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UNDERSTANDING DIABETES, A SERIOUS DISORDER

This is the first of a two-part discussion about diabetes; the second part will run Friday.

With about 17 million people in North America with diabetes, there's a good chance that this Thanksgiving one of your guests may have this serious disorder. November is not only the month for giving thanks, but it is also National Diabetes Month, sponsored by the American Diabetes Association.

Diabetes can cause serious health complications to nearly every part of the body. It contributes to heart disease, stroke, blindness, kidney failure, nerve damage and lower-extremity amputations.

The body turns most food into glucose, or sugar, for energy. The pancreas, an organ near the stomach, makes a hormone called insulin. Insulin helps glucose get into the cells of the body.

When a person has diabetes, the body either doesn't make enough insulin or the body can't use insulin as well as it should. This causes sugars to build up in the blood. As a result, the body loses its main source of fuel, even though the blood contains large amounts of glucose, and sugar overflows into the urine and passes out of the body.

There are different types of diabetes, and their names are sometimes confusing. Type 1 diabetes used to be called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes is an autoimmune disease. Though it develops most often in children and young adults, the disorder can appear at any age.

Type 2 diabetes used to be called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. It's the most common form of diabetes. Type 2 diabetes usually develops in people over the age of 40 and is most common over age 55.

In type 2 diabetes, the pancreas usually produces insulin, but the body cannot use the insulin effectively. The end result is the same as for type 1 diabetes -- an unhealthy buildup of glucose in the blood and an inability of the body to make efficient use of its main source of fuel.

The symptoms of type 2 diabetes develop gradually and are not as noticeable as in type 1 diabetes. Symptoms include feeling tired or ill, frequent urination (especially at night), unusual thirst, weight loss, blurred vision, frequent infections and slow healing of sores.

Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians and some Asian Americans and Pacific Islanders are at particularly high risk.

Risk factors are less well defined for type 1 diabetes than for type 2 diabetes. Autoimmune, genetic and environmental factors are involved in the development of type 1 diabetes.

Gestational diabetes develops during pregnancy. This type usually disappears when the pregnancy is over, but women who have had gestational diabetes have a greater risk of developing type 2 diabetes later in their lives. Gestational diabetes occurs more frequently in African Americans, Hispanic/Latino Americans, American Indians and people with a family history of diabetes than in other groups. As with type 2 diabetes, obesity is also associated with higher risk for gestational diabetes.

Other specific types of diabetes result from specific genetic syndromes, surgery, drugs, malnutrition, infections and other illnesses.

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