让我们谈谈糖尿病

Whether you’ve just been diagnosed or think you could have diabetes, you’re probably nervous, confused, and maybe even a little scared. That’s normal, and everyone featured on HealthCentral with a chronic illness felt just like you do now. But we—and they—are here for you. On this page alone, you’ll discover not only the realities and challenges of the condition, but also the best treatments, helpful lifestyle changes, wisdom from people who have been where you are now, and all the critical information to help you not just manage—but thrive. We’re sure you’ve got a lot of questions...and we’re here to answer them.

What Is Diabetes, Anyway?

每个人都听说过糖尿病。这是世界上最常见的慢性疾病之一，而且仍在崛起。然而，大多数人并不完全理解导致它的原因或如何影响日常生活。许多人认为，因为这种疾病是如此普遍，它并不严重。但如果留下未经处理的，糖尿病会导致心脏病，视力丧失，甚至肢体截肢。

在其最基本的糖尿病（官方名称）是一组疾病，导致人们患有高于正常的糖或葡萄糖的血液。葡萄糖来自蛋白质，碳水化合物和脂肪，您也可以饮用，以及您的肝脏，这使得并储存该物质。

如果一切都根据计划进行，胰腺释放称为胰岛素的激素，有助于将葡萄糖从血液中移动到您的身体的一些细胞中以用于能量。但如果你的身体对胰岛素有抗性，或者没有足够的，那么葡萄糖就会陷入困境。那是你的医生告诉你你有“高血糖”。随着时间的推移，血液中的额外糖会导致炎症和其他主要的健康问题。

About 30 million people in the United States have diabetes, but nearly one quarter of them don’t know it. Let’s take a closer look.

Most Common Types of Diabetes

There are several different types of diabetes and each has its own causes. It’s important to get an accurate diagnosis for which form of the disease you have because treatment will differ depending on type. Here are the basics you should know:

Type 1 Diabetes

也被称为“juvenile” diabetes因为这是小时候经常诊断,1型diabetes is mostly an autoimmune disorder in which your immune system attacks and destroys insulin-making cells in the pancreas. Because of this, your body no longer produces its own insulin, so you need insulin injections every day.

Most people withtype 1 diabetes在童年或年轻的成年期间被诊断出来，但少数人可能不会发展疾病，直到30多岁，40岁或50岁。

Type 2 Diabetes

People with类型2.do produce their own insulin, but their bodies don’tusevery well. They are insulin-resistant.

Type 2, also called “adult-onset”, diabetes is the most common form of the disease. Between 90% to 95% percent of all people with diabetes have type 2. It usually develops in middle age but is sometimes seen in older kids or teens.

Most people with type 2 don’t need to take insulin, but they may need other medications to help bring down blood sugar.

If someone’s blood sugar is higher than normal, but not high enough to be diagnosed as diabetes, that’s consideredprediabetes。

患有前奶油的人具有增加的发展风险。运动和饮食变化通常被规定降低血糖并降低风险。在某些情况下，医生也可以在达二甲双胍，降血药物中进行，以帮助预防2型。

Gestational Diabetes

Gestational diabetes refers to temporary high blood sugar that happens only in pregnancy. Doctors suspect that it’s related to hormonal changes that happen during this time.

Most pregnant women are screened for gestational diabetes during their second trimester with a glucose tolerance test, which involves drinking a glucose-containing beverage on an empty stomach and then having blood drawn to check sugar levels.

Gestational diabetes is usually treated with exercise and diet changes (such as eating less starch and more veggies, fruits, and protein). Some women may need insulin injections, too.

Most of the time, blood sugar levels return to normal once the baby is born; but if you have gestational diabetes during pregnancy, you are also at higher than average risk for developing type 2 later in life.

Other Types of Diabetes

Though rare, these types of diabetes can cause serious health issues if left untreated:

• 单一的糖尿病

  占所有病例的1%到5%,这罕见的泰pe of diabetes is caused by a mutation in a single gene. In most cases, the disease is due to a person’s pancreas not being able to make enough insulin; the condition is usually found in kids.

• 二次糖尿病

  有时,糖尿病is a side-effect of another disease, such as Cushing’s syndrome and cystic fibrosis. Certain medications, including niacin, diuretics, HIV medicines, and anti-seizure drugs, can also lead to high blood sugar.

What Causes Diabetes in the First Place?

The causes of the disease differ depending on what type you have.

类型1的原因

Type 1 diabetes is mostly an autoimmune disorder. In this case, your immune system attacks your body in the same way it might attack invaders like bacteria or viruses, destroying certain cells in your pancreas in a misguided attempt to protect the body. These cells, called beta cells, are the ones that produce insulin. When your body attacks and destroys them, you can no longer make your own insulin.

医生认为，1型糖尿病可能是由基因和环境因素的组合引起的。1型糖尿病可治疗每日胰岛素注射，但不能固化;和生活方式更改，如饮食，运动不会扭转它。

2型原因

Type 2 diabetes is usually caused by a combination of factors. It tends to run in families, and certain genes make you more likely to develop it. It’s also more common in some ethnic groups, including Native Americans, African Americans, Pacific Islanders, Asians, and Latinos.

你是如何吃的，你的活跃程度也很重要。携带额外的身体脂肪，特别是在你的腹部，可以有助于胰岛素抵抗力，这种情况在你的胰腺作出充足的胰岛素，但不能很好地使用它，所以糖在你的血液中积聚，而不是进入你的细胞进行能量。胰岛素抵抗是2型糖尿病的主要原因。

有时，2型糖尿病是由不活跃的胰腺引起的，你的身体没有足够的胰岛素。

Causes of Gestational Diabetes

Genetics and hormonal changes during pregnancy are the culprits of this type.

All women become insulin-resistant late in pregnancy, thanks to hormones released mostly by the placenta. Most of the time, the pancreas amps up production of insulin to make up the difference, but in cases where it can’t keep up, blood sugar levels rise and gestational diabetes develops.

我有糖尿病的症状吗？

A tricky truth about this disease: Sometimes, there are no symptoms or symptoms are so mild that they’re easy to miss. That’s why nearly all pregnant women are screened for gestational diabetes, and the U.S. Preventive Services Task Force recommends screening for adults over 40 who have risk factors such as abdominal obesity.

Other times, symptoms are sudden and clear. Having any of the following signs does not necessarily mean you have diabetes. Instead, consider them a signal to call your doctor:

• 重大渴望：When your blood has too much sugar in it, your body pulls water from surrounding tissues to try to dilute it. That leaves you dehydrated and thirsty. Some diabetics feel like no matter how much they drink, they can’t quench their thirst.
• 很多小便：当血液中有太多的糖时，你的肾脏试图过滤。他们把它倒入你的尿液中，创造更多的小便。在疾病的更高级阶段，膀胱周围受损的神经可能会导致一些人常常感受到尿尿的冲动，即使很少或没有任何东西出来。您还具有更高的尿路感染风险（UTI）。
• Blurry vision:High blood sugar can lead to a leaking of fluids into your eye, causing the lens to swell. That leads to trouble focusing.
• The munchies:如果你一直饿了，即使在好吃的饭后，也可能是一个标志，你的肌肉和其他组织没有得到能量 - 即。葡萄糖 - 他们需要从你吃的食物中吃，因为它在你的血液中挂了。你的肌肉告诉你的大脑，他们正在挨饿（即使你吃了很多），让你再次渴望并继续循环。
• Increase in infections:Type 2 diabetes makes it harder for your immune system to fight off infections, including yeast infections or UTIs. It might also take longer for cuts to heal, because extra glucose prevents white blood cells from doing their repair work.
• 减肥：在不改变饮食的情况下减肥可能是1型糖尿病的标志。如果您的身体无法从食物中获得葡萄糖，它将开始分解自己的脂肪，肌肉和其他燃料组织，导致体重减轻。
• Fatigue:You may feel exhausted and weak because your brain, muscles, and other body systems aren’t getting the energy they need to work properly. If you’re dehydrated, that can make you tired, too.

How Do Doctors Diagnose Diabetes?

The first step in getting a diabetes diagnosis is a blood test. Then, if you are diagnosed with diabetes, your doctor may perform additional testing to figure out which type you have. Correct diagnosis is important since treatment differs depending on type.

Blood Tests for Diabetes

• A1C (or glycated hemoglobin) test.This common test measures what percentage of your red blood cells have been coated with glucose over the past two to three months. The higher your blood sugar, the higher your score. An A1C result below 5.7 is considered normal; 5.7 to 6.4 is prediabetic; 6.5 or above suggests diabetes.
• 空腹血糖试验。Blood will be drawn first thing in the morning before you eat or drink anything other than water. A result under 100 milligrams per deciliter is normal; 100 to 125 mg/dL is prediabetic; 126 mg/dL or above indicates diabetes. Your doctor will likely want to do the test twice before diagnosing you.
• Glucose tolerance test.After getting your blood drawn on an empty stomach, you’ll drink a glucose drink, then have blood drawn again after one or two hours. If your blood sugar is under 140 mg/dL two hours after downing the sugar drink, that’s normal; 140 to 199 is prediabetic; 200 md/dL or over indicates diabetes.
• Random blood sugar test.无论你最近还吃掉了血液。结果200 mg / dl意味着您可能有糖尿病。
• Antibody test.为了帮助差异化1型和2型糖尿病，您的医生也可能吸血以用于“自身抗体”测试，看看您的免疫系统是否正在攻击胰腺。1型的人常用于几种特异性自身抗体的阳性，而具有2型（或罕见的单生糖尿病）的人不会。

Urine Test for Diabetes

If your doctor suspects that you have type 1 diabetes, she may want to test your urine for ketones, chemicals your body produces when it breaks down fat for energy.

测试可以在家或在实验室或医生办公室进行，通过撒尿进入标本杯。极高的酮是一个标志酮症化，糖尿病可能致命并发症需要紧急治疗。

What Is the Best Treatment for Diabetes?

无论你的治疗方式如何，最有可能每天检查你的葡萄糖，甚至每天几次，以便做出关于胰岛素剂量，食物和运动的决定。

To do this, you’ll likely use a home glucose meter to poke your fingertip with a specialized lancet “pen,” then drop the blood onto a test strip in the meter. In some cases, your doc might suggest a continuous glucose monitor, where a tiny sensor is inserted under the skin of your abdomen, arm, or thigh to check glucose levels regularly. The device will alert you if levels fall too low.

Here are a few types of treatments your doctor will consider, based on your diabetes type:

Insulin

所有患有1型糖尿病的人都需要每天服用胰岛素。有些类型或妊娠期糖尿病的人也可能需要胰岛素。有几种不同的方式胰岛素可以送到身体：

• Injection:这是服用胰岛素的最常见方式。注射药物，您将使用注射器或“笔”，通常在腹部，上臂，大腿或屁股中。
• Insulin Pump:People who need multiple injections per day or are high risk of ketoacidosis may prefer an insulin pump, which automatically delivers insulin throughout the day through a tiny catheter that’s worn on your body.
• Insulin Inhaler:一些患有1或2型糖尿病的成年人也可以使用吸入胰岛素，通过吸入器将粉末呼吸到肺部。

口服药物

几种药丸（或液体），与彼此或胰岛素结合使用，可以帮助2型糖尿病的人中降低血糖。这些是some of the common meds：

• actos.andAvandia(thiazolidinediones) reduce circulating fat concentrations and improve sensitivity to insulin.
• amaryl.那Glucotroland微酶（磺酰脲类），普兰丁andStarlix(meglitinide), andJanuviaandOnglyza(DPP-4 inhibitors), trigger the pancreas to produce more insulin.
• Farxiga那Invokana.那and齿条(SGLT2 inhibitors) boost the amount of sugar the kidneys can remove from your blood.
• GlysetandOrecose(alpha-glucosidase inhibitors) slow the digestion and breakdown of starches into glucose and regulate how much glucose is absorbed by the small intestine.
• Metformin (brands namesGlucophage那Glumetza那Fortamet那and雷管）减缓您吃糖的碳水化合物的细分，并减少肝脏产生的葡萄糖。

饮食和锻炼

无论你有什么类型的糖尿病，吃得很好，锻炼会帮助你的健康。也就是说，1型糖尿病不能通过生活方式改变治疗或治愈。无论你吃得多，你都不能让你的胰腺能够再次产生胰岛素。

Diet can be used to help treat type 2 and gestational diabetes, though. One of the most important diet changes someone with type 2 can make is to reduce or cut out sugary drinks like soda and juices that may hike up blood sugar. Eating more low-starch vegetables and lean protein can help, too. Some people with diabetes may need to count the grams of carbohydrate they eat, since consuming a consistent amount at each meal helps balance blood sugar.

Regular exercise can also reduce insulin resistance and improve the way your body uses insulin, keeping type 2 diabetes in check.

Does Diabetes Treatment Cause Complications?

Any medication has potential side effects, and those for diabetes are no exception. But none are as serious as the alternative of not treating it—like heart disease, vision loss, nerve pain, foot ulcers, and even amputations.

这些是some side effects for the most common diabetes treatments:

• Continuous glucose monitoring:Skin irritation, pain, sore muscles.
• Insulin:Low blood sugar, headaches, weight gain, flu-like symptoms. Infection of infusion site if using an insulin pump.
• Oral medications:nausea, diarrhea, gas, sweating, feeling anxious or shaky, weight gain, swelling.

What's Life Like with Diabetes?

看起来，它是一种疾病 - 和生活在一起可能是压力。有些人不了解这种情况，无法掌握你要做的事情。

但由于糖尿病相对普遍，有很多人都能理解，可以帮助让生活变得更轻松。

One of the biggest challenges can be the amount of so-called “self-management” you need to do—checking blood sugar, giving yourself injections, taking medications correctly, and sticking to a healthy diet.

For that reason, many people find working with a certified diabetes educator (CDE) useful. These healthcare providers (often registered nurses or registered dietitians) know the ins and outs of diabetes treatment and are able to come up with systems and solutions that work in real life.

If you find yourself feeling depressed and overwhelmed in the face of your diabetes diagnosis, don’t hesitate to tell your doctor. You are far from alone in feeling this way, and working with a diabetes educator, support group, or mental health counselor can get you back on track.

Where Can I Find Diabetes Communities?

Talking to people who know exactly what you’re going through can be just as important as finding a treatment plan that works. Here are some places to start to make connections, find resources, and meet friends.

Top Diabetes Instagrammers

There’s no shortage of ’grammers from the #T1D and #T2D communities — here’s a sprinkling of some of our faves who are sharing diabetes-friendly recipes and stigma-squashing real-talk.

• Mila Clarke Buckley那@thehangrywoman

Follow because:她将她的生活方式与糖尿病（2016年诊断为2型）变成数字讲故事，分享如何与糖尿病一起生活，仍然享受生活中的更精细的事物，就像芝士汉堡和旅行一样。

• Michelle Laine, APRN-BC那@diabadassaprn

Follow because:This Yale University grad, family nurse practitioner, and Muay Thai kickboxing enthusiast is also a type 1 diabetes patient. Laine doesn’t sugarcoat (pardon the pun) her disease, but she does promise to never let it hold her back.

• Carrie Lane.那@officialcarrielane

Follow because:作为一个妈妈，有1型糖尿病的Laine，股票的所有关于准备孕妇，你怀孕期间的理想A1C水平，以及你的身体（和思想）如何变化。毫无疑问，她不会通过母性分享，所以没有更好的时间来前进并给她一个追随者。

• Carl Franklin and Carrie Brown那@ 2ketodudes.

Follow because:任何这些“格解者谈论食物的人都毫不惊讶，因为糖尿病 - 特别是2-被大部分地管理，以及你如何燃料的身体。他们的食谱范围从美食眼睛糖果“嘿，我可以做到！”

• Christel Oerum那@diabetesstrong_ig

Follow because:She turned a personal blog about exercise and nutrition for type 1 diabetes into one of the largest diabetes health websites, and created the ebook适合糖尿病to inspire anyone who is insulin-dependent.

Top Diabetes-Related Podcasts

• 2 keto dudes.。This podcast follows Carrie Brown and her pal Carl Franklin on their journey from metabolic syndrome and type 2 diabetes to a cleaner and healthier life, which they credit to following a keto diet. Expect convos on the pros, cons, and controversies of keto.

• Juicebox。Scott Benner is an author,blogger，骄傲的留在家里的一个糖尿病的女儿爸爸。虽然他没有糖尿病本人，但他必须学会管理糖尿病，好像这是他自己的，因为他的女儿被诊断出来的时候只有2。

• 我的懒惰胰腺。Type 1 diabetes doesn’t have to hold you back from being an athlete. Kyle Masterman, whose goal is to cycle across Australia, brings on guests who are breaking barriers in sports and fitness—all while living with diabetes. Give it a listen on the way to the gym to help kick your butt into gear.

• Diabetes Daily Grind。Amber Clour, who has lived with type 1 diabetes since childhood, brings together a team of people with type 1 or type 2 diabetes on this engaging podcast. The focus: Real advice about everyday life. No fluff, just reality.

顶级糖尿病支持团体和非利润

• 美国糖尿病协会。这一非营利组织拥有超过565,000名志愿者，540,000名志愿者和400名员工，这是一种旨在估计的力量。在其使命的核心：提高对胰岛素价格的影响和治疗患有糖尿病，并倡导政策变革的影响。

• Diabetes Research Institute Foundation。It starts here with the scientists who are working to find a cure for those living with diabetes. Their goal, a little unconventional, is to put themselves out of business. A cure means their work is done!

• JDRF (Formerly called Juvenile Diabetes Research Foundation)。This one’s for the kids — or, more often than not, parents of kiddos fighting type 1 diabetes. The nonprofit is the leading global organization funding type 1 diabetes research, having raised $2 billion for research to date.

• 采取控制你的糖尿病。The founder of this nonprofit is an endocrinologist who was diagnosed with type 1 diabetes at age 15. Steve Edelman, M.D., brings together patients and experts at conferences across the U.S. to help them better understand and manage their lives with diabetes.

• DiabetesSisters。Hey ladies, welcome to the sisterhood. While diabetes does not discriminate, there’s a whole world of the disease that only affects women (hello pregnancy, menopause, and other hormone-imbalanced moments). Come here for peer support, education, and stories of hope.