Diabetes is a disease in which the body does not produce or properly use insulin, a hormone necessary to convert sugar, starches and other food into the energy needed for daily life. According to the American Diabetes Association, about seven percent of the U.S. population suffers from diabetes – and nearly one-third of those are unaware they have the disease.
Already considered the leading U.S. health crisis, diabetes has reached epidemic proportions in some areas of the country, especially in New York City. In fact, according to The New York Times, one-eighth of the city’s residents suffer from the disease.
Even more alarming is that the diabetes rate in New York City is growing at nearly twice the national average.
New York City
- About 800,000 (1 in 8) people have diabetes in New York City.
- During the last decade, the rate at which diabetes is being diagnosed in New York City has grown to nearly twice the national average (140% compared to 80%).
As a nation, it’s obvious that we need to take action. Developing an understanding of the main types of diabetes, as well as the causes and symptoms of the disease, is the best place to begin. With this education, perhaps we can begin to better predict, prevent and manage diabetes.
Type 1 Diabetes vs. Type 2 Diabetes
There are two main types of diabetes: type 1 diabetes and type 2 diabetes. (Gestational diabetes, a third form of the disease, affects about four percent of pregnant women.)
What Is Type 1 Diabetes?
Type 1 diabetes is an immune disorder in which the body attacks and destroys insulin-producing beta cells in the pancreas. As a result, the body cannot produce insulin and glucose stays in the blood, where it damages all the organ systems.
Because people with type 1 diabetes must take insulin in order to survive – and because it often strikes children - this form of the disease is commonly referred to as insulin-dependent or juvenile-onset diabetes.
What Is Type 2 Diabetes?
Type 2 diabetes is a disorder in which either the body does not produce enough insulin, or the cells ignore the insulin. Similar to type 1 diabetes, type 2 causes a build-up of glucose in the blood which damages the body’s organ systems. This form of the disease is commonly referred to as adult-onset diabetes.
What Causes Diabetes?
Although type 1 diabetes and type 2 diabetes have different causes, they have two primary risk factors in common: genetics and environmental triggers.
Causes of Diabetes Type 1
There is definitely a genetic risk factor associated with type 1 diabetes. In fact, research has identified a total of 18 genes related to type 1 diabetes – and more are expected to be discovered.
Although a genetic predisposition is linked to the disease, it does not explain why some people develop diabetes and others do not. In fact, 85 to 90% of people with a family history of type 1 diabetes never develop the disease, and in most cases, a child needs to inherit risk factors from both parents in order to get the disease.
So if genetics are not entirely to blame…what is?
Some scientists believe that exposure as a child to Coxsackieviruses, a family of intestinal tract viruses known as enterovirus infections may trigger the disease in genetically susceptible individuals. Although the connection is still unclear, a child with an enteric virus is almost six times more likely to develop type 1 diabetes.
Other factors believed to increase the risk of developing type 1 diabetes include:
Causes of Diabetes Type 2
- Ethnicity: Caucasians have the highest rate of type 1 diabetes.
- Climate: Type 1 diabetes occurs more often during winter than summer. In addition, type 1 diabetes is more common in cold climates.
- Childhood Diet: Type 1 diabetes is less frequently found in people who were breastfed as a child. Introducing solid foods at later ages also appears to reduce the likelihood that a child will develop type 1 diabetes.
- Autoantibodies: The majority of people with type 1 diabetes had specific autoantibodies in their blood for many years prior to developing the disease.
- Respiratory infection: One study indicated that a respiratory infection during a child’s first year may offer protection against type 1 diabetes.
The genetic connection in diabetes type 2 is stronger than in type 1 diabetes. In addition, type 2 diabetes is also more dependent on environmental triggers.
Even though a family history of diabetes is one of the strongest risk factors, lifestyle plays an important role. That’s because diets high in fat, with few complex carbohydrates and fiber, accompanied by little exercise contribute to the development of diabetes. This type of lifestyle is common among Americans and Europeans – the places where diabetes type 2 is most prevalent.
The Genetic Risks of
Type 1 Diabetes
- If your father has type 1 diabetes, your risk is 6%.
- If your sibling has type 1 diabetes, your risk is 5%.
- If your mother has type 1 diabetes, your risk is 2%.
- If your identical twin has type 1 diabetes, your risk is 30% to 50%.
- If your parent and one sibling have type 1 diabetes, your risk is 30%.
Many studies indicate that obesity is the strongest risk factor for type 2 diabetes
. In fact, one study indicated that up to 58% of new cases of type 2 diabetes could be prevented with a successful battle against obesity.
Unfortunately, the material conditions and psychological stresses associated with poverty, combined with the often-related lifestyle factors of obesity and inactivity, collide with entrenched social problems in the American culture. To effectively fight the type 2 diabetes epidemic, it will be necessary to address the social issues related to poverty.
Other factors believed to increase the risk of developing type 2 diabetes include:
- Ethnicity: African Americans, Hispanics and Pima Indians are the ethnic groups with the highest risk of type 2 diabetes in the U.S.
- Geography: Regardless of the genetic risk, people in non-Westernized countries tend not to develop type 2 diabetes.
What Are The Symptoms of Diabetes?
The symptoms of both types of diabetes are extremely similar. In type 1 diabetes, however, the symptoms usually develop rapidly. In type 2 diabetes, the symptoms may be so slow to develop – people are often unaware they are sick.
The most common diabetes symptoms include:
- Extreme thirst
- Frequent urination
- Lethargy / drowsiness
- Breath odor (fruity, sweet or wine-like)
- Sugar in urine
- Sudden vision changes, blurred vision
- Increased appetite, constant hunger
- Sudden weight loss
- Heavy, labored breathing
- Vomiting, often mistaken for a case of gastroenteritis
- Stupor / unconsciousness (diabetic ketoacidosis – DKA)
Preventing & Controlling Both Types of Diabetes
If you have diabetes, or even pre-diabetes, the most critical thing you can do is to monitor your blood glucose levels using a blood glucose meter. That’s because maintaining a normal blood glucose range will help prevent many of the health complications associated with diabetes. Always take your insulin, and any other medications, as prescribed.
Also, watch what you eat – diabetes nutrition and foods are good choices…get plenty of exercise…and take a diabetes vitamin supplement.
Regardless of whether you have diabetes or not, you can volunteer for the American Diabetes Association. Raising awareness of the types of diabetes, as well as the causes and symptoms, is our first line of defense against the disease now being called the “biggest public health challenge of the 21st century.”
American Diabetes Association – www.diabetes.org
Mayo Clinic – www.mayoclinic.com
The Genetic Landscape of Diabetes – www.ncbi.nlm.nih.gov
WebMD – www.WebMD.com
The New York Times – www.nytimes.com
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