You know that your family medical history, along with what you eat and how much you weigh, can affect your risk of developing type 2 diabetes. But did you know that your sleep habits can also play a role? It’s true. In fact, sleep deprivation is an often overlooked but significant risk factor for type 2 diabetes, a disease that involves too much glucose (or sugar) in the blood and increases the risk of heart disease.
Diabetes was one of the first diseases described,[107] with an Egyptian manuscript from c. 1500 BCE mentioning "too great emptying of the urine."[108] The Ebers papyrus includes a recommendation for a drink to take in such cases.[109] The first described cases are believed to have been type 1 diabetes.[108] Indian physicians around the same time identified the disease and classified it as madhumeha or "honey urine", noting the urine would attract ants.[108][109]
With a health care system as complicated as ours, it’s hard to take money from one pot and shift it easily to another. Efficiency in each system is crucial. The fact that a necessary facet of diabetes care is increasingly out of reach — while unnecessary and potentially harmful care is easily overused — illustrates how much work still needs to be done.
Diabetes was one of the first diseases described,[107] with an Egyptian manuscript from c. 1500 BCE mentioning "too great emptying of the urine."[108] The Ebers papyrus includes a recommendation for a drink to take in such cases.[109] The first described cases are believed to have been type 1 diabetes.[108] Indian physicians around the same time identified the disease and classified it as madhumeha or "honey urine", noting the urine would attract ants.[108][109]
The accepted view has been that the β-cell dysfunction of established diabetes progresses inexorably (79,82,83), whereas insulin resistance can be modified at least to some extent. However, it is now clear that the β-cell defect, not solely hepatic insulin resistance, may be reversible by weight loss at least early in the course of type 2 diabetes (21,84). The low insulin sensitivity of muscle tissue does not change materially either during the onset of diabetes or during subsequent reversal. Overall, the information on the inhibitory effects of excess fat on β-cell function and apoptosis permits a new understanding of the etiology and time course of type 2 diabetes.

Diabetes affects your body’s ability to process sugar. All food you eat is turned to sugar and used for energy. In Type I diabetes, the body doesn’t make enough insulin, a hormone that carries sugar from your blood to the cells that need it for energy. In Type II diabetes, the body stops responding to insulin. Both cases result in high blood sugar levels, which can cause problems with your eyes, nerves, kidneys, heart and other parts of your body.
Diabetic ketoacidosis can be caused by infections, stress, or trauma, all of which may increase insulin requirements. In addition, missing doses of insulin is also an obvious risk factor for developing diabetic ketoacidosis. Urgent treatment of diabetic ketoacidosis involves the intravenous administration of fluid, electrolytes, and insulin, usually in a hospital intensive care unit. Dehydration can be very severe, and it is not unusual to need to replace 6-7 liters of fluid when a person presents in diabetic ketoacidosis. Antibiotics are given for infections. With treatment, abnormal blood sugar levels, ketone production, acidosis, and dehydration can be reversed rapidly, and patients can recover remarkably well.
You can develop type 2 diabetes at any age, even during childhood. However, type 2 diabetes occurs most often in middle-aged and older people. You are more likely to develop type 2 diabetes if you are age 45 or older, have a family history of diabetes, or are overweight or obese. Diabetes is more common in people who are African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander.
In type 2 diabetes (adult onset diabetes), the pancreas makes insulin, but it either doesn't produce enough, or the insulin does not work properly. Nine out of 10 people with diabetes have type 2. This type occurs most often in people who are over 40 years old but can occur even in childhood if there are risk factors present. Type 2 diabetes may sometimes be controlled with a combination of diet, weight management and exercise. However, treatment also may include oral glucose-lowering medications (taken by mouth) or insulin injections (shots).
Diabetes Tracker –  The American Journal of Preventive Medicine ranked this app, which has no free version, No. 1. It boasts an intensive and easy-to-follow educational component in addition to features for monitoring blood glucose, carbs, net carbs and more. Easy to see the big picture with daily and weekly reports. For some, it may be worth the extra expense.

Carb Manager is the preferred food app for Pamala Moberly, 56, a retired missionary in Tifton, Georgia. “I like that it helps me keep track of total carbs, net carbs, fiber, proteins, and fats. I can even make my own recipes in this app, and it will calculate all of those numbers,” she says. She uses the free version, but adding the subscription service allows you to also enter blood glucose values. (The current subscription price is $8.49 per month or $39.99 per year.)

Insulin works like a key that opens the doors to cells and lets the glucose in. Without insulin, glucose can't get into the cells (the doors are "locked" and there is no key) and so it stays in the bloodstream. As a result, the level of sugar in the blood remains higher than normal. High blood sugar levels are a problem because they can cause a number of health problems.
A great app to add to the list is Wellocity Health. It helps you manage chronic conditions such as heart disease and diabetes by addressing key risk factors. This free app allows users to track medications, vitals and activity and share reports of your progress with your doctor or coach. Actionable insights and realistic goals make it easy to monitor progress and improve. The app also has a built-in community that allow users to share experiences.
No major organization recommends universal screening for diabetes as there is no evidence that such a program improve outcomes.[55][56] Screening is recommended by the United States Preventive Services Task Force (USPSTF) in adults without symptoms whose blood pressure is greater than 135/80 mmHg.[57] For those whose blood pressure is less, the evidence is insufficient to recommend for or against screening.[57] There is no evidence that it changes the risk of death in this group of people.[56] They also recommend screening among those who are overweight and between the ages of 40 and 70.[58]
Like other glucose trackers, Glucose Buddy lets you input blood glucose, medication, and meals, and track trends over time. But it also includes an extensive food database, and it lets you scan bar codes to grab nutrition information from food products. It syncs to the Apple Health app and tracks your steps and other physical activity. All that data can be exported to printable reports you can bring to your medical visits. You’ll need to subscribe to the premium version to access the A1C calculator and get rid of the ads. (The current premium cost is $14.99 per month or $59.99 per year.)
Per the WHO, people with fasting glucose levels from 6.1 to 6.9 mmol/l (110 to 125 mg/dl) are considered to have impaired fasting glucose.[67] people with plasma glucose at or above 7.8 mmol/l (140 mg/dl), but not over 11.1 mmol/l (200 mg/dl), two hours after a 75 gram oral glucose load are considered to have impaired glucose tolerance. Of these two prediabetic states, the latter in particular is a major risk factor for progression to full-blown diabetes mellitus, as well as cardiovascular disease.[68] The American Diabetes Association (ADA) since 2003 uses a slightly different range for impaired fasting glucose of 5.6 to 6.9 mmol/l (100 to 125 mg/dl).[69]
Yes. Once you get a new kidney, you may need a higher dose of insulin. Your appetite will improve so your new kidney will break down insulin better than your injured one. You will use steroids to keep your body from rejecting your new kidney. If your new kidney fails, dialysis treatment can be started while you wait for another kidney. To learn more about kidney transplant click here.
Meanwhile the ADA, in their most recent update on the Standards of Medical Care in Diabetes, have lifted the restriction on sodium in the diet of those with diabetes. This brings the recommended daily levels of sodium for people with diabetes in line with the general population at 2,300 milligrams (mg) per day. They also acknowledge that there is not a single diet that fits all people with diabetes.
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
People with type 1 diabetes are unable to produce any insulin at all. People with type 2 diabetes still produce insulin, however, the cells in the muscles, liver and fat tissue are inefficient at absorbing the insulin and cannot regulate glucose well. As a result, the body tries to compensate by having the pancreas pump out more insulin. But the pancreas slowly loses the ability to produce enough insulin, and as a result, the cells don’t get the energy they need to function properly.
Weight loss. Obesity is a leading risk factor for diabetes. Calculate your BMI to see whether you’re at a healthy weight. If you’re overweight or obese, start making small changes to your eating habits and get more physical activity. Even a small amount of weight loss (7%, or about 14 pounds for a 200-pound woman) can delay or even prevent type 2 diabetes.

^ Emadian A, Andrews RC, England CY, Wallace V, Thompson JL (November 2015). "The effect of macronutrients on glycaemic control: a systematic review of dietary randomised controlled trials in overweight and obese adults with type 2 diabetes in which there was no difference in weight loss between treatment groups". The British Journal of Nutrition. 114 (10): 1656–66. doi:10.1017/S0007114515003475. PMC 4657029. PMID 26411958.

In animals, diabetes is most commonly encountered in dogs and cats. Middle-aged animals are most commonly affected. Female dogs are twice as likely to be affected as males, while according to some sources, male cats are also more prone than females. In both species, all breeds may be affected, but some small dog breeds are particularly likely to develop diabetes, such as Miniature Poodles.[123]


There are some interesting developments in blood glucose monitoring including continuous glucose sensors. The new continuous glucose sensor systems involve an implantable cannula placed just under the skin in the abdomen or in the arm. This cannula allows for frequent sampling of blood glucose levels. Attached to this is a transmitter that sends the data to a pager-like device. This device has a visual screen that allows the wearer to see, not only the current glucose reading, but also the graphic trends. In some devices, the rate of change of blood sugar is also shown. There are alarms for low and high sugar levels. Certain models will alarm if the rate of change indicates the wearer is at risk for dropping or rising blood glucose too rapidly. One version is specifically designed to interface with their insulin pumps. In most cases the patient still must manually approve any insulin dose (the pump cannot blindly respond to the glucose information it receives, it can only give a calculated suggestion as to whether the wearer should give insulin, and if so, how much). However, in 2013 the US FDA approved the first artificial pancreas type device, meaning an implanted sensor and pump combination that stops insulin delivery when glucose levels reach a certain low point. All of these devices need to be correlated to fingersticks measurements for a few hours before they can function independently. The devices can then provide readings for 3 to 5 days.

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
I just wanted to let you know about an app that I use and love. The app is called “Diabetes:M”. It is free and has helped me manage my diabetes. I am a Type 1. It lets you log carbs, insulin, etc. and you can send all of the info from it by e-mail to your provider. It has graphs and charts that help out a lot as well. Hope this helps someone else as much as it has helped me. Thanks.

Type 2 DM is characterized by insulin resistance, which may be combined with relatively reduced insulin secretion.[10] The defective responsiveness of body tissues to insulin is believed to involve the insulin receptor. However, the specific defects are not known. Diabetes mellitus cases due to a known defect are classified separately. Type 2 DM is the most common type of diabetes mellitus.[2]
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
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