Diabetes mellitus is a disorder in which the body cannot convert foods properly into the energy needed for daily activity. When a person eats sugars and starches, the body changes them mainly into a form of sugar called glucose. Glucose is a type of "fuel" that travels through the bloodstream for immediate use or is stored in the Ever for future use.

In diabetes, the mechanism that controls the amount of glucose in the blood breaks down. The glucose builds up to dangerous levels, causing symptoms and damaging body organs. The buildup occurs either because the body does not have enough insulin (the hormone that regulates the glucose level in the blood) or because the insulin is not fully effective on body tissues.

Diabetes tends to run in families, but factors other than heredity are responsible as well. For example, becoming overweight can trigger diabetes in susceptible older people.

There are two main types of diabetes. Type 1, or insulin- dependent diabetes, is the more severe form of the disease. Although this type of diabetes can appear at any age, it generally starts during childhood or adolescence. Lifelong treatment with insulin is required, along with exercise and a controlled diet.

The most common form of diabetes among older people is type II, or noninsulin dependent diabetes. This form accounts for more than 90 percent of all cases. Most people with this type of diabetes do not need insulin injections. They can usually keep their blood glucose levels near normal by controlling their weight, exercising, and following a sensible diet.

Blood glucose levels that are either very high or very low can lead to a serious medical emergency. Diabetics may go into a coma when their blood sugar levels get very high. Low blood sugar can lead to unconsciousness. People who have diabetes must know the warning signs and what to do if problems occur. In addition, long-term complications - which can include stroke, blindness, heart disease, kidney failure, gangrene, and nerve damage - can result from diabetes. Proper blood glucose control will help prevent or lessen these problems.

Symptoms Some people with diabetes feel "run down" or have )vague symptoms that may go unrecognized. Others have symptoms such as increased thirst, frequent urination, unexplained weight loss, fatigue, blurred vision, skin infections or itching, and slow-healing cuts and bruises. These problems should be reported to a doctor, who can test for diabetes.

Treatment

Diabetes cannot be cured, but it can be controlled. Good control requires a careful blend of diet, exercise, and sometimes insulin injections or oral medications.

Diet is very important to lowering blood glucose levels. In planning a diet, the doctor considers the patient's weight and the physical activity he or she engages in each day.

Exercise helps the body bum off some of the excess glucose as energy. Engaging in a regular fitness program has been shown to improve blood glucose levels in older people who have elevated levels.

Drugs are not needed for noninsulin-dependent diabetes if good control can be achieved through diet and exercise. When these measures fail, insulin injections or oral drugs may be prescribed.

Foot care, skin care and dental care are important for people with diabetes. Diabetics should examine their feet every day, taking note of redness or patches of heat. People with diabetes are less able to resist injury and infection. Skin should be kept clean and dry. Teeth and gums need special attention to avoid serious infection.