Causes of Prediabetes

Causes of Prediabetes?

Prediabetes occurs when your body isn't able to keep your blood sugar (glucose) at a normal level. Your sugar is higher than normal, but it's not high enough to be diabetes.

The exact cause of prediabetes is still unknown, although researchers have discovered some genes that are related to insulin resistance. Excess fat and inactivity are to be considered as the important factors in the development of prediabetes.

Most of the glucose in your body comes from the foods you eat, specifically foods that contain carbohydrates can affect your blood sugar levels, not just sweet foods. 

Normally, during digestion, sugar enters your bloodstream and with the help of insulin is then absorbed into the body's cells to give them energy. But when your body can't use insulin the right way, the sugar doesn't move into cells. It stays in your blood instead. This is called insulin resistance.

Insulin is a hormone that comes from the pancreas, a gland located just behind the stomach. When you eat, your pancreas secretes insulin into your bloodstream. As insulin circulates, it acts like a key that unlocks microscopic doors that allow sugar to enter your cells. Insulin lowers the amount of sugar in your bloodstream. As your blood sugar level drops, so does the secretion of insulin from your pancreas.

The buildup of sugar in the blood causes prediabetes. When you have prediabetes, this process begins to work improperly. Instead of fueling your cells, sugar builds up in your bloodstream. This occurs when your pancreas doesn't make enough insulin or your cells become resistant to the action of insulin or both, prediabetes can turn into type 2 diabetes.

People who are overweight, aren't physically active, and have a family history of diabetes are more likely to get prediabetes. Women who have had gestational diabetes are also more likely to get prediabetes. 

<< Symptoms of Prediabetes || Risk Factors of Prediabetes >>

Source & References:

1. Prediabetes - Mayo Clinic. Retrieved last February 19, 2013 
2. Prediabetes Cause - Emedicinehealth.com. Retrieved last February 19, 2013 

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Symptoms of Prediabetes

What are the Symptoms of Prediabetes?

Although most people with prediabetes have no symptoms at all, symptoms of diabetes may include:

• Increased thirst
• Frequent urination
• Fatigue
• Blurred vision

Darkened areas of skin, a condition called acanthosis nigricans, is one of the few signs suggesting you are at risk for diabetes. Common areas that may be affected include the neck, armpits, elbows, knees and knuckles.

The doctor can test your blood to find out if your blood glucose levels are higher than normal. If you are 45 years old or older, your doctor may recommend that you be tested for pre-diabetes, especially if you are overweight.

Who Should be Tested for Prediabetes?

Consult your doctor if you're concerned about diabetes or if you notice any type 2 diabetes signs or symptoms — increased thirst and frequent urination, fatigue, and blurred vision.

Being overweight is a key contributor, along with inactivity, to prediabetes. If your body mass index (BMI) is higher than 25, you are overweight. BMI is a measure of your weight relative to your height. If you’re not sure if you are overweight, ask your doctor.

Even if you are younger than 45, consider getting tested for prediabetes if you are overweight and

• are physically inactive
• have a parent, brother, or sister with diabetes
• have high blood pressure or high cholesterol—blood fat
• have abnormal levels of High-density lipoprotein (HDL) , or good, cholesterol or triglycerides—another type of blood fat
• had gestational diabetes—diabetes that develops only during pregnancy—or gave birth to a baby weighing more than 9 pounds
• are African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American
• have polycystic ovary syndrome, also called PCOS
• have a dark, velvety rash around your neck or armpits
• have blood vessel problems affecting your heart, brain, or legs

If your test results are normal, you should be retested in 3 years. If you have prediabetes, ask your doctor if you should be tested again in 1 year.

<< What is Prediabetes || Causes of Prediabetes >>

Source & References:

1. Prediabetes - MayoClinic.com. Retrieved last February 18, 2013 
2. Prediabetes - Symptoms - webmd.com. Retrieved last February 18, 2013 
3. Diagnosis of Diabaetes and Prediabetes - diabets.niddk.nih.gov. Retrieved last February 18, 2013 

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What is Prediabetes?

What is Prediabetes?

Prediabetes also known as "impaired glucose tolerance" or “impaired fasting glucose,” is the state of  blood sugar (glucose) level is higher than normal, but it's not yet high enough to be classified as type 2 diabetes. Still, without intervention, prediabetes is likely to become type 2 diabetes in 10 years or less. And, a person with prediabetes don't have symptoms, but they are considered to be at high risk of developing heart disease and stroke.

Prediabetes can be an opportunity to a person to improve  himself, because progression from prediabetes to type 2 diabetes isn't inevitable. With healthy lifestyle changes such as eating healthy foods, including physical activity in daily routine and maintaining a healthy weight,  may be able to bring blood sugar level back to normal.

<< Home || Symptoms of Prediabetes >>

Source & References:

1. Prediabetes - Mayo Clinic. Retrieved last February 18, 2013 
2. What is Prediabetes - webmd.com. Retrieved last February 18, 2013 
3. Prediabetes - Amercan Diabetes Association. Retrieved last February 18, 2013 

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Gestational Diabetes

What is Gestational Diabetes?

Gestational diabetes develops during pregnancy (gestation) - usually around the 24th week. About 2 and 10 percent of expectant mothers develop this condition, making it one of the most common health problems of pregnancy. Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose) in your body's main fuel. 

What causes Gestational Diabetes in Pregnancy? 

When you eat, your digestive system breaks most of your food down into a type of sugar called glucose. The glucose enters your bloodstream and then, with the help of insulin (a hormone made by your pancreas), your cells use the glucose as fuel. However, if your body doesn't produce enough insulin too much glucose remains in your blood instead of moving into the cells and getting converted to energy.

We don't know what causes gestational diabetes, but we have some clues. The placenta supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother's insulin in her body. This problem is called insulin resistance. Insulin resistance makes it hard for the mother's body to use insulin. She may need up to three times as much insulin. When insulin is not much sufficient to produce, the blood glucose levels rise too high, resulting in gestational diabetes.

Most women with gestational diabetes don't remain diabetic after the baby is born. Once you've had gestational diabetes, though, you're at higher risk for getting it again during a future pregnancy and for developing diabetes later in life.

How Gestational Diabetes can Affect your Baby?

Gestational diabetes affects the mother in late pregnancy, after the baby's body has been formed, but while the baby is busy growing. Because of this, gestational diabetes does not cause the kinds of birth defects sometimes seen in babies whose mothers had diabetes before pregnancy.

However, untreated or poorly controlled gestational diabetes can hurt your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby's pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat.

This can lead to macrosomia, or a "fat" baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby's pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes.

Chances of Getting Gestational Diabetes

According to the American Diabetes Association your chances of getting gestational diabetes are higher if you...

• you're over 35 years old
• you're overweight
• have had gestational diabetes before
• have given birth to a baby weighing more than 9 pounds
• have a strongly family member with history of diabetes
• have high blood pressure
• have sugar in your urine.
• have too much amniotic fluid
• have had an unexplained miscarriage or stillbirth

A small number of women might be considered at such low risk that they might not have to get tested. You're part of this group if you meet all of the following criteria:

• You're younger than 25.
• Your weight is in a healthy range.
• You're not a member of any racial or ethnic group with a high prevalence of diabetes, including people of Hispanic, African, Native American, South or East Asian, Pacific Island, and indigenous Australian ancestry.
• None of your close relatives have diabetes.
• You've never had a high result on a blood sugar test.
• You've never had an overly large baby or any other pregnancy complication usually associated with gestational diabetes.

Symptoms of Gestational Diabetes

Usually there are no symptoms, or the symptoms are mild and not life threatening to the pregnant woman. The blood sugar (glucose) level usually returns to normal after delivery.

Symptoms may include:

• Blurred vision
• Fatigue
• Frequent infections, including those of the bladder, vagina, and skin
• Increased thirst
• Increased urination
• Nausea and vomiting
• Weight loss despite increased appetite

How will I Know if I have Gestational Diabetes?

Gestational diabetes usually has no symptoms. That's why almost all pregnant women have a glucose-screening test between 24 and 28 weeks.

However, if you're at high risk for diabetes or are showing signs of it (such as having sugar in your urine), your caregiver will recommend this screening test at your first prenatal visit and then repeat the test again at 24 to 28 weeks if the initial result is negative.

By the way, if you get a positive result on a glucose-screening test, it doesn't necessarily mean that you have gestational diabetes. It does mean that you'll need to take a longer follow-up test (a glucose tolerance test, or GTT) to find out.

References

1. Diabetes Basics Retrieved February 15, 2013
2. Gestational diabetes. Retrieved February 16, 2013 
3. Gestational diabetes. Retrieved February 18, 2013  

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Type 2 Diabetes

Overview

Type 2 diabetes mellitus, (formerly noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes), according to World Health Organization (WHO) Type 2 diabetes is the most common form of diabetes, comprises 90% of people with diabetes around the world, and is largely the result of excess body weight and physical inactivity. Until recently, this type of diabetes was seen only in adults but it is now also occurring in children.

In this article, you'll learn the basics about type 2 diabetes, including symptoms, causes and prevention.

What is Type 2 Diabetes?

In type 2 and other types of diabetes, you have too much glucose, also called sugar, in your blood. People with diabetes have problems converting food to energy. After a meal, food is broken down into glucose, which is carried by your blood to cells throughout your body. With the help of the hormone insulin, cells absorb glucose from your blood and use it for energy. Insulin is made in the pancreas, an organ located behind the stomach.

The type 2 diabetes is a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. This is in contrast to diabetes mellitus type 1, in which there is an absolute insulin deficiency due to destruction of islet cells in the pancreas.

People with type 2 diabetes produce insulin; however, either their pancreas does not produce enough insulin or the body cannot use the insulin adequately. This is called insulin resistance. When there isn't enough insulin or the insulin is not used as it should be, glucose (sugar) can't get into the body's cells. When glucose builds up in the blood instead of going into cells, the body's cells are not able to function properly. Other problems associated with the buildup of glucose in the blood include:

• Damage to the body. Over time, the high glucose levels in the blood may damage the nerves and small blood vessels of the eyes, kidneys, and heart and predispose a person to atherosclerosis (hardening) of the large arteries that can cause heart attack and stroke.
• Dehydration. The buildup of sugar in the blood can cause an increase in urination. When the kidneys lose the glucose through the urine, a large amount of water is also lost, causing dehydration.
• Diabetic Coma (Hyperosmolar nonketotic diabetic coma). When a person with type 2 diabetes becomes very ill or severely dehydrated and is not able to drink enough fluids to make up for the fluid losses, they may develop this life-threatening complication.

Causes of Type 2 Diabetes?

People can develop type 2 diabetes at any age, even during childhood, however, those at highest risk for the disease are those who:

• Are over 45 of age
• Are obese or overweight
• Have had gestational diabetes 
• Have family members who have type 2 diabetes
• Have prediabetes
• Are inactive
• Have low HDL cholesterol or high triglycerides levels
• Have high blood pressure
• Are members of certain racial or ethnic groups

Signs and Symptoms of Type 2 Diabetes

People with type 2 diabetes may not have symptoms for years or decades, but as the disease progresses and blood sugar levels rise, symptoms develop. Here is the list of signs and symptoms for people with type 2 diabetes :

• Blurred sight
• Dry, itchy skin
• Increased thirst 
• Increased hunger (especially after eating)
• Frequent need to urinate
• Decreased sensation or numbness in the hands and feet
• Frequent bladder and vaginal infections
• Male impotence (erectile dysfunction)
• Slow healing of cuts or sores
• Tiredness
• Leg cramps

Preventing of Type 2 Diabetes

Many people with type 2 diabetes go undiagnosed for several years and are not diagnosed until they go to the doctor with complications of diabetes. But up to 60% of type 2 diabetes can be prevented. People at risk of type 2 diabetes can delay and even prevent this disease by following a healthy lifestyle. This includes:

• Maintaining a healthy weight
• Regular physical activity
• Making healthy food choices
• Managing blood pressure
• Managing cholesterol levels
• Not smoking.

References

1. "Diabetes" Retrieved January 05, 2013
2. "Am I at Risk for Type 2 Diabetes?" Retrieved February 01, 2013
3. "Type 2 Diabetes" Retrieved February 01, 2013

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Type 1 Diabetes

Overview
Type 1 diabetes (also called juvenile-onset diabetes mellitus and insulin-dependent diabetes mellitus)  is occurs when the body's own immune system destroys the insulin- producing  beta cells of the pancreas. In this article, you'll learn the basics about type 1 diabetes, including symptoms and causes and complications.

Two forms of the Type 1 Diabetes

• Idiopathic type 1 - refers to rare forms of the disease with no known cause.
• Immune-mediated diabetes - an autoimmune disorder in which the body's immune system destroys, or attempts to destroy, the cells in the pancreas that produce insulin, Immune-mediated diabetes is the most common form of type 1 diabetes

Type 1 Diabetes and Insulin

Normally the hormone insulin is secreted by the pancreas in low amounts. When you eat a meal, sugar (glucose) from food stimulates the pancreas to release insulin. The amount that is released is proportional to the amount that is required by the size of that particular meal.

The main role of insulin is to help and move certain nutrients especially sugar or glucose  into the cells of the body's tissues. Cells use sugars and other nutrients from meals as a source of energy to function.

The amount of sugar in the blood decreases once it enters the cells. Normally that signals the beta cells in the pancreas to lower the amount of insulin secreted so that you don't develop low blood sugar levels (hypoglycemia). But the destruction of the beta cells that occurs with type 1 diabetes throws the entire process into disarray.

In people with type 1 diabetes, sugar isn't moved into the cells because insulin is not available. When sugar builds up in the blood instead of going into cells, the body's cells starve for nutrients and other systems in the body must provide energy for many important bodily functions. As a result, high blood sugar develops and can cause:

• Dehydration. The build up of sugar in the blood can cause an increase in urination (to try to clear the sugar from the body). When the kidneys lose the glucose through the urine, a large amount of water is also lost, causing dehydration.
• Weight loss. The loss of sugar in the urine means a loss of calories which provide energy and therefore many people with high sugars lose weight. (Dehydration also contributes to weight loss.)
• Diabetic ketoacidosis (DKA). Without insulin and because the cells are starved of energy, the body breaks down fat cells. Products of this fat breakdown include acidic chemicals called ketones that can be used for energy. Levels of these ketones begin to build up in the blood, causing an increased acidity. The liver continues to release the sugar it stores to help out. Since the body cannot use these sugars without insulin, more sugars piles into the blood stream. The combination of high excess sugars, dehydration, and acid build up is known as "ketoacidosis" and can be life-threatening if not treated immediately.
• Damage to the body. Over time, the high sugar levels in the blood may damage the nerves and small blood vessels of the eyes, kidneys, and heart and predispose a person to atherosclerosis (hardening) of the large arteries that can cause heart attack and stroke.

Incidence 
Type 1 diabetes can occur at any age, but it usually starts in people younger than 20. Symptoms are usually severe and occur rapidly.

The exact cause of type 1 diabetes is not known. Type 1 diabetes accounts for 3% of all new cases of diabetes each year. There is 1 new case per every 7,000 children per year. New cases are less common among adults older than 20. Accounting for only about 5% of the people with diabetes. The condition is more common in whites than in blacks and occurs equally in men and women.

Incidence varies from 8 to 17 per 100,000 in Northern Europe and the U.S. with a high of about 35 per 100,000 in Scandinavia to a low of 1 per 100,000 in Japan and China.

Causes
Diabetes type 1 is induced by one or more of the following:

• Genetic susceptibility - Doctors don't know all the factors that lead to type 1 diabetes. Clearly, the susceptibility to the condition can be inherited.
• Environmental -  Doctors have identified that an environmental trigger plays a role in causing the disease. Type 1 diabetes appears to occur when something in the environment -- a toxin or a virus 
• Diabetogenic trigger  - Some researchers believe that the cow's milk has been implicated as a possible trigger of the autoimmune response that destroys pancreatic beta cells in genetically susceptible hosts, thus causing diabetes mellitus. 
• Exposure to a driving antigen - Some chemicals and drugs preferentially destroy pancreatic cells that lead to loss of insulin production.

Symptoms
The classical symptoms of type 1 diabetes include:

• Increased thirst
• Increased hunger (especially after eating)
• Dry mouth
• Nausea and occasionally vomiting
• Abdominal pain
• Frequent urination
• Unexplained weight loss (even though you are eating and feel hungry)
• Fatigue (weak, tired feeling)
• Blurred vision
• Heavy, labored breathing (Kussmaul respiration)
• Frequent infections of the skin, urinary tract, or vagina

Image source: wikipedia.org

Before a person knows they have diabetes, blood sugar levels can be in a very high range for long periods of time which could cause diabetic ketoacidosis. These symptoms could be:

• Dry skin
• Rapid deep breathing
• Drowsiness
• Fruity smeel to the breath
• Abdominal pain
• Vomiting
• Loss of consciousness(rare)

Tests
The following tests can be used to diagnose diabetes:

• Urinalysis shows glucose and ketone bodies in the urine, but a blood test is required for diagnosis
• Fasting blood glucose is 126 mg/dL or higher
• Random (nonfasting) blood glucose exceeds 200 mg/dL (this must be confined with a fasting test)
• Insulin test (low or undetectable level of insulin)
• C-peptide test (low or undetectable level of the protein C-peptide, a by-product of insulin production)

Complications

Type 1 diabetes can cause different problems, but there are three key complications:

1. Hypoglycemia (low blood sugar; sometimes called an insulin reaction) occurs when blood sugar drops too low.
2. Hyperglycemia (high blood sugar) occurs when blood sugar is too high, and can be a sign that diabetes is not well controlled.
3. Ketoacidosis (diabetic coma) is loss of consciousness due to untreated or under-treated diabetes.

References

1. "Type 1 Diabetes Mellitus". Retrieved 2008-08-04.
2. "Type 1 Diabetes". Retrieved 2013-02-12
3. Kasper, Dennis L; Braunwald, Eugene; Fauci, Anthony; et al. (2005). Harrison's Principles of Internal Medicine (16th ed.). New York: McGraw-Hill. ISBN 0-07-139140-1.
4.  "content.nejm.org". content.nejm.org. Retrieved 29 February 2013.
5. "Endocrinology Health Guide".Retrieved 29 February 2013.

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