Diabetes
Diabetes is a chronic condition that affects how your body uses blood sugar, also called glucose. Glucose gives your cells energy. Insulin, a hormone made by the pancreas, helps move glucose from your blood into your cells.
If your body doesn’t make enough insulin or doesn’t use insulin properly, blood sugar rises. High blood sugar can damage blood vessels and organs, including the heart, brain, kidneys, eyes, and nerves. Early diagnosis and steady management can lower these risks.
There are different types of diabetes. Understanding your type can reduce confusion, guide treatment decisions, and help you know what to expect.
Symptoms
Diabetes may not cause clear symptoms at first. Some people learn they have diabetes during routine blood work.
Common symptoms include:
Increased thirst
Frequent urination
Feeling very tired
Blurred vision
Cuts or sores that heal slowly
Tingling, numbness, or pain in the hands or feet
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.
Causes & Risk Factors
Diabetes develops when the body can't properly regulate blood sugar. The exact cause depends on the type of diabetes. Risk factors increase the likelihood of developing the condition.
Causes
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.
Sometimes it's not immediately clear which type a person has. A diagnosis may be refined as more information becomes available. Understanding that classification can evolve helps reduce uncertainty.
Risk Factors
Some risk factors can be changed. Others cannot.
Modifiable risk factors
Excess body weight
Physical inactivity
High blood pressure
Unhealthy cholesterol levels
Smoking
History of gestational diabetes
Non-modifiable risk factors
Family history of diabetes
Older age
History of prediabetes
Certain genetic conditions
Diabetes is more common in some racial and ethnic communities, including Black, Hispanic or Latino, Native American, and Asian American populations. Differences in access to care, environment, and social factors contribute to this pattern.
Diagnosis
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.
Treatment
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.
Lifestyle Changes
Healthy daily habits support all types of diabetes.
Eating balanced meals with appropriate portions
Limiting sugary drinks and highly processed foods
Staying physically active most days of the week
Reaching and maintaining a healthy weight
Getting enough sleep
Many people monitor their blood sugar at home. Tracking results helps guide food choices, activity, and medication adjustments.
Medications
Medication needs differ between type 1 and type 2 diabetes.
Medications for Type 1 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
orAn 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.
Medications for Type 2 diabetes
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.
Procedures
Most people with diabetes don't 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.
Living With/Prevention
Diabetes is a long-term condition, but many people live full and active lives with proper care.
Ongoing management often includes:
Regular medical visits
Blood sugar monitoring
Blood pressure and cholesterol checks
Eye exams
Foot exams
Kidney function testing
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.
Know Your Type. Know Your Plan.
If you have diabetes or risk factors for it, talk with your healthcare professional about your specific type and treatment options. Clear information and a personalized plan can help you manage blood sugar and support long-term vascular health.
References
American Diabetes Association Professional Practice Committee. 2. Diagnosis and classification of diabetes: Standards of care in diabetes—2025. Diabetes Care. 2025;48(suppl 1):S27-S49. doi:10.2337/dc25-S002
American Heart Association. Preventing and treating diabetes. Accessed December 16, 2025.
Centers for Disease Control and Prevention. Diabetes and your heart. May 15, 2024.
Centers for Disease Control and Prevention. Symptoms of diabetes. May 15, 2024.
Davies MJ, Aroda VR, Collins BS, et al. Management of hyperglycemia in type 2 diabetes, 2022: A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022;45(11):2753-2786. doi:10.2337/dci22-0034
Liu R, Li L, Shao C, Cai H, Wang Z. The impact of diabetes on vascular disease: Progress from the perspective of epidemics and treatments. J Diabetes Res. 2022;2022:1531289. doi:10.1155/2022/1531289
Xue C, Chen K, Gao Z, Bao T, Dong L, Zhao L, Tong X, Li X. Common mechanisms underlying diabetic vascular complications: Focus on the interaction of metabolic disorders, immuno-inflammation, and endothelial dysfunction. Cell Commun Signal. 2023;21:298. doi:10.1186/s12964-023-01288-7
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