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Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.

In order to determine whether or not a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes.

With the FPG test, a fasting blood glucose level between 108 and 125 mg/dl (6.0-6.9 mmol/L) signals pre-diabetes or Impaired Fasting Glucose (IFG). A person with a fasting blood glucose level of 126 mg/dl (7.0mmol/L) or higher has diabetes.

In the OGTT test, a person's blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140(7.7mmol/L) and 199 mg/dl (11.0mmol/L), the person tested has pre-diabetes or Impaired Glucose Tolerance (IGT). If the two-hour blood glucose level is at 200 mg/dl (11.1mmol/L) or higher, the person tested has diabetes.

Type 1 diabetes
Results from the body's failure to produce insulin, the hormone that "unlocks" the cells of the body, allowing glucose to enter and fuel them. It is estimated that 5% of Chinese who are diagnosed with diabetes have type 1 diabetes.

Type 2 diabetes
Results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most Chinese who are diagnosed with diabetes have type 2 diabetes.

Gestational diabetes
Gestational diabetes affects about 4% of all pregnant women - about 135,000 cases in the United States each year. There is no exact number in China now.

Pre-diabetes is considered to be a condition that requires some treatment to prevent the development of Type 2 diabetes. The good news is that the recently completed Diabetes Prevention Program (DPP) study conclusively showed that people with pre-diabetes can prevent the development of type 2 diabetes by making changes in their diet and increasing their level of physical activity.  They may even be able to return their blood glucose levels to the normal range.

While the DPP also showed that some medications may delay the development of diabetes, diet and exercise worked better.  Just 30 minutes a day of moderate physical activity, coupled with a 5-10% reduction in body weight, produced a 58% reduction in Type 2 diabetes.

Too many people develop life-threatening complications because their diabetes is diagnosed too late.

There are many misconceptions about diabetes being a 'mild' condition. But these misconceptions are potentially dangerous. Diabetes is serious — read on and make sure you know if you are at risk.

Diabetes – the risk factors

People at risk of developing Type 2 diabetes are:

people over the age of 40

The vast majority of people with diabetes have Type 2 diabetes. This type usually occurs in people over the age of 40. The older you are, the greater your risk of Type 2 diabetes. If you come from a black or minority ethnic group, you are at increased risk over the age of 25.

a first degree family history of diabetes (mother, father or sibling)

Research has shown that people are more at risk if there is a history of diabetes in close family members. The closer the relative, the greater your risk of diabetes. People from African-Caribbean or Asian cultures living in this country are four to five times more likely to have Type 2 diabetes than white members of the population.

people who are overweight (BMI of 25-30 kg/m2 and above), and who have a sedentary lifestyle

Over 80 per cent of people with Type 2 diabetes are overweight at diagnosis. The more overweight you are, the greater your risk of diabetes.

people who have ischaemic heart disease, cerebrovascular disease, peripheral vascular disease (problems with circulation, including heart attack or stroke) or hypertension (high blood pressure)

If you have been diagnosed with any of these problems with your circulation, have had a heart attack or stroke, or you have high blood pressure, you may be at increased risk of Type 2 diabetes and you should discuss your risk with your healthcare team.

women who have had gestational diabetes (diabetes during pregnancy) - Diabetes UK recommends screening at one year after delivery and then three yearly

Some women when they are pregnant develop a temporary type of diabetes called ?gestational diabetes? Having this, or giving birth to a large baby (4kg/81/2lb or greater) can increase a woman?s risk of going on to develop Type 2 diabetes.

women with polycystic ovary syndrome who are obese

This is a hormonal problem that can affect about one in five women. Symptoms can include irregular or no periods, obesity and often, increased body and facial hair. People with diagnosed PCOS who are also obese have an increased risk of developing Type 2 diabetes.

those known to have impaired glucose tolerance or impaired fasting glycaemia.

If your doctor has previously told you that you have impaired fasting glycaemia (IFG) or impaired glucose tolerance (IGT), this means that your blood glucose levels are higher than normal but that you don?t have diabetes. However, you should be tested regularly to make sure that you have not developed diabetes. If you have IFG or IGT, losing weight, eating a healthy diet and keeping active can help prevent Type 2 diabetes.