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Diabetes affects the way your body uses blood sugar (glucose). This sugar is vital to your health because it's your body's main source of fuel.

Normally, glucose is able to enter your cells because of the action of insulin - a hormone secreted by your pancreas. Insulin acts like a key to unlock microscopic doors that allow glucose into your cells. But in diabetes, this process goes awry. Instead of being transported into your cells, glucose accumulates in your bloodstream and eventually is excreted in your urine. This usually occurs either because your body doesn't produce enough insulin or because the cells don't respond to insulin properly.

Diabetes mainly occurs in two forms:

Type 1 diabetes. This type develops when your pancreas makes little or no insulin. It affects between 5 percent and 10 percent of people with the disease.

Type 2 diabetes. This type is far more common than type 1, affecting between 90 and 95 percent of people with diabetes over age 20. It occurs when your body is resistant to the effects of insulin or your pancreas produces some, but not enough insulin to maintain a normal glucose level.

Factors that affect your blood sugar include:

Food. Food raises your blood sugar level - it's highest one to two hours after a meal. What and how much you eat, and the time of day, also affect your blood sugar level.

Exercise and physical activity. In general, the more active you are, the lower your blood sugar. Physical activity causes sugar to be transported to your cells, where it's used for energy, thereby lowering the levels in your blood. Aerobic exercises such as brisk walking, jogging or biking are especially good. But gardening, housework and even just being on your feet all day also can lower your blood sugar.

Medications. Insulin and oral diabetes medications work to lower your blood sugar. But medications you take for other conditions may affect glucose levels. Corticosteroids, in particular, may raise blood sugar levels. Medications such as thiazides, used to control high blood pressure, and niacin, used for high cholesterol, also may increase blood sugar. If you need to take certain high blood pressure medications, your doctor will likely make changes in your diabetes treatment.

Illness. The physical stress of a cold or other illness causes your body to produce hormones that raise your blood sugar level. The additional sugar helps promote healing. But if you have diabetes, this can be a problem. In addition, a fever increases your metabolism and how quickly sugar is utilized, which can alter the amount of insulin you need. For these reasons, be sure to monitor your glucose levels frequently when you're sick.

Alcohol. Even a small amount of alcohol - about 2 ounces - can cause your sugar levels to fall too low. But sometimes alcohol can cause sugar levels to rise. If you choose to drink, do so only in moderation, and monitor your blood sugar before and after consuming alcohol to see how it affects you. Also, keep in mind that alcohol counts as carbohydrate calories in your diet.

Fluctuations in hormone levels. The female hormone estrogen typically makes cells more responsive to insulin, and progesterone makes cells more resistant. Although these two hormones fluctuate throughout the menstrual cycle, the majority of women don't notice a corresponding change in blood sugar levels. Those who do are more likely to experience changes in blood sugar during the third week of their menstrual cycle, when estrogen and progesterone levels are highest.

Hormone levels also fluctuate during perimenopause - the time before menopause. How this affects blood sugar varies, but most women can control any symptoms with additional exercise and changes in their diet. After menopause, many women with diabetes require about 20 percent less medication because their cells are more sensitive to insulin.

More Americans have diabetes than ever before. The disease affects 17 million adults and children, yet close to a third of them may not know they have it. That's because diabetes can develop gradually over many years, often with no symptoms. Both types of diabetes are serious. The accumulation of glucose in your blood can damage almost every major organ in your body. Eventually, diabetes can be fatal. It's the sixth leading cause of death in the United States.

No one has yet found a cure for diabetes. But the good news is that eating right, maintaining a healthy weight and getting plenty of exercise can help prevent the disease. If you have diabetes, diet and exercise along with medications that control blood sugar can help you continue to live a healthy and active life.

It's not unusual to have diabetes mellitus and yet have no symptoms. Type 2 diabetes, in particular, develops slowly. Many people have type 2 diabetes for as long as eight years before its diagnosed. When symptoms do develop, they often vary. But two symptoms that occur in many people with the disease are increased thirst and frequent urination. That's because excess glucose circulating in your body draws water from your tissues, making you feel dehydrated. To quench your thirst, you drink a lot of water and other beverages, and that leads to more frequent urination.

Another condition, diabetes insipidus, also causes increased thirst and urination, but despite the similar name and symptoms, it's not related to diabetes mellitus. Diabetes insipidus isn't caused by a problem with blood sugar, but rather by a hormone disorder originating in the pituitary gland in your brain that makes your kidneys unable to conserve water.

During digestion, your body breaks down carbohydrates from foods such as bread, rice, pasta, vegetables, fruits, and milk products into various sugar molecules. One of these sugar molecules is glucose, the main energy source for your body. Glucose is absorbed directly into your bloodstream after you eat, but it can't enter your cells without the help of insulin.

Your pancreas - a gland located behind your stomach - produces insulin continuously. When the amount of blood sugar increases after eating, insulin production also increases. The extra insulin "unlocks" your cells so that more sugar can enter, providing your body with energy and maintaining a normal level of sugar in your blood.

Your liver also plays a key role in maintaining a normal blood sugar level. If you have more glucose than your cells need for energy, your body can remove the excess from your bloodstream and store it in your liver as glycogen. Then, when you run low on glucose, if for instance you haven't eaten for a while, or you are exercising for an extended period of time, your body can tap into the stored glucose and release it into your bloodstream.

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