What are the symptoms of diabetes?
People who think they might have diabetes must visit a physician for diagnosis. They might have SOME or NONE of the following symptoms:
Frequent urination
Excessive thirst
Unexplained weight loss
Extreme hunger
Sudden vision changes
Tingling or numbness in hands or feet
Feeling very tired much of the time
Very dry skin
Sores that are slow to heal
More infections than usual.
Nausea, vomiting, or stomach pains may accompany some of these symptoms in the abrupt onset of insulin-dependent diabetes, now called type 1 diabetes.

What are the types of diabetes?
Type 1 diabetes, which was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, may account for about 5% of all diagnosed cases of diabetes. Type 2 diabetes, which was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, may account for about 90% to 95% of all diagnosed cases of diabetes.Gestational diabetes is a type of diabetes that only pregnant women get. If not treated, it can cause problems for mothers and babies. Gestational diabetes develops in 2% to 10% of all pregnancies but usually disappears when a pregnancy is over. Other specific types of diabetesresulting from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses may account for 1% to 5% of all diagnosed cases of diabetes.

What are the risk factors for diabetes?
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. s, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes.
Risk factors are less well defined for type 1 diabetes than for type 2 diabetes, but autoimmune, genetic, and environmental factors are involved in developing this type of diabetes.
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. Obesity is also associated with higher risk. Women who have had gestational diabetes have a 35% to 60% chance of developing diabetes in the next 10–20 years.
Other specific types of diabetes, which may account for 1% to 5% of all diagnosed cases, result from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses.

What is the treatment for diabetes?
Healthy eating, physical activity, and insulin injections are the basic therapies for type 1 diabetes. The amount of insulin taken must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose testing.
Healthy eating, physical activity, and blood glucose testing are the basic therapies for type 2 diabetes. In addition, many people with type 2 diabetes require oral medication, insulin, or both to control their blood glucose levels.
People with diabetes must take responsibility for their day-to-day care, and keep blood glucose levels from going too low or too high.
People with diabetes should see a health care provider who will monitor their diabetes control and help them learn to manage their diabetes. In addition, people with diabetes may see endocrinologists, who may specialize in diabetes care; ophthalmologists for eye examinations; podiatrists for routine foot care; and dietitians and diabetes educators who teach the skills needed for daily diabetes management.
The Diabetes Overview fact sheet from the National Diabetes Information Clearinghouse has additional information.

What causes type 1 diabetes?
The causes of type 1 diabetes appear to be much different than those for type 2 diabetes, though the exact mechanisms for developing both diseases are unknown. The appearance of type 1 diabetes is suspected to follow exposure to an "environmental trigger," such as an unidentified virus, stimulating an immune attack against the beta cells of the pancreas (that produce insulin) in some genetically predisposed people.
For more information about the immune system, visit these pages from The National Institute of Health’s (NIH) National Institute of Allergy and Infectious Diseases Web site:
The Immune System

Can diabetes be prevented?
Researchers are making progress in identifying the exact genetics and "triggers" that predispose some individuals to develop type 1 diabetes, but prevention remains elusive.
A number of studies have shown that regular physical activity can significantly reduce the risk of developing type 2 diabetes. Type 2 diabetes is associated with obesity.
See the Preventing Diabetes section in these FAQs for more information.
Building on this research, CDC’s National Diabetes Prevention Program supports establishing a network of community-based, group lifestyle intervention programs for overweight or obese people at high risk of developing type 2 diabetes. As of early 2011, it was anticipated that 33 U.S. sites will offer group lifestyle interventions in 2011, with plans to expand to other communities.

Is there a cure for diabetes?
In response to the growing health burden of diabetes, the diabetes community has three choices: prevent diabetes; cure diabetes; and improve the quality of care of people with diabetes to prevent devastating complications. All three approaches are actively being pursued by the US Department of Health and Human Services.
Both the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) are involved in prevention activities. The NIH is involved in research to cure both type 1 and type 2 diabetes, especially type 1. CDC focuses most of its programs on making sure that the proven science to prevent complications is put into daily practice for people with diabetes. The basic idea is that if all the important research and science are not applied meaningfully in the daily lives of people with diabetes, then the research is, in essence, wasted.
Several approaches to "cure" diabetes are currently under investigation:
Pancreas transplantation
Islet cell transplantation (islet cells produce insulin)
Artificial pancreas development
Genetic manipulation (fat or muscle cells that don’t normally make insulin have a human insulin gene inserted — then these "pseudo" islet cells are transplanted into people with type 1 diabetes).
Each of these approaches still has a lot of challenges, such as preventing immune rejection; finding an adequate number of insulin cells; keeping cells alive; and others. But progress is being made in all areas.

Why is it important for people with diabetes to be physically active?
Physical activity can help you control your blood glucose, weight, and blood pressure, as well as raise your “good” cholesterol and lower your “bad” cholesterol. It can also help prevent heart and blood flow problems, reducing your risk of heart disease and nerve damage, which are often problems for people with diabetes.
How much and how often should people with diabetes exercise?
Experts recommend moderate-intensity physical activity for at least 30 minutes on 5 or more days of the week. Some examples of moderate-intensity physical activity are walking briskly, mowing the lawn, dancing, swimming, or bicycling.
If you are not accustomed to physical activity, you may want to start with a little exercise, and work your way up. As you become stronger, you can add a few extra minutes to your physical activity. Do some physical activity every day. It’s better to walk 10 or 20 minutes each day than one hour once a week.
Talk to your health care provider about a safe exercise plan. He or she may check your heart and your feet to be sure you have no special problems. If you have high blood pressure, eye, or foot problems, you may need to avoid some kinds of exercise.
For more information, see Controlling Your Diabetes from the Center for Disease Control and Prevention’s (CDC) publication, Take Charge of Your Diabetes.

What are some good types of physical activity for people with diabetes?
Walking vigorously, hiking, climbing stairs, swimming, aerobics, dancing, bicycling, skating, skiing, tennis, basketball, volleyball, or other sports are just some examples of physical activity that will work your large muscles, increase your heart rate, and make you breathe harder – important goals for fitness.
In addition, strength training exercises with hand weights, elastic bands, or weight machines can help you build muscle. Stretching helps to make you flexible and prevent soreness after other types of exercise.
Do physical activities you really like. The more fun you have, the more likely you will do it each day. It can be helpful to exercise with a family member or friend.

Are there any safety considerations for people with diabetes when they exercise?
Exercise is very important for people with diabetes to stay healthy, but there are a few things to watch out for.
You should avoid some kinds of physical activity if you have certain diabetes complications. Exercise involving heavy weights may be bad for people with blood pressure, blood vessel, or eye problems. Diabetes-related nerve damage can make it hard to tell if you’ve injured your feet during exercise, which can lead to more serious problems. If you do have diabetes complications, your health care provider can tell you which kinds of physical activity would be best for you. Fortunately, there are many different ways to get exercise.
Physical activity can lower your blood glucose too much, causing hypoglycemia, especially in people who take insulin or certain oral medications. Hypoglycemia can happen at the time you’re exercising, just afterward, or even up to a day later. You can get shaky, weak, confused, irritable, anxious, hungry, tired, or sweaty. You can get a headache, or even lose consciousness.
To help prevent hypoglycemia during physical activity, check your blood glucose before you exercise. If it's below 100, have a small snack. In addition, bring food or glucose tablets with you when you exercise just in case. It is not good for people with diabetes to skip meals at all, but especially not prior to exercise. After you exercise, check to see how it has affected your blood glucose level. If you take insulin, ask your health care provider if there is a preferable time of day for you to exercise, or whether you should change your dosage before physical activity, before beginning an exercise regimen.
On the other hand, you should not exercise when your blood glucose is very high because your level could go even higher. Do not exercise if your blood glucose is above 300, or your fasting blood glucose is above 250 and you have ketones in your urine.
When you exercise, wear cotton socks and athletic shoes that fit well and are comfortable. After you exercise, check your feet for sores, blisters, irritation, cuts, or other injuries.
Drink plenty of fluids during physical activity, since your blood glucose can be affected by dehydration.

What healthy food choices should I make?
Eat smaller portions. Learn what a serving size is for different foods and how many servings you need in a meal.
Eat less fat. Choose fewer high-fat foods and use less fat for cooking. You especially want to limit foods that are high in saturated fats or trans fat, such as:
Fatty cuts of meat.
Fried Foods
Whole milk and dairy products made from whole milk.
Cakes, candy, cookies, crackers, and pies.
Salad dressings.
Lard, shortening, stick margarine, and nondairy creamers.

What should I eat more of?
Eat more fiber by eating more whole-grain foods. Whole grains can be found in:
Breakfast cereals made with 100% whole grains.
Oatmeal.
Whole grain rice.
Whole-wheat bread, bagels, pita bread, and tortillas.
Eat a variety of fruits and vegetables every day. Choose fresh, frozen, canned, or dried fruit and 100% fruit juices most of the time. Eat plenty of veggies like these:
Dark green veggies (e.g., broccoli, spinach, brussels sprouts).
Orange veggies (e.g., carrots, sweet potatoes, pumpkin, winter squash).
Beans and peas (e.g., black beans, garbanzo beans, kidney beans, pinto beans, split peas, lentils).

What should I eat less of?
Eat fewer foods that are high in sugar, such as:
Fruit-flavored drinks.
Sodas.
Tea or coffee sweetened with sugar.
Use less salt in cooking and at the table. Eat fewer foods that are high in salt, such as:
Canned and package soups.
Canned vegetables.
Pickles.
Processed meats.

Where can I learn about making a diabetes meal plan?
Contact a registered dietitian to make a meal plan just for you.
Visit the Academy of Nutrition and Dietetics, formerly the American Dietetic Association Web site to find a nutrition professional that can help you develop a healthy meal plan (www.eatright.org).
Visit the American Association of Diabetes Educators to find a diabetes educator (www.diabeteseducator.org).
Visit the American Diabetes Association Web site for more information on carbohydrate counting and the exchange method (www.diabetes.org).

Prevent Diabetes
Research studies have found that moderate weight loss and exercise can prevent or delay type 2 diabetes among adults at high-risk of diabetes. Find out more about the risk factors for type 2 diabetes, what it means to have prediabetes, and what you can do to prevent or delay diabetes. See also EAT RIGHT and BE ACTIVE.

What is CDC doing to promote lifestyle changes that prevent or delay type 2 diabetes?
CDC initiated the National Diabetes Prevention Program, which helps organizations make a difference in the health of their community.

What are the most important things to do to prevent diabetes?
The Diabetes Prevention Program (DPP), a major federally funded study of 3,234 people at high risk for diabetes, showed that people can delay and possibly prevent the disease by losing a small amount of weight (5 to 7 percent of total body weight) through 30 minutes of physical activity 5 days a week and healthier eating.
For more information, see the National Diabetes Education Program’s Small Steps. Big Rewards. Prevent Type 2 Diabetes Campaign

When should I be tested for diabetes?
Anyone aged 45 years or older should consider getting tested for diabetes, especially if you are overweight. If you are younger than 45, but are overweight and have one or more additional risk factors (see below), you should consider getting tested.

What are the risk factors which increase the likelihood of developing diabetes?
Being overweight or obese.
Having a parent, brother, or sister with diabetes.
Being , American Indian, Asian American, Pacific Islander, or Hispanic American/Latino heritage.
Having a prior history of gestational diabetes or birth of at least one baby weighing more than 9 pounds.
Having high blood pressure measuring 140/90 or higher.
Having abnormal cholesterol with HDL ("good") cholesterol is 35 or lower, or triglyceride level is 250 or higher.
Being physically inactive—exercising fewer than three times a week.
For more information, see the National Diabetes Information Clearinghouse’s Am I at Risk for Type 2 Diabetes?

How does body weight affect the likelihood of developing diabetes?
Being overweight or obese is a leading risk factor for type 2 diabetes. Being overweight can keep your body from making and using insulin properly, and can also cause high blood pressure. TheDiabetes Prevention Program (DPP), a major federally funded study of 3,234 people at high risk for diabetes, showed that moderate diet and exercise of about 30 minutes or more, 5 or more days per week, or of 150 or more minutes per week, resulting in a 5% to 7% weight loss can delay and possibly prevent type 2 diabetes.

What is prediabetes?
People with blood glucose levels that are higher than normal but not yet in the diabetic range have "prediabetes." Doctors sometimes call this condition impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. Insulin resistance and prediabetes usually have no symptoms. You may have one or both conditions for several years without noticing anything.
If you have prediabetes, you have a higher risk of developing type 2 diabetes. In additon, people with prediabetes also have a higher risk of heart disease.
Progression to diabetes among those with prediabetes is not inevitable. Studies suggest that weight loss and increased physical activity among people with prediabetes prevent or delay diabetes and may return blood glucose levels to normal.

Can vaccines cause diabetes?
No. Carefully performed scientific studies show that vaccines do not cause diabetes or increase a person’s risk of developing diabetes. In 2002, the Institute of Medicine reviewed the existing studies and released a report concluding that the scientific evidence favors rejection of the theory that immunizations cause diabetes. The only evidence suggesting a relationship between vaccination and diabetes comes from Dr. John B. Classen, who has suggested that certain vaccines if given at birth may decrease the occurrence of diabetes, whereas if initial vaccination is performed after 2 months of age the occurrence of diabetes increases. Dr. Classen's studies have a number of limitations and have not been verified by other researchers.

Prediabetes
A person with prediabetes has a blood sugar level higher than normal, but not high enough for a diagnosis of diabetes. He or she is at higher risk for developing type 2 diabetes and other serious health problems, including heart disease, and stroke. Without lifestyle changes to improve their health, 15% to 30% of people with prediabetes will develop type 2 diabetes within five years.
A person with certain risk factors is more likely to develop prediabetes and type 2 diabetes. These risk factors include: age, especially after 45 years of age; being overweight or obese; a family history of diabetes; having an , Hispanic/Latino, American Indian, Asian American, or Pacific Islander racial or ethnic background; a history of diabetes while pregnant (gestational diabetes) or having given birth to a baby weighing nine pounds or more; and being physically active less than three times a week.

Could you have prediabetes? Take the quiz and find out if you are at risk. Click on the prediabetes test widget on the right hand side of this page and answer the seven questions to get your prediabetes score.
If you do have prediabetes, research shows that doing just two things can help you prevent or delay type 2 diabetes: Lose 5% to 7% of your body weight, which would be 10 to 14 pounds for a 200-pound person; and get at least 150 minutes each week of physical activity, such as brisk walking.
National Diabetes Prevention Program: A way to prevent diabetes
Lifestyle change programs offered through the National Diabetes Prevention Program, which is led by CDC, can help you reach these goals. Trained lifestyle coaches lead classes to help participants improve their food choices, increase physical activity, and learn coping skills to maintain weight loss and healthy lifestyle changes.
Visit CDC’s online registry of recognized organizations to find out if there is a lifestyle class being offered at this time in your community. If you don’t find a CDC-recognized program in your area, a local YMCA may offer a similar program. Visit the Y program Web site for information about more local programs. In addition, maybe you know of a local organization—gym, faith-based organization, health care facility, or other—that would be a good host for the classes. Please share this information with them.

Diabetes Health Concerns
body. The good news is that you can prevent most of these problems by keeping your blood glucose (blood sugar) under control, eating healthy, being physical active, working with your health care provider to keep your blood pressure and cholesterol under control, and getting necessary screening tests.

How can diabetes affect cardiovascular health?
Cardiovascular disease is the leading cause of early death among people with diabetes. Adults with diabetes are two to four times more likely than people without diabetes to die of heart disease or experience a stroke. Also, about 70% of people with diabetes have high blood pressure, a risk factor for cardiovascular disease.

How are cholesterol, triglyceride, weight, and blood pressure problems related to diabetes?
People with type 2 diabetes have high rates of cholesterol and triglyceride abnormalities, obesity, and high blood pressure, all of which are major contributors to higher rates of cardiovascular disease. Many people with diabetes have several of these conditions at the same time. This combination of problems is often called metabolic syndrome (formerly known as Syndrome X). The metabolic syndrome is often defined as the presence of any three of the following conditions: 1) excess weight around the waist; 2) high levels of triglycerides; 3) low levels of HDL, or "good," cholesterol; 4) high blood pressure; and 5) high fasting blood glucose levels. If you have one or more of these conditions, you are at an increased risk for having one or more of the others. The more conditions that you have, the greater the risk to your health.

How can I be "heart healthy" and avoid cardiovascular disease if I have diabetes?
To protect your heart and blood vessels, eat right, get physical activity, don’t smoke, and maintain healthy blood glucose, blood pressure, and cholesterol levels. Choose a healthy diet, low in salt. Work with a dietitian to plan healthy meals. If you’re overweight, talk about how to safely lose weight. Ask about a physical activity or exercise program. Quit smoking if you currently do. Get a hemoglobin A1C test at least twice a year to determine what your average blood glucose level was for the past 2 to 3 months. Get your blood pressure checked at every doctor’s visit, and get your cholesterol checked at least once a year. Take medications if prescribed by your doctor.

How can diabetes affect the eyes?
In diabetic eye disease, high blood glucose and high blood pressure cause small blood vessels to swell and leak liquid into the retina of the eye, blurring the vision and sometimes leading to blindness. People with diabetes are also more likely to develop cataracts – a clouding of the eye’s lens, and glaucoma – optic nerve damage. Laser surgery can help these conditions.

How can I keep my eyes healthy if I have diabetes?
There’s a lot you can do to prevent eye problems. A recent study shows that keeping your blood glucose level closer to normal can prevent or delay the onset of diabetic eye disease. Keeping your blood pressure under control is also important. Finding and treating eye problems early can help save sight.
It is best to have an eye doctor give you a dilated eye exam at least once a year. The doctor will use eye drops to enlarge (dilate) your pupils to examine the backs of your eyes. Your eyes will be checked for signs of cataracts or glaucoma, problems that people with diabetes are more likely to get.
Because diabetic eye disease may develop without symptoms, regular eye exams are important for finding problems early. Some people may notice signs of vision changes. If you’re having trouble reading, if your vision is blurred, or if you’re seeing rings around lights, dark spots, or flashing lights, you may have eye problems. Be sure to tell your health care team or eye doctor about any eye problems you may have.

How can diabetes affect the kidneys?
In diabetic kidney disease (also called diabetic nephropathy), cells and blood vessels in the kidneys are damaged, affecting the organs’ ability to filter out waste. Waste builds up in your blood instead of being excreted. In some cases this can lead to kidney failure. When the kidneys fail, a person has to have his or her blood filtered through a machine (a treatment called dialysis) several times a week, or has to get a kidney transplant.

How can I keep my kidneys healthy if I have diabetes?
There’s a lot you can do to prevent kidney problems. A recent study shows that controlling your blood glucose can prevent or delay the onset of kidney disease. Keeping your blood pressure under control is also important.
Diabetic kidney disease happens slowly and silently, so you might not feel that anything is wrong until severe problems have developed. Therefore, it is important to get your blood and urine checked for kidney problems each year.
Your doctor can learn how well your kidneys are working by testing every year for microalbumin (a protein) in the urine. Microalbumin in the urine is an early sign of diabetic kidney disease. Your doctor can also do a yearly blood test to measure your kidney function.
Go to the doctor if you develop a bladder or kidney infection; symptoms include cloudy or bloody urine, pain or burning when you urinate, an urgent need to urinate often, back pain, chills, or fever.

How can diabetes affect nerve endings?
Having high blood glucose for many years can damage the blood vessels that bring oxygen to some nerves, as well as the nerve coverings. Damaged nerves may stop sending messages, or send messages too slowly or at the wrong times. Numbness, pain, and weakness in the hands, arms, feet, and legs may develop. Problems may also occur in various organs, including the digestive tract, heart, and sex organs. Diabetic neuropathy is the medical term for damage to the nervous system from diabetes. The most common type is peripheral neuropathy, which affects the arms and legs.
An estimated 50% of those with diabetes have some form of neuropathy, but not all with neuropathy have symptoms. People with diabetes can develop nerve problems at any time, but the longer a person has diabetes, the greater the risk. The highest rates of neuropathy are among people who have had the disease for at least 25 years.
Diabetic neuropathy also appears to be more common in people who have had problems controlling their blood glucose levels, in those with high levels of blood fat and blood pressure, in overweight people, and in people over the age of 40.

How can I prevent nerve damage if I have diabetes?
You can help keep your nervous system healthy by keeping your blood glucose as close to normal as possible, getting regular physical activity, not smoking, taking good care of your feet each day (see below), having your health care provider examine your feet at least 4 times a year, and getting your feet tested for nerve damage at least once a year.

Why is it especially important to take care of my feet if I have diabetes?
Nerve damage, circulation problems, and infections can cause serious foot problems for people with diabetes. Sometimes nerve damage can deform or misshape your feet, causing pressure points that can turn into blisters, sores, or ulcers. Poor circulation can make these injuries slow to heal. Sometimes this can lead to amputation of a toe, foot, or leg.

What should I do on a regular basis to take care of my feet?
Look for cuts, cracks, sores, red spots, swelling, infected toenails, splinters, blisters, and calluses on the feet each day. Call your doctor if such wounds do not heal after one day.
If you have corns and calluses, ask your doctor or podiatrist about the best way to care for them.
Wash your feet in warm—not hot—water and dry them well.
Cut your toenails once a week or when needed. Cut toenails when they are soft from washing. Cut them to the shape of the toe and not too short. File the edges with an emery board.
Rub lotion on the tops and bottoms of feet—but not between the toes—to prevent cracking and drying.
Wear shoes that fit well. Break in new shoes slowly, by wearing them 1 to 2 hours each day for the first 1 to 2 weeks.
Wear stockings or socks to avoid blisters and sores.
Wear clean, lightly padded socks that fit well; seamless socks are best.
Always wear shoes or slippers, because when you are barefoot it is easy to step on something and hurt your feet.
Protect your feet from extreme heat and cold.
When sitting, keep the blood flowing to your lower limbs by propping your feet up and moving your toes and ankles for a few minutes at a time.
Avoid smoking, which reduces blood flow to the feet.
Keep your blood sugar, blood pressure, and cholesterol under control by eating healthy foods, staying active, and taking your diabetes medicines.

How can diabetes affect the digestion?
Gastroparesis, otherwise known as delayed gastric emptying, is a disorder where, due to nerve damage, the stomach takes too long to empty itself. It frequently occurs in people with either type 1 or type 2 diabetes.
Symptoms of gastroparesis include heartburn, nausea, vomiting of undigested food, an early feeling of fullness when eating, weight loss, abdominal bloating, erratic blood glucose levels, lack of appetite, gastroesophageal reflux, and spasms of the stomach wall.

How can diabetes affect oral health?
Because of high blood glucose, people with diabetes are more likely to have problems with their teeth and gums. And like all infections, dental infections can make your blood glucose go up. Sore, swollen, and red gums that bleed when you brush your teeth are a sign of a dental problem called gingivitis. Another problem, called periodontitis, happens when your gums shrink or pull away from your teeth.
People with diabetes can have tooth and gum problems more often if their blood glucose stays high. Also, smoking makes it more likely for you to get a bad case of gum disease, especially if you have diabetes and are age 45 or older.
People with diabetes are also prone to other mouth problems, like fungal infections, poor post-surgery healing, and dry mouth.

How can I keep my mouth, gums, and teeth healthy if I have diabetes?
You can help maintain your oral health by keeping your blood glucose as close to normal as possible, brushing your teeth at least twice a day, and flossing once a day. Keep any dentures clean. Get a dental cleaning and exam twice a year, and tell your dentist that you have diabetes. Call your dentist with any problems, such as gums that are red, sore, bleeding, or pulling away from the teeth; any possible tooth infection; or soreness from dentures.

How can diabetes affect my sexual response?
Many people with diabetic nerve damage have trouble having sex. For example, men can have trouble maintaining an erection and ejaculating. Women can have trouble with sexual response and vaginal lubrication. Both men and women with diabetes can get urinary tract infections and bladder problems more often than average.

How can diabetes affect my mood?
Several studies suggest that diabetes doubles the risk of depression, although it’s still unclear why. The psychological stress of having diabetes may contribute to depression, but diabetes’ metabolic effect on brain function may also play a role. At the same time, people with depression may be more likely to develop diabetes.
The risk of depression increases as more diabetes complications develop. When you are depressed, you do not function as well, physically or mentally; this makes you less likely to eat properly, exercise, and take your medication regularly.
Psychotherapy, medication, or a combination of both can treat depression effectively. In addition, studies show that successful treatment for depression also helps improve blood glucose control.

How does diabetes affect how I respond to a cold or flu?
Being sick by itself can raise your blood glucose. Moreover, illness can prevent you from eating properly, which further affects blood glucose.
In addition, diabetes can make the immune system more vulnerable to severe cases of the flu. People with diabetes who come down with the flu may become very sick and may even have to go to a hospital. You can help keep yourself from getting the flu by getting a flu shot every year. Everyone with diabetes—even pregnant women—should get a yearly flu shot. The best time to get one is between October and mid-November, before the flu season begins.

What should I do when I am sick?
Be sure to continue taking your diabetes pills or insulin. Don’t stop taking them even if you can’t eat. Your health care provider may even advise you to take more insulin during sickness.
Test your blood glucose every four hours, and keep track of the results.
Drink extra (calorie-free) liquids, and try to eat as you normally would. If you can’t, try to have soft foods and liquids containing the equivalent amount of carbohydrates that you usually consume.
Weigh yourself every day. Losing weight without trying is a sign of high blood glucose.
Check your temperature every morning and evening. A fever may be a sign of infection.
Call your health care provider or go to an emergency room if any of the following happen to you:
You feel too sick to eat normally and are unable to
keep down food for more than 6 hours.
You're having severe diarrhea.
You lose 5 pounds or more.
Your temperature is over 101 degrees F.
Your blood glucose is lower than 60 mg/dL or
remains over 300 mg/dL.
You have moderate or large amounts of ketones in
your urine.
You're having trouble breathing.
You feel sleepy or can't think clearly.
What routine medical examinations and tests are needed for people with diabetes?
Your doctors should—
Measure your blood pressure at every visit.
Check your feet for sores at every visit, and give a thorough foot exam at least once a year.
Give you a hemoglobin A1C test at least twice a year to determine what your average blood glucose level was for the past 2 to 3 months.
Test your urine and blood to check your kidney function at least once a year.
Test your blood lipids (fats)—total cholesterol; LDL, or low-density lipoprotein (“bad” cholesterol); HDL, or high-density lipoprotein (“good” cholesterol); and triglycerides at least once a year.
You should also get a dental checkup twice a year, a dilated eye exam once a year, an annual flu shot, and a pneumonia shot.

How does maintaining healthy blood glucose levels help people with diabetes stay healthy?
Research studies in the United States and other countries have shown that controlling blood glucose benefits people with either type 1 or type 2 diabetes. In general, for every 1% reduction in results of A1C blood tests (e.g., from 8.0% to 7.0%), the risk of developing eye, kidney, and nerve disease is reduced by 40%.

How does maintaining a healthy body weight help people with diabetes stay healthy?
Most people newly diagnosed with type 2 diabetes are overweight. Excess weight, particularly in the abdomen, makes it difficult for cells to respond to insulin, resulting in high blood glucose. Often, people with type 2 diabetes are able to lower their blood glucose by losing weight and increasing physical activity. Losing weight also helps lower the risk for other health problems that especially affect people with diabetes, such as cardiovascular disease.
How does maintaining a healthy blood pressure level help people with diabetes stay healthy?
About 70% of adults with diabetes have high blood pressure or use prescription medications to reduce high blood pressure. Maintaining normal blood pressure—less than 130/80 millimeters of mercury (mm Hg) helps to prevent damage to the eyes, kidneys, heart, and blood vessels. Blood pressure measurements are written like a fraction, with the two numbers separated by a slash. The first number represents the pressure in your blood vessels when your heart beats (systolic pressure); the second number represents the pressure in the vessels when your heart is at rest (diastolic pressure).
In general, for every 10 mm Hg reduction in systolic blood pressure (the first number in the fraction), the risk for any complication related to diabetes is reduced by 12%. Maintaining normal blood pressure control can reduce the risk of eye, kidney, and nerve disease (microvascular disease) by approximately 33%, and the risk of heart disease and stroke (cardiovascular disease) by approximately 33% to 50%. Healthy eating, medications, and physical activity can help you bring high blood pressure down.

How does maintaining healthy cholesterol levels help people with diabetes stay healthy?
Several things, including having diabetes, can make your blood cholesterol level too high. When cholesterol is too high, the insides of large blood vessels become narrowed, even clogged, which can lead to heart disease and stroke, the biggest health problems for people with diabetes. Maintaining normal cholesterol levels will help prevent these diseases and can help prevent circulation problems—an issue for people with diabetes. Have your cholesterol checked at least once a year. Total cholesterol should be less than 200; LDL (“bad” cholesterol) should be less than 100; HDL (“good” cholesterol) should be more than 40 in men and more than 50 in women; and triglycerides should be less than 150. Healthy eating, medications, and physical activity can help you reach your cholesterol targets. Keeping cholesterol levels under control can reduce the risk of cardiovascular complications of diabetes by 20% to 50%.

How does exercise help people with diabetes stay healthy?
Physical activity can help you control your blood glucose, weight, and blood pressure, as well as raise your “good” cholesterol and lower your “bad” cholesterol. It also can help prevent heart and blood flow problems.
Experts recommend moderate-intensity physical activity for at least 30 minutes on 5 or more days of the week. Talk to your health care provider about a safe exercise plan. He or she may check your heart and your feet to be sure you have no special problems. If you have high blood pressure, eye, or foot problems you may need to avoid some kinds of exercise.

How does quitting smoking help people with diabetes stay healthy?
Smoking puts people with diabetes at particular risk. Smoking raises your blood glucose, cholesterol, and blood pressure, all of which people with diabetes need to be especially concerned about. When you have diabetes and use tobacco, the risk of heart and blood vessel problems is even greater. If you quit smoking, you'll lower your risk for heart attack, stroke, nerve disease, kidney disease, and oral disease.

Why is it important for people with diabetes to get an annual flu shot?
Diabetes can make the immune system more vulnerable to severe cases of the flu. People with diabetes who come down with the flu may become very sick and may die. You can help keep yourself from getting the flu by getting a flu shot every year. Everyone with diabetes—even pregnant women—should get a yearly flu shot. The best time to get one is between October and mid-November, before the flu season begins.

Groups Especially Affected by Diabetes
How are women especially affected by diabetes?
Of the 25.6 million adults with diabetes in the United States in 2010, 12.6 million were women. The risk of heart disease, the most common complication of diabetes, is more serious among women than men. Among people with diabetes who have had a heart attack, women have lower survival rates and a poorer quality of life than men. Women with diabetes have a shorter life expectancy than women without diabetes, and women are at greater risk of blindness from diabetes than men. Death rates for women aged 25-44 years with diabetes are more than 3 times the rate for women without diabetes.
Women with diabetes must also plan childbearing carefully. It is especially important to keep blood glucose levels as near to normal as possible before and during pregnancy, to protect both mother and baby. Pregnancy itself may affect insulin levels, as well as diabetes-related eye and kidney problems.

What is gestational diabetes?
Gestational diabetes is a type of diabetes, or high blood sugar, that only pregnant women get. If a woman gets high blood sugar when she's pregnant, but she never had high blood sugar before, she has gestational diabetes.
Managing gestational diabetes is very important in order to protect the baby. Babies born to mothers with uncontrolled gestational diabetes can be overly large at birth, making delivery more dangerous. These babies can also have breathing problems. Moreover, children exposed to diabetes in the womb are more likely to become obese during childhood and adolescence, and develop type 2 diabetes later in life.
Usually, gestational diabetes goes away after the baby is born. However, women who have had gestational diabetes are at higher risk for developing type 2 diabetes later in life, so healthy eating, physical activity, and weight maintenance are important steps to prevention.

What racial and ethnic groups are especially affected by diabetes?
s, Hispanic/Latino Americans, American Indians, Asian Americans, and Pacific Islander Americans are at particularly high risk for type 2 diabetes. In addition, gestational diabetes occurs more frequently in s, Hispanic/Latino Americans, and American Indians than in other groups.

Why do some racial and ethnic groups have higher rates of diabetes?
Diabetes can indeed “run in families," meaning that heredity often makes someone more likely to develop diabetes. Researchers believe that certain genes affecting immune response can play a role in the development of type 1 diabetes, while genes affecting insulin function can contribute to the development of type 2 diabetes. While s, Hispanic/Latino Americans, American Indians, Asian Americans, and Pacific Islander Americans have a slightly lower rate of type 1 diabetes, they are at a higher risk for type 2 diabetes than the rest of the population.
Many researchers think that some s, Hispanic/Latino Americans, American Indians, Asian Americans, and Pacific Islander Americans inherited a "thrifty gene" which helped their ancestors store food energy better during times when food was plentiful, to survive during times when food was scarce. Now that “feast or famine” situations rarely occur for most people in the United States, the gene which was once helpful may now put these groups at a higher risk for type 2 diabetes.
In addition, poverty, lack of access to health care, cultural attitudes and behaviors are barriers to preventive and diabetes management care for some minority Americans.

How are children especially affected by diabetes?
Type 1 diabetes, which used to be called juvenile diabetes, is usually first diagnosed in children, teens, or young adults. In type 1 diabetes, the body's immune system attacks and destroys beta cells in the pancreas, so that they no longer make insulin. People with type 1 diabetes must take insulin every day. Approximately one of every 400 to 500 children and adolescents has type 1 diabetes.
Type 2 diabetes, a disease usually diagnosed in adults aged 40 years or older, is now becoming more common among children and adolescents, particularly in American Indians, s, and Hispanic/Latinos.
Among youth, obesity, physical inactivity, and prenatal exposure to diabetes in the mother have become widespread, and may contribute to the increased development of type 2 diabetes during childhood and adolescence.

How are older adults especially affected by diabetes?
As we age, our risk for developing diabetes increases. More than one-third of all cases of diagnosed diabetes occur in people aged 65 years or older. Of people in the United States aged 65 years or older, approximately 26.9% (10.9 million) have diabetes. Diabetes often leads to chronic conditions that eventually result in death, such as heart disease and kidney disease. Thus, diabetes is often responsible for, but not listed as, the cause of many deaths.

How are some veterans affected by diabetes?
Vietnam veterans exposed to the herbicide Agent Orange may be at increased risk for developing type 2 diabetes. In the year 2000, the Veterans Administration announced that it would recognize diabetes as a Vietnam service-related disease.