The term diabetes can be confusing because it encompasses several different types, including one called type 1 diabetes. What is type 1 diabetes? Like all types of diabetes, it involves high blood sugar levels. Also, like the other forms of diabetes, it’s a metabolic disorder. Unlike the other forms, type 1 diabetes is additionally an autoimmune disorder. To properly understand what type 1 diabetes is, let’s take a look at the type 1 diabetes definition and symptoms.

Just What Is Type 1 Diabetes, Exactly?

You might recognize type 1 diabetes by its former names: juvenile-onset diabetes or insulin-dependent diabetes mellitus (IDDM). This disease is now referred to as type 1 diabetes. The illness itself hasn’t changed. Type 1 diabetes is a serious illness that occurs when the body’s immune system attacks an organ called the pancreas and the insulin-producing beta cells within it, leaving the body without the insulin it needs to escort glucose out of the bloodstream and into the body’s various cells.

There are two parts to that type 1 diabetes definition. It’s an autoimmune disorder and a metabolic disorder. Type 1 diabetes is the only form of diabetes in which the body turns on itself and destroys something needed for survival. This is the autoimmune aspect of type 1.

The other part of this disease is like the other forms of diabetes and involves metabolism. When you eat carbohydrates, your digestive system breaks them down into sugars known as glucose. The glucose is released into your bloodstream where, when your body is working properly, insulin has been released by the pancreas to carry it into cells for energy. In type 1 diabetes, the immune system has destroyed the pancreas’s ability to make insulin. Thus, blood glucose levels rise to dangerous levels. Type 1 diabetes can make you sick both short- and long-term.

Most of the time, type 1 diabetes develops in children, adolescents, or young adults; however, this type of diabetes can develop at any age ("What Are the Symptoms of Diabetes in a Child?"). Type 1 sometimes develops slowly over the course of many years. It’s known then as latent autoimmune diabetes of the adult, or LADA.

Type 1 diabetes accounts for only five- to ten percent of all cases of diabetes; nonetheless, it affects many people. It’s the second most common disease of childhood, behind only asthma. Over one million Americans are living with type 1 diabetes, and almost 18,000 children were diagnosed with it between 2011-2012.

This is a serious disease that impacts millions. It’s important to uncover the cause to determine how to best treat, and possibly even cure, it.

What is the Cause of Type 1 Diabetes?  

Researchers are studying this disease to determine exactly what causes type 1 diabetes, including why some people’s immune systems turn against the pancreas and insulin-producing beta cells. Much is still unknown, but here’s what is understood about the causes of type 1 diabetes.

• Possibly having what new research has identified as hybrid insulin peptides (HIPs) that trigger the immune system to make the autoantibodies that attack the pancreas (American Diabetes Association, 2017)
• Genetic predisposition to type 1 diabetes
• Exposure to certain viruses, including, but not limited to, the coxsackie and mumps viruses (only a problem in genetically predisposed individuals)
• Exposure to certain environmental toxins in genetically predisposed individuals

When this autoimmune malfunction is set in motion, people often notice certain symptoms. Knowing what they are can help you know what to watch for.

Type 1 Diabetes Symptoms

Type 1 diabetes symptoms in adults and type 1 diabetes symptoms in a child are very similar. Symptoms may include:

• Unusual fatigue
• Hunger, even after eating
• Unintentional weight loss
• Excessive thirst
• Frequent urination
• Blurred vision
• Numbness or tingling in hands and feet
• Moodiness or irritability, especially in kids

Sometimes, though, there are no symptoms at first. The disease silently progresses until it is severe. Then symptoms may include:

• Fruity breath
• Rapid breathing
• Dry skin and/or mouth
• Nausea or vomiting
• Stomach pain

If you notice any of these diabetes symptoms in a child or in yourself, it’s important to see your primary care physician for an evaluation. Is type 1 diabetes curable? Unfortunately, it is not. However, it is very treatable ("How Do You Treat Diabetes? Medications, Diet, Stem Cells").

Type 1 diabetes treatment can involve you and a healthcare team made up of professionals specializing in various aspects of diabetes. You might work with your primary care doctor, an endocrinologist, dietitian, dentist, eye doctor, foot doctor, mental health specialist, and diabetes educators. You will work together as a team to treat diabetes because it impacts your whole self.  

Further, making lifestyle changes such as proper nutrition and enough physical activity treats diabetes. People with type 1 diabetes also take insulin multiple times per day to control their blood sugar levels.

Type 1 diabetes is a serious illness that affects your whole system. Despite this, active treatment makes it possible to live a full life with type 1 diabetes.

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Uncontrolled diabetes is diabetes that, for various reasons, isn’t properly treated and managed. The result is blood glucose (sugar) levels that soar and remain too high, a condition called hyperglycemia. For someone with diabetes, blood sugar levels should range between 70 and 140 ml/dL depending on when the reading is done. Blood glucose levels fluctuate with fasting, eating, and exercising. In uncontrolled diabetes, blood sugar climbs to 180 ml/dL or higher.

Hyperglycemia is extremely dangerous; indeed, almost every organ and system in the body is at risk for serious damage if diabetes isn’t properly managed.  Uncontrolled diabetes can cause strokes, heart disease, and neuropathy (nerve damage). Knowing why uncontrolled diabetes happens can help you avoid it so you can live and feel well.

Causes of Uncontrolled Diabetes

Uncontrolled diabetes happens for a variety of reasons. Sometimes, people don’t know that they have diabetes. Type 2 diabetes can sneak up on people insidiously, with few warning signs and symptoms until blood sugar has spiked out of control. In most cases, severe hyperglycemia arising from unmanaged diabetes relates to uncontrolled diabetes type 2, although both type 1 and type 2 diabetes can become out of control.

To understand how severe hyperglycemia develops, it helps to know what goes wrong in the body when someone has diabetes. In diabetes, there is a problem with insulin in the body. Insulin is a hormone that acts as an important key, unlocking the cells of the body so that glucose can leave the bloodstream and enter the cells.

Without insulin, the glucose produced during digestion stays in the blood instead of entering the cells. Blood sugar accumulates, and if levels rise without intervention, people can become very ill.

Diabetes needs to be monitored and managed daily to ensure that blood sugar levels are stable and in the healthy range. A number of factors can cause uncontrolled diabetes:

• Improper diet and inadequate nutrition
• Illness other than diabetes that can interfere in diabetes treatment
• Inadequate physical activity
• Medications for other conditions can interfere with diabetes medication
• Wrong dose or type of diabetes medication or skipping doses of diabetes medication
• Mental health conditions, such as depression, that interfere in someone’s ability to adequately manage his or her diabetes ("Uncontrolled Diabetes and Mental Health Complications")

One or more of these factors can cause uncontrolled diabetes. If any of these applies to you, learn the signs and symptoms of severe hyperglycemia to know when you need medical help.

Symptoms and Signs of Uncontrolled Diabetes

Symptoms don’t always appear immediately when blood sugar levels begin to climb. Sometimes, diabetes becomes out of control gradually. Once you do notice symptoms of diabetes, your blood glucose might already be above 180 mg/mL and doing damage to your body. Watch for the following signs (most people won’t have all of them) that your blood sugar might be creeping ever higher:

• Excessive, unquenchable thirst
• Increased urination
• Frequent infections, especially yeast infections
• Cuts or infections that take too long to heal
• Hunger, eating more, but no weight gain
• Unexplained weight loss
• Fatigue
• Blurred vision
• Tingling or numbness in extremities
• Skin changes (tags, discoloration, infections, blisters)
• High blood pressure
• High cholesterol
• Kidney problems
• Fruity, sweet, or chemical-like breath (many describe it as smelling like nail polish remover)
• Ketoacidosis, or the accumulation in the blood of ketones, the byproduct created when the body tries to burn fat for energy; ketoacidosis is a medical emergency

These uncontrolled diabetes symptoms serve as warning signs that blood sugar is causing damage and needs to be treated immediately.

Controlling Your Diabetes

Severe hypoglycemia is frightening, and it’s wise to take it seriously. If your diabetes does become uncontrolled, it doesn’t mean that you’re doomed to face terrible health problems for the rest of your life. Uncontrolled diabetes means that blood sugar has spiked too high and that it’s time to take measures to bring it back down to healthy levels. It’s possible to regain control of your blood sugar.

Work with your doctor and other members of your diabetes treatment team to manage diabetes. Some important aspects of taking charge of this disease include:

• Monitoring your blood glucose levels throughout the day, every day by testing your blood at home with a special device
• Creating a meal plan and sticking to it
• Getting lots of physical activity
• Taking your diabetes medication and working with your doctor to monitor its effectiveness

Experts at Johns Hopkins Health System recommend keeping a log book to record your blood sugar levels and reasons for unusual spikes and dips. This allows you to see patterns and make adjustments to do more of what works and less of what doesn’t. A log book also can be a valuable tool for discussing your diabetes management with your doctor.

Avoiding uncontrolled diabetes is primarily a matter of monitoring your blood glucose levels, symptoms, lifestyle, and medications in order to remain healthy and thrive.

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Is there anything that can be done to reverse erectile dysfunction from diabetes? Fortunately, there is.

Erectile dysfunction (ED) from diabetes is extremely common, affecting up to 75 percent of men with either type 1 or type 2 diabetes (Cowley, 2017). It doesn’t have to be a permanent condition. Understanding the causes of ED and the workings of diabetes can help you know what you can do to reverse erectile dysfunction from diabetes.

Diabetes and ED each have complex causes and effects. They can be physical, psychological, or both ("Is It Erectile Dysfunction from Diabetes or Performance Anxiety?"). Likewise, the effects can be physical and psychological. For example, erectile dysfunction can be caused by diabetes; it’s an effect of the high blood sugar of the disease. It also can be a result of stress and anxiety over having the disorder. Effective ED treatment should address both causes and effects, physical and psychological.

How to Reverse Erectile Dysfunction from Diabetes: Know and Address the Risk Factors

While up to 75 percent of men with diabetes develop ED, 25 percent do not. ED is not inevitable. If you do develop ED, you’re not doomed for life. Knowing risk factors for this sexual disorder can help you prevent it from happening or treat it when it develops. Common risk factors for erectile dysfunction in diabetes include:

• Poorly managed blood sugar levels, including chronically high blood sugar
• Being overweight or obese
• Inactivity
• Having a poor diet
• High blood pressure
• Stress
• Anxiety
• Taking certain medications, such as for diabetic nerve pain, blood pressure, or depression

Part of reversing erectile dysfunction with diabetes involves managing these risk factors, for the more you can eliminate, the better your chances of ending ED.

In addition to addressing the risk factors, there are other treatment approaches to reverse ED: medication; herbs, supplements; and alternative remedies, and lifestyle. Let’s explore each of these.

Reversing Erectile Dysfunction from Diabetes with Medication

You may have heard of Viagra. It’s practically a household name thanks to effective advertising. Viagra is one of several medications used to treat erectile dysfunction. There are several different medications in the class. Together, they’re the phosphodiesterase-5 inhibitors. Available medications are

• sildenafil (Viagra)
• tadalafil (Cialis)
• vardenafil (Levitra)
• avanafil (Spedra)

Approximately 50 to 70 percent of men with diabetes respond favorably to the phosphodiesterase-5 inhibitors. If this medication doesn’t work for you or you’d rather not take it, there are a few other options for medication.

Testosterone replacement therapy is a common approach. Additionally, doctors sometimes prescribe medication in the form of pills, suppositories, and injections, all designed to increase blood flow to the penis.

If pharmaceutical treatment isn’t effective, herbal treatments and alternative remedies might work well instead.

Herbs, Supplements, and Alternative Remedies to Reverse Erectile Dysfunction from Diabetes

Herbal remedies and supplements have been found by some to be successful in reversing ED. Consider these with two important caveats: While there have been some studies into their effectiveness for ED from diabetes, the numbers are small and more research is needed to determine their safety and efficacy; also, herbs and supplements can have very dangerous side effects that impact the brain and the body. This list contains items that have been successful for some for treating ED with diabetes. It’s here as a starting point for your own research, which should include a talk with your doctor.

• Folic acid
• Vitamin E
• Zinc
• Amino acid (l-arginine and l-citrulline)
• DHEA
• Ginseng
• Yohimbe
• Epimedium
• Maritime pine extract
• Maca

Alternative treatments such as acupuncture, yoga, tai chi, massage, and other mind-body approaches may also help both ED and diabetes. Because of the nature of diabetes, it’s important to check with your doctor before starting any new activity or medication of any type.

Reversing Erectile Dysfunction from Diabetes with Your Lifestyle

Making healthy changes helps erectile dysfunction, and it improves diabetes as well. That’s a double bonus for ED because controlling blood sugar in itself is a way to reverse ED.

Some healthy lifestyle changes you can make for ED and diabetes are

• Increasing physical activity
• Lose weight
• Find and use stress management techniques (such as developing a hobby, etc.)
• Stop smoking if you smoke
• Limit or eliminate alcohol
• Physical therapy to strengthen the pelvic muscles

An important part of reversing ED from diabetes is keeping an open relationship with your doctor and the rest of your care team. Adding or continuing mental health therapy is important, too. Many times, people don’t want to talk about ED. Given that it’s so common, though, doctors know the reason and are there to work with you.

Understanding erectile dysfunction and diabetes helps you to take the right action to reverse it.

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What is diabetes? is a very common question. More than likely, you’ve heard quite a bit about the disease yet still wonder what diabetes is. If so, you’re not alone, for diabetes is complex. Answering this question is important because some types of diabetes are preventable and knowing the definition of diabetes can help you stay healthy ("What Causes Diabetes?"). Even if you or a loved one already has it, the more you know about what diabetes is, the better you can manage it for a quality life.

The simplest diabetes definition is blood sugar levels that are too high. The official term for this condition is hyperglycemia. While this is indeed what diabetes is, it fails to fully answer the question what is diabetes?

Diabetes is actually a group of diseases (there are multiple types of diabetes) in which someone has problems with a hormone called insulin, blood sugar (glucose), and metabolism (how the body uses digested food for energy). Type 1 diabetes, in addition to being a metabolic disease, is also considered to be an autoimmune disease ("What Is the Difference Between Type 1 and Type 2 Diabetes?").

To understand any diabetes definition, it’s necessary to know some specific terms as well as how the body metabolizes food into energy.

What is Diabetes? Terms to Know

Important terms in understanding diabetes include:

• Glucose—blood sugar used by cells for energy; the main source of energy for the body
• Hyperglycemia—too much glucose in the blood
• Insulin—a hormone produced by the pancreas that takes glucose from the blood and escorts it into the cells as well as places extra in the liver for later release
• Insulin resistance—when the body has insulin but doesn’t use it properly
• Pancreas—the organ, tucked behind the stomach, that produces insulin and releases it into the bloodstream
• Beta cells—insulin-producing cells within the pancreas
• Liver—the organ in which insulin stores extra glucose to be released between meals when cells need energy

Glucose and Insulin: What Happens in Diabetes

When someone without diabetes eats, their body turns carbohydrates into glucose during digestion. As blood glucose levels rise, the pancreas revs up to make and release insulin. Insulin then travels through the bloodstream with the glucose to unlock the cells and let glucose pass into them.

Glucose can’t enter the cells on its own but must have the help of insulin to get in. When someone has diabetes, their body either doesn’t make enough insulin or doesn’t use insulin efficiently. Either way, sugar stays in the blood rather than going into the cells for immediate use or into the liver for storage.

Insulin is in constant demand. Blood glucose levels perpetually fluctuate, and it is insulin’s job to keep them steady. Hypoglycemia refers to low blood sugar. When hypoglycemia occurs, the body makes you feel hungry so you eat. While it waits for food, the liver releases stored glucose, and insulin delivers it to cells. If there is a problem with insulin, glucose builds up in the blood rather than flowing into cells. This is hyperglycemia, and it’s what happens in diabetes.

What is Diabetes? It’s Serious

Diabetes is hyperglycemia, but high blood sugar doesn’t do justice to a diabetes definition. In understanding what diabetes is, it’s important to look beyond its baseline definition.

Diabetes is a disease that:

• Begins at the cellular level, with improper insulin functioning
• Involves high blood sugar levels because this glucose can’t get into the cells or the liver
• Can cause dangerous health problems such as heart disease, stroke, eye problems including blindness, nerve damage, kidney damage, foot and leg problems that may lead to amputations
• Is the sixth leading cause of death in the United States

What is diabetes? Diabetes is a serious illness in which the body can’t metabolize the glucose that has been created from the digestion of carbohydrates due to problems with insulin ("Diabetes Symptoms and Signs in Adults, Men, Women and Children").

What is diabetes? A proper diabetes definition must include the fact that, while it’s serious and has no cure, diabetes can be managed and health problems prevented. The key is to monitor and control blood sugar levels to keep them on target. You can live a healthy life and be well even with diabetes ("What is a Diabetes Support Group? Where Can I Find One?").

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Complications from uncontrolled diabetes, including mental health complications, can be serious. When diabetes is uncontrolled, blood sugar (glucose) spikes to dangerous levels, a condition known as severe hyperglycemia. This occurs when, for various reasons, diabetes isn’t properly managed. Dire consequences can arise from extreme hyperglycemia. Awareness of uncontrolled diabetes complications can help people manage their diabetes and avoid mental health complications and physical problems.

Controlling diabetes can be very difficult. While regular medical checkups are necessary as well as visits with other members of a diabetes management team, diabetes is a disease that is largely self-managed. Diabetes demands constant treatment through vigilant monitoring, adjustment, and action throughout the day, every day.

Medication is often needed many times a day, and lifestyle management—including proper diet and nutrition, exercise, and self-care—must be rigorously followed. If anything slides, diabetes can become uncontrolled.

Uncontrolled Diabetes Complications

When diabetes self-management falters or when diabetes is undiagnosed and thus untreated, both physical and mental health suffer. Hyperglycemia can damage every system and every organ in the body. Uncontrolled diabetes complications can involve:

• The cardiovascular system (such as the heart and blood vessels)
• Nerves
• Eyes
• Kidneys
• Digestive tract
• The mouth (including teeth and gums)
• Feet
• Skin
• Ears/hearing

Hyperglycemia also impacts the brain. Diabetes has been implicated as a factor in Alzheimer’s disease. Further, uncontrolled diabetes leads to mental health complications.

Mental Health Complications and Uncontrolled Diabetes

Diabetes and mental health have a rather enmeshed relationship. Mental health conditions can contribute to the development of diabetes. Likewise, living with diabetes can contribute to the development of disorders like depression, anxiety, eating disorders, and more. Psychotic disorders, like schizophrenia, have a strong correlation with diabetes ("What’s the Link Between Diabetes and Mental Illness?").

Sometimes, mental health disorders such as depression can be a factor in blood sugar reaching out-of-control levels. As mentioned, diabetes is largely self-managed, and the constant care it requires is difficult to sustain with depression’s fatigue, low motivation, and poor self-care (including lack of nutrition and physical activity).

Having diabetes can cause mental health complications. On a physical level, high blood sugar affects the functioning of the brain. One way the brain is harmed by hyperglycemia is at the neurochemical level. Hormones like serotonin, dopamine, norepinephrine, cortisol, and others play a significant role in mental health and functioning. Excess blood sugar affects neurochemical levels and operation, leading to complications.

On a mental/emotional level, the demands of living with and managing diabetes can cause great distress. For example, when frustrations are high or health worries soar, mental health can suffer.

These are risks of having diabetes. When diabetes is uncontrolled and high blood glucose levels affect the brain, mental health troubles can become more pronounced. Uncontrolled diabetes can increase the risk of mental health problems such as:

• Increased emotional stress (hyperglycemia can increase the presence of stress hormones, and stress hormones can cause blood sugar to rise)
• Diabetes distress (a mental health condition involving stress, anxiety, and depression-like symptoms)
• Mood swings ("Does Diabetes Cause Mood Swings?")
• Mental confusion ("Diabetes and Irrational Behavior, Mental Confusion")
• Anxiety
• Depression
• Eating disorders

Uncontrolled diabetes and mental health complications have an adverse effect on the quality of life and a sense of wellbeing. The fact that mental health challenges and diabetes contribute to and worsen each other makes this a vicious circle that can be hard to break.

However, it is indeed possible to control diabetes and improve mental health. Awareness of the complications that stem from the relationship is a great starting point. Use the information to begin to make small, positive changes every day. Both diabetes symptoms and mental health will improve.

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Because of the possibility that not all antipsychotics are safe in diabetes treatment, in 2003 the FDA began requiring pharmaceutical companies to use warning labels on atypical antipsychotics ("Do Antipsychotic Medications Cause Diabetes?"). These labels alert people to the risks of antipsychotics and diabetes. This is an important and necessary precaution because atypical antipsychotics are widely used. People take them for many conditions:

• Psychotic disorders like schizophrenia
• Bipolar disorder
• Depression
• Anxiety
• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder (OCD)
• Autism
• Tic disorder
• Tourette’s syndrome
• Eating disorders
• Dementia

These disorders negatively impact lives, and without proper treatment, symptoms can become distressing and disruptive. Atypical antipsychotics are frequently successful in reducing symptoms so that people can live better; however, they carry the risk of the development or worsening of type 2 diabetes.

Antipsychotics and diabetes can be a dangerous combination because antipsychotics often lead to weight gain and hyperglycemia (high blood sugar). This can make someone’s diabetes treatment less effective, with blood glucose levels becoming increasingly difficult to control. Are any antipsychotics safe in diabetes treatment? Here are some things researchers are learning.

Antipsychotics and Diabetes: Different Medications Have Different Risks

Two classes of antipsychotics are available: conventional and atypical. Each alleviates symptoms of psychosis and other mental health conditions. Atypical antipsychotics, the newer class, is used to treat a broader range of conditions. Atypical antipsychotics are also more likely to cause hyperglycemia (high blood sugar levels), which in turn can lead to type 2 diabetes or worsen existing diabetes.

The difference between the two classes has to do with how they work in the brain. That said, medical professionals and scientists aren’t entirely sure how either one works but suspect that conventional antipsychotics block dopamine receptors in the brain while atypical antipsychotics block numerous additional chemical receptors (depending on the individual medication) in addition to dopamine.

The conventional class is less likely to cause high blood sugar that the newer class. If you’ve been prescribed any of these medications, your risk of interference with diabetes treatment may be less:

• droperidol (Droleptan)
• fluphenazine (Prolixin)
• flupenthixol (Depixol, Fluanxol)
• haloperidol (Haldol)
• pimozide (Orap)
• thioridazine (Mellaril)
• thiothixene (Navance)
• trifluoperazine (Stelazine)
• zuclopenthixol (Clopixol)

Atypical antipsychotics have a much stronger association with diabetes, largely because of the weight gain that is a common side-effect.  Among the atypical antipsychotics you or a loved one might take:

• aripiprazole (Abilify)
• asenapine (Saphris)
• clozapine (Clozaril, Clopine, Clozapine Synthon, Denzapine, FazaClo, Zaponex)
• iloperidone (Fanapt)
• lurasidone (Latuda)
• paliperidone (Invega)
• quetiapine (Seroquel)
• risperidone (Risperdal)
• ziprasidone (Geodon)

These don’t have equal effects and side effects. Among the atypical antipsychotics, some are safer than others in diabetes treatment.

Atypical Antipsychotics: Which are Safest for Diabetes?

Atypical antipsychotics frequently cause weight gain. This weight gain is often significant enough to lead to obesity, higher low-density lipoprotein (LDL) cholesterol (the “bad” cholesterol), and an increase in triglycerides (lipids, or fats, found in the blood).

Atypical antipsychotics differ in their degree of risk. Those that cause the most weight gain have the closest association with diabetes.

Atypical Antipsychotics That are Most Dangerous for Diabetes

• chlorpromazine (Thorazine)
• clozapine (Clozaril)
• olanzapine (Zyprexa)

Atypical Antipsychotics That Have a Moderate Risk for Diabetes

• risperidone (Risperdal)
• quetiapine (Seroquel)

Atypical Antipsychotics That Have a Lower Risk for Diabetes

• aripiprazole (Abilify)
• ziprasidone (Geodon)

Evidence from multiple studies indicates that safe antipsychotics in diabetes treatment are those that cause the least amount of weight gain and the health problems that come with it, thus making blood sugar levels easier to control. The best antipsychotics for diabetes may be conventional antipsychotics or the atypical antipsychotics aripiprazole and ziprasidone.

The relationship between mental health disorders, antipsychotics, and diabetes is complex. Much is still unknown regarding the relationship between them. Further complicating matters is the fact that everyone is unique. Two people on the same medication won’t experience the same effects. Therefore, to discover the safest antipsychotic medication that carries the lowest diabetes risk, arm yourself with information, and discuss your options with your doctor. When you’re proactive, you have a better chance of minimizing risks and keeping yourself healthy.

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Diabetes is a serious, life-long disease, and the question, Do I have diabetes? is a common worry. Rightly so, as approximately six percent of the American population has diabetes, and for those in certain ethnic groups, the rate is nearly double (Collazo-Clavell, 2001). Further, one in three adults in the U.S. is at risk for developing type 2 diabetes (American Diabetes Association, n.d.). “Do I have diabetes” is a great question to ask because it equips you with the information you need to prevent or manage this illness.

Diabetes has three primary forms: type 1, type 2, and gestational diabetes. Type 1 is rare, comprising only five- to 10 percent of diabetes cases, leaving all the rest for type 2. Gestational diabetes occurs only in pregnancy so is not numbered among these statistics. When people are concerned about diabetes, it is typically type 2 that applies ("What Are the Diabetes Risk Factors?").

How Do I Know I Have Diabetes? Check This Diabetes Symptoms List

The only way to know with certainty if you have diabetes is by visiting your doctor. Diabetes must be diagnosed by a physician who will ask you questions about your lifestyle and any symptoms you might be having, and then he or she will order lab tests to check your blood sugar level. Diabetes involves hyperglycemia, or high blood sugar, and the only way to know if you have it is with lab tests.

Of course, there are symptoms and risk factors that can serve as warning signs, alerting you to the possibility that you have diabetes. Consider this diabetes symptoms list to see if you have some of them:

• Increased thirst
• Frequent urination
• Increased hunger
• Weight gain (or sometimes weight loss)
• Blurred vision
• Fatigue
• Frequent or slow-healing infections
• Erectile dysfunction
• Dry skin, itchy skin
• Acanthosis, or darkening of the skin on the neck, armpits, or other areas of the body

Unfortunately, many of these symptoms don’t appear until your blood glucose levels have climbed high enough for a type 2 diabetes diagnosis. If you have any of the above symptoms (most people don’t have all of them), it’s a good idea to have a medical check-up ("What Are Type 2 Diabetes Symptoms?").

You don’t have to passively wait for symptoms to appear, however. Because symptoms don’t appear immediately, you might wonder, How do I know I have diabetes? Knowing the risk factors can help you take action if you are concerned about having diabetes.

Risk Factors of Type 2 Diabetes

If you have any of the following risk factors, your chances of developing type 2 diabetes increase.

• Family history (a parent or sibling with diabetes increases your risk)
• Prior gestational diabetes
• Older age (risk increases after age 45)
• Race/ethnicity (African Americans, Latino/a Americans, Native Americans, Pacific Islanders, and some Asian Americans have a higher risk than others)
• Current impaired glucose tolerance (prediabetes)
• Sedentary lifestyle
• Obesity

Of these risk factors, perhaps the two biggest are also the ones in your control: weight and activity level. Seventy-five percent of people with type 2 diabetes either are or have been obese (American Diabetes Association, 2011). Weight is key because body fat makes it difficult for the hormone, insulin to get glucose out of the bloodstream and into the cells of the body. This creates hyperglycemia and leads to a host of other health problems.

You Can Prevent and Treat Type 2 Diabetes

There is good news: you can prevent type 2 diabetes from developing, and if you already have it, you can do things to minimize its impact on your health and life. If you are concerned that you have diabetes, see your doctor and get screened. Test results can tell you whether or not you have it so you can begin treatment or take measures to prevent it from developing.

The biggest impact comes from lifestyle changes. Manage your weight; eat nutritiously; avoid processed foods, foods high in fat and cholesterol, and sugar (including sugary drinks); and be active, exercising about 20 minutes per day five times a week. Your doctor can tell you if you have diabetes, and you can take charge of your lifestyle to prevent or manage it well.

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Diabetes of the brain, sometimes called type 3 diabetes, is a nickname occasionally used to describe Alzheimer’s disease, a type of dementia that involves significant cognitive decline and progressively worsens over time. While diabetes of the brain isn’t an official diagnosis or medical term, it does highlight the connection between the disease and the brain ("Diabetes and Dementia: Can Diabetes Lead to Alzheimer’s Disease?"). While much has yet to be discovered, researchers have demonstrated that diabetes affects the brain, usually in harmful, damaging ways.

Ongoing research studies seek to determine how diabetes affects the brain ("How Diabetes Causes Brain Fog and Memory Loss: Can Anything Help?"). While many questions remain unanswered, thus far studies implicate diabetes in damage to the brain. Quoting researcher Zhanjun Zhang, MD, Schieszer (2015) explains that, “All these studies draw us a definite and defined conclusion that type 2 diabetes destroys the central nervous system, especially in the brain.”

Let’s look at how diabetes affects the brain, both structure and function.

Diabetes and the Brain: Changes and Damage

Understanding the nature of diabetes can shed light on what goes wrong in the brain.

• When the body digests food, one of the byproducts is glucose, or sugar.
• Glucose enters the bloodstream and travels around the body to enter cells and provide energy.
• The hormone insulin is supposed to escort glucose into the cells of the body, but in diabetes, either the body doesn’t make insulin (type 1) or it doesn’t make enough or use it efficiently (type 2).
• Glucose remains in the bloodstream, building too high. This high blood sugar is called hyperglycemia. It damages blood vessels, nerves, and causes extensive damage.
• Sometimes blood sugar drops too low, a condition called hypoglycemia. This is dangerous, too.

Problems with insulin and glucose help explain how diabetes affects the brain. Glucose is the brain’s main energy source, and both hyper- and hypoglycemia can cause harm. When this sugar is stuck in the bloodstream, it can’t nourish the brain.  It becomes starved of oxygen and nutrients, which compromise physical structures, hormones, and cognitive functioning. Chronic hyperglycemia stresses the brain, damages nerve cells, and harms both large and small blood vessels.

In diabetes, brain damage can be extensive, affecting areas such as the:

• Hippocampus (volume reduced by four percent; Schieszer, 2015)
• Amygdala
• Cerebral cortex
• Temporal lobe
• Frontal lobe
• Precuneus

Other casualties of diabetes include:

• Atrophy
• Reduced total brain volume (by almost three percent; Schieszer, 2015)
• Changes in white matter
• Loss of density in gray matter
• Loss of brain cells
• Changes in the connections and communication pathways between different regions in the brain, decreasing efficiency

While both type 1 diabetes and type 2 diabetes can affect the brain, type 2 diabetes is implicated more. Professionals speculate that this is linked to the cardiovascular problems accompanying type 2. Because of overweight or obesity and a sedentary lifestyle, people with diabetes type 2 often develop cardiovascular disease, high blood pressure, and high cholesterol. These also impact brain health, and when combined with hyper- and hypoglycemia, can further damage structures.

In addition to wreaking havoc on brain structures, does diabetes affect brain function? It absolutely can. Functioning deficits are effects of structural damage.

Symptoms of Brain Damage from Diabetes

Injury to brain structures, lost density, and other negative changes cause a decline in cognitive functioning. Sometimes people think of this deterioration as symptoms of diabetes-induced brain damage because they can be observed and measured.

Decreased executive functioning interferes in the ability to plan, organize, focus, and concentrate. Thinking can become rigid and inflexible. Memory declines, as does the ability to monitor thoughts and emotions and maintain self-control.

Perhaps surprisingly, these negative effects of diabetes and brain function aren’t inevitable. A 2017 study examined children with type 1 diabetes (Sukel). It’s logical to assume that diabetes also harms the brains of kids. It can and often does. But this study found that these children actually had improved cognitive functioning and increased connectivity between brain regions.

This is an encouraging indication that the brain is resilient and can heal. It needs help, though.

Controlling Diabetes and Brain Health

The best way to treat brain damage from diabetes is to prevent it from developing. That said, if you or a loved one lives with diabetes and has begun to experience cognitive decline, it’s possible to stop its progression.

The best way to prevent problems or improve brain health and diabetes is through lifestyle changes such as:

• Losing weight if needed
• Maintaining your weight once you’ve reached a healthy level
• Eating nutritiously
• Avoiding processed foods and sugar
• Keeping alcohol consumption to a minimum
• Stopping smoking if you smoke
• Increasing physical activity and regular exercise

These actions are all important choices for a healthy brain and body. Controlling diabetes can minimize the damage that is nicknamed “diabetes of the brain” and keep you mentally sharp.

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Diabetic nerve pain is nerve damage, or neuropathy, that can occur in people living with diabetes. There are four different types of diabetic neuropathy:

1. peripheral (the most common type)
2. autonomic
3. radiculoplexus (also known as diabetic amyotrophy)
4. mononeuropathy (or focus neuropathy)

Diabetic nerve pain symptoms and experiences vary according to type. People can experience just one type or more than one.

Consequences of nerve damage in diabetes can be dire. People might experience physical and emotional pain that lead to diminished quality of life, mental health problems such as anxiety and depression, and increased mortality rates compared to those without diabetic nerve pain ("Diabetic Nerve Pain and Depression"). Given that almost 45 percent of people living with diabetes develop at least one type of neuropathy (Gore, et al., 2005), understanding the symptoms, causes, and treatments is crucial.

Diabetic Nerve Pain Symptoms

Diabetic nerve pain symptoms typically develop gradually; unfortunately, people sometimes don’t notice them until irreversible nerve damage has already occurred. Knowing what to watch for can help minimize damage or lead to earlier treatment.

Symptoms depend on the type of neuropathy experienced and where in the body the damage is located. While diabetes nerve damage is most common in the feet and legs, it can occur anywhere in the body. Regardless of where nerve pain occurs, symptoms can range from mild to disabling. These are common symptoms:

Diabetic Peripheral Neuropathy:

• Tingling
• Pain that is burning, stabbing, sharp, or shooting
• Muscle weakness
• Reduced ability to feel pain
• Sensitivity to touch
• Loss of balance
• Loss of coordination
• Foot problems (ulcers, infections, pain)

Autonomic Neuropathy:

• Hits the autonomic nervous system, the system that controls the heart, bladder, digestive system, sex organs, and eyes
• Symptoms affect the area of nerve damage and include pain as well as functional problems in the given system

Radiculoplexus Neuropathy

• Severe pain in the legs, buttocks, and hips
• Difficulty standing from a seated position
• Weight loss
• Abdominal swelling

Mononeuropathy

• Damage to one specific nerve, often in the face, torso, or leg pain
• Vision problems, including double vision and difficulty focusing
• Carpal tunnel syndrome
• Bell’s palsy (paralysis on one side of the face)

Causes of Diabetic Nerve Damage

While there are multiple contributing factors to neuropathy, or diabetic nerve pain, there is one primary cause: hyperglycemia, or high blood sugar. Hyperglycemia is a problem in diabetes because it occurs easily and can cause extensive damage throughout the body. Diabetes involves a problem with the metabolism of glucose. Glucose, or sugar, is created when the body digests carbohydrates. It’s used by the cells for fuel, but in diabetes, glucose can’t get into the cells so accumulates in the bloodstream. The more glucose—sugar—in the blood, the more damage someone experiences.

Too much blood sugar damages nerves directly as well as weakens the walls of small blood vessels called capillaries that supply nutrients and oxygen to the nerves. Other factors contributing to nerve damage and pain include:

• Inflammation of the nerves due to the immune system attacking them
• Genetic factors that make someone more prone to damage and pain
• Smoking
• Alcohol abuse

Certain risk factors increase the likelihood that someone with diabetes will develop nerve damage. The longer someone has lived with diabetes, the higher their chances of developing nerve problems. Kidney disease, which can be caused by diabetes, damages nerves because of toxins that remain in the bloodstream. Being overweight, with a BMI over 24, is another risk factor.

The moment you start to notice symptoms, especially if you experience any of the diabetic nerve pain causes, it’s important to check in with your doctor to begin treatment. While most nerve damage is irreversible (except, perhaps, mononeuropathy, which often disappears on its own over the course of months), you can minimize pain and maintain an active lifestyle with treatment.

Nerve Pain Treatments in Diabetes

Because diabetic nerve damage, pain, and other symptoms affect all aspects of someone’s life, it’s important to treat the whole person—complete physical and mental health—rather than only targeting the area of pain. Typical treatment approaches include:

• Controlling blood sugar to avoid spikes
• Medication
• Nutritional supplements
• Physical activity
• Foot care, including wearing supportive, well-fitting shoes
• Acupuncture
• Applying capsicum cream (an analgesic derived from chili peppers)
• Mental health therapy

You can find detailed information about these treatments in "What Treatment for Diabetic Nerve Pain is Available?"

Diabetes can damage nerves, and it can cause significant pain as well as lower quality of life. Pay close attention to symptoms of diabetic nerve pain in order to reduce its negative impact on your life.

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Diabetes mellitus and bipolar disorder frequently occur together, and this comorbidity isn’t a random coincidence. More than half (53%) of people with bipolar have either type 2 diabetes or prediabetes, a state of elevated blood sugar levels that aren’t yet high enough for a diabetes diagnosis (Woods, 2015). Someone with bipolar disorder is three times more likely to develop diabetes than someone in the general population.

These two serious illnesses are connected in many ways. One can contribute to the development of the other and they complicate each other’s treatment. Medication side-effects play a part in the link between diabetes and bipolar disorder as well.

Bipolar and diabetes type 2 each can lessen the quality of life and even shorten life. Bipolar disorder reduces the life expectancy of men by eight and a half years and women by nine years compared to average expectancy; add diabetes, and the risk of early death doubles (Charles et al., 2016). Upon reviewing numerous published studies, Charles and colleagues also identified the sobering fact that the suicide risk for people with bipolar is twenty times greater than among the general population, and when someone with bipolar disorder has diabetes, the suicide risk climbs nearly one and a half times that.

Because of the serious nature of combined bipolar disorder and diabetes, it’s important to understand the relationship between them. Awareness can lead to better treatment and management, which can improve mental health and wellness.

The Relationship Between Diabetes and Bipolar Disorder

These illnesses make each other worse. A problem in diabetes is difficulty keeping blood sugar levels within a healthy range. Bipolar disorder interferes with this glycemic control. Similarly, diabetes leads to changes in brain chemistry that are at work in bipolar disorder ("What are the Effects of Diabetes on Mood Disorders?").

The disruptions in glycemic control and brain chemistry can lead to dangerous swings in both blood sugar and mood ("Does Diabetes Cause Mood Swings?"). Diabetic swings in blood sugar are worsened when someone has bipolar disorder; likewise, emotional highs and lows in bipolar disorder are more intense when diabetes is present, too.

Another link between these conditions is weight. Overweight and obesity are the primary causes of diabetes. Bipolar disorder interferes in the body’s ability to utilize fat for energy. Instead, fat accumulates leading to weight gain.

Antipsychotic medications used to treat bipolar disorder also contribute to weight gain ("Are There Any Safe Antipsychotics in Diabetes Treatment?"). With 54-68 percent of people with bipolar disorder overweight or obese, the high incidence of diabetes among people with bipolar disorder seems logical (Thompson Jr., 2010).

Diabetes, Bipolar, Brain, and Body

Both bipolar disorder and diabetes change the brain. The glucose and insulin problems of diabetes negatively impact the brain’s energy supply and use. The brain’s prefrontal cortex—the area of the brain where thinking, reasoning, decision-making, and other higher-order functions take place—undergoes chemical changes because of both illnesses. The changes caused by the mental- and physical illness combination damage the brain. Effects include:

• Brain atrophy, including diminished gray matter density
• A decrease in the volume of the hippocampus
• Cognitive problems
• Impaired social functioning
• Increased risk of dementia
• Imbalances in the hypothalamic-pituitary-adrenal axis (an effect is increased levels of the stress hormone cortisol)
• Thyroid abnormalities
• Immune system dysfunctions
• Chronic inflammation

These are serious effects of combined diabetes and bipolar disorder. Treating these conditions is crucial for both physical and mental health.

Treating and Managing Diabetes and Bipolar Disorder

Treating and managing both serious illnesses at the same time is challenging, as the treatment for one can interfere in the treatment of the other, and trying to manage both can quickly become overwhelming.

Bipolar disorder involves mood swings from mania to depression. When someone is experiencing mania, they may have a difficult time focusing on the strict treatment regimen required for diabetes. Depression can zap energy and motivation to such a degree that diabetes management drops off. Then, when blood sugar is uncontrolled because diabetes is poorly managed, clear thinking is impaired and mood swings can ensue, exacerbating bipolar symptoms.

Bipolar disorder treatment involves medication. Unfortunately for diabetes, many bipolar medications such as olanzapine (Zyprexa) and clozapine (Clozaril) cause weight gain and thus contribute to or worsen diabetes.

Lithium is another widely used bipolar medication. It can cause diabetes insipidus, a disease unrelated to diabetes mellitus. Lithium and type 2 diabetes mellitus have a mild connection; indeed, lithium can cause transient hyperglycemia, or temporary high blood sugar. When lithium is stopped, blood sugar returns to normal.

Talking openly with your doctor about the best medications for co-occurring bipolar and diabetes will help minimize harmful side effects. In addition, developing treatment goals with your doctor and enlisting a support system to help you follow them is important for managing both bipolar disorder and diabetes and staying mentally and physically well. A key component of effective management is stability. Stabilizing blood sugar, mood, and lifestyle will benefit the whole you, not just the illnesses.

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