To get energy from the starches and sugar we eat, everyone needs adequate supplies of a hormone called insulin. People with diabetes either do not make enough insulin or are unable to make efficient use of whatever insulin they do manage to produce. Without insulin, sugar builds up in the blood, eventually leading to a host of serious problems. Diabetes (referred to medically as diabetes mellitus) can start in childhood, but more often appears later in life. There is no cure for this disease, but it can be controlled. Left uncontrolled, it can result in damage to the heart, kidneys, eyes, blood vessels, and nerves.

Causes

In people with “Type I” diabetes–the kind that usually appears in childhood–, the pancreas makes too little insulin or none at all. In those with “Type II” diabetes–which typically develops in adults–, the pancreas continues to manufacture insulin, but the body fails to make use of it.

Signs/Symptoms

The tip-off that you have diabetes is a set of symptoms that includes fatigue, great thirst, weight loss, frequent urination, and increased vulnerability to infection. Wounds may heal slowly. You may also feel as though you are eating more than usual.

Care

People with Type I diabetes usually need regular injections of insulin. Type II diabetes can often be controlled with a special diet, exercise, and oral medicines, though temporary insulin injections may be necessary during periods of stress and times of illness. Since there is no cure, you will need treatment for the rest of your life.

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What You Should Do

• The more closely you follow your doctor’s instructions, the better your chances of preventing or delaying dangerous complications.
• It is very important to take the medication prescribed by your doctor exactly as directed. Never stop taking this medicine without talking to your doctor first.
• Be sure to test your urine or blood for sugar (glucose) as often as your doctor directs.
• Make a point of exercising regularly. Your doctor will suggest an exercise program you can follow.
• Eat wholesome, balanced meals at regular, fixed times. It is best to have 3 meals a day, plus 2 or 3 snacks. Your doctor or nutritionist will give you a special diet to guide your starch and sugar intake.
• Your doctor may advise you to lose weight. Losing as little as 10 to 15 pounds can improve your blood sugar levels.
• Always wear a medic-alert pendant or bracelet identifying you as a diabetic.
• Learn about your disease and about the signs of hypoglycemia and ketoacidosis (see below).

Call Your Doctor If…

• You have any questions about medicine, activity, or diet.
• You continue to have symptoms of diabetes (such as increased thirst and urination).

Seek Care Immediately If…

• You develop symptoms of low blood sugar (hypoglycemia). These symptoms include confusion, sweating, weakness, paleness, and a rapid heartbeat. In severe cases, hypoglycemia can progress to seizures and coma.
• You develop symptoms of ketoacidosis (a dangerous chemical imbalance in the body). These symptoms include a fruity odor on the breath, a speed-up or slow-down in breathing, and a very sleepy feeling.
• You develop vomiting or have diarrhea.
• You notice numbness, tingling, or pain in your feet or hands.
• You feel chest pain.
• Your symptoms get worse, even though you are following your doctor’s orders.