What Is Diabetes?

Diabetes is a disorder of metabolism--the way our bodies use digested food for growth and energy. Most of the food we eat is broken down by the digestive juices into a simple sugar called glucose. Glucose is the main source of fuel for the body.

After digestion, the glucose passes into our bloodstream where it is available for body cells to use for growth and energy. For the glucose to get into the cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.

When we eat, the pancreas is supposed to automatically produce the right amount of insulin to move the glucose from our blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the body cells do not respond to the insulin that is produced. As a result, glucose builds up in the blood, overflows into the urine, and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

Who Gets Diabetes?

Diabetes is not contagious. People cannot "catch" it from each other. However, certain factors can increase one's risk of developing diabetes. People who have family members with diabetes (especially type 2 diabetes ), who are overweight, or who are African American, Hispanic, or Native American are all at greater risk of developing diabetes.

Type 1 diabetes occurs equally among males and females, but is more common in whites than in nonwhites. Data from the World Health Organization's Multinational Project for Childhood Diabetes indicate that type 1 diabetes is rare in most Asian, African, and American Indian populations. On the other hand, some northern European countries, including Finland and Sweden, have high rates of type 1 diabetes. The reasons for these differences are not known.

Type 2 diabetes is more common in older people, especially older women who are overweight, and occurs more often among African Americans, Hispanics, and American Indians. Compared with non-Hispanic whites, diabetes rates are about 60 percent higher in African Americans and 110 to 120 percent higher in Mexican Americans and Puerto Ricans. American Indians have the highest rates of diabetes in the world. Among Pima Indians living in the United States, for example, half of all adults have type 2 diabetes. The prevalence of diabetes is likely to increase because older people, Hispanics, and other minority groups make up the fastest growing segments of the U.S. population.

What You Should Know about Blood Sugar

Sulfonylureas, meglitinides, and insulin are the types of diabetes medicines that can make blood sugar go too low. Low blood sugar can happen for many reasons:

• Delaying or skipping a meal.
• Eating too little food at a meal.
• Getting more exercise than usual.
• Taking too much diabetes medicine.
• Drinking alcohol.

You know your blood sugar may be low when you feel one or more of the following:

• Dizzy or light-headed.
• Hungry.
• Nervous and shaky.
• Sleepy or confused.
• Sweaty.

If you think your blood sugar is low, test it to see for sure. If your blood sugar is at or below 70 mg/dl, eat one of these items to get 15 grams of carbohydrate:

• 1/2 cup (4 oz.) of any fruit juice.
• 1 cup (8 oz.) of fat-free or low-fat milk.
• 4 teaspoons of granulated white sugar.
• 1/3 cup (3 oz.) regular soda.
• 6 to 7 small Lifesavers® or 4 large Lifesavers®.
• Glucose gel or tablets (take the amount noted on package to add up to 15 grams of carbohydrate).

Test your blood sugar again 15 minutes later. If it is still below 70 mg/dl, then eat another 15 grams of carbohydrate. Then test your blood sugar again in 15 minutes. If you cannot test your blood sugar right away but you feel symptoms of low blood sugar, eat one of the items listed above.

If your blood sugar is not low, but you will not eat your next meal for at least an hour, then have a snack with starch and protein. Here are some examples:

• Crackers and peanut butter or cheese.
• Half of a ham or turkey sandwich.
• A cup of milk and crackers or cereal.