Let's Talk About Diabetes

无论你刚刚被确诊，或者认为你可以有糖尿病，你可能紧张，困惑，甚至有点害怕。这是正常的，每个人都特色在HealthCentral以慢性病症感觉就像你现在要做的。但是，我们和他们，在这里为您服务。On this page alone, you’ll discover not only the realities and challenges of the condition, but also the best treatments, helpful lifestyle changes, wisdom from people who have been where you are now, and all the critical information to help you not just manage—but thrive. We’re sure you’ve got a lot of questions...and we’re here to answer them.

What Is Diabetes, Anyway?

Everyone’s heard of diabetes. It’s one of the most common chronic diseases in the world and rates are still on the rise. Yet most people don’t fully understand what causes it or how it affects everyday life. Many think that because the disorder is so widespread, it isn’t serious. But if left untreated, diabetes can lead to heart disease, vision loss, and even limb amputation.

在最基本的,糖尿病(官方name) is a group of disorders that cause people to have higher-than-normal levels of sugar—or, glucose—in their blood. Glucose comes from the protein, carbohydrates, and fats that you eat and drink, as well your liver, which makes and stores the substance.

If everything is going according to plan, your pancreas releases a hormone called insulin that helps move glucose from the bloodstream into some of the cells of your body to be used for energy. But if your body is resistant to insulin, or doesn’t make enough of it, the glucose gets stuck hanging out in your blood. That’s when your doc will tell you that you have “high blood sugar.” As time goes on, the extra sugar in your blood causes inflammation and other major health troubles.

About 30 million people in the United States have diabetes, but nearly one quarter of them don’t know it. Let’s take a closer look.

糖尿病的最常见的类型

有几种不同类型的糖尿病，每个人都有自己的原因。要得到准确的诊断为形成你有这种疾病的治疗，因为会根据不同的类型是很重要的。下面是你应该知道的基本知识：

Type 1 Diabetes

Also called“juvenile” diabetesbecause it’s often diagnosed in childhood, type 1 diabetes is mostly an autoimmune disorder in which your immune system attacks and destroys insulin-making cells in the pancreas. Because of this, your body no longer produces its own insulin, so you need insulin injections every day.

Most people with1型糖尿病are diagnosed during childhood or young adulthood, but a small number of people may not develop the disease until their 30s, 40s, or even 50s.

2型糖尿病

People withtype 2do produce their own insulin, but their bodies don’t用very well. They are insulin-resistant.

2型，也被称为“成人发病”，糖尿病是疾病的最常见形式。所有糖尿病患者的人之间90％至95％的百分比有2型。它常见于中年，但在年龄较大的孩子或青少年有时会看到。

Most people with type 2 don’t need to take insulin, but they may need other medications to help bring down blood sugar.

如果一个人的血糖高于正常值，但不够高，不足以诊断为糖尿病，这是考虑prediabetes。

People with prediabetes have an increased risk of developing type 2. Exercise and diet changes are often prescribed to lower blood sugar and reduce the risk. In some cases, a doctor may also prescribe metformin, a blood-sugar lowering drug to help prevent type 2.

Gestational Diabetes

Gestational diabetes refers to temporary high blood sugar that happens only in pregnancy. Doctors suspect that it’s related to hormonal changes that happen during this time.

Most pregnant women are screened for gestational diabetes during their second trimester with a glucose tolerance test, which involves drinking a glucose-containing beverage on an empty stomach and then having blood drawn to check sugar levels.

妊娠期糖尿病通常与运动和饮食结构的变化（比如少食用淀粉多的蔬菜，水果和蛋白质）处理。有些妇女可能需要注射胰岛素了。

在大多数情况下，一旦宝宝出生后血糖水平恢复正常;但如果你在怀孕期间有妊娠糖尿病，你也比以后患2型平均风险较高的。

Other Types of Diabetes

虽然数量很少，如果不及时治疗这些类型的糖尿病可导致严重的健康问题：

• Monogenic Diabetes

  占所有病例的1％至5％，这种罕见类型的糖尿病是由单个基因中的突变引起的。在大多数情况下，这种疾病是由于一个人的胰腺不能够产生足够的胰岛素;这种症状通常在孩子找到。

• Secondary Diabetes

  有时，糖尿病是另一种疾病的副作用，如库欣综合征和囊性纤维化。某些药物，包括烟酸，利尿剂，艾滋病毒药物，以及抗惊厥药物，也可导致高血糖。

是什么原因导致糖尿病的发生吗？

The causes of the disease differ depending on what type you have.

Causes of Type 1

Type 1 diabetes is mostly an autoimmune disorder. In this case, your immune system attacks your body in the same way it might attack invaders like bacteria or viruses, destroying certain cells in your pancreas in a misguided attempt to protect the body. These cells, called beta cells, are the ones that produce insulin. When your body attacks and destroys them, you can no longer make your own insulin.

Doctors believe that type 1 diabetes may be caused by a combination of genes and environmental factors. Type 1 diabetes is treatable with daily insulin injections but isn’t curable; and lifestyle changes like diet and exercise won’t reverse it.

Causes of Type 2

2型糖尿病通常是由多种因素的组合引起的。它往往在家庭中，和某些基因使你更有可能发展它。这也是在某些族裔群体，包括土著美国人，非裔美国人，太平洋岛民，亚洲人，拉美裔和更常见。

How you eat and how active you are also important. Carrying extra body fat, especially in your belly, can contribute to insulin resistance, a situation where your pancreas makes plenty of insulin, but doesn’t use it well, so sugar builds up in your blood rather than going into your cells for energy. Insulin resistance is a major cause of type 2 diabetes.

Sometimes, type 2 diabetes is caused by an underactive pancreas and your body doesn’t make enough insulin.

Causes of Gestational Diabetes

Genetics and hormonal changes during pregnancy are the culprits of this type.

All women become insulin-resistant late in pregnancy, thanks to hormones released mostly by the placenta. Most of the time, the pancreas amps up production of insulin to make up the difference, but in cases where it can’t keep up, blood sugar levels rise and gestational diabetes develops.

Do I Have the Symptoms of Diabetes?

A tricky truth about this disease: Sometimes, there are no symptoms or symptoms are so mild that they’re easy to miss. That’s why nearly all pregnant women are screened for gestational diabetes, and the U.S. Preventive Services Task Force recommends screening for adults over 40 who have risk factors such as abdominal obesity.

其他时间，症状是突然的和明确的。有下列任何体征并不一定意味着你患有糖尿病。相反，考虑他们的信号打电话给你的医生：

• Major thirst:When your blood has too much sugar in it, your body pulls water from surrounding tissues to try to dilute it. That leaves you dehydrated and thirsty. Some diabetics feel like no matter how much they drink, they can’t quench their thirst.
• A lot of pee:When there’s too much sugar in the blood, your kidneys try and filter it out. They dump it into your urine, creating more pee. In more advanced stages of the disease, damaged nerves around the bladder may cause some people to feel the urge to pee frequently, even if little or nothing comes out. You also have a higher risk of urinary tract infections (UTIs).
• 视力模糊：高血糖会导致液体进入您的眼睛的泄漏，导致晶状体膨胀。这带来了麻烦对焦。
• 该零食：If you’re hungry all the time, even after a good meal, it could be a sign that your muscles and other tissues aren’t getting the energy—i.e. glucose—they need from the food you’re eating, because it’s hung up in your bloodstream. Your muscles tell your brain that they’re starving (even though you ate plenty), making you hungry again and continuing the cycle.
• Increase in infections:2型糖尿病就更难你的免疫系统对抗感染，包括酵母感染，尿路感染或。它可能还需要更长的时间削减愈合，因为多余的葡萄糖防止白血球无法开展维修工作。
• Weight loss:Losing weight without changing your diet could be a sign of type 1 diabetes. If your body can’t get the glucose it needs from food, it will start to break down its own fat, muscles, and other tissues for fuel, leading to weight loss.
• Fatigue:You may feel exhausted and weak because your brain, muscles, and other body systems aren’t getting the energy they need to work properly. If you’re dehydrated, that can make you tired, too.

怎么做医生诊断糖尿病？

在得到糖尿病诊断中的第一步是验血。然后，如果你被诊断患有糖尿病，医生可能会执行额外的测试出哪种类型的你的身影。正确的诊断是因为根据类型不同治疗重要。

验血为糖尿病

• A1C (or glycated hemoglobin) test.已包这种常见的测试测量你的红血细胞的比例与葡萄糖在过去的两到三个月。较高的血糖，你的分数越高。下面5.7 A1C结果被认为是正常;5.7至6.4是糖尿病前期;6.5或以上表明糖尿病。
• Fasting blood sugar test.Blood will be drawn first thing in the morning before you eat or drink anything other than water. A result under 100 milligrams per deciliter is normal; 100 to 125 mg/dL is prediabetic; 126 mg/dL or above indicates diabetes. Your doctor will likely want to do the test twice before diagnosing you.
• Glucose tolerance test.After getting your blood drawn on an empty stomach, you’ll drink a glucose drink, then have blood drawn again after one or two hours. If your blood sugar is under 140 mg/dL two hours after downing the sugar drink, that’s normal; 140 to 199 is prediabetic; 200 md/dL or over indicates diabetes.
• 随机血糖检测。Blood is drawn at any time of day, whether you’ve eaten recently or not. A result of 200 mg/dL means you may have diabetes.
• Antibody test.To help differentiate between type 1 and type 2 diabetes, your doctor may also draw blood for an “autoantibody” test, to see if your immune system is attacking your pancreas. People with type 1 often test positive for several specific autoantibodies, while those with type 2 (or the rare monogenic diabetes) won’t.

Urine Test for Diabetes

If your doctor suspects that you have type 1 diabetes, she may want to test your urine for ketones, chemicals your body produces when it breaks down fat for energy.

The test can be done at home or in a lab or doctor’s office by peeing into a specimen cup. Extremely high levels of ketones are a sign ofketoacidosis, a potentially fatal complication of diabetes that requires emergency treatment.

What Is the Best Treatment for Diabetes?

Whatever your path of treatment, most likely you’ll start by checking your glucose every day, or even several times per day, in order to make decisions about insulin dosages, food, and exercise.

要做到这一点，你可能会使用家用血糖仪具有专门的柳叶刀捅你的指尖“笔”，然后放下血到在仪表测试条。在某些情况下，您的文档可能会建议连续血糖监测仪，其中一个微小的传感器是你的腹部皮肤下插入，手臂或大腿定期检查血糖水平。该设备会提醒你，如果水平降得太低。

这里有几个类型的治疗，医生会考虑，根据您的糖尿病类型：

胰岛素

All people with type 1 diabetes need to take insulin daily. Some people with type 2 or gestational diabetes may need insulin as well. There are a couple of different ways insulin can be delivered to the body:

• 注射：This is the most common way to take insulin. To inject the drug, you will use a syringe or “pen,” usually in your belly, upper arm, thigh, or butt.
• 胰岛素Pump:谁需要每天多次注射或者酮症酸中毒的高危人群可能更喜欢胰岛素泵，它通过多数民众赞成戴在身上一个微小导管自动提供全天胰岛素。
• 胰岛素Inhaler:Some adults with type 1 or 2 diabetes can also use inhaled insulin, a powder you breathe into your lungs through an inhaler.

Oral Medications

Several pills (or liquids), used in combination with each other or with insulin, can help lower blood sugar in people with type 2 diabetes. These are一些常见吃药:

• Actos和Avandia（噻唑烷二酮）降低循环脂肪浓度，提高对胰岛素的敏感性。
• Amaryl,Glucotrol的和Micronase(sulfonylureas),Prandin和Starlix（氯茴苯酸），和的Januvia和ONGLYZA(DPP-4 inhibitors), trigger the pancreas to produce more insulin.
• Farxiga,Invokana和Jardiance(SGLT2 inhibitors) boost the amount of sugar the kidneys can remove from your blood.
• Glyset和Orecose（α-葡糖苷酶抑制剂）减缓淀粉的消化和分解成葡萄糖和调节多少葡萄糖被小肠吸收。
• Metformin (brands names格华止,Glumetza,Fortamet和Riomet) slows the breakdown of carbohydrates you eat into sugar, and reduces how much glucose your liver produces.

Diet and Exercise

Eating well and exercising will help your health no matter what type of diabetes you have. That said, type 1 diabetes can’t be treated or cured through lifestyle changes. No matter how well you eat, you can’t make your pancreas be able to produce insulin again.

饮食可用于帮助治疗2型和妊娠糖尿病，但。其中最重要的饮食改变人与2型可以是减少或切割出像苏打水和果汁，可能加息多达血糖含糖饮料。多吃低淀粉蔬菜和瘦肉蛋白可以帮助了。有些糖尿病人可能需要计算他们所吃的克碳水化合物，因为每餐消费一致的量有助于平衡血糖。

经常锻炼还可以降低胰岛素抵抗，改善你的身体使用胰岛素的方式，保持2型糖尿病的检查。

Does Diabetes Treatment Cause Complications?

Any medication has potential side effects, and those for diabetes are no exception. But none are as serious as the alternative of not treating it—like heart disease, vision loss, nerve pain, foot ulcers, and even amputations.

这些都是一些副作用，最常见糖尿病治疗：

• Continuous glucose monitoring:Skin irritation, pain, sore muscles.
• 胰岛素：低血糖，头痛，体重增加，出现流感样症状。输液部位的感染，如果使用胰岛素泵。
• Oral medications:nausea, diarrhea, gas, sweating, feeling anxious or shaky, weight gain, swelling.

What's Life Like with Diabetes?

Look, it’s a disease—and living with it can be stressful. Some people don’t understand the condition and can’t grasp what you’re going through.

But because diabetes is relatively common, there are a lot of people who do understand and can help make life a little easier.

One of the biggest challenges can be the amount of so-called “self-management” you need to do—checking blood sugar, giving yourself injections, taking medications correctly, and sticking to a healthy diet.

For that reason, many people find working with a certified diabetes educator (CDE) useful. These healthcare providers (often registered nurses or registered dietitians) know the ins and outs of diabetes treatment and are able to come up with systems and solutions that work in real life.

如果你发现自己心情郁闷，并在你的糖尿病诊断面对不堪重负，不要犹豫，告诉你的医生。你决不单单有这样的情绪，并与糖尿病教育，支持小组，或心理健康辅导员的工作可以让你回到正轨。

在哪里可以找到糖尿病社区？

Talking to people who know exactly what you’re going through can be just as important as finding a treatment plan that works. Here are some places to start to make connections, find resources, and meet friends.

Top Diabetes Instagrammers

There’s no shortage of ’grammers from the #T1D and #T2D communities — here’s a sprinkling of some of our faves who are sharing diabetes-friendly recipes and stigma-squashing real-talk.

• Mila Clarke Buckley,@thehangrywoman

Follow because:She turns her lifestyle with diabetes (diagnosed with type 2 in 2016) into digital storytelling, sharing how to live with diabetes and still enjoy the finer things in life, like cheeseburgers and travel.

• 米歇尔·莱恩，APRN-BC,@diabadassaprn

Follow because:这耶鲁大学毕业，家庭护士，和泰拳爱好者也是1型糖尿病患者。莱恩没有糖衣（原谅双关语）她的病，但她确实有希望永远不要让它阻止她。

• Carrie Lane,@officialcarrielane

Follow because:As a mama-to-be, Laine, who has type 1 diabetes, shares all about prepping to get pregnant, your ideal A1C levels during pregnancy, and how your body (and mind) change throughout. She’ll no doubt keep sharing through motherhood, so there’s no better time to go ahead and give her a follow.

• Carl Franklin and Carrie Brown,@2ketodudes

Follow because:It’s no surprise to anyone that a lot of these 'grammers talk about food, because diabetes—especially type 2—is managed, in large part, with how you fuel your body. Their recipes range from gourmet eye candy to “hey, I can make that!”

• Christel Oerum,@diabetesstrong_ig

Follow because:她拒绝了一个个人博客关于运动和营养的1型糖尿病为国内规模最大的糖尿病健康网站之一，并创造了电子书Fit With Diabetesto inspire anyone who is insulin-dependent.

顶级糖尿病相关的播客

• 2 Keto Dudes。该播客如下卡丽·布朗和她的PAL号从代谢综合征他们的旅程卡尔·富兰克林和2型糖尿病的清洁和健康的生活，他们的信用，以下列酮饮食。预计对利弊和酮的争议convos。

• Juicebox。Scott Benner is an author,blogger和proud stay-at-home dad of a daughter with type 1 diabetes. Though he doesn’t have diabetes himself, he had to learn to manage diabetes as if it were his own, since his daughter was only 2 when she was diagnosed.

• My Lazy Pancreas。1型糖尿病没有阻止你从一名运动员。凯尔马斯特曼，其目标是周期横跨澳洲，带来的是谁在运动和健身 - 同时患有糖尿病的生活打破壁垒的客人。给它一个侦听的方式去健身房帮助踢你的屁股到齿轮。

• Diabetes Daily Grind。Amber Clour, who has lived with type 1 diabetes since childhood, brings together a team of people with type 1 or type 2 diabetes on this engaging podcast. The focus: Real advice about everyday life. No fluff, just reality.

Top Diabetes Support Groups and Non-Profits

• American Diabetes Association。With more than 565,000 volunteers, 540,000 members, and 400 staff, this nonprofit is a force to be reckoned with. At the heart of their mission: Raising awareness about the impact of insulin prices and treatments for those with diabetes and advocating for policy changes.

• 糖尿病研究所基金会。它开始在这里与谁正在努力寻找那些生活与治疗糖尿病的科学家。他们的目标，有点标新立异，是把自己歇业。治愈意味着他们的工作就完成了！

• JDRF（以前称为青少年糖尿病研究基金会）。这是给孩子们——或者更经常比没有t, parents of kiddos fighting type 1 diabetes. The nonprofit is the leading global organization funding type 1 diabetes research, having raised $2 billion for research to date.

• 以你的控制糖尿病。这个非营利的创始人是谁在15岁时被诊断为1型糖尿病患者的内分泌学家史蒂夫埃德尔曼，医学博士，汇集了患者和专家在美国各地的会议，以帮助他们更好地理解和糖尿病管理自己的生活。

• DiabetesSisters。Hey ladies, welcome to the sisterhood. While diabetes does not discriminate, there’s a whole world of the disease that only affects women (hello pregnancy, menopause, and other hormone-imbalanced moments). Come here for peer support, education, and stories of hope.