Diabetes Mellitus Is A Hormonal Condition In Which?

Diabetes Mellitus Is A Hormonal Condition In Which
What is diabetes mellitus? – Diabetes mellitus is a condition in which the body does not produce enough of the hormone insulin, resulting in high levels of sugar in the bloodstream. There are many different types of diabetes; the most common are type 1 and type 2 diabetes, which are covered in this article.

  • Gestational diabetes occurs during the second half of pregnancy and is covered in a separate article.
  • Diabetes can also be caused by disease or damage to the pancreas, Cushing’s syndrome, acromegaly and there are also some rare forms.
  • Diabetes mellitus is linked with an increased risk of heart attacks, strokes, poor blood circulation to the legs and damage to the eyes, feet and kidneys.

Early diagnosis and strict control of blood sugar, blood pressure and cholesterol levels can help to prevent or delay these complications associated with diabetes. Maintaining a healthy lifestyle (regular exercise, eating healthily and maintaining a healthy weight) is important in reducing the risk of developing type 2 diabetes.

Which hormone is responsible for diabetes mellitus?

Endocrine Connection – Diabetes occurs when the pancreas, a gland behind the stomach, does not produce enough of the hormone insulin, or the body cannot use insulin properly. Insulin helps carry sugar from the bloodstream into the cells. Once inside the cells, sugar is converted into energy for immediate use or stored for the future.

  • That energy fuels many of our bodily functions.
  • The body produces glucose from the foods you eat.
  • The liver also releases sugar when you are not eating.
  • The pancreas produces the hormone insulin, which allows glucose from the bloodstream to enter the body’s cells where it is used for energy.
  • In type 2 diabetes, too little insulin is produced, or the body cannot use insulin properly, or both.

This results in a build-up of glucose in the blood. People with diabetes are at risk of developing serious health problems ( complications ). If your blood glucose level stays too high for too long, complications can include:

Blindness Kidney disease and failure Nerve damage which can result in nerve pain or injury to the feet or other extremities without feeling pain Heart attacks (with or without symptoms) Stroke

There are three blood tests that can be used to check the levels of glucose in your blood and diagnose prediabetes or diabetes:

Fasting Blood Glucose Test (FBG): Blood is drawn in the morning after you go without food overnight or for at least 8 hours. Oral Glucose Tolerance Test (OGTT): This test is also done in the morning after going without food overnight or for at least 8 hours. Blood is drawn before you drink 8 ounces of a sugar solution and 2 hours after. This test is more precise but less convenient than the FBG test. Hemoglobin A1C Test (A1C): This test shows what your average blood glucose levels have been over the past 3 months. You can eat and drink normally before the test.

If you are living with diabetes, lifestyle is an important part of your care. It is very important that you eat a good balance of real foods every day and exercise regularly. Managing your diabetes also means taking medicine, if needed, and testing your blood sugar levels each day.

Prediabetes occurs when blood glucose levels are higher than normal, but not high enough for a diabetes diagnosis. Over time, this can increase your risk of heart disease and stroke, as well as your risk of developing type 2 diabetes. Unfortunately, prediabetes symptoms are hard to spot, so many people have the condition and do not know it.

The U.S. Centers for Disease Control indicates that about 79 million American adults over the age of 20 have prediabetes. As the population ages, becomes increasingly overweight and increasingly inactive, the number of adults with prediabetes continues to grow.

Being obese or overweight Not getting enough exercise A family history of type 2 diabetes Being 45 or older African American, Latino/Hispanic or American Indian family background Having had gestational diabetes Giving birth to a baby weighing more than 9 pounds

Preventing prediabetes is done with lifestyle changes, including a healthy diet that is high in vegetables and fruits and low in fat and processed foods. Regular physical activity, averaging 30 minutes five days per week, is also important. Maintaining a healthy weight or losing 5–10% of your weight if you are overweight, can also help.

In addition to lifestyle changes, a few drugs have been proven to lower the risk of developing diabetes if you have prediabetes. These drugs do have side effects, and their benefits wear off when you stop taking the drug, making lifestyle change the best option for tackling this problem. Type 1 diabetes, sometimes called insulin-dependent diabetes or juvenile diabetes, can develop at any age but most often occurs in children, teens, and young adults.

In type 1 diabetes, a person’s pancreas produces little or no insulin, so insulin treatment is needed for a lifetime. The causes of type 1 diabetes are not fully known. In most cases, the body’s immune system attacks and destroys the part of the pancreas that produces insulin.

This occurs over a period of time. So early on in type 1 diabetes, people may not have any symptoms. It is only when enough of the insulin producing cells are affected and insulin levels are low that the blood sugar rises and symptoms of diabetes start to occur. Because type 1 is an autoimmune disease, people with other autoimmune, conditions, such as Hashimoto’s disease or primary adrenal insufficiency (also known as Addison’s Disease), are more likely to develop type 1 diabetes.

Overall, cases of type 1 diabetes seem to be increasing. The symptoms of type 1 diabetes can look like other conditions or medical problems. If you (or your child) have these symptoms, talk with your doctor as soon as possible.

Increased thirst Increased urination Constant hunger Weight loss Blurred vision Constantly feeling tired

People with type 1 diabetes must have daily injections of insulin to keep a normal level of glucose in the blood. Blood glucose is kept under the best control with three or more injections per day using long and short acting insulin, or when insulin is delivered throughout the day with an insulin pump.

A healthy diet, exercise, and regular monitoring of blood glucose levels are also important to manage diabetes. Type 2 diabetes is the most common form of the disease, affecting 90–95% of people with diabetes. In type 2 diabetes, the body is resistant to the action of insulin, meaning it cannot use insulin properly, so it cannot carry sugar into the cells.

Although the body makes some insulin, it is not enough to overcome this resistance. You are more likely to develop type 2 diabetes if you are overweight, have a family history of diabetes, or have a history of diabetes during pregnancy. Other groups more likely to have the disease are people over age 45 and non-Caucasians.

  1. A simple blood test can tell you if you have diabetes.
  2. Individuals with this condition have a pancreas that is able to produce insulin, but their bodies are unable to use or process the insulin that is made.
  3. Over time, the pancreas may stop creating insulin altogether, but type 2 diabetes starts with the inability to process the insulin that is made.

Being older (over 45) and overweight are the greatest risk factors for developing diabetes. Other factors that increase your chances of developing high blood glucose include:

Having a parent or sibling with diabetes Having an African American, Latino/Hispanic, or American Indian family background Having had gestational diabetes (diabetes during pregnancy) or giving birth to a baby weighing more than 9 pounds Having high blood pressure (140/90 mm Hg or higher) Having low levels of HDL (good) cholesterol (below 35 mg/dL in men or 45 mg/dL in women) or high levels of triglycerides (above 250 mg/dL) Having polycystic ovary syndrome (PCOS) Being physically inactive

People with both type 1 and type 2 have high blood glucose levels, but the reasons for those high levels differ. Differences between type 1 and type 2 diabetes include: Age of diagnosis: Type 1 is typically diagnosed in children or young people (but it can be diagnosed in older individuals as well), while type 2 diabetes is generally diagnosed in adults and occasionally children.

  1. Treatment options : For individuals with type 1 diabetes, the only effective treatment is insulin.
  2. For people with type 2 diabetes, oral medications (pills), insulin, or non-insulin injectables may be used.
  3. Hypoglycemia : Blood sugar levels can drop to dangerously low levels in people with type I diabetes, but it can also occur in individuals with type 2 diabetes.

Certain medications, such as insulin, may increase the risk of hypoglycemia. Preventability: While certain experimental medications may postpone the development of type 1 diabetes, there are no means of preventing type 1 diabetes. Type 2 diabetes can sometimes be prevented with lifestyle changes.

  1. Gestational Diabetes is a temporary form of diabetes that can occur when a woman is pregnant.
  2. During pregnancy, the placenta produces hormones that help the baby develop.
  3. These hormones also block the effects of insulin in the woman’s body, increasing her blood sugar levels.
  4. Most women who have gestational diabetes have no symptoms.

If a woman has high blood sugar in pregnanct, she will have to follow a special diet for the rest of the pregnancy. In some cases, she may also need to take insulin. High blood sugar in women with gestational diabetes can affect them and their baby. These risks include:

Premature delivery and preeclampsia (pregnancy-induced high blood pressure). The baby grows too large. Very large babies may get stuck in the birth canal and have birth injuries. Large size also increases the chances of needing a cesarean (surgical) delivery. May cause stillbirth. Uncontrolled gestational diabetes also increases the risk of jaundice and breathing problems in the newborn. After birth, the baby may develop low blood sugar (hypoglycemia), a potentially dangerous condition. While in the womb, the baby’s pancreas produces large amounts of insulin in response to the mother’s high blood sugar, and it continues to do so after delivery. Without the sugar supplied by the mother, excess insulin can cause the baby’s own glucose level to drop too low.

Gestational diabetes affects about 4–8 of every 100 pregnant women in the United States. Any pregnant woman can develop the condition, but some women are at greater risk than others. Among women with the below risk factors, as many as 14 in 100 develop gestational diabetes. Known risk factors include:

Age (older than 25 years; the risk is even greater after age 35) Race (occurs more often in African Americans, Hispanics, American Indians, and Asian Americans) Overweight and obesity Personal history of gestational diabetes or prediabetes Having delivered a baby weighing more than 9 pounds Family history of type 2 diabetes (in parents or siblings)

Monogenic Diabetes (MODY) is the least common form of diabetes. It is developed as a result of single gene mutations. Monogenic diabetes appears in several forms and most often affects young people.

Do I need to be checked for prediabetes? If I have prediabetes, should I be checked for type 2 diabetes? How often? Should I take medicine to treat my prediabetes? What are the benefits and risks of prediabetes medicines? How can I lose weight if I need to? What can I (or my child) do to keep blood glucose level on target? What should I (or my child) eat? Which medicines do I (or my child) need? What type of exercise is best for me (or my child)? How often should I (or my child) check blood glucose levels? Should I (or my child) see a diabetes educator? Should I (or my child) see an endocrinologist? Should I have my blood glucose level tested? What are the results of my testing and what do they mean? What can I do to bring my glucose levels back to normal? What can I do to prevent gestational diabetes? I have gestational diabetes. How often should I check my blood glucose level? How often should I check my blood glucose after my baby is born? Can gestational diabetes lead to other health problems?

Endocrine Library >>

What is the main cause of diabetes mellitus?

The role of glucose – Glucose — a sugar — is a source of energy for the cells that make up muscles and other tissues.

Glucose comes from two major sources: food and the liver. Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin. The liver stores and makes glucose. When glucose levels are low, such as when you haven’t eaten in a while, the liver breaks down stored glycogen into glucose. This keeps your glucose level within a typical range.

The exact cause of most types of diabetes is unknown. In all cases, sugar builds up in the bloodstream. This is because the pancreas doesn’t produce enough insulin. Both type 1 and type 2 diabetes may be caused by a combination of genetic or environmental factors. It is unclear what those factors may be.

What is diabetes mellitus explain the hormonal regulation of glucose?

Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high.

Urination and thirst are increased, and people may lose weight even if they are not trying to. Diabetes damages the nerves and causes problems with the sense of touch. Diabetes damages blood vessels and increases the risk of heart attack, stroke, chronic kidney disease, and vision loss. Doctors diagnose diabetes by measuring blood sugar levels. People with diabetes need to follow a healthy diet that is low in refined carbohydrates (including sugar), saturated fat, and processed foods. They also need to exercise, maintain a healthy weight, and usually take medications to lower blood sugar levels.

There are many types of sugar. Some sugars are simple, and others are complex. Table sugar (sucrose) is made of two simpler sugars called glucose and fructose. Milk sugar (lactose) is made of glucose and a simple sugar called galactose. The carbohydrates in starches, such as bread, pasta, rice, and similar foods, are long chains of different simple sugar molecules.

  1. Sucrose, lactose, carbohydrates, and other complex sugars must be broken down into simple sugars by enzymes in the digestive tract before the body can absorb them.
  2. Once the body absorbs simple sugars, it usually converts them all into glucose, which is an important source of fuel for the body.
  3. Glucose is the sugar that is transported through the bloodstream and taken up by cells.

The body can also make glucose from fats and proteins. Blood “sugar” really means blood glucose. The levels of glucose in the blood vary normally throughout the day. They rise after a meal and return to pre-meal levels within about 2 hours after eating.

  1. Once the levels of glucose in the blood return to pre-meal levels, insulin production decreases.
  2. The variation in blood glucose levels is usually within a narrow range, about 70 to 110 milligrams per deciliter (mg/dL), or 3.9 to 6.1 millimoles per liter (mmol/L) of blood in healthy people.
  3. If people eat a large amount of carbohydrates, the levels may increase more.

People older than 65 years tend to have slightly higher levels, especially after eating. Prediabetes is a condition in which blood glucose levels are too high to be considered normal but not high enough to be labeled diabetes. People have prediabetes if their fasting blood glucose level is between 100 mg/dL (5.6 mmol/L) and 125 mg/dL (6.9 mmol/L) or if their blood glucose level 2 hours after a glucose tolerance test is between 140 mg/dL (7.8 mmol/L) and 199 mg/dL (11.0 mmol/L).

Prediabetes carries a higher risk of future diabetes as well as heart disease. Decreasing body weight by 5 to 10% through diet and exercise can significantly reduce the risk of developing diabetes. In type 1 diabetes (formerly called insulin -dependent diabetes or juvenile-onset diabetes), the body’s immune system attacks the insulin -producing cells of the pancreas, and more than 90% of them are permanently destroyed.

The pancreas, therefore, produces little or no insulin, Only about 5 to 10% of all people with diabetes have type 1 disease. Most people who have type 1 diabetes develop the disease before age 30, although it can develop later in life. Scientists believe that an environmental factor—possibly a viral infection or a nutritional factor during childhood or early adulthood—causes the immune system to destroy the insulin -producing cells of the pancreas.

A genetic predisposition makes some people more susceptible to an environmental factor. In type 2 diabetes (formerly called non– insulin -dependent diabetes or adult-onset diabetes), the pancreas often continues to produce insulin, sometimes even at higher-than-normal levels, especially early in the disease.

However, the body develops resistance to the effects of insulin, so there is not enough insulin to meet the body’s needs. As type 2 diabetes progresses, the insulin -producing ability of the pancreas decreases. Type 2 diabetes was once rare in children and adolescents but has become more common.

  • However, it usually begins in people older than 30 and becomes progressively more common with age.
  • About 26% of people older than 65 have type 2 diabetes.
  • People of African, Asian American, American Indian, Alaskan native, and Spanish or Latin American ancestry are at increased risk of developing type 2 diabetes.

Type 2 diabetes tends to run in families. Certain disorders and medications can affect the way the body uses insulin and can lead to type 2 diabetes. Examples of common states (conditions) that result in impaired insulin use are The two types of diabetes can have very similar symptoms if the blood glucose is significantly elevated.

Increased thirst Increased urination Increased hunger

Other symptoms of diabetes include

Blurred vision Drowsiness Nausea Decreased endurance during exercise

In people with type 1 diabetes, the symptoms often begin abruptly and dramatically. A serious condition called diabetic ketoacidosis Diabetic Ketoacidosis Diabetic ketoacidosis is an acute complication of diabetes that occurs mostly in type 1 diabetes mellitus.

  • Symptoms of diabetic ketoacidosis include nausea, vomiting, abdominal pain, and a characteristic.
  • Read more, a complication in which the body produces excess acid, may quickly develop.
  • In addition to the usual diabetes symptoms of excessive thirst and urination, the initial symptoms of diabetic ketoacidosis also include nausea, vomiting, fatigue, and—particularly in children—abdominal pain.

Breathing tends to become deep and rapid as the body attempts to correct the blood’s acidity (see Acidosis Acidosis Acidosis is caused by an overproduction of acid that builds up in the blood or an excessive loss of bicarbonate from the blood (metabolic acidosis) or by a buildup of carbon dioxide in the blood.

  • Read more ), and the breath smells fruity and like nail polish remover.
  • Without treatment, diabetic ketoacidosis can progress to coma and death, sometimes very quickly.
  • After type 1 diabetes has begun, some people have a long but temporary phase of near-normal glucose levels (honeymoon phase) due to partial recovery of insulin secretion.
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People with type 2 diabetes may not have any symptoms for years or decades before they are diagnosed. Symptoms may be subtle. Increased urination and thirst are mild at first and gradually worsen over weeks or months. Eventually, people feel extremely fatigued, are likely to develop blurred vision, and may become dehydrated.

  1. Because people with type 2 diabetes produce some insulin, ketoacidosis Diabetic Ketoacidosis Diabetic ketoacidosis is an acute complication of diabetes that occurs mostly in type 1 diabetes mellitus.
  2. Symptoms of diabetic ketoacidosis include nausea, vomiting, abdominal pain, and a characteristic.
  3. Read more does not usually develop even when type 2 diabetes is untreated for a long time.

Rarely, the blood glucose levels become extremely high (even exceeding 1,000 mg/dL ). Such high levels often happen as the result of some superimposed stress, such as an infection or medication use. When the blood glucose levels get very high, people may develop severe dehydration Dehydration Dehydration is a deficiency of water in the body.

  1. Vomiting, diarrhea, excessive sweating, burns, kidney failure, and use of diuretics may cause dehydration.
  2. People feel thirsty, and as dehydration.
  3. Read more, which may lead to mental confusion, drowsiness, and seizures, a condition called hyperosmolar hyperglycemic state Hyperosmolar Hyperglycemic State (HHS) Hyperosmolar hyperglycemic state is a complication of diabetes mellitus that most often occurs in type 2 diabetes.

Symptoms of hyperosmolar hyperglycemic state include extreme dehydration and. read more, Many people with type 2 diabetes are diagnosed by routine blood glucose testing before they develop such severely high blood glucose levels. High blood glucose levels also cause disturbances in the body’s immune system, so people with diabetes mellitus are particularly susceptible to bacterial and fungal infections.

Measuring the level of glucose in the blood

Doctors check blood glucose levels in people who have symptoms of diabetes, such as increased thirst, urination, or hunger. Additionally, doctors may check blood glucose levels in people who have disorders that can be complications of diabetes, such as frequent infections, foot ulcers, and yeast infections.

  • To accurately evaluate blood glucose levels, doctors usually use a blood sample taken after people have fasted overnight.
  • Diabetes can be diagnosed if fasting blood glucose levels are 126 mg/dL (7.0 mmol/L) or higher.
  • However, it is possible to use blood samples taken after people have eaten.
  • Some elevation of blood glucose levels after eating is normal, but even after a meal the levels should not be very high.

Diabetes can be diagnosed if a random (not done after fasting) blood glucose level is higher than 200 mg/dL (11.1 mmol/L). Doctors can also measure the level of a protein, hemoglobin A1C (also called glycosylated or glycolated hemoglobin), in the blood, which reflects the person’s long-term trends in blood glucose levels rather than rapid changes.

Hemoglobin is the red, oxygen-carrying substance in red blood cells. When blood is exposed to high blood glucose levels over a period of time, glucose attaches to the hemoglobin and forms glycosylated hemoglobin. The hemoglobin A1C level blood test is reported as the percentage of hemoglobin that is A1C,

Measurements of hemoglobin A1C can be used to diagnose diabetes when testing is done by a certified laboratory (not by instruments used at home or in a doctor’s office). People with a hemoglobin A1C level of 6.5% or more have diabetes. If the level is between 5.7 and 6.4, they have prediabetes and are at risk of developing diabetes.

In this test, people fast, have a blood sample taken to determine the fasting blood glucose level, and then drink a special solution containing a large, standard amount of glucose. More blood samples are then taken over the next 2 to 3 hours and are tested to determine whether the glucose in the blood rises to abnormally high levels.

Blood glucose levels are often checked during a routine physical examination. Checking the levels of glucose in the blood regularly is particularly important in older people because diabetes is so common in later life. People may have diabetes, particularly type 2 diabetes, and not know it.

Are 35 years or older Have overweight or obesity Have a sedentary lifestyle Have a family history of diabetes Have had diabetes during pregnancy or had a baby who weighed more than 9 pounds (4,000 grams) at birth Have cardiovascular disease Have fatty liver disease Have racial or ethnic ancestry that is associated with high risk Have HIV infection

People with these risk factors should be screened for diabetes at least once every three years. Diabetes risk can also be estimated using a risk calculators from the American Diabetes Association, Doctors may measure fasting blood glucose levels and hemoglobin A1C level, or do an oral glucose tolerance test.

Diet Exercise Weight loss Education In type 1 diabetes, insulin injections In type 2 diabetes, often medications by mouth and sometimes insulin or other medications by injection

Diet, exercise, and education are the cornerstones of treatment of diabetes and often the first recommendations for people with mild diabetes. Weight loss is important for people who are overweight. People who continue to have elevated blood glucose levels despite lifestyle changes, or have very high blood glucose levels and people with type 1 diabetes (no matter their blood glucose levels) also require medication.

  1. Because complications are less likely to develop if people with diabetes strictly control their blood glucose levels, the goal of diabetes treatment is to keep blood glucose levels as close to the normal range as possible.
  2. It is helpful for people with diabetes to carry or wear medical identification (such as a bracelet or tag) to alert health care practitioners to the presence of diabetes.

This information allows health care practitioners to start life-saving treatment quickly, especially in the case of injury or change in mental status. People with diabetes benefit greatly from learning about the disorder, understanding how diet and exercise affect their blood glucose levels, and knowing how to avoid complications.

A nurse trained in diabetes education can provide information about managing diet, exercising, monitoring blood glucose levels, and taking medication. Diet management is very important in people with either type of diabetes mellitus. Doctors recommend a healthy, balanced diet and efforts to maintain a healthy weight.

People with diabetes can benefit from meeting with a dietitian or a diabetes educator to develop an optimal eating plan. Such a plan includes

Avoiding simple sugars and processed foods Increasing dietary fiber Limiting portions of carbohydrate-rich and fatty foods (especially saturated fats)

People with type 1 diabetes and certain people with type 2 diabetes may use carbohydrate counting or the carbohydrate exchange system to match their insulin dose to the carbohydrate content of their meal. “Counting” the amount of carbohydrate in a meal is used to calculate the amount of insulin the person takes before eating.

However, the carbohydrate-to- insulin ratio (the amount of insulin taken for each gram of carbohydrate in the meal) varies for each person, and people with diabetes need to work closely with a dietician who has experience in working with people with diabetes to master the technique. Some experts have advised use of the glycemic index (a measure of the impact of an ingested carbohydrate-containing food on the blood glucose level) to delineate between rapid and slowly metabolized carbohydrates, although there is little evidence to support this approach.

Exercise, in appropriate amounts (at least 150 minutes a week spread out over at least three days), can also help people control their weight and improve blood glucose levels. Because blood glucose levels go down during exercise, people must be alert for symptoms of hypoglycemia.

  • Some people need to eat a small snack during prolonged exercise, decrease their insulin dose, or both.
  • Poor eyesight may make it hard for people to read glucose meters and dose scales on insulin syringes.
  • People with arthritis or Parkinson disease or who have had a stroke may have problems manipulating the syringe.

In addition to learning about diabetes itself, people with multiple medical disorders may have to learn how to fit management of diabetes in with their management of other disorders. Learning about how to avoid complications, such as dehydration, skin breakdown, and circulation problems, and to manage factors that can contribute to complications of diabetes, such as high blood pressure and high cholesterol levels, is especially important.

  1. Such problems become more common as people age, whether they have diabetes or not.
  2. Many older people have difficulty following a healthy, balanced diet that can control blood glucose levels and weight.
  3. Changing long-held food preferences and dietary habits may be hard.
  4. Some people have other disorders that can be affected by diet and may not understand how to integrate the dietary recommendations for their various disorders.

Some people cannot control what they eat because someone else is cooking for them—at home or in a nursing home or other institution. When people with diabetes do not do their own cooking, the people who shop and prepare meals for them must also understand the diet that is needed.

These people and their caregivers usually benefit from meeting with a dietitian to develop a healthy, feasible eating plan. Some people may have a difficult time adding exercise to their daily life, particularly if they have not been active in the past or if they have a disorder that limits their movement, such as arthritis.

However, they may be able to add exercise to their usual routine. For example, people can walk instead of drive or climb the stairs instead of take the elevator. Taking the medications used to treat diabetes, particularly insulin, may be difficult for some people.

For those with vision problems or other problems that make accurately filling a syringe difficult, a caregiver can prepare the syringes ahead of time and store them in the refrigerator. People whose insulin dose is stable may purchase prefilled syringes. Prefilled insulin pen devices may be easier for people with physical limitations.

Some of these devices have large numbers and easy-to-turn dials. Poor vision, limited manual dexterity due to arthritis, tremor, or stroke, or other physical limitations may make monitoring blood glucose levels more difficult for some people. However, special monitors are available.

Some have large numerical displays that are easier to read. Some provide audible instructions and results. Some monitors read blood glucose levels through the skin and do not require a blood sample. People can consult a diabetes educator to determine which meter is most appropriate. Monitoring blood glucose levels is an essential part of diabetes care.

Routine blood glucose monitoring provides the information needed to make necessary adjustments in medications, diet, and exercise regimens. It is potentially harmful to wait until there are symptoms of low or high blood glucose levels to check blood glucose.

Between 80 and 130 mg/dL (4.4 and 7.2 mmol/L) fasting (before meals) Less than 180 mg/dL (10.0 mmol/L) 2 hours after meals

Hemoglobin A1C levels should be less than 7%. Some people use a continuous glucose monitor (CGM), an external device that is attached to the body and continuously records blood glucose levels. When this type of device is used, doctors use a different measurement to determine how well blood glucose levels are being controlled.

  • They use a value called time in range.
  • Time in range is the percentage of time over a specific period that the blood glucose level is at the person’s goal level.
  • The usual range is 70 to 180 mg/mL (3.9 to 9.9 mmol/L).
  • Some other goals are keeping systolic blood pressure less than 140 mm Hg and diastolic blood pressure less than 90 mm Hg.

For people with diabetes who have heart disease or are at high risk for heart disease, the blood pressure goal is less than 130/80 mm Hg. Many things cause blood glucose levels to change:

Diet Exercise Stress Illness Medications Time of day

The blood glucose levels may jump after people eat foods they did not realize were high in carbohydrates. Emotional stress, an infection, and many medications tend to increase blood glucose levels. Blood glucose levels increase in many people in the early morning hours because of the normal release of hormones (growth hormone and cortisol ), a reaction called the dawn phenomenon.

  • Blood glucose may shoot too high if the body releases certain hormones in response to low blood glucose levels (Somogyi effect).
  • Exercise may cause the levels of glucose in the blood to fall low.
  • Blood glucose levels can be measured easily at home or anywhere.
  • A fingerstick glucose test is most often used to monitor blood glucose.

Most blood glucose monitoring devices (glucose meters) use a drop of blood obtained by pricking the tip of the finger with a small lancet. The lancet holds a tiny needle that can be poked into the finger or placed in a spring-loaded device that easily and quickly pierces the skin.

Most people find that the pricking causes only minimal discomfort. Then, a drop of blood is placed on a reagent strip. The strip contains chemicals that undergo changes depending on the glucose level. The glucose meter reads the changes in the test strip and reports the result on a digital display. Some devices allow the blood sample to be obtained from other sites, such as the palm, forearm, upper arm, thigh, or calf.

Home glucose meters are smaller than a deck of cards. Continuous glucose monitoring (CGM) systems use a small glucose sensor placed under the skin. The sensor measures blood glucose levels every few minutes. There are two types of CGMs, with different purposes: Professional CGMs collect continuous blood glucose information over a period of time (72 hours to up to 14 days).

Health care providers use this information to make treatment recommendations. Professional CGMs do not provide data to the person with diabetes. Personal CGMs are used by the person and provide real-time blood glucose data on a small portable monitor or on a connected smart phone. Alarms on the CGM system can be set to sound when blood glucose levels drop too low or climb too high, so the device can help people quickly identify worrisome changes in blood glucose.

CGM systems are particularly helpful in certain circumstances, such as in people with type 1 diabetes who have frequent, rapid changes in blood glucose (particularly when the glucose levels sometimes go very low), which are difficult to identify with fingerstick testing.

CGM systems allow people to measure the period of time that their blood glucose stays within a certain range, and doctors use this measurement to set goals for treatment and adjust insulin dose. Keeping a record of blood glucose levels and reporting them to their doctor or nurse helps doctors and nurses provide advice in adjusting the dose of insulin or the oral antihyperglycemic medication.

Many people can learn to adjust the insulin dose on their own as necessary. Some people who have mild or early type 2 diabetes that is well-controlled with one or two medications may be able to monitor their fingerstick glucose levels relatively infrequently.

Doctors can monitor treatment using a blood test called hemoglobin A1C. When the blood glucose levels are high, changes occur in hemoglobin, the protein that carries oxygen in the blood. These changes are in direct proportion to the blood glucose levels over an extended period. The higher the hemoglobin A1C level, the higher the person’s glucose levels have been.

Thus, unlike the blood glucose measurement, which reveals the level at a particular moment, the hemoglobin A1C measurement demonstrates whether the blood glucose levels have been controlled over the previous few months. People with diabetes aim for a hemoglobin A1C level of less than 7%.

Achieving this level is sometimes difficult, but the lower the hemoglobin A1C level, the less likely people are to have complications. Doctors may recommend a slightly higher or lower target for certain people depending on their particular health situation. However, levels above 9% show poor control, and levels above 12% show very poor control.

Most doctors who specialize in diabetes care recommend that hemoglobin A1C be measured every 3 to 6 months. Although urine can also be tested for the presence of glucose, checking urine is not a good way to monitor or adjust treatment. Urine testing can be misleading because the amount of glucose in the urine may not reflect the current level of glucose in the blood.

  1. Blood glucose levels can get very low or reasonably high without any change in the glucose levels in the urine.
  2. People with type 1 diabetes may have more frequent swings in blood glucose levels because insulin production is completely absent.
  3. Infection, delayed movement of food through the stomach, and other hormonal disorders may also contribute to blood glucose swings.

In all people who have difficulty controlling blood glucose, doctors look for other disorders that might be causing the problem and also give people additional education on how to monitor diabetes and take their medications. No treatments prevent the onset of type 1 diabetes mellitus.

Some medications may induce remission of early type 1 diabetes in some people, possibly because they prevent the immune system from destroying the cells of the pancreas. However, these changes are temporary, and the medications cause side effects that limit their use. Type 2 diabetes can be prevented with lifestyle changes.

People who are overweight and lose as little as 7 percent of their body weight and who increase physical activity (for example, walking 30 minutes per day) can decrease their risk of diabetes mellitus by more than 50%. Metformin, a medication that is used to treat diabetes, may reduce the risk of diabetes in people with impaired glucose regulation.

JDRF (previously called Juvenile Diabetes Research Foundation): General information on type 1 diabetes mellitus

What does diabetes do to hormones?

GLP-1 (glucagon-like peptide-1), GIP (glucose-dependent insulinotropic polypeptide) and amylin: – GLP-1 (glucagon-like peptide-1), GIP (glucose-dependent insulinotropic polypeptide) and amylin are other hormones that also regulate mealtime insulin. GLP-1 and GIP are incretin hormones.

When released from your gut, they signal the beta cells to increase their insulin secretion and, at the same time, decrease the alpha cells’ release of glucagon. GLP-1 also slows down the rate at which food empties from your stomach, and it acts on the brain to make you feel full and satisfied. People with type 1 diabetes have absent or malfunctioning beta cells so the hormones insulin and amylin are missing and the hormone GLP1 cannot work properly.

This may explain, in part, why individuals with diabetes do not suppress glucagon during a meal and have high blood sugars after a meal.

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What happens in diabetes mellitus?

With diabetes, your body either doesn’t make enough insulin or can’t use it as well as it should. Diabetes is a chronic (long-lasting) health condition that affects how your body turns food into energy. Your body breaks down most of the food you eat into sugar (glucose) and releases it into your bloodstream.

  • When your blood sugar goes up, it signals your pancreas to release insulin.
  • Insulin acts like a key to let the blood sugar into your body’s cells for use as energy.
  • With diabetes, your body doesn’t make enough insulin or can’t use it as well as it should.
  • When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream.

Over time, that can cause serious health problems, such as heart disease, vision loss, and kidney disease, There isn’t a cure yet for diabetes, but losing weight, eating healthy food, and being active can really help. Other things you can do to help:

Take medicine as prescribed. Get diabetes self-management education and support. Make and keep health care appointments.

More than 37 million US adults have diabetes, and 1 in 5 of them don’t know they have it. Diabetes is the seventh leading cause of death in the United States. Diabetes is the No.1 cause of kidney failure, lower-limb amputations, and adult blindness. In the last 20 years, the number of adults diagnosed with diabetes has more than doubled,

What are the 3 major symptoms of diabetes mellitus?

If you think that you have diabetes, visit your doctor immediately for a definite diagnosis. Common symptoms include the following:

Frequent urination Excessive thirst Unexplained weight loss Extreme hunger Sudden vision changes Tingling or numbness in the hands or feet Feeling very tired much of the time Very dry skin Sores that are slow to heal More infections than usual

Some people may experience only a few symptoms that are listed above. About 50 percent of people with type 2 diabetes don’t experience any symptoms and don’t know they have the disease.

Why is sugar called diabetes mellitus?

Mellitus – Mellitus means, “pleasant tasting, like honey.” Ancient Chinese and Japanese physicians noticed dogs were particularly drawn to some people’s urine. When the urine was examined they found the urine had a sweet taste. What made the urine sweet were high levels of glucose, or sugar.That is how this discovery of sweet urine became part of the name, diabetes mellitus.

Does hormonal imbalance cause diabetes?

Abstract – An imbalance in sex hormones has an important impact on type 2 diabetes (T2DM) mainly through the involvement of visceral adipose tissue. Androgens have an interesting sex-dimorphic association with T2DM, since hyperandrogenism in females and hypogonadism in males are risk factors for T2DM.

What is diabetes mellitus in simple terms?

(dy-uh-BEE-teez MEH-lih-tus) A disease in which the body does not control the amount of glucose (a type of sugar) in the blood and the kidneys make a large amount of urine. This disease occurs when the body does not make enough insulin or does not use it the way it should.

Why is diabetes mellitus an endocrine disorder?

How is the Endocrine System Related to Diabetes? Written By: Care New England on July 28, 2021 is the most common endocrine disorder in the United States, with over 10% of Americans struggling with either Type 1 or Type 2 diabetes. But what exactly is an endocrine disorder, and how is the endocrine system related to diabetes? Quite simply, diabetes occurs when the pancreas cannot release the normal regulatory hormones, or when the body cannot respond properly to those hormones.

What hormone increases with sugar?

What is the difference between glucagon and insulin? – Glucagon and insulin are both important hormones that play essential roles in regulating your blood glucose (sugar). Both hormones come from your pancreas — alpha cells in your pancreas make and release glucagon, and beta cells in your pancreas make and release insulin.

What hormones are affected by sugar?

1. Obesity – There are two ways that eating candy and other high sugar foods cause weight gain. First, sugar is a carbohydrate that eventually turns into fat. This particular fat is low in nutrients which are empty calories. They have no purpose in your body so they simply add to your body’s mass instead of using them to function.

What part of the body does diabetes mellitus affect?

Diabetes is a serious disease that can affect your eyes, heart, nerves, feet and kidneys. Understanding how diabetes affects your body is important. It can help you follow your treatment plan and stay as healthy as possible.

Is diabetes mellitus high in sugar?

Overview – High blood sugar, also called hyperglycemia, affects people who have diabetes. Several factors can play a role in hyperglycemia in people with diabetes. They include food and physical activity, illness, and medications not related to diabetes.

Is diabetes mellitus high or low blood sugar?

Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high.

Urination and thirst are increased, and people may lose weight even if they are not trying to. Diabetes damages the nerves and causes problems with the sense of touch. Diabetes damages blood vessels and increases the risk of heart attack, stroke, chronic kidney disease, and vision loss. Doctors diagnose diabetes by measuring blood sugar levels. People with diabetes need to follow a healthy diet that is low in refined carbohydrates (including sugar), saturated fat, and processed foods. They also need to exercise, maintain a healthy weight, and usually take medications to lower blood sugar levels.

There are many types of sugar. Some sugars are simple, and others are complex. Table sugar (sucrose) is made of two simpler sugars called glucose and fructose. Milk sugar (lactose) is made of glucose and a simple sugar called galactose. The carbohydrates in starches, such as bread, pasta, rice, and similar foods, are long chains of different simple sugar molecules.

  • Sucrose, lactose, carbohydrates, and other complex sugars must be broken down into simple sugars by enzymes in the digestive tract before the body can absorb them.
  • Once the body absorbs simple sugars, it usually converts them all into glucose, which is an important source of fuel for the body.
  • Glucose is the sugar that is transported through the bloodstream and taken up by cells.

The body can also make glucose from fats and proteins. Blood “sugar” really means blood glucose. The levels of glucose in the blood vary normally throughout the day. They rise after a meal and return to pre-meal levels within about 2 hours after eating.

Once the levels of glucose in the blood return to pre-meal levels, insulin production decreases. The variation in blood glucose levels is usually within a narrow range, about 70 to 110 milligrams per deciliter (mg/dL), or 3.9 to 6.1 millimoles per liter (mmol/L) of blood in healthy people. If people eat a large amount of carbohydrates, the levels may increase more.

People older than 65 years tend to have slightly higher levels, especially after eating. Prediabetes is a condition in which blood glucose levels are too high to be considered normal but not high enough to be labeled diabetes. People have prediabetes if their fasting blood glucose level is between 100 mg/dL (5.6 mmol/L) and 125 mg/dL (6.9 mmol/L) or if their blood glucose level 2 hours after a glucose tolerance test is between 140 mg/dL (7.8 mmol/L) and 199 mg/dL (11.0 mmol/L).

Prediabetes carries a higher risk of future diabetes as well as heart disease. Decreasing body weight by 5 to 10% through diet and exercise can significantly reduce the risk of developing diabetes. In type 1 diabetes (formerly called insulin -dependent diabetes or juvenile-onset diabetes), the body’s immune system attacks the insulin -producing cells of the pancreas, and more than 90% of them are permanently destroyed.

The pancreas, therefore, produces little or no insulin, Only about 5 to 10% of all people with diabetes have type 1 disease. Most people who have type 1 diabetes develop the disease before age 30, although it can develop later in life. Scientists believe that an environmental factor—possibly a viral infection or a nutritional factor during childhood or early adulthood—causes the immune system to destroy the insulin -producing cells of the pancreas.

A genetic predisposition makes some people more susceptible to an environmental factor. In type 2 diabetes (formerly called non– insulin -dependent diabetes or adult-onset diabetes), the pancreas often continues to produce insulin, sometimes even at higher-than-normal levels, especially early in the disease.

However, the body develops resistance to the effects of insulin, so there is not enough insulin to meet the body’s needs. As type 2 diabetes progresses, the insulin -producing ability of the pancreas decreases. Type 2 diabetes was once rare in children and adolescents but has become more common.

However, it usually begins in people older than 30 and becomes progressively more common with age. About 26% of people older than 65 have type 2 diabetes. People of African, Asian American, American Indian, Alaskan native, and Spanish or Latin American ancestry are at increased risk of developing type 2 diabetes.

Type 2 diabetes tends to run in families. Certain disorders and medications can affect the way the body uses insulin and can lead to type 2 diabetes. Examples of common states (conditions) that result in impaired insulin use are The two types of diabetes can have very similar symptoms if the blood glucose is significantly elevated.

Increased thirst Increased urination Increased hunger

Other symptoms of diabetes include

Blurred vision Drowsiness Nausea Decreased endurance during exercise

In people with type 1 diabetes, the symptoms often begin abruptly and dramatically. A serious condition called diabetic ketoacidosis Diabetic Ketoacidosis Diabetic ketoacidosis is an acute complication of diabetes that occurs mostly in type 1 diabetes mellitus.

  • Symptoms of diabetic ketoacidosis include nausea, vomiting, abdominal pain, and a characteristic.
  • Read more, a complication in which the body produces excess acid, may quickly develop.
  • In addition to the usual diabetes symptoms of excessive thirst and urination, the initial symptoms of diabetic ketoacidosis also include nausea, vomiting, fatigue, and—particularly in children—abdominal pain.

Breathing tends to become deep and rapid as the body attempts to correct the blood’s acidity (see Acidosis Acidosis Acidosis is caused by an overproduction of acid that builds up in the blood or an excessive loss of bicarbonate from the blood (metabolic acidosis) or by a buildup of carbon dioxide in the blood.

  • Read more ), and the breath smells fruity and like nail polish remover.
  • Without treatment, diabetic ketoacidosis can progress to coma and death, sometimes very quickly.
  • After type 1 diabetes has begun, some people have a long but temporary phase of near-normal glucose levels (honeymoon phase) due to partial recovery of insulin secretion.

People with type 2 diabetes may not have any symptoms for years or decades before they are diagnosed. Symptoms may be subtle. Increased urination and thirst are mild at first and gradually worsen over weeks or months. Eventually, people feel extremely fatigued, are likely to develop blurred vision, and may become dehydrated.

Because people with type 2 diabetes produce some insulin, ketoacidosis Diabetic Ketoacidosis Diabetic ketoacidosis is an acute complication of diabetes that occurs mostly in type 1 diabetes mellitus. Symptoms of diabetic ketoacidosis include nausea, vomiting, abdominal pain, and a characteristic. read more does not usually develop even when type 2 diabetes is untreated for a long time.

Rarely, the blood glucose levels become extremely high (even exceeding 1,000 mg/dL ). Such high levels often happen as the result of some superimposed stress, such as an infection or medication use. When the blood glucose levels get very high, people may develop severe dehydration Dehydration Dehydration is a deficiency of water in the body.

Vomiting, diarrhea, excessive sweating, burns, kidney failure, and use of diuretics may cause dehydration. People feel thirsty, and as dehydration. read more, which may lead to mental confusion, drowsiness, and seizures, a condition called hyperosmolar hyperglycemic state Hyperosmolar Hyperglycemic State (HHS) Hyperosmolar hyperglycemic state is a complication of diabetes mellitus that most often occurs in type 2 diabetes.

Symptoms of hyperosmolar hyperglycemic state include extreme dehydration and. read more, Many people with type 2 diabetes are diagnosed by routine blood glucose testing before they develop such severely high blood glucose levels. High blood glucose levels also cause disturbances in the body’s immune system, so people with diabetes mellitus are particularly susceptible to bacterial and fungal infections.

Measuring the level of glucose in the blood

Doctors check blood glucose levels in people who have symptoms of diabetes, such as increased thirst, urination, or hunger. Additionally, doctors may check blood glucose levels in people who have disorders that can be complications of diabetes, such as frequent infections, foot ulcers, and yeast infections.

To accurately evaluate blood glucose levels, doctors usually use a blood sample taken after people have fasted overnight. Diabetes can be diagnosed if fasting blood glucose levels are 126 mg/dL (7.0 mmol/L) or higher. However, it is possible to use blood samples taken after people have eaten. Some elevation of blood glucose levels after eating is normal, but even after a meal the levels should not be very high.

Diabetes can be diagnosed if a random (not done after fasting) blood glucose level is higher than 200 mg/dL (11.1 mmol/L). Doctors can also measure the level of a protein, hemoglobin A1C (also called glycosylated or glycolated hemoglobin), in the blood, which reflects the person’s long-term trends in blood glucose levels rather than rapid changes.

  1. Hemoglobin is the red, oxygen-carrying substance in red blood cells.
  2. When blood is exposed to high blood glucose levels over a period of time, glucose attaches to the hemoglobin and forms glycosylated hemoglobin.
  3. The hemoglobin A1C level blood test is reported as the percentage of hemoglobin that is A1C,

Measurements of hemoglobin A1C can be used to diagnose diabetes when testing is done by a certified laboratory (not by instruments used at home or in a doctor’s office). People with a hemoglobin A1C level of 6.5% or more have diabetes. If the level is between 5.7 and 6.4, they have prediabetes and are at risk of developing diabetes.

  1. In this test, people fast, have a blood sample taken to determine the fasting blood glucose level, and then drink a special solution containing a large, standard amount of glucose.
  2. More blood samples are then taken over the next 2 to 3 hours and are tested to determine whether the glucose in the blood rises to abnormally high levels.

Blood glucose levels are often checked during a routine physical examination. Checking the levels of glucose in the blood regularly is particularly important in older people because diabetes is so common in later life. People may have diabetes, particularly type 2 diabetes, and not know it.

Are 35 years or older Have overweight or obesity Have a sedentary lifestyle Have a family history of diabetes Have had diabetes during pregnancy or had a baby who weighed more than 9 pounds (4,000 grams) at birth Have cardiovascular disease Have fatty liver disease Have racial or ethnic ancestry that is associated with high risk Have HIV infection

People with these risk factors should be screened for diabetes at least once every three years. Diabetes risk can also be estimated using a risk calculators from the American Diabetes Association, Doctors may measure fasting blood glucose levels and hemoglobin A1C level, or do an oral glucose tolerance test.

Diet Exercise Weight loss Education In type 1 diabetes, insulin injections In type 2 diabetes, often medications by mouth and sometimes insulin or other medications by injection

Diet, exercise, and education are the cornerstones of treatment of diabetes and often the first recommendations for people with mild diabetes. Weight loss is important for people who are overweight. People who continue to have elevated blood glucose levels despite lifestyle changes, or have very high blood glucose levels and people with type 1 diabetes (no matter their blood glucose levels) also require medication.

  • Because complications are less likely to develop if people with diabetes strictly control their blood glucose levels, the goal of diabetes treatment is to keep blood glucose levels as close to the normal range as possible.
  • It is helpful for people with diabetes to carry or wear medical identification (such as a bracelet or tag) to alert health care practitioners to the presence of diabetes.

This information allows health care practitioners to start life-saving treatment quickly, especially in the case of injury or change in mental status. People with diabetes benefit greatly from learning about the disorder, understanding how diet and exercise affect their blood glucose levels, and knowing how to avoid complications.

A nurse trained in diabetes education can provide information about managing diet, exercising, monitoring blood glucose levels, and taking medication. Diet management is very important in people with either type of diabetes mellitus. Doctors recommend a healthy, balanced diet and efforts to maintain a healthy weight.

People with diabetes can benefit from meeting with a dietitian or a diabetes educator to develop an optimal eating plan. Such a plan includes

Avoiding simple sugars and processed foods Increasing dietary fiber Limiting portions of carbohydrate-rich and fatty foods (especially saturated fats)

People with type 1 diabetes and certain people with type 2 diabetes may use carbohydrate counting or the carbohydrate exchange system to match their insulin dose to the carbohydrate content of their meal. “Counting” the amount of carbohydrate in a meal is used to calculate the amount of insulin the person takes before eating.

  • However, the carbohydrate-to- insulin ratio (the amount of insulin taken for each gram of carbohydrate in the meal) varies for each person, and people with diabetes need to work closely with a dietician who has experience in working with people with diabetes to master the technique.
  • Some experts have advised use of the glycemic index (a measure of the impact of an ingested carbohydrate-containing food on the blood glucose level) to delineate between rapid and slowly metabolized carbohydrates, although there is little evidence to support this approach.

Exercise, in appropriate amounts (at least 150 minutes a week spread out over at least three days), can also help people control their weight and improve blood glucose levels. Because blood glucose levels go down during exercise, people must be alert for symptoms of hypoglycemia.

Some people need to eat a small snack during prolonged exercise, decrease their insulin dose, or both. Poor eyesight may make it hard for people to read glucose meters and dose scales on insulin syringes. People with arthritis or Parkinson disease or who have had a stroke may have problems manipulating the syringe.

In addition to learning about diabetes itself, people with multiple medical disorders may have to learn how to fit management of diabetes in with their management of other disorders. Learning about how to avoid complications, such as dehydration, skin breakdown, and circulation problems, and to manage factors that can contribute to complications of diabetes, such as high blood pressure and high cholesterol levels, is especially important.

Such problems become more common as people age, whether they have diabetes or not. Many older people have difficulty following a healthy, balanced diet that can control blood glucose levels and weight. Changing long-held food preferences and dietary habits may be hard. Some people have other disorders that can be affected by diet and may not understand how to integrate the dietary recommendations for their various disorders.

Some people cannot control what they eat because someone else is cooking for them—at home or in a nursing home or other institution. When people with diabetes do not do their own cooking, the people who shop and prepare meals for them must also understand the diet that is needed.

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These people and their caregivers usually benefit from meeting with a dietitian to develop a healthy, feasible eating plan. Some people may have a difficult time adding exercise to their daily life, particularly if they have not been active in the past or if they have a disorder that limits their movement, such as arthritis.

However, they may be able to add exercise to their usual routine. For example, people can walk instead of drive or climb the stairs instead of take the elevator. Taking the medications used to treat diabetes, particularly insulin, may be difficult for some people.

  1. For those with vision problems or other problems that make accurately filling a syringe difficult, a caregiver can prepare the syringes ahead of time and store them in the refrigerator.
  2. People whose insulin dose is stable may purchase prefilled syringes.
  3. Prefilled insulin pen devices may be easier for people with physical limitations.

Some of these devices have large numbers and easy-to-turn dials. Poor vision, limited manual dexterity due to arthritis, tremor, or stroke, or other physical limitations may make monitoring blood glucose levels more difficult for some people. However, special monitors are available.

  • Some have large numerical displays that are easier to read.
  • Some provide audible instructions and results.
  • Some monitors read blood glucose levels through the skin and do not require a blood sample.
  • People can consult a diabetes educator to determine which meter is most appropriate.
  • Monitoring blood glucose levels is an essential part of diabetes care.

Routine blood glucose monitoring provides the information needed to make necessary adjustments in medications, diet, and exercise regimens. It is potentially harmful to wait until there are symptoms of low or high blood glucose levels to check blood glucose.

Between 80 and 130 mg/dL (4.4 and 7.2 mmol/L) fasting (before meals) Less than 180 mg/dL (10.0 mmol/L) 2 hours after meals

Hemoglobin A1C levels should be less than 7%. Some people use a continuous glucose monitor (CGM), an external device that is attached to the body and continuously records blood glucose levels. When this type of device is used, doctors use a different measurement to determine how well blood glucose levels are being controlled.

  1. They use a value called time in range.
  2. Time in range is the percentage of time over a specific period that the blood glucose level is at the person’s goal level.
  3. The usual range is 70 to 180 mg/mL (3.9 to 9.9 mmol/L).
  4. Some other goals are keeping systolic blood pressure less than 140 mm Hg and diastolic blood pressure less than 90 mm Hg.

For people with diabetes who have heart disease or are at high risk for heart disease, the blood pressure goal is less than 130/80 mm Hg. Many things cause blood glucose levels to change:

Diet Exercise Stress Illness Medications Time of day

The blood glucose levels may jump after people eat foods they did not realize were high in carbohydrates. Emotional stress, an infection, and many medications tend to increase blood glucose levels. Blood glucose levels increase in many people in the early morning hours because of the normal release of hormones (growth hormone and cortisol ), a reaction called the dawn phenomenon.

  • Blood glucose may shoot too high if the body releases certain hormones in response to low blood glucose levels (Somogyi effect).
  • Exercise may cause the levels of glucose in the blood to fall low.
  • Blood glucose levels can be measured easily at home or anywhere.
  • A fingerstick glucose test is most often used to monitor blood glucose.

Most blood glucose monitoring devices (glucose meters) use a drop of blood obtained by pricking the tip of the finger with a small lancet. The lancet holds a tiny needle that can be poked into the finger or placed in a spring-loaded device that easily and quickly pierces the skin.

Most people find that the pricking causes only minimal discomfort. Then, a drop of blood is placed on a reagent strip. The strip contains chemicals that undergo changes depending on the glucose level. The glucose meter reads the changes in the test strip and reports the result on a digital display. Some devices allow the blood sample to be obtained from other sites, such as the palm, forearm, upper arm, thigh, or calf.

Home glucose meters are smaller than a deck of cards. Continuous glucose monitoring (CGM) systems use a small glucose sensor placed under the skin. The sensor measures blood glucose levels every few minutes. There are two types of CGMs, with different purposes: Professional CGMs collect continuous blood glucose information over a period of time (72 hours to up to 14 days).

  1. Health care providers use this information to make treatment recommendations.
  2. Professional CGMs do not provide data to the person with diabetes.
  3. Personal CGMs are used by the person and provide real-time blood glucose data on a small portable monitor or on a connected smart phone.
  4. Alarms on the CGM system can be set to sound when blood glucose levels drop too low or climb too high, so the device can help people quickly identify worrisome changes in blood glucose.

CGM systems are particularly helpful in certain circumstances, such as in people with type 1 diabetes who have frequent, rapid changes in blood glucose (particularly when the glucose levels sometimes go very low), which are difficult to identify with fingerstick testing.

  1. CGM systems allow people to measure the period of time that their blood glucose stays within a certain range, and doctors use this measurement to set goals for treatment and adjust insulin dose.
  2. Eeping a record of blood glucose levels and reporting them to their doctor or nurse helps doctors and nurses provide advice in adjusting the dose of insulin or the oral antihyperglycemic medication.

Many people can learn to adjust the insulin dose on their own as necessary. Some people who have mild or early type 2 diabetes that is well-controlled with one or two medications may be able to monitor their fingerstick glucose levels relatively infrequently.

  • Doctors can monitor treatment using a blood test called hemoglobin A1C.
  • When the blood glucose levels are high, changes occur in hemoglobin, the protein that carries oxygen in the blood.
  • These changes are in direct proportion to the blood glucose levels over an extended period.
  • The higher the hemoglobin A1C level, the higher the person’s glucose levels have been.

Thus, unlike the blood glucose measurement, which reveals the level at a particular moment, the hemoglobin A1C measurement demonstrates whether the blood glucose levels have been controlled over the previous few months. People with diabetes aim for a hemoglobin A1C level of less than 7%.

  • Achieving this level is sometimes difficult, but the lower the hemoglobin A1C level, the less likely people are to have complications.
  • Doctors may recommend a slightly higher or lower target for certain people depending on their particular health situation.
  • However, levels above 9% show poor control, and levels above 12% show very poor control.

Most doctors who specialize in diabetes care recommend that hemoglobin A1C be measured every 3 to 6 months. Although urine can also be tested for the presence of glucose, checking urine is not a good way to monitor or adjust treatment. Urine testing can be misleading because the amount of glucose in the urine may not reflect the current level of glucose in the blood.

Blood glucose levels can get very low or reasonably high without any change in the glucose levels in the urine. People with type 1 diabetes may have more frequent swings in blood glucose levels because insulin production is completely absent. Infection, delayed movement of food through the stomach, and other hormonal disorders may also contribute to blood glucose swings.

In all people who have difficulty controlling blood glucose, doctors look for other disorders that might be causing the problem and also give people additional education on how to monitor diabetes and take their medications. No treatments prevent the onset of type 1 diabetes mellitus.

Some medications may induce remission of early type 1 diabetes in some people, possibly because they prevent the immune system from destroying the cells of the pancreas. However, these changes are temporary, and the medications cause side effects that limit their use. Type 2 diabetes can be prevented with lifestyle changes.

People who are overweight and lose as little as 7 percent of their body weight and who increase physical activity (for example, walking 30 minutes per day) can decrease their risk of diabetes mellitus by more than 50%. Metformin, a medication that is used to treat diabetes, may reduce the risk of diabetes in people with impaired glucose regulation.

JDRF (previously called Juvenile Diabetes Research Foundation): General information on type 1 diabetes mellitus

Generic Name Select Brand Names
insulin Afrezza, Exubera
prednisone Deltasone, Predone, RAYOS, Sterapred, Sterapred DS
metformin Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet, RIOMET ER

What are the 2 hormones that raises blood sugar level?

What is the difference between glucagon and insulin? – Glucagon and insulin are both important hormones that play essential roles in regulating your blood glucose (sugar). Both hormones come from your pancreas — alpha cells in your pancreas make and release glucagon, and beta cells in your pancreas make and release insulin.

What hormone is affected in type 2 diabetes?

Overview – Type 2 diabetes is an impairment in the way the body regulates and uses sugar (glucose) as a fuel. This long-term (chronic) condition results in too much sugar circulating in the bloodstream. Eventually, high blood sugar levels can lead to disorders of the circulatory, nervous and immune systems.

In type 2 diabetes, there are primarily two interrelated problems at work. Your pancreas does not produce enough insulin — a hormone that regulates the movement of sugar into your cells — and cells respond poorly to insulin and take in less sugar. Type 2 diabetes used to be known as adult-onset diabetes, but both type 1 and type 2 diabetes can begin during childhood and adulthood.

Type 2 is more common in older adults, but the increase in the number of children with obesity has led to more cases of type 2 diabetes in younger people. There’s no cure for type 2 diabetes, but losing weight, eating well and exercising can help you manage the disease.

What hormone is elevated in type 2 diabetes?

Fast Facts: –

It is well established that two hormones, glucagon and insulin, must work in perfect unison to maintain healthy blood sugar levels in the body.Type 2 diabetes typically develops when glucagon, which stimulates sugar secretion, and insulin, which stimulates sugar absorption, are off balance.Now, scientists at Johns Hopkins have discovered a third critical “player” in the development of type 2 diabetes-a hormone called kisspeptitn-1, which apparently carries out commands issued by glucagon and directly interferes with insulin production in the pancreas.The discovery may prove to be a long-missing link in the understanding of the origins of the disease.The researchers are currently designing therapies that block kisspeptin-1 from entering the insulin-producing cells of the pancreas.

Working with mice and human blood and liver samples, scientists from the Johns Hopkins Children’s Center have identified a previously unsuspected liver hormone as a critical player in the development of type 2 diabetes, a condition that affects nearly 26 million people in the United States and is a leading cause of heart disease and stroke, as well as kidney, nerve and eye damage.

Results of the research, to be published April 1 in the journal Cell Metabolism, show that the hormone, kisspeptin 1, or K1 — up until now known for its regulation of puberty and fertility — also slows down the production of insulin, the sugar-regulating hormone secreted by the pancreas, and in doing so fuels the development of type 2 diabetes.

The findings provide what researchers consider a missing link in understanding the origins of type 2 diabetes. Two hormones, glucagon and insulin, must work in synchrony to maintain healthy sugar levels in the bloodstream. Secreted when sugar levels drop, glucagon causes the liver to release its strategic reserves of glucose into the bloodstream.

  • When sugar levels rise, insulin acts as an antidote to glucagon, helping the body lower blood sugar by transporting it out of the bloodstream and into organs and tissues as fuel.
  • In type 2 diabetes, pancreatic cells secrete too little or no insulin at all, leading to a dangerous buildup of sugar in the blood.

People with type 2 diabetes and those with early forms of the disease known as pre-diabetes have abnormally high levels of the sugar-boosting hormone glucagon even in the presence of insulin and even when the body doesn’t need more sugar. Researchers have long wondered if abnormal glucagon levels somehow affect the insulin-secreting cells of the pancreas.

  • The prevailing wisdom has been that exposure to chronically elevated glucagon and blood sugar levels take a gradual toll on the pancreas, and its overworked beta cells slowly decrease insulin output until they stop making insulin altogether.
  • The new findings, however, show that the pancreatic cells don’t just get tired; their function is directly suppressed by K1.

Specifically, the researchers found that the liver, stimulated by high levels of glucagon, releases K1 into the bloodstream. K1 then homes in on pancreatic beta cells, where it suppresses insulin secretion. “Our findings suggest that glucagon issues the command, but K1 carries out the orders, and in doing, so it appears to be the very cause of the declining insulin secretion seen in type 2 diabetes,” says lead investigator Mehboob Hussain, M.D., an endocrinologist and metabolism expert at the Johns Hopkins Children’s Center.

Glucagon and insulin alone never really made complete sense,” Hussain adds. “There was always something missing and, we feel, kisspeptin 1 is a very good candidate to be that missing part. All our findings point in this direction.” In one set of experiments, the researchers fattened a group of mice by feeding them calorie-rich food.

Predictably, the mice developed diabetes, their insulin production declined and K1 levels in their blood shot up, the researchers found. When the investigators chemically altered the livers of the diabetic mice to make them incapable of K1 production, the animals’ insulin levels returned to healthy ranges.

  1. Next, the researchers engineered mice whose pancreatic cells were lacking receptors for K1.
  2. Those mice, even when they feasted on high-fat food, maintained healthy insulin production and blood sugar levels.
  3. In other words, the missing K1 receptor rendered these animals’ insulin-secreting cells immune to the effects of K1.

Moreover, the researchers found, K1 levels were notably increased in blood and liver samples obtained from people with type 2 diabetes. Additionally, when researchers exposed mouse pancreatic cells to K1-rich blood plasma obtained from people with type 2 diabetes, the insulin production of these cells dropped.

The identification of K1 as a key player in diabetes, the research team says, offers a possible new treatment target that can lead to the development of drugs that restore the function of the insulin-secreting cells. Currently, diabetes therapy is based on injecting synthetic insulin to maintain blood sugar levels.

However, restoring natural insulin production could, in theory, cure diabetes, instead of simply mitigating its symptoms. The Johns Hopkins team says it has already identified a hormone-like substance that blocks the K1 receptor in the pancreatic cells of mice.

  • The investigators will next study whether this receptor-blocker can restore the function of human pancreatic cells.
  • The identification of K1 also makes evolutionary sense, Hussain adds, and may explain why diabetes is an ancient disease common across species.
  • Hussain and colleagues believe that K1 may have evolved to play an insulin-blunting role and prevent sharp falls in sugar levels during fight-or-flight situations.

“Sugar provides critical fuel when an animal enters combat or is trying to run away from a predator,” Hussain says. “The high levels of insulin after a meal can cause dangerously low levels of blood sugar, which would render the animal weak and vulnerable.

So our theory is that K1 is a defense mechanism that halts the sugar-reducing effects of insulin in such life-and-death situations.” Type 2 diabetes, which is closely associated with high-fat and high-sugar diets and sedentary lifestyles, is the predominant form of the disease, accounting for more than 90 percent of all diabetes cases.

While previously seen mostly in middle-aged and older adults, type 2 diabetes is now increasingly common in younger people and children, a phenomenon fueled by growing obesity rates, experts say. The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases, by the National Institute of Child Health and Human Development and by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grants DK090816, DK084949, DK079637, DK095140, HD066432, HD068777 and AR057759).

  • Additional funding was provided by the Johns Hopkins Dr.
  • Mohan Swami Institute for International Medical Education.
  • Other Johns Hopkins investigators on the study included Woo-Jin Song, Prosenjit Mondal, Andrew Wolfe, Rachel Stamateris, Benny W.T.
  • Ong, Owen C.
  • Lim, Kil S.
  • Yang, Sally Radovick and Horacio J.

Novaira. Researchers from other institutions included Emily A. Farber, Charles R. Farber and Stephen Turner, of the School of Medicine at the University of Virginia, and Laura Alonso of the University of Massachusetts Medical School. : Johns Hopkins Scientists Identify Third Critical Hormone in Type 2 Diabetes – 04/01/2014

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