About Diabetes

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The causes of diabetes are numerous; both genetics and environmental factors such as obesity and lack of exercise play significant roles.

There are 20.8 million children and adults in the United States, or 7% of the population, who have diabetes. In New York City the proportion of the adult population that has been diagnosed with diabetes has increased by 250% in the past ten years. Diabetes has become the fourth leading cause of death in our city. The New York City Department of Health and mental Hygiene estimates that 12.5% of adult New Yorkers - approximately 700,000 people - have diabetes. Of these about 5000,000 have already been diagnosed with the disease and 200,000 do not yet know their condition and thus are at a much greater risk of developing serious complications from diabetes.

Pre-Diabetes is a condition that raises the risk of developing type 2 diabetes, heart disease, and stroke. People with pre-diabetes have blood glucose levels higher than normal, 100 to 125 mg/dL after an overnight fast, but not high enough to be classified as diabetes.

Progression to diabetes among those with pre-diabetes is not inevitable. Studies have shown that people with pre-diabetes who lose weight and increase their physical activity can prevent or delay diabetes and even return their blood glucose levels to normal.

There are several types of diabetes:

Type 1 Diabetes was previously called insulin-dependent diabetes mellitus or juvenile-onset diabetes. Type 1 diabetes develops when the body's immune system destroys pancreatic beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump.

This form of diabetes usually strikes children and young adults, although disease onset can occur at any age. Type 1 diabetes accounts for 5% to 10% of all diagnosed cases of diabetes. Risk factors for type 1 diabetes may be autoimmune, genetic, or environmental. There is no known way to prevent type 1 diabetes.

Type 2 Diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce it. Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. It is no longer called non-insulin-dependent diabetes mellitus or adult-onset diabetes because we now know that it does affect the young and many with this disease require insulin.

Gestational Diabetes is a form of glucose intolerance diagnosed during pregnancy. Gestational diabetes occurs more frequently among African Americans, Hispanic/Latino Americans, and American Indians. It is also more common among obese women and women with a family history of diabetes.

During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. After pregnancy, 5% to 10% of women with gestational diabetes are found to have type 2 diabetes. Women who have had gestational diabetes have a 20% to 50% chance of developing diabetes in the next 5-10 years. Seventy percent of women who have had gestational diabetes will develop type 2 diabetes sometime during their lifetime and their babies are at greater risk for type 2 diabetes.