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Type 1 |
- In autoimmune diseases, such as type 1 diabetes, the immune system mistakenly manufactures antibodies and inflammatory cells that are directed against and cause damage to patients' own body tissues.
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- In persons with type 1 diabetes, the beta cells of the pancreas, which are responsible for insulin production, are attacked by the misdirected immune system. It is believed that the tendency to develop abnormal antibodies in type 1 diabetes is, in part, genetically inherited, though the details are not fully understood.
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- Exposure to certain viral infections or other environmental toxins may serve to trigger abnormal antibody responses that cause damage to the pancreas cells where insulin is made.
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- Some of the antibodies seen in type 1 diabetes include anti-islet cell antibodies, anti-insulin antibodies and anti-glutamic decarboxylase antibodies. These antibodies can be detected in the majority of patients, and may help determine which individuals are at risk for developing type 1 diabetes.
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Type 2 |
- Type 2 diabetes was also previously referred to as non-insulin dependent diabetes mellitus (NIDDM), or adult onset diabetes mellitus (AODM).
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- In type 2 diabetes, patients can still produce insulin, but do so relatively inadequately for their body's needs, particularly in the face of insulin resistance as discussed above. In many cases this actually means the pancreas produces larger than normal quantities of insulin.
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- A major feature of type 2 diabetes is a lack of sensitivity to insulin by the cells of the body (particularly fat and muscle cells).
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- In addition to the problems with an increase in insulin resistance, the release of insulin by the pancreas may also be defective and suboptimal. In fact, there is a known steady decline in beta cell production of insulin in type 2 diabetes that contributes to worsening glucose control.
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- Finally, the liver in these patients continues to produce glucose through a process called gluconeogenesis despite elevated glucose levels. The control of gluconeogenesis becomes compromised.
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- While there is a strong genetic component to developing this form of diabetes, there are other risk factors - the most significant of which is obesity. There is a direct relationship between the degree of obesity and the risk of developing type 2 diabetes, and this holds true in children as well as adults.
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What are the symptoms of diabetes? |
- The early symptoms of untreated diabetes are related to elevated blood sugar levels and loss of glucose in the urine. High amount of glucose in the urine can cause increased urine output and lead to dehydration.
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- The inability of insulin to perform normally has effects on protein, fat and carbohydrate metabolism.
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- A relative or absolute insulin deficiency eventually leads to weight loss despite an increase in appetite
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- Some untreated diabetes patients also complain of fatigue, nausea and vomiting.
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- Patients with diabetes are prone to developing infections of the bladder, skin, and vaginal areas.
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- Fluctuations in blood glucose levels can lead to blurred vision. Extremely elevated glucose levels can lead to lethargy and coma
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How is diabetes diagnosed? |
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The fasting blood glucose (sugar) test is the preferred way to diagnose diabetes. It is easy to perform and convenient. After the person has fasted overnight (at least 8 hours), a single sample of blood is drawn and sent to the laboratory for analysis. This can also be done accurately in a doctor’s office using a glucose meter.
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Normal fasting plasma glucose levels are less than 100 milligrams per deciliter (mg/dl).
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Fasting plasma glucose levels of more than 126 mg/dl on two or more tests on different days indicate diabetes.
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A random blood glucose test can also be used to diagnose diabetes. A blood glucose level of 200 mg/dl or higher indicates diabetes.
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- When fasting blood glucose stays above 100mg/dl, but in the range of 100-126mg/dl, this is known as impaired fasting glucose (IFG).
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- While patients with IFG do not have the diagnosis of diabetes, this condition carries with it its own risk and concerns and is addressed elsewhere.
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