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Am Fam Physician. 1999;60(2):647-648

What is diabetes?

Diabetes is a disease that occurs when your body doesn't make enough insulin or doesn't use insulin the right way. Insulin is a hormone that helps your body use sugar (glucose) for energy. Because your body has a problem with insulin, sugar builds up in your blood. Your body can't use it for energy, and some of the sugar passes out of your body unused in urine.

What are the different types of diabetes?

There are three types of diabetes:

  • Type 1 (also called insulin-dependent) diabetes

  • Type 2 (also called non–insulin-dependent) diabetes

  • Pregnancy-related (also called gestational) diabetes

Type 1 diabetes develops most often in children and young adults. It is treated with insulin. Type 2 diabetes is much more common and usually develops in older adults. Type 2 diabetes is treated with diet, exercise, pills or insulin. Some women develop diabetes during pregnancy. Although this type of diabetes goes away after pregnancy, women who have had it may develop type 2 diabetes later in life.

What health problems can diabetes cause?

Over time, high blood sugar levels can damage your eyes, blood vessels, nerves and kidneys. Damage to your blood vessels increases your risk of heart attack and stroke. Besides the long-term health risks of high blood sugar levels, diabetes can also cause episodes of hypoglycemia (low blood sugar), hyperglycemia (high blood sugar) and ketoacidosis.

  • Hypoglycemia occurs when your blood sugar falls too low—when you have too much insulin in your blood or haven't eaten enough.

  • Hyperglycemia occurs when your blood sugar level is too high—when you don't have enough insulin in your blood.

  • Ketoacidosis occurs when you don't have enough insulin in your blood and your body starts breaking down fats for energy instead of using blood sugar. This process leaves behind wastes called ketones. Ketoacidosis is a risk for people with type 1 diabetes.

How will my family doctor treat my diabetes?

The goal of treatment is to keep your blood sugar level as close to normal as possible. To do this, your doctor may give you pills or insulin. Sometimes diabetes can be controlled without medicine if the person loses weight, eats a healthy diet and exercises.

Your doctor will also watch your blood sugar level closely by checking your blood and urine. Your doctor will want to see you regularly to check for other problems (complications) caused by your diabetes, such as foot or vision problems.

How do I know if I am controlling my blood sugar level?

Checking your blood sugar regularly can help you control it. By monitoring your blood sugar you can see how food, exercise, medicine and insulin affect your blood sugar. It also can signal if you need a change in your treatment plan.

How do I check my blood sugar level?

Follow your doctor's advice and the directions that come with the test strips. Here are the basics of how to check your blood sugar:

  1. Take one test strip from the bottle or box.

  2. Use an alcohol pad to clean the finger that you're going to prick.

  3. Prick your finger with a lancet or spring-loaded device (these are ways to make a small cut in your finger) to get a drop of blood.

  4. Put the drop of blood on the test strip. Wait for the length of time it says on the package.

  5. When the strip changes color, compare it to the box or bottle. This will give you a number for your blood sugar level. (If you are using a glucose meter, skip this step.)

  6. If you are using a glucose meter, put the strip in the meter. The meter will give you a number for your blood sugar level.

How often should I check my blood sugar?

Check your blood sugar as often as your doctor suggests. You may need to do it more often at first, during times when you feel sick or stressed, during pregnancy, or when you're changing your medicine or insulin dose.

How does what I eat affect my diabetes?

When you eat, you put sugar in your blood. Making wise food choices can help you keep your blood sugar at the right level. What you eat can also affect your overall health. Some people have high cholesterol levels and need to watch how much fat and cholesterol they eat. Other people may need to lose weight and must limit the number of calories in their diet. Your doctor will help you find the right nutritional plan for you.

Will exercise help?

Yes. Exercise can help the body better use the insulin it has, resulting in a lower blood sugar level. Exercise is also good for your heart, cholesterol levels, blood pressure and weight—all factors that affect your risk of heart attack and stroke. Talk with your doctor about starting an exercise program.

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Copyright © 1999 by the American Academy of Family Physicians.

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