Your Health: Diabetes

November is National Diabetes Month. Most of us know someone with diabetes, but we may not understand just what this disease is.
Diabetes occurs when the body doesn’t make enough insulin or when the insulin becomes ineffective. Insulin is a hormone made by the pancreas that helps move glucose (blood sugar) from the blood into the cells of our bodies, where the glucose acts as a source of life-sustaining energy for our muscles and tissues. When insulin is insufficient or ineffective, the sugar level in our blood increases, causing diabetes.
There are several types of diabetes. In type 1 diabetes, one’s pancreas does not produce enough insulin. This is usually a genetic problem where one’s own immune system attacks and destroys the cells that create insulin in the pancreas. This type of diabetes often starts in childhood and has the most serious health complications.
Type 2 diabetes occurs when one’s cells become resistant to the effects of insulin, causing sugar to build up in the bloodstream. Being overweight is a major contributing factor. Genetics and environmental factors may also play a role in this type of diabetes. Type 2 diabetes is the most common type and can occur at any age. It is also preventable.
Prediabetes often precedes type 2 diabetes. This condition occurs when the blood sugar is higher than normal, but not high enough to cause any obvious health problems. It is estimated that perhaps 80 million people in the U.S. have this condition, which, if not recognized and treated, could go on to type 2 diabetes.
Symptoms of diabetes depend on how high one’s blood sugar is. These include:
– Frequent urination
– Increased thirst
– Extreme hunger
– Unexplained weight loss
Risk factors for diabetes depend on the type of diabetes. For type 1, these factors include genetics, environment, dietary habits, race and geography. Risk factors for type 2 include obesity, inactivity, family history, age and pregnancy.
Complications of diabetes take time to develop. The longer one has diabetes and the higher the blood sugar, the worse the complications. Eventually, these complications can cause significant disability and possibly early death. Diabetic complications include:
– Cardiovascular disease, especially heart attacks and strokes.
– Nerve (neuropathy) and blood vessel damage involving the legs and feet sometimes leading to amputation.
– Eye damage.
– Kidney damage, often leading to dialysis or even to kidney transplantation.
– Increased risk of Alzheimer’s disease as well as certain cancers.
My next column will cover the tests, treatment and prevention of diabetes.
Terry Hollenbeck, M.D., is an urgent-care physician at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view his previous columns on his website, valleydoctor.wordpress.com, or email him at

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. Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.