Question:
I have read here of Type 1 individuals who have difficulty at bed time
with Hypos. For my self, often my largest reading is the first one in
the morning before breakfast. I was told that the liver pumps out sugar
when we are sleeping. So here finally is the question, Is that a
difference between the Types? Thanks... Van
Answer:
Hope the info below will help you understand diabetes.
Ed
WHAT IS DIABETES?
Diabetes is a group of disorders that have in common high blood glucose
(sugar) levels. People with diabetes either do not make enough insulin or do
not use it properly. Insulin is a hormone from the pancreas. (A hormone is a
chemical that is made in one part of the body but has its effect in another
part). Insulin has numerous functions related to the conversion of starches,
proteins, and fats to energy.
Blood glucose levels PEOPLE WITH DIABETES EITHER DO NOT MAKE ENOUGH INSULIN
OR DO NOT USE IT PROPERLY.
Blood glucose (sugar) levels vary throughout the day, rising after a meal
and returning to normal after two to three hours. Normally, the fasting
glucose level (10 hours after the last meal) should be below 110 mg/dL(USA)
or 6.1 mmol/L (Canada). Both the fasting and after-meal glucose levels tend
to rise as we age.
Main types of diabetes
Type 1 diabetes: This accounts for about 10% of all diabetes in the United
States. Type 1 diabetes is one of several diseases (called autoimmune) in
which the body destroys its own cells. In the case of type 1 diabetes, these
are cells in the pancreas called beta-cells, which are located in the islets
of the pancreas. Many patients with type 1 diabetes have other autoimmune
diseases (such as those involving the thyroid and adrenal glands). After the
beta cells are destroyed, no insulin is produced and blood glucose levels
rise. Furthermore, without insulin which allows glucose to be used as
energy, the body is dependent on fat for energy. This causes a
life-threatening condition called ketoacidosis. Prior to the discovery of
insulin, patients died from this shortly after diagnosis. This rarely
happens today. Although type 1 diabetes usually presents in children and
adolescents, it can occur at any age.
TYPE 1 DIABETES ACCOUNTS FOR ABOUT 10% OF ALL DIABETES IN THE UNITED STATES.
Type 2 diabetes: There are two reasons why blood glucose levels rise with
this disease. First, insulin is not used properly by the tissues that take
glucose from the blood (especially the muscle and liver). In addition,
although the body still makes insulin, not enough insulin is produced.
Indeed, over time the insulin deficiency seen with type 2 diabetes becomes
quite profound and insulin injections are required to prevent severe
elevations in blood glucose levels. Although type 2 diabetes usually
presents in adults, it can present at any age. Indeed, there is currently a
dramatic increase in this disease presenting in adolescents, thought in part
to be due to the sedentary lifestyle and obesity developing in these young
individuals. There is usually a family history of diabetes, and this disease
is usually associated with obesity.
Gestational diabetes: This is when high blood glucose levels occur in the
second half of pregnancy. About 5% of all pregnant women develop this.
Therefore, it is recommended that women be screened for gestational diabetes
with an oral glucose tolerance test at approximately their 24th week of
their pregnancy. Untreated, this condition leads to large babies resulting
in difficult and possibly dangerous births. Although this condition
disappears after the pregnancy, women with gestational diabetes have a high
risk for developing type 2 diabetes later in life.
Risk factors for type 1 and type 2 diabetes
Although we don't understand why most people get diabetes, there are some
risks which increase the chance of developing diabetes.
Type 1 diabetes:
Family history: 10% of people with type 1 diabetes have a family history. If
an identical twin has the disease, the risk of the other twin getting it is
only 30-40%.
Type 2 diabetes:
Age: over 45 years in all adults
Ethnic groups: African Americans, Native Americans, Asian Americans, and
Hispanics all have an increased risk of developing type 2 diabetes at a
younger age.
Obesity and sedentary life style
Family history: If one identical twin develops type 2 diabetes, the risk of
the other twin getting it is almost 100%.
Women who have had gestational diabetes
Diagnosis
Type 1 diabetes:
The diagnosis of type 1 diabetes is usually straightforward. These people
are usually losing weight, have high blood glucose levels, and often have
ketones in their urine. ALTHOUGH WE DON'T UNDERSTAND WHY MOST PEOPLE GET
DIABETES, THERE ARE SOME RISKS WHICH INCREASE THE CHANCE OF DEVELOPING
DIABETES.
Type 2 diabetes:
To diagnose type 2 diabetes, one needs to have either
Fasting glucose (overnight) above 126 mg/dL (USA) or 6.9 mmol/L (Canada)
Random glucose above 200 mg/dL (USA) or 11.1 mmol/L (Canada) with frequent
urination and excessive thirst
An abnormal oral glucose tolerance test (blood is taken two hours after a
glucose drink)
If one of these three criteria is found, one of them must be repeated to
confirm the diagnosis. Usually, this would be the fasting blood glucose.
Screening
Type 1 diabetes:
There are currently no recommendations for general screening for type 1
diabetes.
Type 2 diabetes:
For type 2 diabetes, screening with a fasting blood glucose test is
recommended for the following situations:
All adults over the age of 45 years; if normal, screening should be repeated
in 3 years.
Screening should occur earlier and more frequently for:
women with a history of gestational diabetes or having a baby weighing
greater than 9 pounds
ethnic groups with an increased risk of developing type 2 diabetes (African
Americans, Asian Americans, Native Americans, and Hispanics)
individuals with a family history of type 2 diabetes
individuals who are obese or have a sedentary lifestyle
individuals with hypertension or high triglyceride (blood fat) levels
