skeleton-body-kidneys-diabetes-risk
Diabetes is the leading cause of kidney failure in the U.S.
(ISTOKEPHOTO)
Type 2 diabetes is the most common type of diabetes by far—making up more than 90% of the 24 million cases in the U.S.

Experts use words like "epidemic" and "worldwide crisis" when they talk about it: Millions of people have it and a staggering number are expected to get it (300 million worldwide by 2025, according to one study).

Diabetes doesn't get the attention of, say, cancer or scary viruses. One reason might be because type 2 diabetes is so incredibly common—about 20% of people over age 60 get it. A large chunk of the population just seems to have the genetic programming to develop the disease with age.

Type 2 diabetes is showing up in young people
However, diabetes is also on the rise because our modern lifestyle—lots of food and little exercise—speeds up the process.

High Blood Sugar
Diabetes High Blood Sugar Doctor-Patient Video
It's like a poison in the body  Watch video
So people who might have developed this "old-age disease" in their 60s and 70s are now developing the disease much earlier due to obesity and lack of exercise; sometimes in their teens or in childhood.

Anyone can get diabetes. But some people are at much higher risk, particularly those who are obese. (Are you overweight? Use this body mass index calculator to find out.)

One in three children born in the U.S. in 2000 will develop diabetes at some point in their life (including more than half of Hispanic females), according to a Centers for Disease Control and Prevention study published in 2003.

But not all is gloom and doom. If you have diabetes, you have a lot more control over the disease now than just about any other point in history. And if you have prediabetes, you have a good chance of preventing or delaying the disease by making lifestyle changes or taking medication.

What happens in the body when you have type 2 diabetes
With type 2 diabetes, the muscles and liver that normally take up blood sugar and use it for energy begin to lose their sensitivity to the hormone insulin, a condition known as insulin resistance.

The pancreas, which contains the insulin-making beta cells, responds to the body's insulin resistance by churning out even more of the hormone. Even though insulin levels may increase to a degree, even the increased amount is not sufficient to prevent blood sugar from becoming too high. (In contrast, type 1 diabetes is a less-common autoimmune disease that destroys the insulin-producing cells, although some people don't fit neatly into either category.)

The excess blood sugar in diabetes can wreak havoc on blood vessels all over the body and cause complications. It can severely damage the eyes, kidneys, nerves, and other body parts; cause sexual problems; and double the risk of heart attack and stroke.

Eventually, insulin-producing cells can shut down and stop producing the hormone completely. Some people with type 2 diabetes need insulin, but most don't. (It's type 1 diabetes that requires insulin shots to survive; about one-third of people with type 2 use insulin.) You may need to inject insulin to help replace or supplement your own natural production of the hormone and to help your body overcome insulin resistance.

Good news about managing type 2 diabetes
The good news is that if you eat healthier carbohydrates and more fiber, blood sugar drops. And exercise can increase the insulin sensitivity of muscles, which will then absorb more blood sugar. If diet and exercise alone won't do it, there are drugs that boost the muscle's sensitivity to insulin and curb blood sugar.

In the past 10 years a slew of new drugs have come on the market that control blood sugar in new and innovative ways. Blood-sugar testing has made huge strides too—some monitors now require only tiny amounts of blood and give results in seconds.

So much of this illness is under the patient's control. But having that much control over a disease isn't a cakewalk. You may need to battle psychological demons to remain motivated over the long haul and learn how to live with diabetes and still feel alive.

"The good news is that with diabetes, 90% is up to the patient," says Yvonne Thigpen, the diabetes program coordinator at Mount Clemens Regional Medical Center in Michigan. "The bad news is that 90% of diabetes management is up to them."

Last updated: Aug 03, 2010