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Precision Medicine for Personalized Patient Care

Diabetes (Diabetes Mellitus)

A disease in which the body does not control the amount of glucose (a type of sugar) in the blood and the kidneys make a large amount of urine. This disease occurs when the body does not make enough insulin or does not use it the way it should.

The American Diabetes Association (ADA) recommends that testing to detect prediabetes and type 2 diabetes be considered in adults who are overweight or obese and have one or more additional risk factors for diabetes. In adults without these risk factors, testing should begin at age 45.

Diabetes affects an estimated 29.1 million people in the United States. It is the seventh leading cause of death, and the leading cause of kidney failure, non-traumatic lower limb amputations, and, in working-age adults, blindness.

Diabetes is a group of chronic diseases that affect metabolism—the way the body uses food for energy and growth. Millions of people have diabetes, which can lead to serious health problems if it is not managed well. Conventional medical treatments and following a healthy lifestyle, including watching your weight, can help you prevent, manage, and control many complications of diabetes.


About Diabetes

There are three different types of diabetes-type 1, type 2, and gestational. All three types of diabetes involve problems with how our bodies respond to the hormone insulin. Most of the food we eat is broken down into glucose, a type of sugar and the main fuel for our bodies. To use glucose, our bodies need insulin. People with type 1 diabetes produce little or no insulin. People with type 2 diabetes do not respond normally to the insulin their bodies make.

About 90 to 95 percent of people diagnosed with diabetes have type 2 diabetes. Only about 5 percent have type 1 diabetes, which is usually diagnosed in childhood or early adulthood and requires treatment with insulin. Gestational diabetes affects only pregnant women. It usually goes away after the birth, but it increases the risk of the mother developing diabetes later in life. For more information about diabetes and related conditions, see the National Diabetes Information Clearinghouse Web site at diabetes.niddk.nih.gov.

Risk Factors for Type 2 Diabetes

People who develop type 2 diabetes are more likely to have the following characteristics:

• age 45 or older
• overweight or obese
• physically inactive
• parent or sibling with diabetes
• family background that is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American
• history of giving birth to a baby weighing more than 9 pounds
• history of gestational diabetes
• high blood pressure—140/90 or above—or being treated for high blood pressure
• high-density lipoprotein (HDL), or good, cholesterol below 35 milligrams per deciliter (mg/dL), or a triglyceride level above 250 mg/dL
• polycystic ovary syndrome, also called PCOS
• predieteacosis nigricans, a condition associated with insulin resistance, characterized by a dark, velvety rash around the neck or armpits
• history of CVD


Preventing Diabetes

Research studies have found that moderate weight loss and exercise can prevent or delay type 2 diabetes among adults at high-risk of diabetes. Find out more about the risk factors for type 2 diabetes, what it means to have prediabetes, and what you can do to prevent or delay diabetes.

Key Facts

A healthy diet, physical activity, and blood glucose testing are the basic tools for managing type 2 diabetes. Your health care providers will help you learn to manage your diabetes and track how well you are controlling it. It is very important not to replace proven conventional medical treatment for diabetes with an unproven health product or practice.

Managing Diabetes


Eat Right

Eat smaller portions. Learn what a serving size is for different foods and how many servings you need in a meal.

Eat less fat. Choose fewer high-fat foods and use less fat for cooking. You especially want to limit foods that are high in saturated fats or trans fat, such as:
• Fatty cuts of meat.
• Fried Foods
• Whole milk and dairy products made from whole milk.
• Cakes, candy, cookies, crackers, and pies.
• Salad dressings,
• Lard, shortening, stick margarine, and nondairy creamers.

Be Active

Physical activity can help you control your blood glucose, weight, and blood pressure, as well as raise your “good” cholesterol and lower your “bad” cholesterol. It can also help prevent heart and blood flow problems, reducing your risk of heart disease and nerve damage, which are often problems for people with diabetes.

Stay Healthy

It’s very important for you to take your diabetes medicines exactly as directed. Not taking medications correctly may lower the level of glucose and cause the insulin your body to go up. The medicines then become less effective when taken. Some people report not feeling well as a reason for stopping their medication or not taking it as prescribed. Tell your doctor if your medicines are making you sick. He or she may be able to help you deal with side effects so you can feel better. Don’t just stop taking your medicines, because your health depends on it.

Sources

• Grant RW, Moore AF, and Florez JC. Genetic architecture of type 2 diabetes: recent progress and clinical implications. Diabetes Care. 2009;32(6):1107–1114.
• PubMed Health Glossary
• Diabetes Prevention Program Research Group. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374(9702):1677–1686.
• The National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892-2560, Telephone: 301.496.3583
• Centers for Disease Control and Prevention (CDC)