Diabetes

Diabetes may not cause clear symptoms at first. Some people learn they have diabetes during routine blood work.

Common symptoms include:

Very high blood sugar can cause severe symptoms such as confusion, vomiting, or trouble staying awake. Call 9-1-1 or seek urgent care if someone becomes unresponsive or very ill.

The American Diabetes Association recognizes four main categories of diabetes. Clear classification helps guide treatment and reduces the risk of misdiagnosis.

• Type 1 diabetes: The immune system attacks the insulin-producing cells in the pancreas. The body makes little or no insulin. People with type 1 diabetes need insulin from the time of diagnosis.
• Type 2 diabetes: The body becomes resistant to insulin and does not use it effectively. Over time, the pancreas may produce less insulin. Blood sugar levels gradually rise.
• Gestational diabetes: Develops during pregnancy when hormonal changes make it harder for the body to use insulin. Blood sugar often returns to normal after pregnancy, but the risk of future diabetes is higher.
• Specific types due to other causes: Some forms result from genetic conditions, diseases of the pancreas, or certain medications. These types are less common but still require accurate diagnosis and individualized treatment.

Clinicians diagnose diabetes using blood tests that measure blood sugar.

Common tests include:

• Fasting plasma glucose (FPG): Measures blood sugar after not eating for at least 8 hours.
• A1C test: Shows average blood sugar over the past 2 to 3 months.
• Oral glucose tolerance test (OGTT): Measures blood sugar before and after drinking a glucose beverage.

In most cases, diagnosis requires two abnormal results. A clinician may repeat the same test on another day or use a different test to confirm the diagnosis.

Correct classification of diabetes type is an important part of diagnosis because treatment depends on it.

The goals of treatment are to keep blood sugar in a safe range and reduce the risk of blood vessel damage. Treatment depends strongly on the type of diabetes. Not every person needs the same plan.

Healthy daily habits support all types of diabetes.

Many people monitor their blood sugar at home. Tracking results helps guide food choices, activity, and medication adjustments.

Medication needs differ between type 1 and type 2 diabetes.

People with type 1 diabetes require lifelong insulin therapy because their bodies produce little or no insulin.

Treatment usually includes:

• Multiple daily insulin injections using long-acting and rapid-acting insulin

or

• An insulin pump that delivers insulin continuously

Many people now use automated insulin delivery systems. These systems combine a continuous glucose monitor with an insulin pump. The device adjusts insulin delivery based on real-time glucose levels. This approach can improve blood sugar control and reduce low blood sugar episodes.

People with type 1 diabetes also receive education on matching insulin doses to food intake, physical activity, and blood sugar trends.

Type 2 diabetes treatment is often stepwise.

• Metformin is commonly the first medication for many people.
• Other oral or injectable medications may be added if needed.
• Some newer medications help lower cardiovascular and kidney risk in people with heart or kidney disease.
• Insulin may be added if other medications do not maintain blood sugar in a safe range or if blood sugar is very high at diagnosis.

Treatment plans consider age, other medical conditions, risk of low blood sugar, and personal goals.

Most people with diabetes do not need procedures to control blood sugar.

Some individuals with severe obesity and type 2 diabetes may benefit from metabolic or bariatric surgery. These procedures can improve blood sugar control in selected patients. Decisions are individualized and require long-term follow-up.

Diabetes is a long-term condition, but many people live full and active lives with proper care.

Ongoing management often includes:

If you have prediabetes, lifestyle changes can lower your risk of developing type 2 diabetes.

Understanding your diabetes type, staying engaged in your care, and working with your healthcare team can help protect your blood vessels and overall health.