Part I – History and Definition of Diabetes

Diabetes is a shortened version of the full name, diabetes mellitus, derived from the Greek word diabetes meaning siphon (to pass through) and the Latin word mellitus meaning sweet. In ancient times diabetes was known as the “sugar urine disease” and was commonly tested for by observing whether ants were attracted to a person's urine.

In 1922, the discovery and purification of insulin from the pancreases of cows at the University of Toronto led to availability of effective treatment. The first biosynthetic insulin was developed and approved for mass production in 1982. It is identical in chemical structure to that produced in human pancreatic beta cells.

Prevalence and Trends

Globally, as of 2010, an estimated 285 million people had diabetes, with type 2 making up approximately 90 percent. The frequency of diabetes cases is increasing rapidly, and by 2030, this number is estimated to nearly double. Diabetes is most prevalent in developed nations. The increase in incidences in developing countries follows the adoption of a Western high-calorie diet and low-activity lifestyle.

For at least 20 years, diabetes rates in North America have been increasing substantially. The Centers for Disease Control (CDC) has termed the change an epidemic. About five to ten percent are type 1, with the remainder being type 2. A CDC assessment completed in 2003 states that one in three Americans born after 2000 will develop diabetes in their lifetimes.

More than 24 million Americans have diabetes; of those, about 6 million are not aware that they have the disease. If the spread of type 2 diabetes continues at its current rate, the number of people diagnosed in the United States will increase from about 16 million in 2005 to 48 million in 2050.

These numbers are tragic considering that nine cases out of ten could be avoided with diet and lifestyle changes.  The keys to preventing or possibly reversing this disease are maintaining a normal weight for height, daily physical activity, healthy diet and avoiding smoking.

Definitions and Types

Diabetes is a group of diseases marked by high levels of blood sugar resulting from defects in insulin production, insulin action or both. It is the leading cause of kidney failure in the United States as well as a major cause of heart disease and stroke. Normal fasting blood sugar is below 100 mg/dL. For a prediabetic diagnosis, blood sugar levels should fall between between 100-125 mg. A blood sugar level of 200 or above is defined as diabetic.

Type 1 Diabetes

Type 1 diabetes is an auto-immune disease and was previously called insulin-dependent or juvenile-onset diabetes. It develops when the body's immune system destroys the pancreatic beta cells which are responsible for manufacturing insulin, a hormone that regulates blood sugar. These persons must have insulin regularly delivered by injection or a pump.

Type 1 mainly affects children and young adults, although the disease can occur at any age. There is no known way of preventing this form of diabetes.

Prediabetes

This is a diagnosis given when there is evidence of glucose intolerance—the body is less able to effectively process simple carbohydrates—but, unlike type 2 diabetes, the blood sugar does remain elevated.  

Prediabetes is normally reversible through effective weight management and regular physical activity. Making changes in weight, exercise and diet cannot only prevent progression of the disease, but can also normalize blood sugar.

Type 2 Diabetes

This was previously called non-insulin-dependent or adult-onset diabetes. In adults, type 2 accounts for approximately 90 to 95 percent of cases. This type is associated with older age, being overweight and having a sedentary lifestyle.

Many persons, particularly those with prediabetes or recently diagnosed with type 2, are able to control their blood sugar through a combination of weight management, healthy diet and regular physical activity. This can enable motivated individuals to avoid the necessity of medication and greatly reduces their risk for complications including diabetes-related diseases.

Gestational Diabetes

This form of diabetes is most commonly diagnosed during the last trimester of pregnancy. Although it usually resolves after the baby is born, those women affected are at increased risk of developing type 2 diabetes later in life.

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