Let's Talk About Diabetes

Whether you’ve just been diagnosed or think you could have diabetes, you’re probably nervous, confused, and maybe even a little scared. That’s normal, and everyone featured on HealthCentral with a chronic illness felt just like you do now. But we—and they—are here for you. 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.

At its most basic, diabetes mellitus (the official 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.

关于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.

Most Common Types of Diabetes

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

也叫“少年”糖尿病because 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 withtype 1 diabetes儿童期或成年早期期间被确诊，但少数人可能不会发病，直到30多岁，40多岁，甚至50多岁。

Type 2 Diabetes

People withtype 2do produce their own insulin, but their bodies don’tuse很好。他们是胰岛素抵抗。

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。

大多数人患有2型并不需要用胰岛素，但他们可能需要的其他药物，以帮助降低血糖。

If someone’s blood sugar is higher than normal, but not high enough to be diagnosed as diabetes, that’s considered糖尿病前期。

与糖尿病前期的人，患2型运动和饮食结构的变化往往规定降低血糖和降低风险的风险增加。在某些情况下，医生也可能会开二甲双胍，血糖降低药物，以帮助预防2型。

妊娠糖尿病

妊娠期糖尿病是指临高血糖出现这种情况只有在怀孕。医生怀疑，它涉及到在这个时候，发生荷尔蒙的变化。

大多数孕妇及其与糖耐量试验，其中包括空腹喝含葡萄糖的饮料孕中期筛查妊娠糖尿病，然后抽血检查血糖水平。

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。

糖尿病的其他类型

Though rare, these types of diabetes can cause serious health issues if left untreated:

• 单基因糖尿病

  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。

• 继发性糖尿病

  Sometime, diabetes is a side-effect of another disease, such as Cushing’s syndrome and cystic fibrosis. Certain medications, including niacin, diuretics, HIV medicines, and anti-seizure drugs, can also lead to high blood sugar.

What Causes Diabetes in the First Place?

本病的病因不同取决于什么类型你。

原因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.

医生认为，1型糖尿病可通过基因和环境因素的组合引起的。1型糖尿病是可以治疗的，每天注射胰岛素，但不可治愈;和生活方式的改变，像饮食和锻炼不会扭转它。

原因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.

妊娠糖尿病的原因

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?

关于这个疾病的一个棘手的道理：有时候，没有症状或症状很温和，以至于他们很容易错过。这就是为什么几乎所有的孕妇筛查妊娠糖尿病，和美国预防服务工作组建议筛选了40名成人谁拥有的危险因素如腹部肥胖。

Other times, symptoms are sudden and clear. Having any of the following signs does not necessarily mean you have diabetes. Instead, consider them a signal to call your doctor:

• Major thirst:当你的血液中有过多的糖在里面，你的身体周围的组织，试图淡化它拉水。这使得你脱水，口渴。有些糖尿病患者觉得不管喝多少，都无法解渴。
• 很多撒尿的：当有血液中的糖分过多，你的肾脏尝试和过滤出来。他们倾倒入你的尿液，创造更多的撒尿。在疾病的更高级阶段，膀胱周围神经损伤可能会导致一些人感到冲动频繁小便，即使很少或没有出来。你也有尿路感染（尿路感染）的风险较高。
• Blurry vision:High blood sugar can lead to a leaking of fluids into your eye, causing the lens to swell. That leads to trouble focusing.
• 该零食：如果你饿了所有的时间，甚至是一顿美餐之后，它可能是一个迹象，表明你的肌肉和其他组织都没有得到能量，即。葡萄糖，它们从食物你吃的是需要的，因为它挂了你的血液。你的肌肉告诉你的大脑，他们正在挨饿（即使你吃了很多），让你饿了，不断循环。
• 增加感染：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:在不改变你的饮食减肥可能是1型糖尿病的一个标志。如果你的身体不能让它从食物中所需要的葡萄糖，它会开始打破其自身的脂肪，肌肉和其他组织为燃料，导致体重减轻。
• 疲劳：因为你的大脑，肌肉和身体其他系统没有得到他们需要正常工作的能量你可能会感到疲惫和虚弱。如果你脱水，可以让你累了。

How Do Doctors Diagnose Diabetes?

The first step in getting a diabetes diagnosis is a blood test. Then, if you are diagnosed with diabetes, your doctor may perform additional testing to figure out which type you have. Correct diagnosis is important since treatment differs depending on type.

Blood Tests for Diabetes

• A1C（或糖化血红蛋白）试验。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.
• 葡萄糖耐量试验。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.
• Random blood sugar test.抽血在一天中的任何时候，无论你最近还是没吃过。200毫克/分升的结果意味着你可能患有糖尿病。
• 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

如果医生怀疑你有1型糖尿病，她可能要测试你的尿液酮体，化学品时，它打破了脂肪供能你的身体产生。

该测试可以在家里或在实验室或小便制作成标本杯医生的办公室进行。非常高的水平酮是一个标志ketoacidosis, 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.

To do this, you’ll likely use a home glucose meter to poke your fingertip with a specialized lancet “pen,” then drop the blood onto a test strip in the meter. In some cases, your doc might suggest a continuous glucose monitor, where a tiny sensor is inserted under the skin of your abdomen, arm, or thigh to check glucose levels regularly. The device will alert you if levels fall too low.

Here are a few types of treatments your doctor will consider, based on your diabetes type:

胰岛素

1型糖尿病患者所有的人都需要每天注射胰岛素。有些人2型或妊娠糖尿病可能需要注射胰岛素也。有几个不同的方式胰岛素可输送到身体：

• Injection:这是拿胰岛素最常见的方式。注入的药物，你会用注射器或“笔”，通常在你的腹部，上臂，大腿，臀部或。
• 胰岛素Pump:People who need multiple injections per day or are high risk of ketoacidosis may prefer an insulin pump, which automatically delivers insulin throughout the day through a tiny catheter that’s worn on your body.
• 胰岛素吸入剂：Some adults with type 1 or 2 diabetes can also use inhaled insulin, a powder you breathe into your lungs through an inhaler.

口服药物

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 aresome of the common meds:

• Actosand文迪雅（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andMicronase（磺酰脲类），PrandinandSTARLIX（氯茴苯酸），和JanuviaandONGLYZA（DPP-4抑制剂），触发胰腺产生更多的胰岛素。
• Farxiga,Invokana, andJardiance（SGLT2抑制剂）促进糖的肾脏从血液中移除量。
• GlysetandOrecose（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。
• 二甲双胍（品牌名格华止,Glumetza,Fortamet, andRiomet）减慢碳水化合物的你吃成糖的分解，并降低你的肝脏多少葡萄糖产生。

Diet and Exercise

饮食和锻炼将有助于你的健康，不管你是什么类型的糖尿病。这就是说，1型糖尿病无法通过改变生活方式来治疗或治愈。无论你吃了不好，你不能让你的胰腺能够再次产生胰岛素。

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。

Regular exercise can also reduce insulin resistance and improve the way your body uses insulin, keeping type 2 diabetes in check.

不治疗糖尿病引起并发症？

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.

These are some side effects for the most common diabetes treatments:

• 连续血糖监测：Skin irritation, pain, sore muscles.
• 胰岛素:Low blood sugar, headaches, weight gain, flu-like symptoms. Infection of infusion site if using an insulin pump.
• 口服药物：恶心，腹泻，气，出汗，感觉焦虑或摇摇欲坠，体重增加，浮肿。

什么是糖尿病的一生，象？

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.

但由于糖尿病是比较常见的，有很多的人谁不明白，可以让生活变得更轻松。

其中最大的挑战可能是所谓的“自我管理”的你需要做的检查血糖量，给自己打针，正确服用药物，并坚持健康的饮食。

出于这个原因，许多人发现有认证的糖尿病教育者（CDE）有用的工作。这些医疗服务提供者（通常是注册护士或注册营养师）知道的插件和糖尿病治疗的出局，并能拿出系统和解决方案，工作在现实生活中。

If you find yourself feeling depressed and overwhelmed in the face of your diabetes diagnosis, don’t hesitate to tell your doctor. You are far from alone in feeling this way, and working with a diabetes educator, support group, or mental health counselor can get you back on track.

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.

顶级糖尿病Instagrammers

有没有“从＃grammers T1D和T2D＃社区的短缺 - 这里是一些我们喜爱谁共享糖尿病友好的食谱和柱头挤压实时通话洒。

• 米拉·克拉克巴克利,@thehangrywoman

遵循这是因为：她把她的糖尿病患者的生活方式（2016年诊断为2型）到数字化的故事，分享如何生活与糖尿病和仍然享受精致生活，像芝士汉堡和旅行。

• Michelle Laine, APRN-BC,@diabadassaprn

遵循这是因为：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。

• 嘉莉巷,@officialcarrielane

遵循这是因为：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.

• 卡尔·富兰克林和卡丽·布朗,@ 2ketodudes

遵循这是因为：这已经不是什么奇怪的人，很多这些“grammers的谈论食物，因为糖尿病，尤其是2 - 进行管理，在很大程度上，随你怎么您的身体加油。他们的食谱范围从美味的眼睛糖果“哎，我可以作出这样的！”

• 克里斯特尔Oerum,@diabetesstrong_ig

遵循这是因为：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 Diabetes激励人谁是胰岛素依赖型。

Top Diabetes-Related Podcasts

• 2 Keto Dudes。This podcast follows Carrie Brown and her pal Carl Franklin on their journey from metabolic syndrome and type 2 diabetes to a cleaner and healthier life, which they credit to following a keto diet. Expect convos on the pros, cons, and controversies of keto.

• Juicebox。斯科特本纳是一位作家，博客, and 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.

• 我的懒惰胰腺。1型糖尿病没有退缩from being an athlete. Kyle Masterman, whose goal is to cycle across Australia, brings on guests who are breaking barriers in sports and fitness—all while living with diabetes. Give it a listen on the way to the gym to help kick your butt into gear.

• 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

• 美国糖尿病协会。拥有超过565,000名志愿者，54万名会员和400名工作人员，这是非营利性与不可忽视的力量。在他们的使命的心脏：提高认识有关胰岛素的价格和治疗的影响，对于那些患有糖尿病和提倡政策变化。

• Diabetes Research Institute Foundation。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 (Formerly called Juvenile Diabetes Research Foundation)。这是一个为孩子们 - 或者，更往往不是kiddos的父母吵架1型糖尿病。非营利性的是全球领先的机构资金1型糖尿病的研究，已经提出了用于研究十亿$ 2日期。

• Taking Control of Your Diabetes。The founder of this nonprofit is an endocrinologist who was diagnosed with type 1 diabetes at age 15. Steve Edelman, M.D., brings together patients and experts at conferences across the U.S. to help them better understand and manage their lives with diabetes.

• 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.