Diabetes

Although technically not a digestive disease, diabetes is so closely associated with the pancreas that the decision was made to include information about this condition. Much of the material on this page has been derived from the following sites.

American Diabetes Association
Medline Plus
National Institute of Diabetes and Digestive and Kidney Diseases

Please visit MUSC Health Endocrinology, Diabetes & Metabolic Diseases Services for more information

What is diabetes?

Diabetes is a disorder of metabolism – that is, the way the body uses digested food for growth and energy. Most of the food people eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body.

What is Insulin?

Diabetes occurs when glucose builds up in the blood due to the pancreas not producing enough insulin (or not using it correctly) resulting in low energy levels. Insulin is a hormone that your body's cells need to absorb glucose.

After food that you eat is digested, glucose passes into the bloodstream. For glucose to get into cells (to produce energy), insulin must be present. The pancreas is supposed to automatically produces the right amount of insulin to move glucose from blood into the cells.

In people with diabetes, the pancreas either produces little or no insulin, or the cells do not respond to the insulin that is produced. The glucose builds up in the blood. The body naturally tries to rid the excess glucose from the body by filtering the blood. The excess glucose 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.

The body also loses water as it attempts to eliminate the glucose. This is why people with diabetes become thirsty and experience bouts of frequent urination.

What is pre-diabetes?

Pre-diabetes, which is becoming more and more common in the United States, is a condition in which blood sugar levels are higher than normal, yet not quite high enough to be actually deemed full-blown diabetes. Pre-diabetes may also be referred to as impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. IFG is tested after overnight fasting, while IGT is determined after a two-hour oral glucose tolerance test (OGTT). Some people have both IFG and IGT.

Fortunately, there are some things you can do to prevent or delay the onset of diabetes:

engage in physical activity (recommended 30 minutes per day, five days per week)
reduce fat in your diet
lose 5–7 percent of your body weight

People with IGT found that diet and exercise resulting in a 5 to 7 percent weight loss —that's about 10 to 14 pounds for a person that weighs 200 pounds— lowered the incidence of type 2 diabetes by nearly 60 percent.

Type I diabetes

Some facts about type 1 diabetes include:

it develops most often in children, but can occur at any age
it is more common in whites than non-whites
Northern European countries have a higher incidence rate (yet the reason for this is unknown)

Type II diabetes

Type 2 diabetes is more common in:

older people
people who are overweight
African Americans
American Indians

How common is diabetes?

National survey data from the CDC estimates the crude prevalence of diagnosed and undiagnosed diabetes in various populations, United States, 2017-2020:

18-44 years old — 4.8%
45-64 years old — 18.9%
65 years or older — 29.2%
Men — 15.4%
Women — 14.1%
Non-Hispanic whites — 13.6%
Non-Hispanic blacks — 17.4%

Diabetes prevalence in the United States is likely to increase for several reasons:

a large segment of the population is aging
Hispanics/Latinos and other minority groups at increased risk make up the fastest-growing segment of the U.S. population
Americans are increasingly overweight and sedentary

According to estimates from the U.S. Centers for Disease Control (CDC), diabetes will eventually affect one in every three people born in the year 2000 in the United States. The CDC also projects that the prevalence of diagnosed diabetes in the United States will increase 165% by the year 2050.

Diabetes screening

Some important reasons to be screened for diabetes include:

it is estimated that 26 million people in the United States have diabetes, yet only 18 million have been diagnosed
approximately 79 million adults in the U.S. have pre-diabetes
diabetes is widely recognized as one of the leading causes of death and disability in the U.S.; in 2006, it was the seventh leading cause of death
approximately 71,000 people die of diabetes every year in the United States
diabetes is likely to be underreported as the underlying cause of death on death certificates
healthcare costs for diabetes in the U.S. are estimated to be more than $245 billion per year

Complications from diabetes

Diabetes is a dangerous condition because it can exist undetected for years. During this time, many conditions can develop as a result of this underlying problem.

Diabetes is associated with long-term complications that affect almost every part of the body, such as:

blindness
heart and blood vessel disease
stroke
kidney failure
amputations
nerve damage

Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes.

Managing diabetes

People with diabetes should see a health care provider who will help them learn to manage their diabetes and who will monitor their diabetes control. Most people with diabetes get care from primary care physicians. Often, having a team of providers can improve diabetes care.

A healthcare team can include:

a primary care provider (such as a family practice doctor, a pediatrician, or an internist)
an endocrinologist (a specialist in diabetes care)
a dietitian, nurse, and/or other health care providers who are certified diabetes educators
a podiatrist (foot care specialist)
an ophthalmologist or optometrist (for vision care)

Weight and diabetes

Managing your weight is probably the most significant step you can take to manage a diabetic or pre-diabetic condition. However, managing diabetes requires a doctor's care. Weight alone may not be sufficient.

Diet and diabetes

The American Diabetes Association is just one excellent resource for people who are concerned about managing their diabetes. But it must be stressed that medical tests need to be performed in order to arrive at an accurate diagnosis.