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.

什么是糖尿病，无论如何？

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.

大约有30亿人在美国有糖尿病，但近四分之一人不知道它。让我们来仔细看看。

糖尿病的最常见的类型

有几种不同类型的糖尿病和each has its own causes. It’s important to get an accurate diagnosis for which form of the disease you have because treatment will differ depending on type. Here are the basics you should know:

1型糖尿病

Also called“juvenile” diabetes因为它通常确诊童年，1型糖尿病主要是一种自身免疫性疾病，其中免疫系统攻击并破坏胰岛素使胰腺细胞。正因为如此，你的身体不再生产自己的胰岛素，所以你需要注射胰岛素的每一天。

大多数人1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

与人type 2做自己生产胰岛素，但他们的身体不采用very well. They are insulin-resistant.

Type 2, also called “adult-onset”, diabetes is the most common form of the disease. Between 90% to 95% percent of all people with diabetes have type 2. It usually develops in middle age but is sometimes seen in older kids or teens.

大多数人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。

与人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.

Gestational diabetes is usually treated with exercise and diet changes (such as eating less starch and more veggies, fruits, and protein). Some women may need insulin injections, too.

Most of the time, blood sugar levels return to normal once the baby is born; but if you have gestational diabetes during pregnancy, you are also at higher than average risk for developing type 2 later in life.

糖尿病的其他类型

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

1型糖尿病主要是一种自身免疫性疾病。在这种情况下，你的免疫系统攻击你的身体以同样的方式可能像攻击细菌或病毒入侵，在引入歧途的企图保护身体破坏某些细胞在你的胰腺。这些细胞，称为β细胞，是产生胰岛素的人。当你的身体攻击和破坏它们，你不能再使自己的胰岛素。

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

Type 2 diabetes is usually caused by a combination of factors. It tends to run in families, and certain genes make you more likely to develop it. It’s also more common in some ethnic groups, including Native Americans, African Americans, Pacific Islanders, Asians, and Latinos.

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

遗传与怀孕期间荷尔蒙的变化是这种类型的罪魁祸首。

所有女人都会变得怀孕胰岛素抵抗后期，由于通过胎盘释放激素大都。在大多数情况下，胰腺安培了胰岛素的生产，以补足差额，但在情况下，它无法跟上，血糖水平升高和妊娠糖尿病的发展。

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。
• The munchies: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:Type 2 diabetes makes it harder for your immune system to fight off infections, including yeast infections or UTIs. It might also take longer for cuts to heal, because extra glucose prevents white blood cells from doing their repair work.
• Weight loss:减肥不改变你的饮食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.This common test measures what percentage of your red blood cells have been coated with glucose over the past two to three months. The higher your blood sugar, the higher your score. An A1C result below 5.7 is considered normal; 5.7 to 6.4 is prediabetic; 6.5 or above suggests diabetes.
• Fasting blood sugar test.你吃或水以外的任何东西喝血前将绘制的第一件事是在早晨。下每分升100毫克的结果是正常的;100〜125毫克/分升是糖尿病前期;126毫克/分升或以上指示糖尿病。你的医生可能会要你诊断之前做测试两次。
• Glucose tolerance test.让你的血液空腹抽取后，你会喝葡萄糖饮料，然后让血液再次一两个小时后得出。如果你的血糖在140毫克击落含糖饮料，这是正常的之后/ dL的2小时;140至199是前驱糖尿病;200 MD / dL以上的指示糖尿病。
• 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.
• 抗体测试。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.

尿检为糖尿病

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.

什么是最好的治疗糖尿病？

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：

Insulin

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.
• 胰岛素泵：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。
• Insulin 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(thiazolidinediones) reduce circulating fat concentrations and improve sensitivity to insulin.
• Amaryl,Glucotrol和Micronase(sulfonylureas),Prandin和Starlix(meglitinide), and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(alpha-glucosidase inhibitors) slow the digestion and breakdown of starches into glucose and regulate how much glucose is absorbed by the small intestine.
• Metformin (brands namesGlucophage,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.

Diet can be used to help treat type 2 and gestational diabetes, though. One of the most important diet changes someone with type 2 can make is to reduce or cut out sugary drinks like soda and juices that may hike up blood sugar. Eating more low-starch vegetables and lean protein can help, too. Some people with diabetes may need to count the grams of carbohydrate they eat, since consuming a consistent amount at each meal helps balance blood sugar.

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?

任何药物都有潜在的副作用，以及那些糖尿病患者也不例外。但是，没有一个是严重不治疗的替代方案中，如心脏疾病，视力减退，神经疼痛，足部溃疡，甚至截肢。

这些都是一些副作用，最常见糖尿病治疗：

• Continuous glucose monitoring:皮肤红肿，疼痛，肌肉酸痛。
• 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.

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。

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。

Where Can I Find Diabetes Communities?

谈起，谁知道你正在经历什么人可以是一样重要的，因为找到一个治疗计划工程。这里有一些地方开始进行连接，寻找资源，和朋友见面。

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.

• 米拉·克拉克巴克利,@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:This Yale University grad, family nurse practitioner, and Muay Thai kickboxing enthusiast is also a type 1 diabetes patient. Laine doesn’t sugarcoat (pardon the pun) her disease, but she does promise to never let it hold her back.

• 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。

• 糖尿病日常工作。琥珀Clour，从小谁已经1型糖尿病与生活类型，汇集了一队人1型或在此接合播客2型糖尿病。焦点：关于日常生活的真实意见。无绒毛，只是现实。

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。It starts here with the scientists who are working to find a cure for those living with diabetes. Their goal, a little unconventional, is to put themselves out of business. A cure means their work is done!

• JDRF（以前称为青少年糖尿病研究基金会）。This one’s for the kids — or, more often than not, 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。嘿，女士们，欢迎姐妹。虽然糖尿病，而且一视同仁，有疾病的整个世界，只有对妇女的影响（你好怀孕，更年期和其他激素不平衡的时刻）。来这里的同行的支持，教育和希望的故事。