Diabetes, as defined by the American Diabetes Association (ADA)
, is a group of diseases characterized by high levels of blood glucose (sugar). Diabetes results when the body is not able to produce or properly use insulin. Insulin is a hormone that acts like a key to get the glucose from food into the cells. Without enough insulin the glucose stays in the blood stream. The consequences of too much sugar in the blood is that over time, several organs in the body are affected including the kidney, the eye, nerves and the cardiovascular system.
Type 1 diabetes is an auto-immune disease, which destroys the beta cells of the pancreas, which normally produce insulin. Therefore, the person with type 1 diabetes must take multiple daily insulin injections. Type 1 diabetes accounts for 5-10% of diabetes cases.
Warning Signs for Type 1 diabetes: (usually come on suddenly)
- Frequent thirst and urination
- Unexplained weight loss
- Extreme fatigue
- Blurry vision
- Nausea and vomiting
- Fruity odor on breath
Type 2 is the most common type of diabetes. It accounts for 90-95% of diabetes cases. Type 2 diabetes occurs when the body fails to make enough insulin or properly use it. Aspects of type 2 diabetes include:
- Gradual onset often with few or no symptoms.
- Some people with type 2 diabetes can control their blood sugars through meal planning and exercise. Others will need medication, including insulin or other injectable medications.
- Most people with type 2 diabetes are over age 40; however, it is becoming increasingly more common among children and young adults.
Risk factors for type 2 diabetes include:
- Family history of diabetes
- High blood pressure/cholesterol
- History of Gestational diabetes
- Being African American, Native American, Asian, Hispanic American or Pacific Islander
- Polycystic ovary syndrome
Warning Signs for type 2: (often develop gradually)
• Any warning sign listed for type 1 above
• Vaginal yeast infections in women
• Frequent infections
• Cuts that are slow to heal
• Tingling or numbness in feet or hands
Often, no symptoms are present, and diabetes can be unnoticed for several years. Meanwhile, the damaging effects of high blood sugar are beginning.
Gestational diabetes is a form of diabetes that occurs in 4.1% of pregnancies in Connecticut. Gestational diabetes usually requires treatment only during pregnancy but puts the mother, and the child, at high-risk for later development of diabetes. Treatment involves meal planning, physical activity, and in some cases insulin. Treatment to bring the mother’s blood sugar into a healthy range helps prevent complications in the infant. These include low blood sugar at birth and larger size (greater than 9 lbs.).
Risk factors for Gestational diabetes include:
• Being an ethnic minority
• Having a family history of diabetes
For more information on prediabetes and how to prevent type 2 diabetes, please visit the Connecticut Department of Public Health's Prediabetes Web Site
The diagnosis of diabetes is made when the symptoms described above are present and there is a random blood sugar greater than or equal to 200 mg/dl, or when a fasting blood sugar is greater than or equal to 126 mg/dl. Diabetes can also be diagnosed with a two-hour glucose tolerance test. This test involves drinking a sugary beverage and checking blood sugars. A result of greater than or equal to 200 mg/dl two hours after the drink also means a diagnosis of diabetes. In addition, an A1c value (the three month average of blood sugar) that is 6.5% or higher also means diabetes.
Diabetes can affect many parts of the body causing serious health problems. If you have diabetes you need to be aware of these risks and take care of yourself to prevent complications.
How can diabetes effect the heart and brain?
Diabetes puts people at greater risk for heart disease and stroke. In fact, heart disease and stroke are the most common complications of diabetes. Controlling blood glucose levels (A1c), blood pressure, and cholesterol can help prevent heart disease/stroke. Ask your health care provider about your ABCs (A1c, blood pressure and cholesterol). Also, losing weight if necessary, and not smoking can all help decrease heart disease/stroke risk.
How can diabetes effect the eyes?
Diabetic eye disease or retinopathy causes damage to the blood vessels in the retina. This can cause severe vision loss or blindness. To reduce this risk good blood glucose and blood pressure control is important.
If you have diabetes, most doctors recommend a yearly-dilated eye exam. A dilated eye exam means eye drops are used to enlarge your pupils. This allows the inside of your eyes to be checked for signs of disease.
Diabetes also puts people at higher risk of cataracts (clouding of the lens of the eye) and glaucoma (increase in pressure inside the eye that leads to optic nerve damage and loss of vision).
How can diabetes effect the kidneys?
High blood glucose levels can damage the kidneys. Kidney disease (nephropathy) can lead to kidney failure. Diabetes is the most common cause of kidney failure. Steps to reduce the risk or slow kidney damage include: Achieving good glucose control, having your urine tested for protein in the urine (microalbuminuria) yearly and achieving good blood pressure control (130/80).
How can diabetes effect the feet?
Over time people with diabetes can damage the nerves in all parts of the body. This is called neuropathy. Nerve damage in the feet is the most common. It can lead to numbness or pain although some people have no symptoms. If a person has numbness in their feet they may not feel a cut or blister which can go on to become infected. The longer a person has diabetes, the greater the risk of having nerve problems. However, when type 2 diabetes is diagnosed, half of the people already have signs of nerve damage in the feet. To prevent foot problems have a foot exam each year by a physician or trained health care provider. Ask your doctor to show you how to care for your feet at home and if you smoke, quit.
How is diabetes related to depression?
Depression is more common in people with diabetes. Depression can make you want to “give up” or not care anymore about things, including diabetes. This can make the control of your diabetes more difficult. Be sure to talk with your healthcare provider who can refer you for help.
How is diabetes related to oral health?
People with diabetes are more likely have gum disease, which can result in tooth loss. Disorders in the mouth may also lead to heart disease in people with diabetes. Keep your mouth free of disease and your heart will benefit too.
It is important to get dental check-ups twice a year, and floss and brush daily.
Diabetes and Tobacco
Smoking has many bad health effects. The best-known effect is that it causes cancer but it also damages the blood vessels and nerves. Lower your chances of damage to the blood vessels and nerves by not smoking.
For help to quit smoking, Connecticut residents can call the Quitline at 1-800-784-8669.
Diabetes and Flu or Pneumonia
If you have diabetes a flu shot could save your life. People with diabetes are more likely to get very sick from the flu and are more often hospitalized and more likely to die from flu. Ask your doctor if the flu or pneumonia shot is right for you.
The HealthMap Vaccine Finder
can help you to find a clinic giving flu shots in your area of Connecticut. They have a web-based searchable database for public seasonal flu clinics. Please be sure and check the details section of each listing for any special requirements for the clinic.
There are also short-term concerns associated with diabetes. These include hypoglycemia, (low blood sugar) diabetic ketoacidosis, and very high blood sugars called hyperglycemic hyperosmolar states. Work with your health care team to learn how to prevent these. In addition, when blood sugars are higher than recommended, people tend to feel tired and run down.
For more information on diabetes self-management education and the locations of diabetes education centers and self-management programs, visit the Diabetes Prevention and Control Program’s Self-Management Education Web Site
Learn about the Diabetes Self-Management Program by watching this video (in Spanish).
To find a diabetes educator
as well as some helpful, short diabetes videos, visit the following website: www.diabeteseducator.org
For more information on the locations of diabetes education centers and self-management programs
, visit the Diabetes Prevention and Control Program’s Self-management Education Web Site
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Community Health Centers (CHC's)
People without insurance can contact a Community Health Center (CHC). CHCs work on a sliding fee scale. Many hospitals also have clinics that can help.
To find a Diabetes Prevention Program
near you, visit the Connecticut Department of Public Health's Prediabetes Web Site
Department of Public Health Contact Information
Connecticut Diabetes Prevention and Control Program (DPCP)
410 Capitol Ave, MS 11-CHLS
Hartford, CT 06134
P: (860) 509-7737
F: (860) 509-7855