Treatment of Diabetes
A landmark study, the 10-year, multi-center Diabetes Control and Complications Trial (DCCT), has now shown that intensifying diabetes management with stricter control of blood sugar levels can reduce long-term complications.
The results of DCCT are extraordinary in that they prove that tight control of glucose levels can in fact dramatically slow the onset and progression of diabetic complications in both Type I and Type II diabetes. Additionally, researchers have found strict attention to diet and exercise also helps in the management of diabetes.

Management of Type I Diabetes
Virtually everyone with Type I diabetes (and more than one in three people with Type II) must inject insulin to make up for their deficiency.
Until recently, insulin came only from the pancreases of cows and pigs (with pork insulin more closely duplicating human insulin). While beef, pork and beef/pork combinations are still widely used, there are now two types of "human" insulin available: semisynthetic (made by converting pork insulin to a form identical to human) and recombinant (made by using genetic engineering). All insulin helps glucose levels remain near normal (about 70 to 120 mg/dl).
Different types of insulin work for different periods of time. The numbers shown below are only averages. The onset (how long it takes to reach the bloodstream to begin lowering the blood sugar), peaking (how long it takes to reach maximum strength) and duration (how long it continues to lower the blood sugar) of insulin activity can vary from person to person and even from day to day in the same person.

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