Q: What is diabetes?
A: The term "diabetes" covers several diseases caused by problems with insulin, the hormone that helps maintain a healthy level of glucose -- the sugar your body uses for energy -- in your body. When you don't have enough insulin, or your body's cells are prevented from receiving and using this hormone (so-called "insulin resistance"), unused glucose builds up in your blood -- a condition called "hyperglycemia." Diabetes is a condition of chronic hyperglycemia that often causes no symptoms for years while irreversibly damaging major body organs and systems including eyes, heart and blood vessels, brain, and kidneys.

Q: What are the different types of diabetes?
A: About one in 10 people with diabetes has type 1 diabetes mellitus, which usually develops during childhood, with loss of adequate insulin production in the body and need for daily administration of insulin. Type 2 diabetes mellitus is far more common, affecting some 15 million Americans; it most often occurs in people who are over age 40 and obese but is increasingly seen in obese children, paralleling the rising rate of obesity in Americans of all ages. Type 2 diabetics produce some insulin, but the body doesn't respond effectively to it, a condition called "insulin resistance." Gestational diabetes -- in which a woman's first occurrence of diabetic signs and symptoms occurs during pregnancy -- is relatively rare.

Q: What are the signs and symptoms of diabetes?
A: Generally speaking, symptoms include frequent urination, extreme thirst, blurred vision, fatigue, unexplained weight loss, and hunger. Slow healing and recurring vaginal, bladder, and skin infections may occur, and tingling or numbness in hands or feet. Important: Type 2 diabetics may go for years without symptoms -- increasing the risk of serious complications.

Q: Is there a test for diabetes?
A: Testing a person's urine for glucose was once used to detect diabetes, but a test called "fasting blood glucose" is now considered more accurate. For this test, you fast (don't eat) overnight or for 8 hours. Then a blood sample is drawn to measure your glucose level. "Normal" blood glucose is between 70 and 100 milligrams per deciliter of blood (mg/dL). A level of 126 mg/dL or greater on two tests confirms the diagnosis of diabetes. It's recommended that adults have a fasting blood glucose test at age 45 and every 3 years thereafter.

Q: How is diabetes treated?
A: Let's start by talking about self-care to prevent the onset of diabetes -- in particular, about maintaining a healthy weight, which helps prevent type 2 diabetes. A healthy diet with moderate portions helps keep diabetes at bay, as does regular exercise. People diagnosed with diabetes may receive daily insulin injections (almost always needed for type 1 diabetes); prescription drugs that lower blood glucose or promote insulin action; or a combination of these therapies. If you have diabetes, your doctor is your best source for information about your personal treatment needs.

Q: I've just been diagnosed with type 2 diabetes. What kind of diet is best for me?
A: Until recently, people with diabetes were told to follow restricted diets, measure and weigh food portions precisely, and eat at specific times of day. But doctors now know that the best diet for helping to control diabetes is very similar to what everyone should eat to safeguard health, with a focus on fiber-rich foods such as whole grains, vegetables, legumes (such as peas and beans), and fruits. Even foods with sugar in them may sometimes be permitted! You also should keep your fat intake below 30% of your total daily calories, and your cholesterol level in a healthy range, to reduce your risk of heart disease -- which is higher in diabetics. Your doctor is your best source of information about your daily dietary needs. However, you should also be aware that how much you eat can have as powerful an influence on diabetes control as what you eat. For example, eating a large meal can raise blood sugar to undesirable levels -- and skipping a meal can drop it too far. So following a regular eating pattern can be a strong factor in controlling your diabetes. Remember, for a person with diabetes, consistent intake of healthy foods is important not only for nutrition but also as a part of the overall treatment plan. Be sure to follow your doctor's diet recommendations closely; consult a nutritionist if this is recommended. Eating healthfully should quickly become an enjoyable part of your plan for daily diabetes control.