Diabetes is a disorder of metabolism, in which the body does not produce or properly use insulin. It is a life-long disease marked by elevated levels of blood glucose.
The hormone insulin, made in the pancreas (a large gland behind the stomach) helps control levels of the sugar glucose, which is needed to fuel many chemical processes.
In a healthy person
When food is digested, glucose levels in the bloodstream rise.
The pancreas automatically produces the right amount of insulin, which helps body cells take up glucose.
Insulin also helps convert glucose into glycogen, which is stored in the liver and muscles until needed for fuel.
Hormones regulate the release of insulin by causing blood sugar levels to drop, which in turn causes the pancreas to secrete less insulin.
In a person with diabetes mellitus
The pancreas either produces insufficient levels of or no insulin or the cells do not respond appropriately to the insulin that is produced.
Glucose builds up.
After food is digested, if the pancreas cannot produce enough insulin, the body is forced to break down fats instead of glucose for energy.
Poisonous chemicals called ketones are excreted in the urineand also build up in the bloodstream, leading to ketoacidosis, a serious condition that may cause coma or death.
If the body is unable to use insulin properly, glucose is locked out of cells and circulates through the body without being absorbed.
Glucose overflows into the urine, and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.High levels of sugar in the blood and urine impair the body’s ability to fight infections and may lead to ketoacidosis.
What are the incidence and risk factors of diabetes ?
An estimated 18.2 million people in the United States have diabetes:13 million have been diagnosed, and about 5.2 million people are unaware that they have the disease. Each year, about 1.3 million people aged 20 or older are diagnosed with diabetes. Type 1 diabetes is more common in whites than in nonwhites. Data from the World Health Organization indicates that type 1 diabetes is rare in most African, American Indian, and Asian populations. Type 2 diabetes is more common in older people, especially in people who are overweight, African Americans, American Indians, some Asian Americans, Native Hawaiians and other Pacific Islander Americans, and Hispanic Americans. The prevalence of diabetes in the United States is increasing primarily because a large segment of the population is aging, and Hispanic Americans and other at-risk groups make up the fastest-growing segment of the U.S. population. Finally, Americans are increasingly overweight and sedentary.
There are many risk factors for diabetes, including:
Family history of diabetes (parent or sibling)
Obesity
Age greater than 45 years
Certain ethnic groups (particularly African-American and Hispanic American)
Gestational diabetes or delivering a baby weighing more than 9 pounds
High blood pressure
High blood levels of triglycerides (a type of fat molecule)
High blood cholesterol level.
The American Diabetes Association recommends that all adults be screened for diabetes at least every three years. A person at high risk should be screened more often.
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