The same symptoms listed above may also affect type 2 diabetes, but usually the symptoms are less obvious. The emergence of type 2 diabetes is gradual and therefore difficult to detect. In fact, some people with type 2 diabetes show no symptoms evident at first. They tend to be diagnosed several years later, when various complications are already present.

Threatening complications:

Without adequate production and action of insulin, glucose stays in the blood, causing chronic hyperglycemia (high blood sugar). This can cause complications in the short and long term, many of which, if not prevented and treated, can be fatal. All have the potential to reduce the quality of life of people with diabetes and their families.

The most common complications in the long term are:

Diabetic nephropathy (kidney disease), which can lead to total kidney failure and the need for dialysis or kidney transplantation.

Diabetic eye disease (retinopathy and macular edema), lesions of the retina of the eye that can cause vision loss.

Diabetic neuropathy (nerve disease) which can lead to ulceration and amputation of feet and lower limbs.

Cardiovascular disease, which affects the heart and blood vessels and could cause fatal complications such as coronary heart disease (which causes heart attack) and stroke.

Diabetes is the fourth leading cause of death by disease in the world. Each year 3.8 million people die from causes related to diabetes.

Diabetes is preventable
Changes in the living environment, and early detection measures proven to prevent diabetes can significantly reduce the risk of developing type 2 diabetes, delay its onset or at least reduce its impact. For people with type 1 diabetes is not yet possible to prevent the disease. However, much can be done to prevent or delay diabetes complications if people have access to adequate care, medication and adequate monitoring equipment.

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In a study involving over 11,000 people with no history of diabetes, hemoglobin A1c test more accurately determined who would develop the disease compared with glucose testing, which measures blood sugar levels at a point in the time.

The A1c test was also able to better predict the risk of stroke (CVA), heart disease and death from diabetes, the researchers report in the New England Journal of Medicine.

The team found that people who had A1c levels of 6 percent or more were at greater risk of developing diabetes.

“The A1c has significant advantages over blood glucose test,” said Dr. Elizabeth Selvin from Johns Hopkins University in Baltimore and leader of the study.

The blood sugar levels can vary from day to day and from hour to hour.

The A1c test is more reliable, repeatable and allows doctors to follow the average glucose levels over time. The quantities are not affected by stress and disease and patients do not have to fast before the test, as with glucose, the researchers said.

In January, the American Diabetes Association recommended A1C test to control the disease and to identify people who may be at risk of developing it.

In the study, Selvin’s team examined blood samples from 11,092 middle-aged adults without diabetes whites and blacks, drawn between 1990 and 1992.

The researchers compared the A1c test with fasting glucose to identify those most at risk for diabetes, heart disease and stroke and die.

During the 15 years of follow up, 2251 people were diagnosed with diabetes, 1198 were heart disease, 358 stroke and died 1447, the team said.

Doctors think that it is normal to have A1C levels between 5 and 5.5 percent. With each increase, the researchers found that increased the incidence of diabetes.

Persons with levels between 6 and 6.5 percent were nine times more likely than those within the normal range to develop the disease.

According to the study, currently there are 9 million Americans with undiagnosed diabetes.

Diabetes occurs when the body becomes unable to use insulin effectively. The blood sugar levels rise, leading to complications such as heart disease, blindness and kidney failure.

About 24 million Americans have diabetes, according to the Centers for Disease Control and Prevention (CDC for its acronym in English).

The disease costs the United States about 132,000 million dollars a year on disability, lost productivity and premature deaths.

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It may be the case that the body does not produce enough insulin, which is when the diabetes is type 1, or can not use it produces, that is when there is type 2 diabetes.

Type 1 diabetes, which is also known as insulin dependent diabetes, immune or juvenile home, is the result of an autoimmune reaction, in which the body’s defense system attacks insulin-producing cells. People with this type of diabetes produce very little or no insulin injections they need every day and thus control the blood glucose levels. Type 1 diabetes can affect people of any age but usually occurs mainly in children or young adults.

Type 2 diabetes, known as noninsulin dependent or adult, is more common in people over 45 years are overweight. However, following the rise of obesity among young people, is lowering the age of those affected. These patients often need insulin injections because they can control the glucose in your body by paying attention to your diet, exercising and taking oral medication.

This type of diabetes is most prevalent, accounting for 90-95 percent of all cases of this disease, and if not properly diagnosed and treated can develop serious complications that can generate even premature death. Not surprisingly, each year 3.8 million people die worldwide of causes related to this disease, ranking it as the fourth leading cause of death.

Besides these two types of diabetes, gestational diabetes exists that some women develop, usually on a temporary basis during pregnancy. This type of diabetes occurs between 2 and 5% of all pregnancies and in these cases there is an increased risk of developing type 2 diabetes over time.

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Clear evidence of this shift is experienced by all pregnant women, who usually notice the morning the unpleasant symptoms of hypoglycemia: nausea, drowsiness, tiredness, weakness, etc..

As pregnancy progresses, metabolic adaptation intensifies, reaching great importance during the last 20 weeks of pregnancy. All these metabolic changes lead to a number of considerations when they occur in a diabetic woman:

• In some patients Diabetes first appears during pregnancy.
• The conventional criteria for diagnosing diabetes are not applicable during pregnancy
• As pregnancy progresses there is an increase in insulin requirements.
• The usual criteria of strict metabolic control are not applicable during pregnancy

Detection of gestational diabetes mellitus (GDM)

The data suggest the possibility of DMG are:

* Family history of diabetes, especially among first-degree relatives.
* Glycosuria (glucose in urine) in a second fasting urine sample (see below).
* A history of:

• Abortions unexplained.
• Infants large for gestational age.
• Malformations in the newborn.

* Significant maternal obesity (90 kg or more).

Some minor data are multiparity, recurrent pregnancy toxemia and premature births repeated. The presence of more than one data increases the probability of having a disorder in glucose metabolism.

Glycosuria (glucose in urine) is a common finding, as 15% of pregnant women have it, so the search for cases based on this information alone is ineffective. The validity of this test may increase when using a second sample Fasting urine issued upon awakening is neglected and collected a second sample 15 minutes later when the patient is still fasting.

Suspected cases of GDM should be seen every 15 days by the endocrinologist, working together he and the obstetrician. It should take the usual prenatal measures. It should place special emphasis on weight control.

At each visit, you must perform a blood glucose after eating. If this test does not exceed 120 mg/dL), evidence of oral glucose tolerance should be deferred until the week 37 th -38 th of gestation, at which time more likely to test positive. If at any visit after eating glucose exceeds 120 mg/dL, should be tested for glucose tolerance without delay.

If the test is negative in early pregnancy does not, however, the diagnosis and the test should be repeated at 37-38 weeks, before making a final decision. Patients who have a negative tolerance test at 37-38 weeks is considered normal. If the test is positive diagnosis can be made of gestational diabetes and is offered to patients on a diet and was controlled in the same way as a diabetic clinic.

If the ideal criteria of glycemic control are not achieved soon, you start taking insulin. In cases well controlled and uncomplicated spontaneous delivery is expected. The existence of an increased need for insulin during pregnancy does not necessarily indicate that diabetes persists after delivery.

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