Diabetes is a condition that happens when your blood sugar (glucose) is too high.

It develops when your pancreas doesn’t make enough insulin or any at all, or when
your body isn’t responding to the effects of insulin properly. Diabetes affects
people of all ages. Most forms of diabetes are chronic (lifelong), and all forms
are manageable with medications and/or lifestyle changes.
Glucose (sugar) mainly comes from carbohydrates in your food and drinks. It’s your
body’s go-to source of energy. Your blood carries glucose to all your body’s cells
to use for energy.
When glucose is in your bloodstream, it needs help — a “key” — to reach its final
destination. This key is insulin (a hormone). If your pancreas isn’t making enough
insulin or your body isn’t using it properly, glucose builds up in your
bloodstream, causing high blood sugar (hyperglycemia).
Over time, having consistently high blood glucose can cause health problems, such
as heart disease, nerve damage and eye issues.
The technical name for diabetes is diabetes mellitus. Another condition shares the
term “diabetes” — diabetes insipidus — but they’re distinct. They share the name
“diabetes” because they both cause increased thirst and frequent urination.
Diabetes insipidus is much rarer than diabetes mellitus.
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What are the types of diabetes?
There are several types of diabetes. The most common forms include:
• Type 2 diabetes: With this type, your body doesn’t make enough insulin
and/or your body’s cells don’t respond normally to the insulin (insulin
resistance). This is the most common type of diabetes. It mainly affects adults,
but children can have it as well.
• Prediabetes: This type is the stage before Type 2 diabetes. Your blood
glucose levels are higher than normal but not high enough to be officially
diagnosed with Type 2 diabetes.
• Type 1 diabetes: This type is an autoimmune disease in which your
immune system attacks and destroys insulin-producing cells in your pancreas for
unknown reasons. Up to 10% of people who have diabetes have Type 1. It’s usually
diagnosed in children and young adults, but it can develop at any age.
• Gestational diabetes: This type develops in some people during
pregnancy. Gestational diabetes usually goes away after pregnancy. However, if you
have gestational diabetes, you’re at a higher risk of developing Type 2 diabetes
later in life.
Other types of diabetes include:
• Type 3c diabetes: This form of diabetes happens when your pancreas
experiences damage (other than autoimmune damage), which affects its ability to
produce insulin. Pancreatitis, pancreatic cancer, cystic fibrosis and
hemochromatosis can all lead to pancreas damage that causes diabetes. Having your
pancreas removed (pancreatectomy) also results in Type 3c.
• Latent autoimmune diabetes in adults (LADA): Like Type 1 diabetes, LADA
also results from an autoimmune reaction, but it develops much more slowly than
Type 1. People diagnosed with LADA are usually over the age of 30.
• Maturity-onset diabetes of the young (MODY): MODY, also called
monogenic diabetes, happens due to an inherited genetic mutation that affects how
your body makes and uses insulin. There are currently over 10 different types of
MODY. It affects up to 5% of people with diabetes and commonly runs in families.
• Neonatal diabetes: This is a rare form of diabetes that occurs within
the first six months of life. It’s also a form of monogenic diabetes. About 50% of
babies with neonatal diabetes have the lifelong form called permanent neonatal
diabetes mellitus. For the other half, the condition disappears within a few months
from onset, but it can come back later in life. This is called transient neonatal
diabetes mellitus.
• Brittle diabetes: Brittle diabetes is a form of Type 1 diabetes that’s
marked by frequent and severe episodes of high and low blood sugar levels. This
instability often leads to hospitalization. In rare cases, a pancreas transplant
may be necessary to permanently treat brittle diabetes.
How common is diabetes?
Diabetes is common. Approximately 37.3 million people in the United States have
diabetes, which is about 11% of the population. Type 2 diabetes is the most common
form, representing 90% to 95% of all diabetes cases.
About 537 million adults across the world have diabetes. Experts predict this
number will rise to 643 million by 2030 and 783 million by 2045.
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Symptoms and Causes


The severity of symptoms can vary based on the type of diabetes you have. These
symptoms are usually more intense in Type 1 diabetes than Type 2 diabetes.
What are the symptoms of diabetes?
Symptoms of diabetes include:
• Increased thirst (polydipsia) and dry mouth.
• Frequent urination.
• Fatigue.
• Blurred vision.
• Unexplained weight loss.
• Numbness or tingling in your hands or feet.
• Slow-healing sores or cuts.
• Frequent skin and/or vaginal yeast infections.
It’s important to talk to your healthcare provider if you or your child has these
symptoms.
Additional details about symptoms per type of diabetes include:
• Type 1 diabetes: Symptoms of T1D can develop quickly — over a few weeks
or months. You may develop additional symptoms that are signs of a severe
complication called diabetes-related ketoacidosis (DKA). DKA is life-threatening
and requires immediate medical treatment. DKA symptoms include vomiting, stomach
pains, fruity-smelling breath and labored breathing.
• Type 2 diabetes and prediabetes: You may not have any symptoms at all,
or you may not notice them since they develop slowly. Routine bloodwork may show a
high blood sugar level before you recognize symptoms. Another possible sign of
prediabetes is darkened skin on certain parts of your body (acanthosis nigricans).
• Gestational diabetes: You typically won’t notice symptoms of
gestational diabetes. Your healthcare provider will test you for gestational
diabetes between 24 and 28 weeks of pregnancy.
What causes diabetes?
Too much glucose circulating in your bloodstream causes diabetes, regardless of the
type. However, the reason why your blood glucose levels are high differs depending
on the type of diabetes.
Causes of diabetes include:
• Insulin resistance: Type 2 diabetes mainly results from insulin
resistance. Insulin resistance happens when cells in your muscles, fat and liver
don’t respond as they should to insulin. Several factors and conditions contribute
to varying degrees of insulin resistance, including obesity, lack of physical
activity, diet, hormonal imbalances, genetics and certain medications.
 • Autoimmune disease: Type 1 diabetes and LADA happen when your immune
system attacks the insulin-producing cells in your pancreas.
• Hormonal imbalances: During pregnancy, the placenta releases hormones
that cause insulin resistance. You may develop gestational diabetes if your
pancreas can’t produce enough insulin to overcome the insulin resistance. Other
hormone-related conditions like acromegaly and Cushing syndrome can also cause Type
2 diabetes.
• Pancreatic damage: Physical damage to your pancreas — from a condition,
surgery or injury — can impact its ability to make insulin, resulting in Type 3c
diabetes.
• Genetic mutations: Certain genetic mutations can cause MODY and
neonatal diabetes.
Long-term use of certain medications can also lead to Type 2 diabetes, including
HIV/AIDS medications and corticosteroids.
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What are the complications of diabetes?

Diabetes can lead to acute (sudden and severe) and long-term complications — mainly
due to extreme or prolonged high blood sugar levels.
Acute diabetes complications
Acute diabetes complications that can be life-threatening include:
• Hyperosmolar hyperglycemic state (HHS): This complication mainly
affects people with Type 2 diabetes. It happens when your blood sugar levels are
very high (over 600 milligrams per deciliter or mg/dL) for a long period, leading
to severe dehydration and confusion. It requires immediate medical treatment.
• Diabetes-related ketoacidosis (DKA): This complication mainly affects
people with Type 1 diabetes or undiagnosed T1D. It happens when your body doesn’t
have enough insulin. If your body doesn’t have insulin, it can’t use glucose for
energy, so it breaks down fat instead. This process eventually releases substances
called ketones, which turn your blood acidic. This causes labored breathing,
vomiting and loss of consciousness. DKA requires immediate medical treatment.
• Severe low blood sugar (hypoglycemia): Hypoglycemia happens when your
blood sugar level drops below the range that’s healthy for you. Severe hypoglycemia
is very low blood sugar. It mainly affects people with diabetes who use insulin.
Signs include blurred or double vision, clumsiness, disorientation and seizures. It
requires treatment with emergency glucagon and/or medical intervention.
Long-term diabetes complications
Blood glucose levels that remain high for too long can damage your body’s tissues
and organs. This is mainly due to damage to your blood vessels and nerves, which
support your body’s tissues.
Cardiovascular (heart and blood vessel) issues are the most common type of long-
term diabetes complication. They include:
• Coronary artery disease.
• Heart attack.
• Stroke.
• Atherosclerosis.
Other diabetes complications include:
• Nerve damage (neuropathy), which can cause numbness, tingling and/or
pain.
• Nephropathy, which can lead to kidney failure or the need for dialysis
or transplant.
• Retinopathy, which can lead to blindness.
• Diabetes-related foot conditions.
• Skin infections.
• Amputations.
 • Sexual dysfunction due to nerve and blood vessel damage, such as
erectile dysfunction or vaginal dryness.
• Gastroparesis.
• Hearing loss.
• Oral health issues, such as gum (periodontal) disease.
Living with diabetes can also affect your mental health. People with diabetes are
two to three times more likely to have depression than people without diabetes.
Diagnosis and Tests

Diagnosing Diabetes
How is diabetes diagnosed?
Healthcare providers diagnose diabetes by checking your glucose level in a blood
test. Three tests can measure your blood glucose level:
• Fasting blood glucose test: For this test, you don’t eat or drink
anything except water (fast) for at least eight hours before the test. As food can
greatly affect blood sugar, this test allows your provider to see your baseline
blood sugar.
• Random blood glucose test: “Random” means that you can get this test at
any time, regardless of if you’ve fasted.
• A1c: This test, also called HbA1C or glycated hemoglobin test, provides
your average blood glucose level over the past two to three months.
To screen for and diagnose gestational diabetes, providers order an oral glucose
tolerance test.
The following test results typically indicate if you don’t have diabetes, have
prediabetes or have diabetes. These values may vary slightly. In addition,
healthcare providers rely on more than one test to diagnose diabetes.

Type of test

Fasting blood glucose test

In-range (mg/dL)
Less than 100.
Prediabetes (mg/dL)
100 to 125.
Random blood glucose test
In-range (mg/dL)
N/A.
Prediabetes (mg/dL)
N/A.
A1c
In-range (mg/dL)
Less than 5.7%.
Management and Treatment

Managing Diabetes
How is diabetes managed?
Diabetes is a complex condition, so its management involves several strategies. In
addition, diabetes affects everyone differently, so management plans are highly
individualized.
The four main aspects of managing diabetes include:
• Blood sugar monitoring: Monitoring your blood sugar (glucose) is key to
determining how well your current treatment plan is working. It gives you
information on how to manage your diabetes on a daily — and sometimes even hourly —
basis. You can monitor your levels with frequent checks with a glucose meter and
finger stick and/or with a continuous glucose monitor (CGM). You and your
healthcare provider will determine the best blood sugar range for you.
• Oral diabetes medications: Oral diabetes medications (taken by mouth)
help manage blood sugar levels in people who have diabetes but still produce some
insulin — mainly people with Type 2 diabetes and prediabetes. People with
gestational diabetes may also need oral medication. There are several different
types. Metformin is the most common.
• Insulin: People with Type 1 diabetes need to inject synthetic insulin
to live and manage diabetes. Some people with Type 2 diabetes also require insulin.
There are several different types of synthetic insulin. They each start to work at
different speeds and last in your body for different lengths of time. The four main
ways you can take insulin include injectable insulin with a syringe (shot), insulin
pens, insulin pumps and rapid-acting inhaled insulin.
• Diet: Meal planning and choosing a healthy diet for you are key aspects
of diabetes management, as food greatly impacts blood sugar. If you take insulin,
counting carbs in the food and drinks you consume is a large part of management.
The amount of carbs you eat determines how much insulin you need at meals. Healthy
eating habits can also help you manage your weight and reduce your heart disease
risk.
• Exercise: Physical activity increases insulin sensitivity (and helps
reduce insulin resistance), so regular exercise is an important part of management
for all people with diabetes.
Due to the increased risk for heart disease, it’s also important to maintain a
healthy:
• Weight.
• Blood pressure.
• Cholesterol.
Prevention
How can I prevent diabetes?
You can’t prevent autoimmune and genetic forms of diabetes. But there are some
steps you can take to lower your risk for developing prediabetes, Type 2 diabetes
and gestational diabetes, including:
• Eat a healthy diet, such as the Mediterranean diet.
• Get physically active. Aim for 30 minutes a day at least five days a
week.
• Work to achieve a weight that’s healthy for you.
• Manage your stress.
• Limit alcohol intake.
• Get adequate sleep (typically 7 to 9 hours) and seek treatment for
sleep disorders.
• Quit smoking.
• Take medications as directed by your healthcare provider to manage
existing risk factors for heart disease.
It’s important to note that there are some diabetes risk factors you can’t change,
such as your genetics/family history, age and race. Know that Type 2 diabetes is a
complex condition that involves many contributing factors.
Outlook / Prognosis
What is the prognosis for diabetes?
The prognosis (outlook) for diabetes varies greatly depending on several factors,
including:
• The type of diabetes.
• How well you manage the condition over time and your access to diabetes
care.
• Your age at diagnosis/how long you’ve had diabetes.
• If you have other health conditions.
• If you develop diabetes complications.
Chronic high blood sugar can cause severe complications, which are usually
irreversible. Several studies have shown that untreated chronic high blood sugar
shortens your lifespan and worsens your quality of life.
In the United States, diabetes is the eighth leading cause of death. A large number
of people with diabetes will die from a heart attack or stroke.
However, it’s important to know that you can live a healthy life with diabetes. The
following are key to a better prognosis:
 • Lifestyle changes.
• Regular exercise.
• Dietary changes.
• Regular blood sugar monitoring.
Studies show that people with diabetes may be able to reduce their risk of
complications by consistently keeping their A1c levels below 7%.
Living With
When should I see my healthcare provider?
If you haven’t been diagnosed with diabetes, you should see a healthcare provider
if you have any symptoms of diabetes, such as increased thirst and frequent
urination.
If you have diabetes, you should see your provider who helps you manage diabetes
(such as an endocrinologist) regularly.
A note from Cleveland Clinic
Being diagnosed with diabetes is a life-changing event, but it doesn’t mean you
can’t live a happy and healthy life. Managing diabetes involves consistent care and
diligence. While it’ll likely be very overwhelming at first, over time you’ll get a
better grasp on managing the condition and being in tune with your body.
Be sure to see your healthcare provider(s) regularly. Managing diabetes involves a
team effort — you’ll want medical professionals, friends and family on your side.
Don’t be afraid to reach out to them if you need help.

Medically Reviewed
Last reviewed by a Cleveland Clinic medical professional on 02/17/2023.
Learn more about our editorial process.
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