Quality Health

Family Medical Care

Diabetes Mellitus and Pre-diabetes/Impaired Glucose Tolerance

Diabetes is a disease in which your blood glucose, or sugar, levels are too high because your body’s insulin doesn’t function properly. Insulin is a hormone that is needed for your body to use the glucose you eat for energy. In type 1 diabetes, your body doesn’t make enough insulin. In type 2 diabetes, your body can make insulin but cannot use it well because your cells become resistant to the insulin. Without enough insulin or properly functioning insulin, the glucose stays in your blood rather than entering your cells. High levels of glucose in the blood can damage small blood vessels in your kidneys, heart,eyes, and nerves, so untreated diabetes can cause heart disease, stroke, kidney disease, blindness, and numbness due to nerve damage. Pre-diabetes or impaired glucose tolerance (IGT) occurs when your blood sugar is higher than normal but is not yet high enough to be classified as type 2 diabetes. Without lifestyle changes (eating healthy foods, exercising, and maintain a healthy body weight), pre-diabetes will become type 2 diabetes within 10 years.

Type 1 diabetes is an autoimmune condition, which means that your body’s immune system inappropriately attacks its own insulin-producing cells in the pancreas. It accounts for only about 5% of all cases of adult diabetes. The cause is unknown, but genetic predisposition is known to play a major role. Certain viruses and foods in early life might trigger the autoimmune reaction. Type 2 diabetes accounts for 95% of all cases of diabetes in adults. Risk factors for type 2 diabetes include genetic predisposition, obesity, and Hispanic/African/Asian descent. Obesity is the greatest risk factor for type 2 diabetes because it causes your body to develop “insulin resistance,” a state in which your body cannot use the insulin it produces.

The most common symptoms of diabetes are the following :
  • Excessive thirst
  • Frequent urination
  • Feeling tired
  • Unintended weight-loss
  • Blurred vision
  • Sores that are slow to heal
  • Dry, itchy skin
  • Numbness or tingling in your feet

Aside from the asking about the symptoms mentioned above, your doctor may order several blood tests.
  • A random blood sugar test measures your blood sugar at any point in the day regardless of when you ate. A blood sugar greater than 200 mg/dL indicates diabetes. A blood sugar between 140-200 indicates pre-diabetes.
  • A fasting blood sugar test measures your blood sugar after not eating or drinking after 8-12 hours. A blood sugar greater than 126 mg/dL indicates diabetes. A blood sugar between 100-126 indicates pre-diabetes.
  • A hemoglobin A1C test measures your average blood sugar over the past few months. A value over 6.5% indicates diabetes. A value between 5.7% and 6.4% indicates pre-diabetes.
  • An oral glucose tolerance test (OGTT) involves drinking a special glucose solution, and your blood sugar is measured before and after drinking the solution. After 1 hour of drinking the solution, your blood sugar should be less than 200mg/dL. After 2 hours, your blood sugar should be less than 140mg/dL.

All patients with type 1 diabetes will require insulin therapy because the body does not make enough insulin. There are many different kinds of insulin therapy so be sure to talk to your doctor about the different options. Patients with type 1 diabetes will also require frequent home testing of blood sugar levels, daily exercise, careful monitoring of amount of carbohydrates eaten, and possibly other medications. Adhering to the treatment plan is vital for patients with type 1 diabetes to lead long, active lives. For patients with type 2 diabetes, it is especially important to change diet, lose weight, and exercise because obesity is the most significant risk factor for the disease. There are also many different oral medications that your doctor might prescribe, the most common of which is Metformin. Some patients may require a second medication, such as insulin, sulfonylureas, thiazolidinediones, GLP-agonists, DPP-IV inhibitors, Meglitidines, or alpha-glucosidase inhibtors. Again, be sure to talk to your doctor about the various options. Furthermore, quitting smoking, lowering cholesterol, and lowering your blood pressure can help prevent the complications associated with type 2 diabetes. It is crucial to adhere to treatment plans to prevent the many severe complications of diabetes,including heart disease, stroke, kidney disease, blindness, and nerve disease.

There is nothing one can do to prevent type 1 diabetes. However, to help prevent type 2 diabetes, it is important to eat healthy foods, maintain a healthy weight, and exercise.

To read more about type 1 diabetes, please visit: To read more about type 2 diabetes, please visit: For an overview on diabetes, please visit: To read more about pre-diabetes, please visit: