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{{short description|Group of endocrine diseases characterized by high blood sugar levels}}{{About|the common insulin disorder|the urine hyper-production disorder|Diabetes insipidus|other uses|Diabetes (disambiguation)}}{{pp-pc|small=yes}}{{use American English|date=January 2023}}

factoids

| image = Blue circle for diabetes.svg| image_size = 250px| alt = A hollow circle with a thick blue border and a clear centreDATE=17 MARCH 2006 URL-STATUS=DEAD ARCHIVE-DATE=5 AUGUST 2007, | field = Endocrinology

• Frequent urination
• Increased thirst
• Increased hunger

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• Metabolic imbalances
• Cardiovascular diseases
• Nerve and brain damage
• Kidney failure
• Gastrointestinal changesWEB, Diabetes,www.who.int/news-room/fact-sheets/detail/diabetes, www.who.int, 1 October 2022, 26 February 2023,web.archive.org/web/20230226173058/https://www.who.int/news-room/fact-sheets/detail/diabetes, live, JOURNAL, Krishnasamy S, Abell TL, Diabetic Gastroparesis: Principles and Current Trends in Management, Diabetes Therapy, 9, Suppl 1, 1–42, July 2018, 29934758, 6028327, 10.1007/s13300-018-0454-9, JOURNAL, Saedi E, Gheini MR, Faiz F, Arami MA, Diabetes mellitus and cognitive impairments, World Journal of Diabetes, 7, 17, 412–422, September 2016, 27660698, 5027005, 10.4239/wjd.v7.i17.412, free,

}}| duration = Remission may occur, but diabetes is often life-long

• Type 1 diabetes
• Type 2 diabetes
• Gestational diabetes

{edih}| causes = Insulin insufficiency or gradual resistance

• Type 1: genetics and environmental factors
• Type 2: Obesity, lack of exercise, genetics,WEB, Causes of Diabetes - NIDDK,www.niddk.nih.gov/health-information/health-topics/Diabetes/causes-diabetes/Pages/index.aspx, National Institute of Diabetes and Digestive and Kidney Diseases, 10 February 2016, June 2014, live, 2 February 2016,www.niddk.nih.gov/health-information/health-topics/Diabetes/causes-diabetes/Pages/index.aspx," title="web.archive.org/web/20160202083725www.niddk.nih.gov/health-information/health-topics/Diabetes/causes-diabetes/Pages/index.aspx,">web.archive.org/web/20160202083725www.niddk.nih.gov/health-information/health-topics/Diabetes/causes-diabetes/Pages/index.aspx,

}}

• High blood sugar
• Increased HbA1c

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• Lifestyle changes
• Diabetes medication

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• Insulin
• Anti-hyperglycaemicsWEB, MSDManuals.com,www.msdmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/drug-treatment-of-diabetes-mellitus, Drug Treatment of Diabetes Mellitus, Brutsaert EF, February 2017, 12 October 2018, 12 October 2018,web.archive.org/web/20181012214514/https://www.msdmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/drug-treatment-of-diabetes-mellitus, live,

}}WEBSITE=WWW.DIABETESATLAS.ORG ARCHIVE-DATE=1 MAY 2020 URL-STATUS=LIVE, | deaths = 4.2 million (2019)}}Diabetes mellitus, often known simply as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels.WEB, Diabetes,www.who.int/health-topics/diabetes, live, 29 January 2023, World Health Organization, 29 January 2023,web.archive.org/web/20230129101252/https://www.who.int/health-topics/diabetes, WEB, Diabetes Mellitus (DM) - Hormonal and Metabolic Disorders,www.msdmanuals.com/en-gb/home/hormonal-and-metabolic-disorders/diabetes-mellitus-dm-and-disorders-of-blood-sugar-metabolism/diabetes-mellitus-dm, MSD Manual Consumer Version, 1 October 2022, 1 October 2022,web.archive.org/web/20221001070047/https://www.msdmanuals.com/en-gb/home/hormonal-and-metabolic-disorders/diabetes-mellitus-dm-and-disorders-of-blood-sugar-metabolism/diabetes-mellitus-dm, live, Diabetes is due to either the pancreas not producing enough insulin, or the cells of the body becoming unresponsive to the hormone’s effects.BOOK, Shoback DG, Gardner D, Greenspan’s basic & clinical endocrinology, 2011, McGraw-Hill Medical, New York, 978-0-07-162243-1, Chapter 17, 9th, Classic symptoms include thirst, polyuria, weight loss, and blurred vision. If left untreated, the disease can lead to various health complications, including disorders of the cardiovascular system, eye, kidney, and nerves.JOURNAL, Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN, July 2009, Hyperglycemic crises in adult patients with diabetes,care.diabetesjournals.org/content/32/7/1335.full, live, Diabetes Care, 32, 7, 1335–1343, 10.2337/dc09-9032, 2699725, 19564476,care.diabetesjournals.org/content/32/7/1335.full," title="web.archive.org/web/20160625075136care.diabetesjournals.org/content/32/7/1335.full,">web.archive.org/web/20160625075136care.diabetesjournals.org/content/32/7/1335.full, 2016-06-25, Untreated or poorly treated diabetes accounts for approximately 1.5 million deaths every year.The major types of diabetes are type 1 and type 2.WEB,www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes, Symptoms and Causes of Diabetes, National Institute of Diabetes and Digestive and Kidney Diseases, US National Institutes of Health, 2024, 16 May 2024, The most common treatment for type 1 is insulin replacement therapy (insulin injections), while anti-diabetic medications (such as metformin and semaglutide) and lifestyle modifications can be used to manage type 2. Gestational diabetes, a form that arises during pregnancy in some women, normally resolves shortly after delivery.As of 2021, an estimated 537 million people had diabetes worldwide accounting for 10.5% of the adult population, with type 2 making up about 90% of all cases. It is estimated that by 2045, approximately 783 million adults, or 1 in 8, will be living with diabetes, representing a 46% increase from the current figures.WEB, Facts & figures,idf.org/about-diabetes/facts-figures/, 2023-08-10, International Diabetes Federation, 2023-08-10,web.archive.org/web/20230810231724/https://idf.org/about-diabetes/facts-figures/, live, The prevalence of the disease continues to increase, most dramatically in low- and middle-income nations.JOURNAL, De Silva AP, De Silva SH, Haniffa R, Liyanage IK, Jayasinghe S, Katulanda P, Wijeratne CN, Wijeratne S, Rajapaksa LC, 6, Inequalities in the prevalence of diabetes mellitus and its risk factors in Sri Lanka: a lower middle income country, International Journal for Equity in Health, 17, 1, 45, April 2018, 29665834, 5905173, 10.1186/s12939-018-0759-3, free, Rates are similar in women and men, with diabetes being the seventh leading cause of death globally.WEB, The top 10 causes of death,www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death, www.who.int, 18 May 2020, 24 September 2021,web.archive.org/web/20210924191646/https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death, live, The global expenditure on diabetes-related healthcare is an estimated US$760 billion a year.JOURNAL, Bommer C, Sagalova V, Heesemann E, Manne-Goehler J, Atun R, Bärnighausen T, Davies J, Vollmer S, 6, Global Economic Burden of Diabetes in Adults: Projections From 2015 to 2030, Diabetes Care, 41, 5, 963–970, May 2018, 29475843, 10.2337/dc17-1962, 3538441, free, {{TOC limit}}

Signs and symptoms

(File:Main symptoms of diabetes.svg|thumb|upright=1.5|Overview of the most significant symptoms of diabetes) (File:Diabetes complications.jpg|thumb|Retinopathy, nephropathy, and neuropathy are potential complications of diabetes)The classic symptoms of untreated diabetes are polyuria, thirst, and weight loss.BOOK, Feather, Adam, Kumar and Clark’s Clinical Medicine, Randall, David, Waterhouse, Mona, Elsevier, 2021, 978-0-7020-7868-2, 10th, 699–741, Several other non-specific signs and symptoms may also occur, including fatigue, blurred vision, and genital itchiness due to Candida infection. About half of affected individuals may also be asymptomatic. Type 1 presents abruptly following a pre-clinical phase, while type 2 has a more insidious onset; patients may remain asymptomatic for many years.BOOK, Goldman, Lee, Goldman-Cecil Medicine, Schafer, Andrew, Elsevier, 2020, 978-0-323-53266-2, 26th, 1490–1510, Diabetic ketoacidosis is a medical emergency that occurs most commonly in type 1, but may also occur in type 2 if it has been longstanding or if the individual has significant β-cell dysfunction.BOOK, Penman, Ian, Davidson’s Principles and Practice of Medicine, Ralston, Stuart, Strachan, Mark, Hobson, Richard, Elsevier, 2023, 978-0-7020-8348-8, 24th, 703–753, Excessive production of ketone bodies leads to signs and symptoms including nausea, vomiting, abdominal pain, the smell of acetone in the breath, deep breathing known as Kussmaul breathing, and in severe cases decreased level of consciousness. Hyperosmolar hyperglycemic state is another emergency characterised by dehydration secondary to severe hyperglycaemia, with resultant hypernatremia leading to an altered mental state and possibly coma.JOURNAL, Willix, Clare, Griffiths, Emma, Singleton, Sally, May 2019, Hyperglycaemic presentations in type 2 diabetes,www1.racgp.org.au/ajgp/2019/may/hyperglycaemic-presentations-in-type-2-diabetes, Australian Journal of General Practice, 48, 5, 263–267, 10.31128/AJGP-12-18-4785, 31129935, 167207067, free, 2023-08-10, 2023-08-10,web.archive.org/web/20230810230515/https://www1.racgp.org.au/ajgp/2019/may/hyperglycaemic-presentations-in-type-2-diabetes, live, Hypoglycaemia is a recognised complication of insulin treatment used in diabetes.JOURNAL, Amiel, Stephanie A., 2021-05-01, The consequences of hypoglycaemia,doi.org/10.1007/s00125-020-05366-3, Diabetologia, 64, 5, 963–970, 10.1007/s00125-020-05366-3, 1432-0428, 8012317, 33550443, An acute presentation can include mild symptoms such as sweating, trembling, and palpitations, to more serious effects including impaired cognition, confusion, seizures, coma, and rarely death. Recurrent hypoglycaemic episodes may lower the glycaemic threshold at which symptoms occur, meaning mild symptoms may not appear before cognitive deterioration begins to occur.

Long-term complications

The major long-term complications of diabetes relate to damage to blood vessels at both macrovascular and microvascular levels.WEB, Diabetes - long-term effects,www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes-long-term-effects, 2023-08-12, Better Health Channel, Department of Health, Victoria, 2023-10-29,web.archive.org/web/20231029233716/https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes-long-term-effects, live, JOURNAL, Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio E, Ingelsson E, Lawlor DA, Selvin E, Stampfer M, Stehouwer CD, Lewington S, Pennells L, Thompson A, Sattar N, White IR, Ray KK, Danesh J, 6, Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies, Lancet, 375, 9733, 2215–2222, June 2010, 20609967, 2904878, 10.1016/S0140-6736(10)60484-9, Diabetes doubles the risk of cardiovascular disease, and about 75% of deaths in people with diabetes are due to coronary artery disease.JOURNAL, 6, O’Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX, Anderson JL, Jacobs AK, Halperin JL, Albert NM, Brindis RG, Creager MA, DeMets D, Guyton RA, Hochman JS, Kovacs RJ, Kushner FG, Ohman EM, Stevenson WG, Yancy CW, January 2013, 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, Circulation, 127, 4, e368, 10.1161/CIR.0b013e3182742cf6, 23247304, free, Other macrovascular morbidities include stroke and peripheral artery disease.JOURNAL, Papatheodorou K, Banach M, Bekiari E, Rizzo M, Edmonds M, 11 March 2018, Complications of Diabetes 2017, Journal of Diabetes Research, 2018, 3086167, 10.1155/2018/3086167, 5866895, 29713648, free, Microvascular disease affects the eyes, kidneys, and nerves. Damage to the retina, known as diabetic retinopathy, is the most common cause of blindness in people of working age. The eyes can also be affected in other ways, including development of cataract and glaucoma. It is recommended that people with diabetes visit an optometrist or ophthalmologist once a year.WEB, Diabetes eye care,medlineplus.gov/ency/patientinstructions/000078.htm, 2018-03-27, MedlinePlus, National Library of Medicine, Maryland, 2018-03-28,web.archive.org/web/20180328102348/https://medlineplus.gov/ency/patientinstructions/000078.htm, live, Diabetic nephropathy is a major cause of chronic kidney disease, accounting for over 50% of patients on dialysis in the United States.BOOK, Wing, Edward J, Cecil Essentials of Medicine, Schiffman, Fred, Elsevier, 2022, 978-0-323-72271-1, 10th, Pennsylvania, 282–297, 662–677, Diabetic neuropathy, damage to nerves, manifests in various ways, including sensory loss, neuropathic pain, and autonomic dysfunction (such as postural hypotension, diarrhoea, and erectile dysfunction). Loss of pain sensation predisposes to trauma that can lead to diabetic foot problems (such as ulceration), the most common cause of non-traumatic lower-limb amputation.Based on extensive data and numerous cases of gallstone disease, it appears that a causal link might exist between type 2 diabetes and gallstones. People with diabetes are at a higher risk of developing gallstones compared to those without diabetes.JOURNAL, Yuan, Shuai, Gill, Dipender, Giovannucci, Edward L., Larsson, Susanna C., March 2022, Obesity, Type 2 Diabetes, Lifestyle Factors, and Risk of Gallstone Disease: A Mendelian Randomization Investigation, Clinical Gastroenterology and Hepatology, 20, 3, e529–e537, 10.1016/j.cgh.2020.12.034, 33418132, free, 10044/1/86461, free, There is a link between cognitive deficit and diabetes; studies have shown that diabetic individuals are at a greater risk of cognitive decline, and have a greater rate of decline compared to those without the disease.JOURNAL, Cukierman T, Gerstein HC, Williamson JD, December 2005, Cognitive decline and dementia in diabetes--systematic overview of prospective observational studies, Diabetologia, 48, 12, 2460–2469, 10.1007/s00125-005-0023-4, 16283246, free, The condition also predisposes to falls in the elderly, especially those treated with insulin.JOURNAL, Yang Y, Hu X, Zhang Q, Zou R, November 2016, Diabetes mellitus and risk of falls in older adults: a systematic review and meta-analysis, Age and Ageing, 45, 6, 761–767, 10.1093/ageing/afw140, 27515679, free,

Causes{| class“wikitable” style@float:right; margin:10px”

! Feature !! Type 1 diabetes !! Type 2 diabetes! Onset|Gradual! Age at onsetwww.usnews.com/news/health-news/articles/2023-09-28/over-a-third-of-adults-with-type-1-diabetes-werent-diagnosed-until-after-30 >| Mostly in adults! Body size JOURNAL = MEDICINE PAGES = 1–5 DOI = 10.1383/MEDC.30.1.1.28264, Often obese! Ketoacidosis| Rare! Autoantibodies| Absent! Endogenous insulin| Normal, decreased or increased! Heritability TITLE = CO-AGGREGATION AND HERITABILITY OF ORGAN-SPECIFIC AUTOIMMUNITY: A POPULATION-BASED TWIN STUDY VOLUME = 182 PAGES = 473–480 PMID = 32229696 PMC = 7182094, HYTTINEN V, KAPRIO J, KINNUNEN L, KOSKENVUO M, TUOMILEHTO J > TITLE = GENETIC LIABILITY OF TYPE 1 DIABETES AND THE ONSET AGE AMONG 22,650 YOUNG FINNISH TWIN PAIRS: A NATIONWIDE FOLLOW-UP STUDY VOLUME = 52 PAGES = 1052–1055 PMID = 12663480 DOI-ACCESS = FREE, CONDON J, SHAW JE, LUCIANO M, KYVIK KO, MARTIN NG, DUFFY DL > TITLE = A STUDY OF DIABETES MELLITUS WITHIN A LARGE SAMPLE OF AUSTRALIAN TWINS VOLUME = 11 PAGES = 28–40 PMID = 18251672 S2CID = 18072879 ACCESS-DATE = 2021-12-27 ARCHIVE-URL = HTTPS://WEB.ARCHIVE.ORG/WEB/20230701154034/HTTPS://WWW.PURE.ED.AC.UK/WS/FILES/11913813/STUDY_OF_DIABETES_MELLITUS_WITHIN_A_LARGE_SAMPLE_OF_AUSTRALIAN_TWINS.PDF TITLE = THE CONCORDANCE AND HERITABILITY OF TYPE 2 DIABETES IN 34,166 TWIN PAIRS FROM INTERNATIONAL TWIN REGISTERS: THE DISCORDANT TWIN (DISCOTWIN) CONSORTIUM VOLUME = 18 PAGES = 762–771 PMID = 26678054 S2CID = 17854531, free, ! Prevalence(age standardized)|