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Diabetes Overview

Diabetes affects the body's ability to use blood sugar for energy. The main types include type 1 diabetes, type 2 diabetes, and gestational diabetes. Diabetes insipidus, a rare disorder, is not related to diabetes mellitus (sugar diabetes). Diabetes symptoms may include increased thirst and urination, blurred vision, and fatigue.

Overview & Facts

Understanding diabetes is the first step to managing it. Get information on diabetes causes, risk factors, warning signs, and prevention tips.

What Is Diabetes?

Diabetes Overview

Diabetes is the most common disorder of the endocrine (hormone) system.


What Are the Causes of Diabetes?

Diabetes occurs when the body cannot regulate blood sugars. Are the causes for type 1 and type 2 diabetes different? Find out.


Are You at Risk?

Are You at Risk for Diabetes?

A family history and age increases the risk for type 2 diabetes. Read what other risk you have; you may be surprised to find that there are some risk factors for type 2 diabetes that you can change.

Are You at Risk for Gestational Diabetes?

Learn about risk factors for diabetes in pregnancy.



Diabetes Prevention

Type 1 diabetes can’t be prevented, but type 2 diabetes has modifiable risk factors which can help you lower your risk for the disease. Find out how.

Preventing Type 2 Diabetes

Did you know that despite having the risks for developing diabetes, some steps can help in preventing type 2 diabetes?  Get information on type 2 diabetes prevention from the National Institutes of Health. This link will take you to their web site.




An early blood testing method called Clinitest introduced by Ames Diagnostics in 1941 entailed mixing urine and water in a test tube and adding a little blue pill that caused a chemical reaction that could cause severe physical burn injury due to extreme heat. The color of the liquid would indicate whether there was glucose in the urine.

In 1969, the first portable blood glucose meter was created by Ames Diagnostics. It was called the Ames Reflectance Meter (ARM). Ames later became a part of Bayer. The device looked a lot like the tricorder devices used in the original Star Trek series. They cost about $650 and were only for doctors to use in their practices or hospitals. Portable blood glucose meters for home use by patients were not sold in the U.S. until the 1980's.

Dr. Richard Bernstein, author of the popular book Dr. Bernstein's Diabetes Solution, was the first person to use a portable meter to check his blood sugar levels at home. He was an engineer at the time and in bad health due to Type 1 diabetes. He obtained an ARM meter meant only for physicians. Since he wasn't a physician at the time, he talked his wife (who was a psychiatrist) into obtaining the device for him. His diabetes condition drastically improved. He then campaigned for portable home blood glucose meters for patient use at home. He was unable to get medical journals to publish his studies, so at 43 years old he went to medical school and became an endocrinologist.

India has the highest population of people with type 2 diabetes, more than any other country in the world.

The country with the highest percentage of people with type 2 diabetes is a tiny island in the South Pacific called Nauru. It is the world's third smallest country after the Vatican City and Monaco.

The earliest known written record that likely referred to diabetes was in 1500 B.C in the Egyptian Ebers papyrus. It referred to the symptoms of frequent urination.

Diabetes symptoms such as thirst, weight loss, and excess urination were recognized for more than 1200 years before the disease got a name.

The Greek physician Aretaeus was credited with coming up with the name "diabetes" in the first century A.D. and thought a snake bite caused diabetes.

Dr. Thomas Willis (1621-1675) called diabetes the "pissing evil" and described the urine of people with type 2 diabetes as "wonderfully sweet, as if it was imbued with honey or sugar." He was also the first to describe pain and stinging from nerve damage due to diabetes.

Diabetes is a Greek word that means "to pass through." It was observed that urine quickly passed through patients with diabetes. The word mellitus is from Latin and means "sweet like honey."

In ancient times, doctors would test for diabetes by tasting urine to see if it was sweet. People who tasted urine to check for diabetes were called "water tasters." Other diagnostic measures included checking to see if urine attracted ants or flies.

In the late 1850's a French physician named Priorry advised his patients with diabetes to eat large quantities of sugar. Obviously, that method of treatment did not last.

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Home > Diseases and Conditions > Diabetes


Last reviewed: May 10, 2010.

Diabetes is a chronic (lifelong) disease marked by high levels of sugar in the blood.

See also:

  • Gestational diabetes

  • Metabolic syndrome

  • Type 1 diabetes

  • Type 2 diabetes

Causes, incidence, and risk factors

Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both.

To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested:

  • A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body.

  • An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel.

People with diabetes have high blood sugar. This is because:

  • Their pancreas does not make enough insulin

  • Their muscle, fat, and liver cells do not respond to insulin normally

  • Both of the above

There are three major types of diabetes:

  • Type 1 diabetes is usually diagnosed in childhood. Many patients are diagnosed when they are older than age 20. In this disease, the body makes little or no insulin. Daily injections of insulin are needed. The exact cause is unknown. Genetics, viruses, and autoimmune problems may play a role.

  • Type 2 diabetes is far more common than type 1. It makes up most of diabetes cases. It usually occurs in adulthood, but young people are increasingly being diagnosed with this disease. The pancreas does not make enough insulin to keep blood glucose levels normal, often because the body does not respond well to insulin. Many people with type 2 diabetes do not know they have it, although it is a serious condition. Type 2 diabetes is becoming more common due to increasing obesity and failure to exercise.

  • Gestational diabetes is high blood glucose that develops at any time during pregnancy in a woman who does not have diabetes. Women who have gestational diabetes are at high risk of type 2 diabetes and cardiovascular disease later in life.

Diabetes affects more than 20 million Americans. Over 40 million Americans have pre-diabetes (early type 2 diabetes).

There are many risk factors for type 2 diabetes, including:

  • Age over 45 years

  • A parent, brother, or sister with diabetes

  • Gestational diabetes or delivering a baby weighing more than 9 pounds

  • Heart disease

  • High blood cholesterol level

  • Obesity

  • Not getting enough exercise

  • Polycystic ovary disease (in women)

  • Previous impaired glucose tolerance

  • Some ethnic groups (particularly African Americans, Native Americans, Asians, Pacific Islanders, and Hispanic Americans)


High blood levels of glucose can cause several problems, including:

  • Blurry vision

  • Excessive thirst

  • Fatigue

  • Frequent urination

  • Hunger

  • Weight loss

However, because type 2 diabetes develops slowly, some people with high blood sugar experience no symptoms at all.

Symptoms of type 1 diabetes:

  • Fatigue

  • Increased thirst

  • Increased urination

  • Nausea

  • Vomiting

  • Weight loss in spite of increased appetite

Patients with type 1 diabetes usually develop symptoms over a short period of time. The condition is often diagnosed in an emergency setting.

Symptoms of type 2 diabetes:

  • Blurred vision

  • Fatigue

  • Increased appetite

  • Increased thirst

  • Increased urination


1. Not Knowing Your Disease

“You are your own doctor 99.9% of the time,” says Andrew Ahmann, MD, director of the Harold Schnitzer Diabetes Health Center at Oregon Health and Science University in Portland, Ore.

By that he means that you are the one watching your diet, making sure you exercise, and taking your medication on schedule. Understanding how diabetes works will help you make better decisions about how to monitor and manage it. Classes on coping with diabetes are an excellent but underused resource.

“Not enough patients seek them out, and not enough doctors send their patients to them,” Ahmann says.

That’s unfortunate, because not only do they offer essential information; they are often de facto support groups as well, bringing together people who are experiencing the same issues and difficulties and giving them a forum in which to meet and talk with each other.

2. Expecting Too Much Too Soon

One of the biggest hurdles in controlling your blood sugar is sticking to the necessary adjustments you must make to your eating and exercise habits. Many patients become frustrated and give up because they don’t see results right away, says endocrinologist Preethi Srikanthan, MD, assistant clinical professor of medicine at UCLA’s David Geffen School of Medicine.

“Most people expect something dramatic is going to happen right away,” she says. “But it has taken them a decade or two to get to this point, and it will take a while for them to even to get to that initial 5%-10% reduction in weight…These are challenges that must be taken in small steps.”

Expecting too much change right away is a mistake. So is doing too much before you are ready, especially when it comes to exercise, Ahmann says. He advises starting off slowly and easing into the habit.

“If they do more than they can tolerate, they will often quit,” he says. “Or they will do too much and hurt themselves.”

Be sure to talk with your health-care provider before starting a new exercise program, especially if you aren’t already active. He or she can help plan a routine that’s safe and effective, as well as set realistic goals.

3. Going it Alone

There are a lot of resources out there to help you manage your disease. Don’t ignore the fact that one of the most helpful might be right there at home. Spouses, partners, friends, and family members can all make excellent exercise buddies.

“One error that people make when it comes to exercise is that they try to do it on their own without help from other people,” Ahmann says.

There are other advantages to the buddy system. Enlist your spouse or significant other in your efforts to stick your medication schedule and to maintain a healthy diet.

“Eating alone can be a problem,” Ahmann says.

4. Neglecting Other Problems

In her practice, Srikanthan sees a lot of patients who are dealing with more than just their diabetes. Depression and stress are common among people with the disease, and both can have a negative impact on blood sugar levels.

Constant stress, for example, may produce hormones that hamper the ability of insulin to do its job. “Stress should be considered as a significant contributor to glycemic variation by both patients and physicians,” Srikanthan says.

Ahmann agrees.

“Anything to reduce stress will improve your blood sugar,” he says.

Exercise helps relieve stress and there’s evidence that meditation and massage will have benefits on blood sugar levels, says Ahmann.

People with diabetes are twice as likely to be depressed, and an estimated one of every three people with diabetes have symptoms of depression. The lethargy common to depression can be so discouraging that you might give up your efforts to take care of your diabetes. Not only will that make your diabetes worse, it may also intensify your depression, creating a vicious cycle.

There’s good news, though. According to a new study, treating depression in patients with type 2 diabetes improved their mental and physical health.

“You need to recognize depression and work with it,” Srikanthan says.

5. Misunderstanding and Misusing Medications

Ahmann says that many of his patients share a common misconception when it comes to the drugs used to control their disease.

“They think that medications are more powerful than diet and exercise,” he says.

That’s not necessarily true. In many cases, type 2 diabetes can be controlled by a combination of a healthy diet and regular exercise without the need for medication.

Among patients who do require medications, Ahmann says, one mistake stands out.

“It’s surprising how many people miss doses,” he says.

That’s a quick way to wreck your blood sugar level, so it’s a problem that needs to be recognized and addressed.

“You need to be honest with your [health care] provider that this is an issue,” says Ahmann, who points out that often the solution is for your doctor to change your dosing schedule to one that better suits you. “There are options.”

6. Making Poor Food Choices

When it comes to food and blood sugar, the big mistake is not the single candy bar that you couldn’t resist, Srikanthan says. The bigger picture matters more; unhealthy eating habits, in the long term, will have a worse effect on your blood sugar.

“People think it’s a one-time diversion, but no, it’s a consistent problem that affects your test results,” she says.

    The two biggest hurdles, Srikanthan says, are calories and carbohydrates. You have to control both in order to keep your blood sugar level steady.

    “Try to be aware of what’s going into your mouth,” she says.

    That means keeping a diet diary to keep track of what you are eating and reading nutrition labels so that you can calculate the proper amounts of the foods you choose to eat.

    Failing to eat on a regular schedule is another common mistake. Ahmann often sees patients who miss breakfast or who are too busy during the day to notice they are hungry.

    “At home that evening, they tend to lose control, eating a large dinner and then snacking throughout the evening,” he says.

      Diet details-What you should &shouldn't eat

      A registered dietitian can help you put together a diet based on your health goals, tastes and lifestyle and can provide valuable information on how to change your eating habits.

      Recommended foods
      With MNT, quality is much more important than quantity. Make your calories count with these nutritious foods:

      • Healthy carbohydrates. During digestion, sugars (simple carbohydrates) and starches (complex carbohydrates) break down into blood glucose. Focus on the healthiest carbohydrates, such as fruits, vegetables, whole grains, legumes (beans, peas and lentils) and low-fat dairy products.
      • Fiber-rich foods. Dietary fiber includes all parts of plant foods that your body can't digest or absorb. Fiber can decrease the risk of heart disease and help control blood sugar levels. Foods high in fiber include vegetables, fruits, nuts, legumes (beans, peas and lentils), whole-wheat flour and wheat bran.
      • Heart-healthy fish. Eat heart-healthy fish at least twice a week. Fish can be a good alternative to high-fat meats. Cod, tuna and halibut, for example, have less total fat, saturated fat and cholesterol than do meat and poultry. Fish such as salmon, mackerel and herring are rich in omega-3 fatty acids, which promote heart health by lowering blood fats called triglycerides. However, avoid fried fish and fish with high levels of mercury, such as tilefish, swordfish and king mackerel.
      • 'Good' fats. Foods containing monounsaturated and polyunsaturated fats — such as avocados, almonds, pecans, walnuts, olives, and canola, olive and peanut oils — can help lower your cholesterol levels. Eat them sparingly, however, as all fats are high in calories.

      Foods to avoid
      Diabetes increases your risk of heart disease and stroke by accelerating the development of clogged and hardened arteries. Foods containing the following can work against your goal of a heart-healthy diet.

      • Saturated fats. High-fat dairy products and animal proteins such as beef, hot dogs, sausage and bacon contain saturated fats. Get no more than 7 percent of your daily calories from saturated fat.
      • Trans fats. These types of fats are found in processed snacks, baked goods, shortening and stick margarines and should be avoided completely.
      • Cholesterol. Sources of cholesterol include high-fat dairy products and high-fat animal proteins, egg yolks, shellfish, liver and other organ meats. Aim for no more than 200 milligrams (mg) of cholesterol a day.
      • Sodium. Aim for less than 2,000 mg of sodium a day.





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