What is Diabetes?
What is diabetes mellitus?
First of all, diabetes mellitus, often just called ‘diabetes’, is a chronic, metabolic disease, which means that it is a long-lasting disease that affects the way food is digested inside the body. As food is processed into small molecules that can be used as a source of energy by the body’s cells, carbohydrates mainly turn into glucose, which is released into the bloodstream.
The amount of sugar in the blood, called the glycemia, is regulated by insulin, a hormone produced by the pancreas, an abdominal organ. To put it simply, insulin acts like a key that makes blood sugar enter the body’s cells, hence lowering blood sugar. This effect is said to be hypoglycemic.
In case of diabetes, either insulin production is insufficient, or your body is unable to use the insulin it makes as well as it should, a phenomenon called insulin resistance. In either case, there is an excess of sugar in your bloodstream that can cause serious harm.1
How is diabetes diagnosed?
Diagnosis relies on blood sugar tests, sometimes in different situations: when fasting, before and after drinking a glucose-containing liquid, the HbA1c test measuring your average blood sugar over the past 2 to 3 months, or a random blood sugar test. In case of diabetes types other than type 2, other tests are required.2
How can type 2 diabetes be diagnosed?
There are several ways to diagnose diabetes. Each way usually needs to be repeated on a second day to diagnose diabetes. Testing should be carried out in a health care setting (such as your doctor’s office or a lab). If your doctor determines that your blood glucose level is very high or if you have classic symptoms of high blood glucose in addition to one positive test, your doctor may not require a second test to diagnose diabetes. Here are the three common ways of diagnosing diabetes:
- HbA1C : The HbA1C test measures your average blood glucose for the past 2 to 3 months. The advantages of being diagnosed this way are that you don’t have to fast or drink anything. Diabetes is diagnosed at an HbA1C ≥6.5%
- Fasting plasma glucose (FPG) : This test checks your fasting blood glucose levels. Fasting means after not having anything to eat or drink (except water) for at least 8 hours before the test. This test is usually done first thing in the morning, before breakfast. Diabetes is diagnosed at a fasting blood glucose ≥126 mg/dL
- Oral glucose tolerance test (OGTT) : The OGTT is a 2-hour test that checks your blood glucose levels before and 2 hours after you drink a special sweet drink. It tells the doctor how your body processes glucose. Diabetes is diagnosed at a 2-hour blood glucose ≥200 mg/dL
Is diabetes a common condition?
The answer is YES. According to the International Diabetes federation, 537 million adults are living with diabetes worldwide, what represents 1 in 10. The total number of people with diabetes is predicted to rise to 643 million (1 in 9 adults) by 2030 and 784 million (1 in 8 adults) by 2045. Diabetes caused 6.7 million deaths in 2021 – 1 every 5 seconds.3
In the US alone, 30.3 million adults have diabetes, and it is estimated that 1 in 4 of them don’t know they have it.1 It is also estimated that diabetes caused directly 1.5 million deaths worldwide in 2012, and an additional 2.2 million deaths by high blood glucose increasing the risk of cardiovascular and other diseases.2
I have heard that there are different kinds of diabetes. Is this true?
Indeed, though we should rather say that there are different types of diabetes. The most common form is known as type 2 diabetes: about 90% of diabetes cases belong to type 2. It usually occurs in adults, when resistance to insulin develops, or when the production of insulin becomes insufficient. For years, symptoms can go unnoticed, hence the necessity of blood sugar tests in at-risk people, especially when considering that type 2 diabetes can be delayed, or even prevented thanks to healthy lifestyle measures.3,4
Type 1 diabetes, once called juvenile diabetes (or insulin-dependent diabetes) occurs when the pancreas produces no insulin, or very little. It is thought to be due to an autoimmune reaction (the immune system attacks the body by mistake), and it roughly affects 5% of diabetes patients. Unlike type 2 diabetes, most cases develop quickly and are diagnosed in children, teenagers or young adults, but it can develop at any age. Type 1 diabetes cannot be prevented, and it requires taking insulin every day to survive.3,5
Other types of diabetes exist, but on this website, the main focus is on type 2 diabetes. For any further questions about diabetes and its other forms, please check with your physician.
I have heard about a condition called ‘prediabetes’. What is it?
Prediabetes is a condition in which the blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. Millions of people worldwide do not know that they have prediabetes, that is why it is important to get screened for the condition.5
Prediabetic persons may develop type 2 diabetes in later life. There is a rule of “thirds” - about one third of prediabetic people will develop diabetes in the next 5 years, one third will remain prediabetic, while one third will revert to normal.6
Yes, those who have prediabetes are at a higher risk of cardiovascular disease. Weight control can help prevent progression from prediabetes to diabetes and avoid cardiovascular problems.6
