DIABETES 101:

HOW INSULIN RESISTANCE, PRE-DIABETES,
AND TYPE 2 DIABETES ARE LINKED

If you have insulin resistance, your muscle, fat, and
liver cells do not use insulin properly. The pancreas
tries to keep up with the demand for insulin by producing
more. Eventually, the pancreas cannot keep up with the body's
need for insulin, and excess glucose builds up in the
bloodstream. Many people with insulin resistance have high
levels of blood glucose and high levels of insulin circulating
in their blood at the same time.

People with blood glucose levels that are higher than normal
but not yet in the diabetic range have "pre-diabetes." Doctors
sometimes call this condition impaired fasting glucose (IFG)
or impaired glucose tolerance (IGT), depending on the test
used to diagnose it. In a cross-section of American adults
tested during the period 1988 to 1994, 20.1 million had
pre-diabetes (IFG, IGT, or both).

If you have pre-diabetes, you have a higher risk of developing
type 2 diabetes, formerly called adult-onset diabetes or
noninsulin-dependent diabetes. Studies have shown that most
people with pre-diabetes go on to develop type 2 diabetes
within 10 years, unless they lose 5 to 7 percent of their
body weight--which is about 10 to 15 pounds for someone who
weighs 200 pounds--by making modest changes in their diet
and level of physical activity. People with pre-diabetes
also have a higher risk of heart disease.

Type 2 diabetes is sometimes defined as the form of diabetes
that develops when the body does not respond properly to
insulin, as opposed to type 1 diabetes, in which the pancreas
makes no insulin at all. At first, the pancreas keeps up
with the added demand by producing more insulin. In time,
however, it loses the ability to secrete enough insulin in
response to meals.

Insulin resistance can also occur in people who have type
1 diabetes, especially if they are overweight.



DIABETES RELATED DEFINITIONS
AND EXPLANATIONS
=========================

METABOLISM

The term for the way cells chemically change food so that
it can be used to keep the body alive. It is a two-part
process. One part is called catabolism - when the body uses
food for energy. The other is called anabolism-when the
body uses food to build or mend cells. Insulin is necessary
for the metabolism of food.

PERIODONTAL DISEASE

Damage to the gums. People who have diabetes are more likely
to have gum disease than people who do not have diabetes.

RETINA
The center part of the back lining of the eye that senses
light. It has many small blood vessels that are sometimes
harmed when a person has had diabetes for a long time.

ENDOGENOUS

Grown or made inside the body. Insulin made by a person's own
pancreas is endogenous insulin. Insulin that is made from beef
or pork pancreas or derived from bacteria is exogenous because
it comes from outside the body and must be injected.

ENDOCRINE GLANDS

Glands that release hormones into the bloodstream. They affect
how the body uses food (metabolism). They also influence other
body functions. One endocrine gland is the pancreas. It releases
insulin so the body can use sugar for energy.



DIABETES Q AND A:
=========================

QUESTION:

How long do most people have diabetes before it's diagnosed?

ANSWER:

It often depends on what type of diabetes they have. Overall,
nearly 6 million American adults and children have diabetes
and don't know it, many of them for years. Early detection is
important because diabetes can cause more complications the
longer it goes untreated.

Type 1 diabetes is probably harder to overlook because it
often begins with sudden and severe signs and symptoms, such
as nausea, vomiting and stomach pain. That means you're more
likely to visit your doctor, and the disease can be diagnosed
soon after it starts, usually within a few weeks to a few months.

People with type 2 diabetes, on the other hand, often don't
have noticeable symptoms for a long time. On average, people
have diabetes for 8 years before it's diagnosed.

Regular visits to your doctor, even if you're feeling well,
can help make sure you don't have undetected diseases, such
as diabetes. Consider asking your doctor about a fasting blood
sugar test, which isn't usually part of a routine physical exam.
This test, done when you haven't eaten for at least 8 hours, can
reveal problems that a routine, non-fasting blood test can't.