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Pre-diabetes

Pre-diabetes, also known as impaired glucose tolerance, is a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. Pre-diabetes is diagnosed if a person has:

• A fasting blood glucose level between 100-125 mg/dL (126 mg/dL or higher is considered as diabetes)
• A blood glucose level between 140-199 mg/dL two hours after eating high carbs (200 mg/dL is considered as diabetes)

Pre-diabetes is a transitional period that can vary from weeks to years until a person actually develops diabetes. There are 54 million Americans who have pre-diabetes. Research shows that some long-term damage to the body, especially to the heart and circulatory system, may already be occurring in pre-diabetes. People with pre-diabetes can prevent the development of Type 2 diabetes by making changes in their eating habits and increasing their level of physical activity. Blood glucose levels may even return to the normal range.

Type 1 Diabetes

Type 1 diabetes , formerly called "Insulin-Dependent" or "Juvenile Diabetes", is an autoimmune disorder, which results in the destruction of the insulin-producing beta cells in the pancreas, usually leading to an absolute deficiency of insulin. Currently, it is believed that the susceptibility for type 1 diabetes is inherited and the individual experiences a triggering event that begins a misdirected inflammatory response against the pancreatic islet cells.

One of the hallmarks of type 1 diabetes is a period of recovery after an initial period of acute hyperglycemia; this is referred to as the "honeymoon phase". It may last from several weeks to months and is most commonly seen in children.

It is estimated that 5-10% of Americans who are diagnosed with diabetes have Type 1 diabetes. Up to 800,000 persons are estimated to have Type 1 diabetes, with about 30,000 new cases diagnosed each year in the United States. Although type 1 diabetes usually develops before 30 years of age, it can occur at any age. In fact, one-third of the cases of type 1 diabetes are diagnosed in adulthood, but diagnosis is rare after age 45.

Type 2 Diabetes

Type 2 diabetes was formerly called "Non-Insulin Dependent" or "Adult-Onset" diabetes. In type 2 diabetes, the actions and secretion of insulin are impaired, as opposed to the absolute deficiency of insulin that occurs with type 1 diabetes mellitus. Type 2 diabetes is characterized by two major defects: (1) Insulin resistance, in which variable, sometimes normal amounts of insulin are produced, but abnormalities in liver and muscle cells resist its action. Insulin attaches to the cell receptors but glucose is not able to enter; and (2) impaired beta-cell secretion of insulin.

Insulin resistance is the failure of insulin, at relatively normal concentrations, to exert its normal effects. Insulin resistance in the hepatic and peripheral tissues, particularly skeletal muscle, leads to unrestrained glucose production by the liver and diminished insulin-stimulated glucose uptake and utilization in the tissues. Insulin secretion by the pancreatic beta cells is initially sufficient to compensate for insulin resistance, thereby maintaining normal blood glucose levels. Hyperinsulinemia (higher than normal levels of insulin in the bloodstream), which accompanies insulin resistance, can maintain sufficiently normal glucose metabolism as long as pancreatic beta cell function remains normal. However, in patients who develop type 2 diabetes, insulin secretion eventually fails, leading to hyperglycemia and clinical diabetes.