Information about diabetes and how to cope with both type I and type II.

Say “diabetes,” and many people will think of diabetes type I and treatment with insulin. However, there is more than one type of diabetes mellitus (The word mellitus comes from the Latin and means honey sweet). There is more than one type of diabetes for that matter – there is diabetes insipidus (is a Latin word meaning “without taste.”) as opposed to diabetes mellitus, but that is another Health Focus as the two are unrelated.

The symptoms of untreated diabetes mellitus type I can not be totally ignored, but the symptoms of diabetes type II develop very slowly and often pass unnoticed because they are vague and not generally severe. Type II diabetes is the most common form of diabetes – 90% of diabetes cases are type II. It is estimated that around 16 million Americans have type II diabetes and that half of them do not know that they have it.

Insulin is necessary to digest sugar and supply energy. A person with type II diabetes has cells which resist the entry of insulin, so more insulin than normal is needed to overcome this resistance. Insulin resistance prevents glucose in the blood from moving into all cells where it can be used. Most type II diabetics produce normal amounts of insulin. Before the condition starts, the pancreas is able to produce enough insulin to overcome this resistance.

Eventually, the pancreas begins to produce less and less insulin. This leads to an elevated level of sugar in the blood after a meal. This is called hyperglycemia and it is very damaging to the body. The body can not use the sugar so it is excreted in the urine.

Finally, elevated glucose levels destroy the beta cells in the pancreas which produce insulin. This ends insulin production and causes a shift to type I, insulin dependent diabetes mellitus. Without treatment, blood glucose levels will become permanently elevated which will cause even more damage to the body.

Symptoms of type II diabetes include:

Excessive thirst
Extreme hunger
Increased feeling of tiredness
Frequent need to urinate, especially at night
Weight loss
Slow healing of cuts and sores
Frequent infections, especially:
Urinary tract infections
Fungus infections
Impotence in men

Many people discover that they may have diabetes through a routine urinalysis. If abnormal sugar levels are found in your urine, your physician will do follow-up testing to determine which type of diabetes you have. There are several tests available. Correct diagnosis is very important.

Treatment of type II diabetes is individualized, but could include the following:

Diet control and weight loss.
Regular testing of blood glucose levels, blood pressure and cholesterol.
Oral medications to stimulate insulin production and control high blood sugar.
Insulin injections in combination with oral medication if the beta cells begin to fail.
Regular consultation with an eye doctor.
Regular foot examination.

The aim of treatment is to keep blood glucose at or near normal levels at all times. You will have to cooperate fully with your physician and follow the treatment regimen carefully. If you do not cooperate in your treatment, it is possible for type II to develop into type I diabetes after destruction of the beta cells in the pancreas. Avoiding this eventuality with its use of injected insulin and greater possibilities of serious complications should be a powerful incentive to control the diet and have an exercise program.

Serious complications of type I diabetes can include:

High blood pressure with an increased risk of stroke.
Heart disease.
Kidney disease which may lead to kidney failure.
Cataracts, glaucoma and blindness.
Nerve damage (neuropathy) which causes numerous problems including carpel tunnel syndrome, impotence, pain in the hands and feet.
Increased tendency to fungal and bacterial infections.
Amputation following intractable infections or damage caused by lack of adequate blood supply due to blood vessel damage.
Periodontal disease.
Birth defects.
Foot problems.

There is a risk that these complications can also arise from type I diabetes. The risk is not so great as in type II diabetes, but it does exist. Following a careful treatment regimen will minimize the risk.

All diabetics should consult their physician regularly, at least two to four times per year. He/she will want to monitor your blood glucose, cholesterol and urine. You should also keep carefully the records your physician recommends and see your eye doctor and podiatrist regularly.