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Approximately 30 million Americans, or about 9 percent of the population, are affected by diabetes mellitus, commonly known as diabetes. This ongoing condition is marked by consistently high blood sugar levels. While many individuals manage symptoms through insulin therapy and lifestyle adjustments, others may face severe complications. Here’s what you should understand about diabetes mellitus.
1. Diabetes comes in three distinct forms.
In healthy individuals, the pancreas produces sufficient insulin to process sugars into glucose and transport it into cells, where it is utilized for energy.
People with type 2 diabetes, the most prevalent form of the disease, which accounts for roughly 95 percent of all cases, either can't produce enough insulin to move sugars effectively or their cells have become insulin-resistant. This leads to an accumulation of glucose in the blood (also known as hyperglycemia or high blood sugar). Type 2 diabetes usually develops in adults.
Type 1 diabetes, or juvenile diabetes, makes up the remaining 5 percent of chronic cases and typically arises in children and young adults. In this type, the issue is not blood sugar levels but the pancreas' inability to produce sufficient insulin to handle even normal glucose amounts. Consequently, sugar accumulates, resulting in dangerously high levels in the bloodstream.
The third form, gestational diabetes, affects pregnant individuals who were not diabetic before pregnancy. Blood glucose levels tend to rise around the 24th week of gestation, but with proper diet, exercise, and sometimes insulin injections, symptoms can be controlled. Typically, blood sugar levels return to normal after childbirth.
2. The term mellitus in diabetes mellitus translates to "honey sweet."
Around 3000 years ago, ancient Egyptians observed symptoms resembling diabetes, though they hadn’t yet coined the term. It wasn’t until several centuries later that the Greek physician Aretaeus of Cappadocia introduced the name diabetes, derived from the Greek word for "passing through" (a reference to frequent urination, a common symptom of diabetes). In 1675, English doctor Thomas Willis added mellitus, meaning "honey sweet," in response to earlier observations that diabetic urine tasted sweet. Finally, in 1776, English physician Matthew Dobson confirmed that both blood and urine in diabetes patients were sweeter due to elevated glucose levels.
3. The cause of one type of diabetes is well understood, while the other remains unclear.
A person’s lifestyle is a major factor in the development of type 2 diabetes. Risk factors include being overweight or obese, eating a high-calorie diet, smoking, and not getting enough exercise. Foods and beverages high in sugar—soda, candy, ice cream, desserts—can lead to hyperglycemia, but even non-sweet, high-calorie foods can raise blood sugar levels.
Unlike the clear factors contributing to type 2 diabetes, experts are still uncertain about the exact cause of type 1 diabetes. It is known that type 1 is an autoimmune condition, where the immune system attacks and damages insulin-producing cells in the pancreas. Some researchers believe environmental factors, such as viral infections, may trigger this immune response.
4. Family history also influences diabetes risk.
If a parent or sibling has type 2 diabetes, you are more likely to develop pre-diabetes or type 2 diabetes yourself. Lifestyle choices, like diet and exercise habits, play a part in these cases. Genetics are also involved, but having a close relative with diabetes doesn’t mean it’s inevitable for you. Research on identical twins, who share identical genetic makeup, has shown differing risks. When one twin has type 1 diabetes, the other has only a 50 percent chance of developing it, while for type 2, the second twin's risk can be as high as 75 percent.
5. Racial minorities face a higher risk of developing diabetes.
In the U.S., many racial minority groups are at greater risk for type 2 diabetes. Black Americans, Latino Americans, Native Americans, Pacific Islanders, and certain Asian American populations are more likely to experience pre-diabetes and type 2 diabetes compared to white Americans. This can be partly attributed to higher obesity rates within these communities, as obesity is a key risk factor for type 2 diabetes. Socioeconomic factors may also play a part: One study found that people with diabetes living in poverty are less likely to access diabetes clinics and receive proper care than those with middle-income status. Another study revealed that uninsured diabetics have higher blood sugar, blood pressure, and cholesterol levels than those with insurance. Genetics, however, do not seem to explain these patterns.
6. Diabetes is one of the deadliest diseases globally.
With effective management, people with diabetes can lead long and fulfilling lives. However, when left untreated, the disease can result in severe complications. Diabetics are disproportionately affected by chronic kidney disease, adult-onset blindness, and require lower-limb amputations. In the most severe cases, diabetes can be fatal. It ranks as one of the deadliest diseases in the world, claiming more lives than breast cancer and AIDS combined.
7. Millions of Americans are living with pre-diabetes.
The CDC reports that 84 million adults in the U.S. are pre-diabetic. Their blood sugar levels exceed the normal range, but haven't yet reached a level that would classify them as diabetic. For pre-diabetic individuals, fasting blood glucose levels range from 100 to 125 milligrams per deciliter, with anything above that considered diabetic. Those with pre-diabetes are at a greater risk of developing not just type 2 diabetes, but also heart disease and stroke. The good news is that pre-diabetic individuals can take steps such as improving their diet, increasing physical activity, and testing their blood glucose levels regularly to manage their condition. In some cases, doctors may prescribe drugs like metformin to help the body respond better to insulin.
8. After years of steady increase, the rates of diabetes incidence are now on the decline.
Between 1988 and 2014, the rate of new diabetes diagnoses in the U.S. soared by 382 percent. Globally, the number of people with diabetes jumped from 108 million in 1980 to 422 million by 2014.
Thanks to nationwide educational campaigns and prevention strategies, the trend has started to reverse in the U.S., as reported by the CDC. Since reaching a peak in 2009, new diabetes cases in America have decreased by 35 percent. At the same time, the number of people living with diagnosed diabetes has stabilized, suggesting that those with the disease are living longer.
9. The first successful treatment for type 1 diabetes was achieved in 1922.
Before the 20th century, type 1 diabetes was often fatal. Diabetic ketoacidosis, a dangerous buildup of ketones (chemicals produced when the body cannot use glucose and starts breaking down other tissues for energy), caused most patients to die within a year or two of being diagnosed. Seeking a way to save children suffering from juvenile (type 1) diabetes, Canadian doctor Frederick Banting and medical student Charles Best built on previous research, which showed that removing a dog’s pancreas immediately triggered diabetes symptoms. Banting and Best extracted insulin from dog pancreases in the lab of University of Toronto professor J.J.R. Macleod. When they injected the insulin into dogs who had their pancreases removed, they discovered it regulated blood sugar levels. On January 11, 1922, they administered insulin to a human patient and refined the extract to reduce side effects. In 1923, Banting and Macleod were awarded the Nobel Prize in Medicine for their groundbreaking work.
10. A groundbreaking physicist uncovered the distinction between type 1 and type 2 diabetes.
In the 1950s, physicist Rosalyn Yalow and her partner, Solomon Berson, created a method to measure minute amounts of substances in blood. Motivated by Yalow's husband's battle with diabetes, she focused her research on insulin. Their development of the "radioimmunoassay" technology revealed that some diabetes patients were still capable of producing insulin, leading to the classification of the disease into two types: "insulin-dependent" (type 1) and "non-insulin-dependent" (type 2). Prior to this 1959 discovery, the two types were not differentiated. In 1977, Yalow was awarded the Nobel Prize in Medicine for her work on the radioimmunoassay, becoming one of only 12 women to ever win a Nobel Prize in Medicine.
11. Producing a single dose of insulin once required vast quantities of pig parts.
Producing insulin is relatively straightforward today, with most of it being derived from a special, non-disease-causing strain of E. coli bacteria that has been genetically altered to produce insulin. However, this wasn’t always the case. Up until about 40 years ago, it took 2 tons of pig pancreases to produce just 8 ounces of pure insulin, with the pig parts typically being sourced from pork farms.
12. One in four people with diabetes are unaware they have it.
The symptoms of type 2 diabetes may take years to appear, often without prompting patients to consult their doctor. These symptoms include frequent urination, excessive thirst, numbness in the hands and feet, dry skin, blurry vision, fatigue, and slow-healing sores. While none of these symptoms alone may seem alarming, their combination could point to a more serious condition. Type 1 diabetes patients might also experience nausea, vomiting, and stomach pain.
While diabetes symptoms can be serious, they are sometimes subtle and easy to miss. This explains why approximately 25 percent of people with diabetes, or 7.2 million individuals in the U.S., remain undiagnosed. This figure doesn't even account for the many people with pre-diabetes who are unaware they are heading toward diabetes.
