• Idiopathic Type 1 - refers to rare forms of the disease with no known cause.
• Immune-mediated Diabetes - an autoimmune disorder in which the body's immune system destroys, or attempts to destroy, the cells in the pancreas that produce insulin.

• Diabetes mellitus
• insulin-dependent diabetes mellitus (IDDM)
• juvenile diabetes
• sugar diabetes

• high levels of sugar in the blood when tested
• high levels of sugar in the urine when tested
• unusual thirst
• frequent urination
• extreme hunger but loss of weight
• blurred vision
• nausea and vomiting
• extreme weakness and tiredness
• irritability and mood changes

In children, symptoms may be similar to those of having the flu.

The symptoms of type 1 diabetes may resemble other conditions or medical problems. Consult your physician for a diagnosis.

Type 1 diabetes can cause different problems, but there are three key complications:

• Hypoglycemia (low blood sugar; sometimes called an insulin reaction) occurs when blood sugar drops too low.
• Hyperglycemia (high blood sugar) occurs when blood sugar is too high, and can be a sign that diabetes is not well controlled.
• Ketoacidosis (diabetic coma) is loss of consciousness due to untreated or under-treated diabetes.

Specific treatment will be determined by your physician(s) based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

People with type 1 diabetes must have daily injections of insulin to keep the blood sugar level within normal ranges. Other parts of the treatment protocol may include:

• appropriate foods to manage blood sugar level
• exercise to lower and help the body use blood sugar
• regular blood testing for blood-sugar levels
• regular urine testing for ketone levels

• Type 1 diabetes accounts for 5-10 percent of diagnosed cases of diabetes.
• There are an estimated 500,000 to 1 million people with Type 1 diabetes in the US today.
• The risk of developing type 1 diabetes is higher than virtually all other severe chronic diseases of childhood.
• Peak incidence occurs during puberty, around 10 to 12 years of age in girls, and 12 to 14 years of age in boys.
• The symptoms for type 1 diabetes can mimic the flu in children.
• Type 1 diabetes tends to run in families. Brothers and sisters of children with type 1 diabetes have about a 10 percent chance of developing the disease by age 50.
• The identical twin of a person with type 1 diabetes has a 25 to 50 percent chance of developing type 1 diabetes. Sources: National Institute for Diabetes and Digestive and Kidney Disorders and American Diabetes Association.

• age - people over the age of 45 are at higher risk
• family history of diabetes
• being overweight
• not exercising regularly
• being a member of certain racial and ethnic groups, such as African-Americans, Hispanic Americans, and Native Americans
• history of gestational diabetes, or giving birth to a baby that weighed more than 9 pounds
• a low level HDL (high density lipoprotein -- the "good cholesterol")
• a high triglyceride level

The exact cause of type 2 diabetes is unknown. However, there does appear to be a genetic factor which causes it to run in families. And, although a person can inherit a tendency to develop type 2 diabetes, it usually takes another factor, such as obesity, to bring on the disease.

Type 2 diabetes may be prevented or delayed by following a program to eliminate or reduce risk factors -- particularly losing weight and increasing exercise. Information gathered by the Diabetes Prevention Program, sponsored by the National Institutes of Health and the American Diabetes Association, continues to study this possibility.

Diabetes may have a variety of signs and symptoms, including:

• frequent infections that are not easily healed
• frequent urination
• extreme hunger but loss of weight
• unusual thirst
• blurred vision
• extreme weakness and tiredness
• irritability and mood changes
• nausea and vomiting
• high levels of sugar in the blood when tested
• high levels of sugar in the urine when tested
• dry, itchy skin
• tingling or loss of feeling in the hands or feet

Some people who have type 2 diabetes exhibit no symptoms. Symptoms may be mild and almost unnoticeable, or easy to confuse with signs of aging. Half of all Americans who have diabetes do not know it.

The symptoms of type 2 diabetes may resemble other conditions or medical problems. Consult your physician for a diagnosis.

Specific treatment will be determined by your physician(s) based on

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

The goal of treatment is to keep blood-sugar levels as close to normal as possible. Emphasis is on control of blood sugar (glucose) by monitoring the levels, regular physical activity, meal planning, and routine health care. Treatment of diabetes is an ongoing process of management and education that includes not only the person with diabetes, but also health care professionals and family members.

Often type 2 diabetes can be controlled through losing weight, improved nutrition, and exercise alone, but sometimes these are not enough and either oral medications and/or insulin must be used. Treatment often includes

• proper diet
• weight control
• an appropriate exercise program
• proper hygiene
• in some cases, insulin replacement therapy (under the direction of a physician)

Untreated or inappropriately-treated diabetes can cause problems with the kidneys, legs, feet, eyes, heart, nerves, and blood flow, which could lead to kidney failure, gangrene, amputation, blindness, or stroke. For these reasons, it is important to be on a strict treatment plan.

• Of the nearly 16 million Americans with diabetes, 90-95 percent (15.3 million) has type 2 diabetes. Of these, half are unaware they have the disease.
• People with type 2 diabetes often develop the disease after age 45, but are not aware they have diabetes until severe symptoms occur, or they are treated for one of its serious complications.
• The risk for type 2 diabetes increases with age. Nearly 18.4 percent of the United States population between 65 and 74 years of age has diabetes.
• Type 2 diabetes is more prevalent among these populations:
• African-Americans
• Hispanic Americans
• Native Americans
• Type 2 diabetes is nearing epidemic proportions, due to an increased number of older Americans, and a greater prevalence of obesity and a sedentary lifestyle

• obesity
• family history of diabetes
• having given birth previously to a very large infant, a still birth, or a child with a birth defect
• having too much amniotic fluid (polyhydramnios)
• women older than age 25 are at greater risk than younger women

Although the cause of gestational diabetes is not known, there are some theories as to why the condition occurs.

The placenta supplies a growing fetus with nutrients and water, as well as produces a variety of hormones to maintain the pregnancy. Some of these hormones (estrogen, cortisol, and human placental lactogen) can have a blocking effect on insulin. This is called contra-insulin effect, which usually begins about 20 to 24 weeks into the pregnancy.

As the placenta grows, more of these hormones are produced, and insulin resistance becomes greater. Normally, the pancreas is able to make additional insulin to overcome insulin resistance, but when the production of insulin is not enough to overcome the effect of the placental hormones, gestational diabetes results.

Gestational diabetes is diagnosed with a glucose screening test, which involves drinking a glucose drink followed by measurement of glucose levels after a one-hour interval.

If results of the second test are in the abnormal range, gestational diabetes is diagnosed.

Unlike type 1 diabetes, gestational diabetes generally does not cause birth defects. Birth defects usually originate sometime during the first trimester (before the 13th week) of pregnancy. But, the insulin resistance from the contra-insulin hormones produced by the placenta does not usually occur until approximately the 24th week. Women with gestational diabetes generally have normal blood sugar levels during the critical first trimester.

The complications of gestational diabetes are usually manageable and preventable. The key to prevention is careful control of blood sugar levels just as soon as the diagnosis of gestational diabetes is made.

Infants of mothers with gestational diabetes are vulnerable to several chemical imbalances, such as low serum calcium and low serum magnesium levels, but in general, there are two major problems of gestational diabetes: macrosomia and hypoglycemia.

• Macrosomia - refers to a baby that is considerably larger than normal. All of the nutrients the fetus receives come directly from the mother's blood. If the maternal blood has too much glucose, the pancreas of the fetus senses the high glucose levels and produces more insulin in an attempt to use this glucose. The fetus converts the extra glucose to fat. Even when the mother has gestational diabetes, the fetus is able to produce all the insulin it needs. The combination of high blood glucose levels from the mother and high insulin levels in the fetus results in large deposits of fat which causes the fetus to grow excessively large.
  
  
• Hypoglycemia - refers to low blood sugar in the baby immediately after delivery. This problem occurs if the mother's blood sugar levels have been consistently high causing the fetus to have a high level of insulin in its circulation. After delivery, the baby continues to have a high insulin level, but it no longer has the high level of sugar from its mother, resulting in the newborn's blood sugar level becoming very low. The baby's blood sugar level is checked after birth, and if the level is too low, it may be necessary to give the baby glucose intravenously.

Specific treatment will be determined by your physician(s) based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Treatment for gestational diabetes focuses on keeping blood glucose levels in the normal range. Treatment may include:

• special diet
• exercise
• daily blood glucose monitoring
• insulin injections