Diabetes is a chronic metabolic disease in which the body either does not produce or does not fully utilize insulin. As a result, it cannot properly metabolize carbohydrates and, to a lesser extent, protein and fat. Glucose (sugar) builds up in the blood; to rid the body of the excess, the kidneys begin to excrete it in the urine. Although excessive glucose is circulating, the brain and other tissues that need it for fuel are unable to use it. The body begins to break down fat and protein in an attempt to provide an alternate source of fuel, resulting in serious biochemical imbalances.

In the meantime, the high levels of glucose are damaging structures throughout the body, increasing the risk of complications such as heart attack, blindness, kidney failure, stroke, and painful nerve problems. Despite effective treatments, diabetes is one of the leading causes of death in the United States. There are two major forms: Type I, in which the body stops making insulin completely, and Type II, in which the body produces inadequate insulin or is unable to use it fully.

The first type, also called insulin-dependent or juvenile diabetes, usually develops during the first 20 years of life when islet cells in the pancreas are destroyed and can no longer make insulin. Symptoms are frequent urination, weight loss, unusual thirst, weakness, fatigue, and hunger. Type II, also called non-insulin dependent or adult onset diabetes, is most common among overweight older people, although it can occur in persons of normal weight. It develops more slowly than Type I; indeed, many individuals have the disease for years without knowing it.

In addition to symptoms experienced in Type I diabetes, signs may include frequent infections, cramps and tingling sensations, slow healing, impotence in men, and chronic vaginitis in women. The cause of diabetes is unknown, but researchers believe that Type I develops when the immune system destroys the islet cells. The disease tends to run in families, so there may be a genetic component.

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