According to the National Institutes of Health, the reported rate of gestational diabetes is between 2% to 10% of pregnancies. Gestational diabetes usually resolves itself after pregnancy. Having gestational diabetes does, however, put mothers at risk for developing type 2 diabetes later in life. Up to 10% of women with gestational diabetes develop type 2 diabetes. It can occur anywhere from a few weeks after delivery to months or years later.
That’s because when your blood sugar isn’t under control, the excess glucose in your body can increase your chance of developing serious related health conditions. Heart disease, kidney disease, vision issues, and nerve damage are among the problems that can result from poorly managed diabetes, says William Sullivan, MD, a senior physician at the Joslin Diabetes Center and an assistant professor of medicine at Harvard Medical School in Boston.

^ Pignone M, Alberts MJ, Colwell JA, Cushman M, Inzucchi SE, Mukherjee D, Rosenson RS, Williams CD, Wilson PW, Kirkman MS (June 2010). "Aspirin for primary prevention of cardiovascular events in people with diabetes: a position statement of the American Diabetes Association, a scientific statement of the American Heart Association, and an expert consensus document of the American College of Cardiology Foundation". Diabetes Care. 33 (6): 1395–402. doi:10.2337/dc10-0555. PMC 2875463. PMID 20508233.
Metformin is generally recommended as a first line treatment for type 2 diabetes, as there is good evidence that it decreases mortality.[6] It works by decreasing the liver's production of glucose.[87] Several other groups of drugs, mostly given by mouth, may also decrease blood sugar in type II DM. These include agents that increase insulin release, agents that decrease absorption of sugar from the intestines, and agents that make the body more sensitive to insulin.[87] When insulin is used in type 2 diabetes, a long-acting formulation is usually added initially, while continuing oral medications.[6] Doses of insulin are then increased to effect.[6][88]
The treatment of low blood sugar consists of administering a quickly absorbed glucose source. These include glucose containing drinks, such as orange juice, soft drinks (not sugar-free), or glucose tablets in doses of 15-20 grams at a time (for example, the equivalent of half a glass of juice). Even cake frosting applied inside the cheeks can work in a pinch if patient cooperation is difficult. If the individual becomes unconscious, glucagon can be given by intramuscular injection.
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).
Other potentially important mechanisms associated with type 2 diabetes and insulin resistance include: increased breakdown of lipids within fat cells, resistance to and lack of incretin, high glucagon levels in the blood, increased retention of salt and water by the kidneys, and inappropriate regulation of metabolism by the central nervous system.[10] However, not all people with insulin resistance develop diabetes, since an impairment of insulin secretion by pancreatic beta cells is also required.[13]
Diabetes also can cause heart disease and stroke, as well as other long-term complications, including eye problems, kidney disease, nerve damage, and gum disease. While these problems don't usually show up in kids or teens who've had type 2 diabetes for only a few years, they can affect them in adulthood, particularly if their diabetes isn't well controlled.
Genetic variations likely act together with health and lifestyle factors to influence an individual's overall risk of type 2 diabetes. All of these factors are related, directly or indirectly, to the body's ability to produce and respond to insulin. Health conditions that predispose to the disease include overweight or obesity, insulin resistance, prediabetes (higher-than-normal blood sugar levels that do not reach the cutoff for diabetes), and a form of diabetes called gestational diabetes that occurs during pregnancy. Lifestyle factors including smoking, a poor diet, and physical inactivity also increase the risk of type 2 diabetes.

Diabetes mellitus type 2 is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency.[52] This is in contrast to diabetes mellitus type 1 in which there is an absolute insulin deficiency due to destruction of islet cells in the pancreas and gestational diabetes mellitus that is a new onset of high blood sugars associated with pregnancy.[13] Type 1 and type 2 diabetes can typically be distinguished based on the presenting circumstances.[49] If the diagnosis is in doubt antibody testing may be useful to confirm type 1 diabetes and C-peptide levels may be useful to confirm type 2 diabetes,[53] with C-peptide levels normal or high in type 2 diabetes, but low in type 1 diabetes.[54]
Diabetes also can cause heart disease and stroke, as well as other long-term complications, including eye problems, kidney disease, nerve damage, and gum disease. While these problems don't usually show up in kids or teens who've had type 2 diabetes for only a few years, they can affect them in adulthood, particularly if their diabetes isn't well controlled.
Findings from the Diabetes Control and Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study (UKPDS) have clearly shown that aggressive and intensive control of elevated levels of blood sugar in patients with type 1 and type 2 diabetes decreases the complications of nephropathy, neuropathy, retinopathy, and may reduce the occurrence and severity of large blood vessel diseases. Aggressive control with intensive therapy means achieving fasting glucose levels between 70-120 mg/dl; glucose levels of less than 160 mg/dl after meals; and a near normal hemoglobin A1c levels (see below).
A wide scatter of absolute levels of pancreas triacylglycerol has been reported, with a tendency for higher levels in people with diabetes (57). This large population study showed overlap between diabetic and weight-matched control groups. These findings were also observed in a more recent smaller study that used a more precise method (21). Why would one person have normal β-cell function with a pancreas fat level of, for example, 8%, whereas another has type 2 diabetes with a pancreas fat level of 5%? There must be varying degrees of liposusceptibility of the metabolic organs, and this has been demonstrated in relation to ethnic differences (72). If the fat is simply not available to the body, then the susceptibility of the pancreas will not be tested, whereas if the individual acquires excess fat stores, then β-cell failure may or may not develop depending on degree of liposusceptibility. In any group of people with type 2 diabetes, simple inspection reveals that diabetes develops in some with a body mass index (BMI) in the normal or overweight range, whereas others have a very high BMI. The pathophysiologic changes in insulin secretion and insulin sensitivity are not different in obese and normal weight people (73), and the upswing in population rates of type 2 diabetes relates to a right shift in the whole BMI distribution. Hence, the person with a BMI of 24 and type 2 diabetes would in a previous era have had a BMI of 21 and no diabetes. It is clear that individual susceptibility factors determine the onset of the condition, and both genetic and epigenetic factors may contribute. Given that diabetes cannot occur without loss of acute insulin response to food, it can be postulated that this failure of acute insulin secretion could relate to both accumulation of fat and susceptibility to the adverse effect of excess fat in the pancreas.
In those with impaired glucose tolerance, diet and exercise either alone or in combination with metformin or acar
Diabetes in Check, from the recently-IPO'd Everyday Health is a type 2 diabetes management app that features a wide range of tools. It includes diabetes coaching designed by a certified diabetes educator, trackers for blood glucose and medication, reminders, and tools for healthy eating, including a food tracker with a barcode scanner and a recipe database. For a $3.99 subscription, users can get daily personalized food recommendations.
People with diabetes can benefit from education about the disease and treatment, good nutrition to achieve a normal body weight, and exercise, with the goal of keeping both short-term and long-term blood glucose levels within acceptable bounds. In addition, given the associated higher risks of cardiovascular disease, lifestyle modifications are recommended to control blood pressure.[80][81]
Diabetes experts feel that these blood glucose monitoring devices give patients a significant amount of independence to manage their disease process; and they are a great tool for education as well. It is also important to remember that these devices can be used intermittently with fingerstick measurements. For example, a well-controlled patient with diabetes can rely on fingerstick glucose checks a few times a day and do well. If they become ill, if they decide to embark on a new exercise regimen, if they change their diet and so on, they can use the sensor to supplement their fingerstick regimen, providing more information on how they are responding to new lifestyle changes or stressors. This kind of system takes us one step closer to closing the loop, and to the development of an artificial pancreas that senses insulin requirements based on glucose levels and the body's needs and releases insulin accordingly - the ultimate goal.
"The mySugr Junior App was developed to make managing diabetes easier for kids. It also enables parents to keep control over the therapy, even when they're not around and their child is at school or out with friends. The app resembles a game in which the children get points for every entry. The goal is to score a particular amount of points every day. This encourages kids to take care of their diabetes regularly.
"It's never been easier to manage diabetes with all the technological stuff we have at our fingertips," said Steve Lisowski, who lives in Chicago. Lisowski has had type 2 diabetes for 15 years, and currently uses an insulin pump and a continuous glucose monitor to help manage his diabetes. He has used nutrition apps and an overall diabetes-management app.
Your doctor may recommend working with a registered dietitian and a personal trainer to help you set up a diabetes weight loss plan. "Diet and exercise is always encouraged as the first line of therapy, but it works better for some people than others," says Sullivan. If you’re obese and having trouble losing weight with diet and exercise alone, your doctor may recommend medications to suppress your appetite and promote weight loss, or even gastric bypass surgery.ause of nontraumatic blindness and kidney failure.[24] It has also been associated with an increased risk of cognitive dysfunction and dementia through disease processes such as Alzheimer's disease and vascular dementia.[25] Other complications include acanthosis nigricans, sexual dysfunction, and frequent infections.[23]
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
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