Definition

A disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood and urine.

Types

  • Type I. The pancreas makes little or no insulin. Previously called juvenile diabetes, or insulin-dependent diabetes.
  • Type II. The body either resists the effects of insulin, or does not produce enough insulin to maintain normal glucose levels.
  • Gestational. Diabetes diagnosed for the first time during pregnancy.

Causes

Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood.

  • Type I – the exact cause is unknown, but assumed to be an autoimmune disorder. The islets of langerhans cells in the pancreas (where insulin is produced) are destroyed.
  • Type II – Either the body becomes resistant to insulin, or it cannot produce enough of it.

Risk Factors

Type I Diabetes

  • Genetics
  • History of other autoimmune disorders
  • Some viruses

Type II diabetes is more likely to develop in those with more than one risk factor.

  • Age
  • Chronic disease history (heart disease, polycystic ovary syndrome, or stroke)
  • Family history
  • History of depression
  • History of gestational diabetes
  • History of giving birth to a high weight (over 9 lbs) baby
  • Hyperlipidemia
  • Hypertension
  • Overweight / Obese
  • Physical inactivity
  • Race / Ethnicity (African Americans, Alaska Natives, American Indians, Hispanics/Latinx, Native Hawaiians, and Pacific Islanders are more likely to develop diabetes).

Risk factors for gestational diabetes include:

  • Family history of diabetes
  • History of gestational diabetes or prediabetes
  • Overweight / Obesity
  • Physical inactivity
  • Polycystic Ovary Syndrome (PCOS)
  • Previous delivery of a baby weighing more than 9 lbs
  • Race / Ethnicity (African Americans, Alaska Natives, American Indians, Hispanics/Latinx, Native Hawaiians, and Pacific Islanders are more likely to develop gestational diabetes).

Prevention

There is no known way of preventing type I diabetes. Type II diabetes can be prevented by maintaining a healthy lifestyle. This includes:

  • A diet rich in fresh fruit, vegetables, and whole grains
  • Physical activity (strive for 150 minutes per week of moderate intensity exercise)
  • Losing weight (if overweight or obese, losing 5% – 10% of your body weight can decrease your risk of being diagnosed with diabetes)
  • Moving around (avoid being sedentary, and sitting for long periods of time).

While there are no guarantees to prevent gestational diabetes, adopting the same healthy lifestyle can decrease the risk.

Vaccinations

People with diabetes are at higher risk for serious problems from certain diseases. Getting vaccinated is an important step in staying healthy.

Diabetes (even well managed) can make it harder for the immune system to fight off infections, and may increase a person’s risk for serious complications. The CDC recommends that all adults receive:

  • Influenza – recommended every year, age 6 months and older
  • Tdap – (if an adult did not receive it as an adolescent to protect against pertussis (whooping cough), and then a Td (tetanus, diphtheria) booster shot every 10 years.

Additionally, the CDC recommends the following vaccines for adults suffering from diabetes (talk to your doctor about which vaccines are right for you):

  • Hepatitis B Vaccine – People with diabetes have higher rates of hepatitis B than the rest of the population. Outbreaks of hepatitis B associated with blood glucose monitoring procedures have happened among people with diabetes.
  • Pneumococcal Vaccine – People with diabetes are at increased risk for death from pneumonia (lung infection), bacteremia (blood infection) and meningitis (infection of the lining of the brain and spinal cord).
  • Shingles Vaccine (age 55 and older)

COVID-19 and Diabetes

People with diabetes had much higher rates of serious complications and death than people without diabetes (ADA). Diabetics (typically those with type I) can also suffer from diabetic ketoacidosis when very sick with viral illnesses.

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