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American Diabetes Month Focuses on Management and Prevention

Every November, the American Diabetes Association (ADA) and other health care organizations mark American Diabetes Month. It is a time to focus not only on awareness but on prevention and management of this possibly debilitating disease.

According to the ADA, more than 25 million Americans have diabetes, and another 79 million at-risk citizens have prediabetes, so the chances are good that you know someone who could benefit from taking a close look at the healthcare recommendations you'll hear throughout November.

There are two main types of diabetes to be aware of:

Type 1 Diabetes Mellitus (T1DM)

Also called juvenile diabetes and insulin-dependent diabetes, T1DM is an autoimmune disease that causes the antibodies in your bloodstream to go after and destroy the insulin-producing beta (B) cells in the pancreas. As a result, the body of someone with type 1 diabetes doesn't produce enough insulin to maintain balanced glucose levels.

Although genetics plays a role in developing type 1 diabetes, the connection is relatively minor. Doctors aren't absolutely certain what causes type 1 diabetes, though many indicators point to a virus as a trigger for the disease.

People with type 1 diabetes must take daily insulin supplement injections and must watch what they eat, avoiding foods high in sugar or that can throw off their body's glucose levels. Maintaining a healthy lifestyle with plenty of regular exercise is also important for managing the disease.

Type 2 Diabetes Mellitus (T2DM)

Unlike type 1 diabetes, T2DM is insulin-resistant. People with T2DM have what should be plenty of insulin in their systems, but their bodies respond to the insulin in abnormal ways. When normal amounts of insulin won't keep the body's glucose levels down, the pancreas produces more to compensate. Combine this over-production of insulin with weight gain and lack of exercise, and the pancreas gets overworked, leading to prediabetes and then type 2 diabetes.

Type 2 diabetes has a stronger genetic link than does type 1 diabetes, but obesity, sedentary lifestyles, and lack of exercise trigger the disease. Most people who develop T2DM are born with the genes for insulin resistance, and their lifestyle as they get older exacerbates that resistance.

Other types of diabetes

If you're pregnant and you've never had diabetes before, you could develop gestational diabetes during your pregnancy. During pregnancy, hormones block insulin action. In a nondiabetic pregnancy, the woman's body makes enough insulin to overcome this effect. A body that can't compensate for this change, combined with hormones released by the placenta and developing fetus, can lead to gestational diabetes. Fortunately, gestational diabetes usually disappears after the pregnancy ends.

If you have diabetes before you get pregnant, it's called pregestational diabetes, and the treatment and consequences are much different than for gestational diabetes.

Cases of other types of diabetes are rare and usually don't cause severe diabetes in the people who have them. But occasionally, one of these other types is responsible for a more severe case of diabetes:

  • Diabetes due to loss or disease of pancreatic tissue: If you have a disease that necessitates the removal of some of your pancreas, you lose valuable insulin-producing beta cells. This form of diabetes isn't always severe because you also lose glucagon, another pancreatic hormone, which blocks insulin action in your body. So when your body has less glucagon, it needs less insulin.

  • Diabetes due to iron overload: Hemochromatosis results from excessive absorption of iron into the blood. When too much iron is deposited in the pancreas, liver, heart, joints, or nervous system, damage may occur, which can lead to diabetes or other clinical disease.

  • Diabetes due to other diseases: A number of glands in your body produce hormones that block insulin action or have actions that are opposed to insulin actions. If you get a tumor on one of these glands, that upsets the hormone balance. This condition usually gives simple glucose intolerance rather than diabetes, but if you have a genetic tendency to diabetes, you may develop it in this case.

  • Diabetes due to hormone treatments for other diseases: If you take hormones to treat a disease other than diabetes, those hormones could cause diabetes. The hormone most likely to cause diabetes is hydrocortisone, an anti-inflammatory agent used to treat diseases of inflammation, such as arthritis.

  • Diabetes due to other drugs: If you're taking other commonly used drugs, be aware that some of them raise your blood glucose as a side effect. Antihypertensives and drugs used to lower cholesterol have been especially implicated.

For more information about preventing or managing diabetes, visit The American Diabetes Association or the National Diabetes Education Program or check out our For Dummies books about diabetes.

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