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Diabetes - Wikipedia
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id="toc-Signs_and_symptoms-sublist" class="vector-toc-list"> <li id="toc-Long-term_complications" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Long-term_complications"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.1</span> <span>Long-term complications</span> </div> </a> <ul id="toc-Long-term_complications-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Types" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Types"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Types</span> </div> </a> <button aria-controls="toc-Types-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Types subsection</span> </button> <ul id="toc-Types-sublist" class="vector-toc-list"> <li id="toc-Type_1" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Type_1"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Type 1</span> </div> </a> <ul id="toc-Type_1-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Type_2" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Type_2"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Type 2</span> </div> </a> <ul id="toc-Type_2-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Gestational_diabetes" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Gestational_diabetes"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Gestational diabetes</span> </div> </a> <ul id="toc-Gestational_diabetes-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_types" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_types"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.4</span> <span>Other types</span> </div> </a> <ul id="toc-Other_types-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Pathophysiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Pathophysiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Pathophysiology</span> </div> </a> <ul id="toc-Pathophysiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Diagnosis</span> </div> </a> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Prevention</span> </div> </a> <ul id="toc-Prevention-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Comorbidity" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Comorbidity"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Comorbidity</span> </div> </a> <ul id="toc-Comorbidity-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Management" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Management"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Management</span> </div> </a> <button aria-controls="toc-Management-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Management subsection</span> </button> <ul id="toc-Management-sublist" class="vector-toc-list"> <li id="toc-Lifestyle" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Lifestyle"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.1</span> <span>Lifestyle</span> </div> </a> <ul id="toc-Lifestyle-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diabetes_and_youth" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Diabetes_and_youth"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.2</span> <span>Diabetes and youth</span> </div> </a> <ul id="toc-Diabetes_and_youth-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Medications" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Medications"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.3</span> <span>Medications</span> </div> </a> <ul id="toc-Medications-sublist" class="vector-toc-list"> <li id="toc-Glucose_control" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Glucose_control"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.3.1</span> <span>Glucose control</span> </div> </a> <ul id="toc-Glucose_control-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Blood_pressure_lowering" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Blood_pressure_lowering"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.3.2</span> <span>Blood pressure lowering</span> </div> </a> <ul id="toc-Blood_pressure_lowering-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Aspirin" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Aspirin"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.3.3</span> <span>Aspirin</span> </div> </a> <ul id="toc-Aspirin-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.4</span> <span>Surgery</span> </div> </a> <ul id="toc-Surgery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Self-management_and_support" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Self-management_and_support"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.5</span> <span>Self-management and support</span> </div> </a> <ul id="toc-Self-management_and_support-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Epidemiology</span> </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>History</span> </div> </a> <button aria-controls="toc-History-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle History subsection</span> </button> <ul id="toc-History-sublist" class="vector-toc-list"> <li id="toc-Etymology" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Etymology"> <div class="vector-toc-text"> <span class="vector-toc-numb">9.1</span> <span>Etymology</span> </div> </a> <ul id="toc-Etymology-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Society_and_culture" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Society_and_culture"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>Society and culture</span> </div> </a> <button aria-controls="toc-Society_and_culture-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Society and culture subsection</span> </button> <ul id="toc-Society_and_culture-sublist" class="vector-toc-list"> <li id="toc-Diabetes_stigma" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Diabetes_stigma"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.1</span> <span>Diabetes stigma</span> </div> </a> <ul id="toc-Diabetes_stigma-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Racial_and_economic_inequalities" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Racial_and_economic_inequalities"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.2</span> <span>Racial and economic inequalities</span> </div> </a> <ul id="toc-Racial_and_economic_inequalities-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Naming" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Naming"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.3</span> <span>Naming</span> </div> </a> <ul id="toc-Naming-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Other_animals" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Other_animals"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>Other animals</span> </div> </a> <ul id="toc-Other_animals-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">12</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">13</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">14</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Diabetes</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 159 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-159" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">159 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-af badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://af.wikipedia.org/wiki/Diabetes" title="Diabetes – Afrikaans" lang="af" hreflang="af" data-title="Diabetes" data-language-autonym="Afrikaans" data-language-local-name="Afrikaans" class="interlanguage-link-target"><span>Afrikaans</span></a></li><li class="interlanguage-link interwiki-als mw-list-item"><a href="https://als.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Alemannic" lang="gsw" hreflang="gsw" data-title="Diabetes mellitus" data-language-autonym="Alemannisch" data-language-local-name="Alemannic" class="interlanguage-link-target"><span>Alemannisch</span></a></li><li class="interlanguage-link interwiki-am mw-list-item"><a href="https://am.wikipedia.org/wiki/%E1%88%B5%E1%8A%B3%E1%88%AD_%E1%89%A0%E1%88%BD%E1%89%B3" title="ስኳር በሽታ – Amharic" lang="am" hreflang="am" data-title="ስኳር በሽታ" data-language-autonym="አማርኛ" data-language-local-name="Amharic" class="interlanguage-link-target"><span>አማርኛ</span></a></li><li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A7%D9%84%D8%B3%D9%83%D8%B1%D9%8A" title="السكري – Arabic" lang="ar" hreflang="ar" data-title="السكري" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-an mw-list-item"><a href="https://an.wikipedia.org/wiki/Diabetis_mellitus" title="Diabetis mellitus – Aragonese" lang="an" hreflang="an" data-title="Diabetis mellitus" data-language-autonym="Aragonés" data-language-local-name="Aragonese" class="interlanguage-link-target"><span>Aragonés</span></a></li><li class="interlanguage-link interwiki-hyw mw-list-item"><a href="https://hyw.wikipedia.org/wiki/%D5%87%D5%A1%D6%84%D5%A1%D6%80%D5%A1%D5%AD%D5%BF" title="Շաքարախտ – Western Armenian" lang="hyw" hreflang="hyw" data-title="Շաքարախտ" data-language-autonym="Արեւմտահայերէն" data-language-local-name="Western Armenian" class="interlanguage-link-target"><span>Արեւմտահայերէն</span></a></li><li class="interlanguage-link interwiki-as mw-list-item"><a href="https://as.wikipedia.org/wiki/%E0%A6%AC%E0%A6%B9%E0%A7%81%E0%A6%AE%E0%A7%82%E0%A6%A4%E0%A7%8D%E0%A7%B0_%E0%A7%B0%E0%A7%8B%E0%A6%97" title="বহুমূত্ৰ ৰোগ – Assamese" lang="as" hreflang="as" data-title="বহুমূত্ৰ ৰোগ" data-language-autonym="অসমীয়া" data-language-local-name="Assamese" class="interlanguage-link-target"><span>অসমীয়া</span></a></li><li class="interlanguage-link interwiki-ast mw-list-item"><a href="https://ast.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Asturian" lang="ast" hreflang="ast" data-title="Diabetes mellitus" data-language-autonym="Asturianu" data-language-local-name="Asturian" class="interlanguage-link-target"><span>Asturianu</span></a></li><li class="interlanguage-link interwiki-awa mw-list-item"><a href="https://awa.wikipedia.org/wiki/%E0%A4%B8%E0%A5%81%E0%A4%97%E0%A4%B0_%E0%A4%B0%E0%A5%8B%E0%A4%97" title="सुगर रोग – Awadhi" lang="awa" hreflang="awa" data-title="सुगर रोग" data-language-autonym="अवधी" data-language-local-name="Awadhi" class="interlanguage-link-target"><span>अवधी</span></a></li><li class="interlanguage-link interwiki-gn mw-list-item"><a href="https://gn.wikipedia.org/wiki/Tuguyasuka" title="Tuguyasuka – Guarani" lang="gn" hreflang="gn" data-title="Tuguyasuka" data-language-autonym="Avañe'ẽ" data-language-local-name="Guarani" class="interlanguage-link-target"><span>Avañe'ẽ</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/%C5%9E%C9%99k%C9%99rli_diabet" title="Şəkərli diabet – Azerbaijani" lang="az" hreflang="az" data-title="Şəkərli diabet" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D8%AF%DB%8C%D8%A7%D8%A8%D8%AA" title="دیابت – South Azerbaijani" lang="azb" hreflang="azb" data-title="دیابت" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target"><span>تۆرکجه</span></a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%AC%E0%A6%B9%E0%A7%81%E0%A6%AE%E0%A7%82%E0%A6%A4%E0%A7%8D%E0%A6%B0%E0%A6%B0%E0%A7%8B%E0%A6%97" title="বহুমূত্ররোগ – Bangla" lang="bn" hreflang="bn" data-title="বহুমূত্ররোগ" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target"><span>বাংলা</span></a></li><li class="interlanguage-link interwiki-zh-min-nan mw-list-item"><a href="https://zh-min-nan.wikipedia.org/wiki/Thn%CC%82g-ji%C5%8D-p%C4%93%E2%81%BF" title="Thn̂g-jiō-pēⁿ – Minnan" lang="nan" hreflang="nan" data-title="Thn̂g-jiō-pēⁿ" data-language-autonym="閩南語 / Bân-lâm-gú" data-language-local-name="Minnan" class="interlanguage-link-target"><span>閩南語 / Bân-lâm-gú</span></a></li><li class="interlanguage-link interwiki-ba mw-list-item"><a href="https://ba.wikipedia.org/wiki/%D0%A8%D3%99%D0%BA%D3%99%D1%80_%D0%B4%D0%B8%D0%B0%D0%B1%D0%B5%D1%82%D1%8B" title="Шәкәр диабеты – Bashkir" lang="ba" hreflang="ba" data-title="Шәкәр диабеты" data-language-autonym="Башҡортса" data-language-local-name="Bashkir" class="interlanguage-link-target"><span>Башҡортса</span></a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%A6%D1%83%D0%BA%D1%80%D0%BE%D0%B2%D1%8B_%D0%B4%D1%8B%D1%8F%D0%B1%D0%B5%D1%82" title="Цукровы дыябет – Belarusian" lang="be" hreflang="be" data-title="Цукровы дыябет" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-be-x-old mw-list-item"><a href="https://be-tarask.wikipedia.org/wiki/%D0%A6%D1%83%D0%BA%D1%80%D0%BE%D0%B2%D1%8B_%D0%B4%D1%8B%D1%8F%D0%B1%D1%8D%D1%82" title="Цукровы дыябэт – Belarusian (Taraškievica orthography)" lang="be-tarask" hreflang="be-tarask" data-title="Цукровы дыябэт" data-language-autonym="Беларуская (тарашкевіца)" data-language-local-name="Belarusian (Taraškievica orthography)" class="interlanguage-link-target"><span>Беларуская (тарашкевіца)</span></a></li><li class="interlanguage-link interwiki-bh mw-list-item"><a href="https://bh.wikipedia.org/wiki/%E0%A4%B6%E0%A5%81%E0%A4%97%E0%A4%B0_%E0%A4%B0%E0%A5%8B%E0%A4%97" title="शुगर रोग – Bhojpuri" lang="bh" hreflang="bh" data-title="शुगर रोग" data-language-autonym="भोजपुरी" data-language-local-name="Bhojpuri" class="interlanguage-link-target"><span>भोजपुरी</span></a></li><li class="interlanguage-link interwiki-bcl mw-list-item"><a href="https://bcl.wikipedia.org/wiki/Diabetes" title="Diabetes – Central Bikol" lang="bcl" hreflang="bcl" data-title="Diabetes" data-language-autonym="Bikol Central" data-language-local-name="Central Bikol" class="interlanguage-link-target"><span>Bikol Central</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%97%D0%B0%D1%85%D0%B0%D1%80%D0%B5%D0%BD_%D0%B4%D0%B8%D0%B0%D0%B1%D0%B5%D1%82" title="Захарен диабет – Bulgarian" lang="bg" hreflang="bg" data-title="Захарен диабет" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/%C5%A0e%C4%87erna_bolest" title="Šećerna bolest – Bosnian" lang="bs" hreflang="bs" data-title="Šećerna bolest" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-br mw-list-item"><a href="https://br.wikipedia.org/wiki/Diabet" title="Diabet – Breton" lang="br" hreflang="br" data-title="Diabet" data-language-autonym="Brezhoneg" data-language-local-name="Breton" class="interlanguage-link-target"><span>Brezhoneg</span></a></li><li class="interlanguage-link interwiki-bxr mw-list-item"><a href="https://bxr.wikipedia.org/wiki/%D0%A1%D0%B0%D0%B0%D1%85%D0%B0%D1%80%D0%B0%D0%B9_%D0%B4%D0%B8%D0%B0%D0%B1%D0%B5%D1%82" title="Саахарай диабет – Russia Buriat" lang="bxr" hreflang="bxr" data-title="Саахарай диабет" data-language-autonym="Буряад" data-language-local-name="Russia Buriat" class="interlanguage-link-target"><span>Буряад</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Diabetis_mellitus" title="Diabetis mellitus – Catalan" lang="ca" hreflang="ca" data-title="Diabetis mellitus" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cv mw-list-item"><a href="https://cv.wikipedia.org/wiki/%D0%A1%D0%B0%D1%85%C4%83%D1%80%D0%BB%C4%83_%D0%B4%D0%B8%D0%B0%D0%B1%D0%B5%D1%82" title="Сахăрлă диабет – Chuvash" lang="cv" hreflang="cv" data-title="Сахăрлă диабет" data-language-autonym="Чӑвашла" data-language-local-name="Chuvash" class="interlanguage-link-target"><span>Чӑвашла</span></a></li><li class="interlanguage-link interwiki-ceb mw-list-item"><a href="https://ceb.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Cebuano" lang="ceb" hreflang="ceb" data-title="Diabetes mellitus" data-language-autonym="Cebuano" data-language-local-name="Cebuano" class="interlanguage-link-target"><span>Cebuano</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Czech" lang="cs" hreflang="cs" data-title="Diabetes mellitus" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-sn mw-list-item"><a href="https://sn.wikipedia.org/wiki/Chitsvigiri" title="Chitsvigiri – Shona" lang="sn" hreflang="sn" data-title="Chitsvigiri" data-language-autonym="ChiShona" data-language-local-name="Shona" class="interlanguage-link-target"><span>ChiShona</span></a></li><li class="interlanguage-link interwiki-cy mw-list-item"><a href="https://cy.wikipedia.org/wiki/Diabetes" title="Diabetes – Welsh" lang="cy" hreflang="cy" data-title="Diabetes" data-language-autonym="Cymraeg" data-language-local-name="Welsh" class="interlanguage-link-target"><span>Cymraeg</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Sukkersyge" title="Sukkersyge – Danish" lang="da" hreflang="da" data-title="Sukkersyge" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-ary mw-list-item"><a href="https://ary.wikipedia.org/wiki/%D8%B3%D9%83%D8%A7%D8%B1_(%D9%85%D8%B1%D8%B6)" title="سكار (مرض) – Moroccan Arabic" lang="ary" hreflang="ary" data-title="سكار (مرض)" data-language-autonym="الدارجة" data-language-local-name="Moroccan Arabic" class="interlanguage-link-target"><span>الدارجة</span></a></li><li class="interlanguage-link interwiki-se mw-list-item"><a href="https://se.wikipedia.org/wiki/Diabetes" title="Diabetes – Northern Sami" lang="se" hreflang="se" data-title="Diabetes" data-language-autonym="Davvisámegiella" data-language-local-name="Northern Sami" class="interlanguage-link-target"><span>Davvisámegiella</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – German" lang="de" hreflang="de" data-title="Diabetes mellitus" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-dv mw-list-item"><a href="https://dv.wikipedia.org/wiki/%DE%80%DE%A6%DE%86%DE%AA%DE%83%DE%AA_%DE%84%DE%A6%DE%8D%DE%A8" title="ހަކުރު ބަލި – Divehi" lang="dv" hreflang="dv" data-title="ހަކުރު ބަލި" data-language-autonym="ދިވެހިބަސް" data-language-local-name="Divehi" class="interlanguage-link-target"><span>ދިވެހިބަސް</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Suhkurt%C3%B5bi" title="Suhkurtõbi – Estonian" lang="et" hreflang="et" data-title="Suhkurtõbi" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%94%CE%B9%CE%B1%CE%B2%CE%AE%CF%84%CE%B7%CF%82_(%CE%B1%CF%83%CE%B8%CE%AD%CE%BD%CE%B5%CE%B9%CE%B1)" title="Διαβήτης (ασθένεια) – Greek" lang="el" hreflang="el" data-title="Διαβήτης (ασθένεια)" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Spanish" lang="es" hreflang="es" data-title="Diabetes mellitus" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Diabeto" title="Diabeto – Esperanto" lang="eo" hreflang="eo" data-title="Diabeto" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target"><span>Esperanto</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Diabetes" title="Diabetes – Basque" lang="eu" hreflang="eu" data-title="Diabetes" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%AF%DB%8C%D8%A7%D8%A8%D8%AA" title="دیابت – Persian" lang="fa" hreflang="fa" data-title="دیابت" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-hif mw-list-item"><a href="https://hif.wikipedia.org/wiki/Diabetes" title="Diabetes – Fiji Hindi" lang="hif" hreflang="hif" data-title="Diabetes" data-language-autonym="Fiji Hindi" data-language-local-name="Fiji Hindi" class="interlanguage-link-target"><span>Fiji Hindi</span></a></li><li class="interlanguage-link interwiki-fo mw-list-item"><a href="https://fo.wikipedia.org/wiki/Sukursj%C3%BAka" title="Sukursjúka – Faroese" lang="fo" hreflang="fo" data-title="Sukursjúka" data-language-autonym="Føroyskt" data-language-local-name="Faroese" class="interlanguage-link-target"><span>Føroyskt</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Diab%C3%A8te_sucr%C3%A9" title="Diabète sucré – French" lang="fr" hreflang="fr" data-title="Diabète sucré" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Diaib%C3%A9iteas" title="Diaibéiteas – Irish" lang="ga" hreflang="ga" data-title="Diaibéiteas" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-gd mw-list-item"><a href="https://gd.wikipedia.org/wiki/Tinneas_an_t-si%C3%B9cair" title="Tinneas an t-siùcair – Scottish Gaelic" lang="gd" hreflang="gd" data-title="Tinneas an t-siùcair" data-language-autonym="Gàidhlig" data-language-local-name="Scottish Gaelic" class="interlanguage-link-target"><span>Gàidhlig</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Galician" lang="gl" hreflang="gl" data-title="Diabetes mellitus" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-gu mw-list-item"><a href="https://gu.wikipedia.org/wiki/%E0%AA%AE%E0%AA%A7%E0%AB%81%E0%AA%AA%E0%AB%8D%E0%AA%B0%E0%AA%AE%E0%AB%87%E0%AA%B9" title="મધુપ્રમેહ – Gujarati" lang="gu" hreflang="gu" data-title="મધુપ્રમેહ" data-language-autonym="ગુજરાતી" data-language-local-name="Gujarati" class="interlanguage-link-target"><span>ગુજરાતી</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EB%8B%B9%EB%87%A8%EB%B3%91" title="당뇨병 – Korean" lang="ko" hreflang="ko" data-title="당뇨병" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-ha mw-list-item"><a href="https://ha.wikipedia.org/wiki/Ciwon_suga" title="Ciwon suga – Hausa" lang="ha" hreflang="ha" data-title="Ciwon suga" data-language-autonym="Hausa" data-language-local-name="Hausa" class="interlanguage-link-target"><span>Hausa</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%87%D5%A1%D6%84%D5%A1%D6%80%D5%A1%D5%B5%D5%AB%D5%B6_%D5%A4%D5%AB%D5%A1%D5%A2%D5%A5%D5%BF" title="Շաքարային դիաբետ – Armenian" lang="hy" hreflang="hy" data-title="Շաքարային դիաբետ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%AE%E0%A4%A7%E0%A5%81%E0%A4%AE%E0%A5%87%E0%A4%B9" title="मधुमेह – Hindi" lang="hi" hreflang="hi" data-title="मधुमेह" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/%C5%A0e%C4%87erna_bolest" title="Šećerna bolest – Croatian" lang="hr" hreflang="hr" data-title="Šećerna bolest" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-io mw-list-item"><a href="https://io.wikipedia.org/wiki/Diabeto" title="Diabeto – Ido" lang="io" hreflang="io" data-title="Diabeto" data-language-autonym="Ido" data-language-local-name="Ido" class="interlanguage-link-target"><span>Ido</span></a></li><li class="interlanguage-link interwiki-ilo mw-list-item"><a href="https://ilo.wikipedia.org/wiki/Diabetes" title="Diabetes – Iloko" lang="ilo" hreflang="ilo" data-title="Diabetes" data-language-autonym="Ilokano" data-language-local-name="Iloko" class="interlanguage-link-target"><span>Ilokano</span></a></li><li class="interlanguage-link interwiki-bpy mw-list-item"><a href="https://bpy.wikipedia.org/wiki/%E0%A6%A1%E0%A6%BE%E0%A6%AF%E0%A6%BC%E0%A6%BE%E0%A6%AC%E0%A7%87%E0%A6%9F%E0%A6%BF%E0%A6%B8" title="ডায়াবেটিস – Bishnupriya" lang="bpy" hreflang="bpy" data-title="ডায়াবেটিস" data-language-autonym="বিষ্ণুপ্রিয়া মণিপুরী" data-language-local-name="Bishnupriya" class="interlanguage-link-target"><span>বিষ্ণুপ্রিয়া মণিপুরী</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Diabetes_melitus" title="Diabetes melitus – Indonesian" lang="id" hreflang="id" data-title="Diabetes melitus" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-ia mw-list-item"><a href="https://ia.wikipedia.org/wiki/Diabete" title="Diabete – Interlingua" lang="ia" hreflang="ia" data-title="Diabete" data-language-autonym="Interlingua" data-language-local-name="Interlingua" class="interlanguage-link-target"><span>Interlingua</span></a></li><li class="interlanguage-link interwiki-os mw-list-item"><a href="https://os.wikipedia.org/wiki/%D0%A1%C3%A6%D0%BA%C3%A6%D1%80%D0%BD%D0%B8%D0%B7" title="Сæкæрниз – Ossetic" lang="os" hreflang="os" data-title="Сæкæрниз" data-language-autonym="Ирон" data-language-local-name="Ossetic" class="interlanguage-link-target"><span>Ирон</span></a></li><li class="interlanguage-link interwiki-is mw-list-item"><a href="https://is.wikipedia.org/wiki/Sykurs%C3%BDki" title="Sykursýki – Icelandic" lang="is" hreflang="is" data-title="Sykursýki" data-language-autonym="Íslenska" data-language-local-name="Icelandic" class="interlanguage-link-target"><span>Íslenska</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Diabete_mellito" title="Diabete mellito – Italian" lang="it" hreflang="it" data-title="Diabete mellito" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%A1%D7%95%D7%9B%D7%A8%D7%AA" title="סוכרת – Hebrew" lang="he" hreflang="he" data-title="סוכרת" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-jv mw-list-item"><a href="https://jv.wikipedia.org/wiki/Kencing_Manis" title="Kencing Manis – Javanese" lang="jv" hreflang="jv" data-title="Kencing Manis" data-language-autonym="Jawa" data-language-local-name="Javanese" class="interlanguage-link-target"><span>Jawa</span></a></li><li class="interlanguage-link interwiki-kn mw-list-item"><a href="https://kn.wikipedia.org/wiki/%E0%B2%AE%E0%B2%A7%E0%B3%81%E0%B2%AE%E0%B3%87%E0%B2%B9" title="ಮಧುಮೇಹ – Kannada" lang="kn" hreflang="kn" data-title="ಮಧುಮೇಹ" data-language-autonym="ಕನ್ನಡ" data-language-local-name="Kannada" class="interlanguage-link-target"><span>ಕನ್ನಡ</span></a></li><li class="interlanguage-link interwiki-pam mw-list-item"><a href="https://pam.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Pampanga" lang="pam" hreflang="pam" data-title="Diabetes mellitus" data-language-autonym="Kapampangan" data-language-local-name="Pampanga" class="interlanguage-link-target"><span>Kapampangan</span></a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/%E1%83%A8%E1%83%90%E1%83%A5%E1%83%A0%E1%83%98%E1%83%90%E1%83%9C%E1%83%98_%E1%83%93%E1%83%98%E1%83%90%E1%83%91%E1%83%94%E1%83%A2%E1%83%98" title="შაქრიანი დიაბეტი – Georgian" lang="ka" hreflang="ka" data-title="შაქრიანი დიაბეტი" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target"><span>ქართული</span></a></li><li class="interlanguage-link interwiki-ks mw-list-item"><a href="https://ks.wikipedia.org/wiki/%D8%B0%DB%8C%D8%A7%D8%A8%DB%8C%D9%96%D8%B7%D9%94%D8%B3" title="ذیابیٖطٔس – Kashmiri" lang="ks" hreflang="ks" data-title="ذیابیٖطٔس" data-language-autonym="कॉशुर / کٲشُر" data-language-local-name="Kashmiri" class="interlanguage-link-target"><span>कॉशुर / کٲشُر</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D2%9A%D0%B0%D0%BD%D1%82_%D0%B4%D0%B8%D0%B0%D0%B1%D0%B5%D1%82%D1%96" title="Қант диабеті – Kazakh" lang="kk" hreflang="kk" data-title="Қант диабеті" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-kw mw-list-item"><a href="https://kw.wikipedia.org/wiki/Kleves_melys" title="Kleves melys – Cornish" lang="kw" hreflang="kw" data-title="Kleves melys" data-language-autonym="Kernowek" data-language-local-name="Cornish" class="interlanguage-link-target"><span>Kernowek</span></a></li><li class="interlanguage-link interwiki-sw mw-list-item"><a href="https://sw.wikipedia.org/wiki/Kisukari_(ugonjwa)" title="Kisukari (ugonjwa) – Swahili" lang="sw" hreflang="sw" data-title="Kisukari (ugonjwa)" data-language-autonym="Kiswahili" data-language-local-name="Swahili" class="interlanguage-link-target"><span>Kiswahili</span></a></li><li class="interlanguage-link interwiki-gcr mw-list-item"><a href="https://gcr.wikipedia.org/wiki/Djab%C3%A8t_(sendromm)" title="Djabèt (sendromm) – Guianan Creole" lang="gcr" hreflang="gcr" data-title="Djabèt (sendromm)" data-language-autonym="Kriyòl gwiyannen" data-language-local-name="Guianan Creole" class="interlanguage-link-target"><span>Kriyòl gwiyannen</span></a></li><li class="interlanguage-link interwiki-ku mw-list-item"><a href="https://ku.wikipedia.org/wiki/Nexwe%C5%9Fiya_%C5%9Fekir" title="Nexweşiya şekir – Kurdish" lang="ku" hreflang="ku" data-title="Nexweşiya şekir" data-language-autonym="Kurdî" data-language-local-name="Kurdish" class="interlanguage-link-target"><span>Kurdî</span></a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%9A%D0%B0%D0%BD%D1%82_%D0%B4%D0%B8%D0%B0%D0%B1%D0%B5%D1%82%D0%B8" title="Кант диабети – Kyrgyz" lang="ky" hreflang="ky" data-title="Кант диабети" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target"><span>Кыргызча</span></a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Latin" lang="la" hreflang="la" data-title="Diabetes mellitus" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target"><span>Latina</span></a></li><li class="interlanguage-link interwiki-lv mw-list-item"><a href="https://lv.wikipedia.org/wiki/Cukura_diab%C4%93ts" title="Cukura diabēts – Latvian" lang="lv" hreflang="lv" data-title="Cukura diabēts" data-language-autonym="Latviešu" data-language-local-name="Latvian" class="interlanguage-link-target"><span>Latviešu</span></a></li><li class="interlanguage-link interwiki-lb mw-list-item"><a href="https://lb.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Luxembourgish" lang="lb" hreflang="lb" data-title="Diabetes mellitus" data-language-autonym="Lëtzebuergesch" data-language-local-name="Luxembourgish" class="interlanguage-link-target"><span>Lëtzebuergesch</span></a></li><li class="interlanguage-link interwiki-lez mw-list-item"><a href="https://lez.wikipedia.org/wiki/%D0%A8%D0%B5%D0%BA%D0%B5%D1%80%D0%B4%D0%B8%D0%BD_%D0%B4%D0%B8%D0%B0%D0%B1%D0%B5%D1%82" title="Шекердин диабет – Lezghian" lang="lez" hreflang="lez" data-title="Шекердин диабет" data-language-autonym="Лезги" data-language-local-name="Lezghian" class="interlanguage-link-target"><span>Лезги</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Cukrinis_diabetas" title="Cukrinis diabetas – Lithuanian" lang="lt" hreflang="lt" data-title="Cukrinis diabetas" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-nia mw-list-item"><a href="https://nia.wikipedia.org/wiki/F%C3%B6kh%C3%B6_Gulo" title="Fökhö Gulo – Nias" lang="nia" hreflang="nia" data-title="Fökhö Gulo" data-language-autonym="Li Niha" data-language-local-name="Nias" class="interlanguage-link-target"><span>Li Niha</span></a></li><li class="interlanguage-link interwiki-lij mw-list-item"><a href="https://lij.wikipedia.org/wiki/Diabete_Mell%C3%ACo" title="Diabete Mellìo – Ligurian" lang="lij" hreflang="lij" data-title="Diabete Mellìo" data-language-autonym="Ligure" data-language-local-name="Ligurian" class="interlanguage-link-target"><span>Ligure</span></a></li><li class="interlanguage-link interwiki-li mw-list-item"><a href="https://li.wikipedia.org/wiki/S%C3%B3kkergekrenkdje" title="Sókkergekrenkdje – Limburgish" lang="li" hreflang="li" data-title="Sókkergekrenkdje" data-language-autonym="Limburgs" data-language-local-name="Limburgish" class="interlanguage-link-target"><span>Limburgs</span></a></li><li class="interlanguage-link interwiki-lg mw-list-item"><a href="https://lg.wikipedia.org/wiki/Okugwamu_amazzi" title="Okugwamu amazzi – Ganda" lang="lg" hreflang="lg" data-title="Okugwamu amazzi" data-language-autonym="Luganda" data-language-local-name="Ganda" class="interlanguage-link-target"><span>Luganda</span></a></li><li class="interlanguage-link interwiki-lmo mw-list-item"><a href="https://lmo.wikipedia.org/wiki/Diabet_zucherad" title="Diabet zucherad – Lombard" lang="lmo" hreflang="lmo" data-title="Diabet zucherad" data-language-autonym="Lombard" data-language-local-name="Lombard" class="interlanguage-link-target"><span>Lombard</span></a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Cukorbetegs%C3%A9g" title="Cukorbetegség – Hungarian" lang="hu" hreflang="hu" data-title="Cukorbetegség" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target"><span>Magyar</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%A8%D0%B5%D1%9C%D0%B5%D1%80%D0%BD%D0%B0_%D0%B1%D0%BE%D0%BB%D0%B5%D1%81%D1%82" title="Шеќерна болест – Macedonian" lang="mk" hreflang="mk" data-title="Шеќерна болест" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%AA%E0%B5%8D%E0%B4%B0%E0%B4%AE%E0%B5%87%E0%B4%B9%E0%B4%82" title="പ്രമേഹം – Malayalam" lang="ml" hreflang="ml" data-title="പ്രമേഹം" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-mr mw-list-item"><a href="https://mr.wikipedia.org/wiki/%E0%A4%AE%E0%A4%A7%E0%A5%81%E0%A4%AE%E0%A5%87%E0%A4%B9" title="मधुमेह – Marathi" lang="mr" hreflang="mr" data-title="मधुमेह" data-language-autonym="मराठी" data-language-local-name="Marathi" class="interlanguage-link-target"><span>मराठी</span></a></li><li class="interlanguage-link interwiki-xmf mw-list-item"><a href="https://xmf.wikipedia.org/wiki/%E1%83%A8%E1%83%90%E1%83%9C%E1%83%A5%E1%83%90%E1%83%A0%E1%83%98%E1%83%A8_%E1%83%93%E1%83%98%E1%83%90%E1%83%91%E1%83%94%E1%83%A2%E1%83%98" title="შანქარიშ დიაბეტი – Mingrelian" lang="xmf" hreflang="xmf" data-title="შანქარიშ დიაბეტი" data-language-autonym="მარგალური" data-language-local-name="Mingrelian" class="interlanguage-link-target"><span>მარგალური</span></a></li><li class="interlanguage-link interwiki-arz mw-list-item"><a href="https://arz.wikipedia.org/wiki/%D9%85%D8%B1%D8%B6_%D8%A7%D9%84%D8%B3%D9%83%D8%B1" title="مرض السكر – Egyptian Arabic" lang="arz" hreflang="arz" data-title="مرض السكر" data-language-autonym="مصرى" data-language-local-name="Egyptian Arabic" class="interlanguage-link-target"><span>مصرى</span></a></li><li class="interlanguage-link interwiki-mnw mw-list-item"><a href="https://mnw.wikipedia.org/wiki/%E1%80%8F%E1%80%99%E1%80%BA%E1%80%8D%E1%80%AC%E1%80%90%E1%80%BA%E1%81%8A_%E1%80%9A%E1%80%B2" title="ဏမ်ဍာတ်၊ ယဲ – Mon" lang="mnw" hreflang="mnw" data-title="ဏမ်ဍာတ်၊ ယဲ" data-language-autonym="ဘာသာမန်" data-language-local-name="Mon" class="interlanguage-link-target"><span>ဘာသာမန်</span></a></li><li class="interlanguage-link interwiki-ms badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://ms.wikipedia.org/wiki/Penyakit_kencing_manis" title="Penyakit kencing manis – Malay" lang="ms" hreflang="ms" data-title="Penyakit kencing manis" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target"><span>Bahasa Melayu</span></a></li><li class="interlanguage-link interwiki-min badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://min.wikipedia.org/wiki/Diabetes_melitus" title="Diabetes melitus – Minangkabau" lang="min" hreflang="min" data-title="Diabetes melitus" data-language-autonym="Minangkabau" data-language-local-name="Minangkabau" class="interlanguage-link-target"><span>Minangkabau</span></a></li><li class="interlanguage-link interwiki-mn mw-list-item"><a href="https://mn.wikipedia.org/wiki/%D0%A7%D0%B8%D1%85%D1%80%D0%B8%D0%B9%D0%BD_%D1%88%D0%B8%D0%B6%D0%B8%D0%BD" title="Чихрийн шижин – Mongolian" lang="mn" hreflang="mn" data-title="Чихрийн шижин" data-language-autonym="Монгол" data-language-local-name="Mongolian" class="interlanguage-link-target"><span>Монгол</span></a></li><li class="interlanguage-link interwiki-my mw-list-item"><a href="https://my.wikipedia.org/wiki/%E1%80%86%E1%80%AE%E1%80%B8%E1%80%81%E1%80%BB%E1%80%AD%E1%80%AF%E1%80%9B%E1%80%B1%E1%80%AC%E1%80%82%E1%80%AB" title="ဆီးချိုရောဂါ – Burmese" lang="my" hreflang="my" data-title="ဆီးချိုရောဂါ" data-language-autonym="မြန်မာဘာသာ" data-language-local-name="Burmese" class="interlanguage-link-target"><span>မြန်မာဘာသာ</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Dutch" lang="nl" hreflang="nl" data-title="Diabetes mellitus" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ne mw-list-item"><a href="https://ne.wikipedia.org/wiki/%E0%A4%AE%E0%A4%A7%E0%A5%81%E0%A4%AE%E0%A5%87%E0%A4%B9" title="मधुमेह – Nepali" lang="ne" hreflang="ne" data-title="मधुमेह" data-language-autonym="नेपाली" data-language-local-name="Nepali" class="interlanguage-link-target"><span>नेपाली</span></a></li><li class="interlanguage-link interwiki-new mw-list-item"><a href="https://new.wikipedia.org/wiki/%E0%A4%AE%E0%A4%A7%E0%A5%81%E0%A4%AE%E0%A5%87%E0%A4%B9" title="मधुमेह – Newari" lang="new" hreflang="new" data-title="मधुमेह" data-language-autonym="नेपाल भाषा" data-language-local-name="Newari" class="interlanguage-link-target"><span>नेपाल भाषा</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E7%B3%96%E5%B0%BF%E7%97%85" title="糖尿病 – Japanese" lang="ja" hreflang="ja" data-title="糖尿病" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-ce mw-list-item"><a href="https://ce.wikipedia.org/wiki/%D0%A8%D0%B5%D0%BA%D0%B0%D1%80%D0%B0%D0%BD_%D0%B4%D0%B8%D0%B0%D0%B1%D0%B5%D1%82" title="Шекаран диабет – Chechen" lang="ce" hreflang="ce" data-title="Шекаран диабет" data-language-autonym="Нохчийн" data-language-local-name="Chechen" class="interlanguage-link-target"><span>Нохчийн</span></a></li><li class="interlanguage-link interwiki-frr mw-list-item"><a href="https://frr.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Northern Frisian" lang="frr" hreflang="frr" data-title="Diabetes mellitus" data-language-autonym="Nordfriisk" data-language-local-name="Northern Frisian" class="interlanguage-link-target"><span>Nordfriisk</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Diabetes" title="Diabetes – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Diabetes" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Diabetes mellitus" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target"><span>Norsk nynorsk</span></a></li><li class="interlanguage-link interwiki-oc mw-list-item"><a href="https://oc.wikipedia.org/wiki/Diab%C3%A8ta_sucrat" title="Diabèta sucrat – Occitan" lang="oc" hreflang="oc" data-title="Diabèta sucrat" data-language-autonym="Occitan" data-language-local-name="Occitan" class="interlanguage-link-target"><span>Occitan</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%AE%E0%AC%A7%E0%AD%81%E0%AC%AE%E0%AD%87%E0%AC%B9" title="ମଧୁମେହ – Odia" lang="or" hreflang="or" data-title="ମଧୁମେହ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-om mw-list-item"><a href="https://om.wikipedia.org/wiki/Diabetes" title="Diabetes – Oromo" lang="om" hreflang="om" data-title="Diabetes" data-language-autonym="Oromoo" data-language-local-name="Oromo" class="interlanguage-link-target"><span>Oromoo</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Qandli_diabet" title="Qandli diabet – Uzbek" lang="uz" hreflang="uz" data-title="Qandli diabet" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pa mw-list-item"><a href="https://pa.wikipedia.org/wiki/%E0%A8%B8%E0%A8%BC%E0%A9%B1%E0%A8%95%E0%A8%B0_%E0%A8%B0%E0%A9%8B%E0%A8%97" title="ਸ਼ੱਕਰ ਰੋਗ – Punjabi" lang="pa" hreflang="pa" data-title="ਸ਼ੱਕਰ ਰੋਗ" data-language-autonym="ਪੰਜਾਬੀ" data-language-local-name="Punjabi" class="interlanguage-link-target"><span>ਪੰਜਾਬੀ</span></a></li><li class="interlanguage-link interwiki-pnb mw-list-item"><a href="https://pnb.wikipedia.org/wiki/%D8%B4%D9%88%DA%AF%D8%B1" title="شوگر – Western Punjabi" lang="pnb" hreflang="pnb" data-title="شوگر" data-language-autonym="پنجابی" data-language-local-name="Western Punjabi" class="interlanguage-link-target"><span>پنجابی</span></a></li><li class="interlanguage-link interwiki-blk mw-list-item"><a href="https://blk.wikipedia.org/wiki/%E1%80%86%E1%80%AE%E1%82%8F%E1%80%94%E1%80%BD%E1%80%AD%E1%80%AF%E1%80%B8%E1%80%9B%E1%80%B1%E1%80%AC%E1%82%8F%E1%80%82%E1%80%AB%E1%82%8F" title="ဆီႏနွိုးရောႏဂါႏ – Pa'O" lang="blk" hreflang="blk" data-title="ဆီႏနွိုးရောႏဂါႏ" data-language-autonym="ပအိုဝ်ႏဘာႏသာႏ" data-language-local-name="Pa'O" class="interlanguage-link-target"><span>ပအိုဝ်ႏဘာႏသာႏ</span></a></li><li class="interlanguage-link interwiki-pap mw-list-item"><a href="https://pap.wikipedia.org/wiki/Diab%C3%A9tis_Mellitus" title="Diabétis Mellitus – Papiamento" lang="pap" hreflang="pap" data-title="Diabétis Mellitus" data-language-autonym="Papiamentu" data-language-local-name="Papiamento" class="interlanguage-link-target"><span>Papiamentu</span></a></li><li class="interlanguage-link interwiki-ps mw-list-item"><a href="https://ps.wikipedia.org/wiki/%D8%B4%DA%A9%D8%B1%DB%90_%D9%86%D8%A7%D8%B1%D9%88%D8%BA%D9%8A" title="شکرې ناروغي – Pashto" lang="ps" hreflang="ps" data-title="شکرې ناروغي" data-language-autonym="پښتو" data-language-local-name="Pashto" class="interlanguage-link-target"><span>پښتو</span></a></li><li class="interlanguage-link interwiki-jam mw-list-item"><a href="https://jam.wikipedia.org/wiki/Dayabiitis" title="Dayabiitis – Jamaican Creole English" lang="jam" hreflang="jam" data-title="Dayabiitis" data-language-autonym="Patois" data-language-local-name="Jamaican Creole English" class="interlanguage-link-target"><span>Patois</span></a></li><li class="interlanguage-link interwiki-km mw-list-item"><a href="https://km.wikipedia.org/wiki/%E1%9E%87%E1%9F%86%E1%9E%84%E1%9E%BA%E1%9E%91%E1%9E%B9%E1%9E%80%E1%9E%93%E1%9F%84%E1%9E%98%E1%9E%95%E1%9F%92%E1%9E%A2%E1%9F%82%E1%9E%98" title="ជំងឺទឹកនោមផ្អែម – Khmer" lang="km" hreflang="km" data-title="ជំងឺទឹកនោមផ្អែម" data-language-autonym="ភាសាខ្មែរ" data-language-local-name="Khmer" class="interlanguage-link-target"><span>ភាសាខ្មែរ</span></a></li><li class="interlanguage-link interwiki-pms mw-list-item"><a href="https://pms.wikipedia.org/wiki/Diabete" title="Diabete – Piedmontese" lang="pms" hreflang="pms" data-title="Diabete" data-language-autonym="Piemontèis" data-language-local-name="Piedmontese" class="interlanguage-link-target"><span>Piemontèis</span></a></li><li class="interlanguage-link interwiki-nds mw-list-item"><a href="https://nds.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Low German" lang="nds" hreflang="nds" data-title="Diabetes mellitus" data-language-autonym="Plattdüütsch" data-language-local-name="Low German" class="interlanguage-link-target"><span>Plattdüütsch</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Cukrzyca" title="Cukrzyca – Polish" lang="pl" hreflang="pl" data-title="Cukrzyca" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Portuguese" lang="pt" hreflang="pt" data-title="Diabetes mellitus" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Diabet_zaharat" title="Diabet zaharat – Romanian" lang="ro" hreflang="ro" data-title="Diabet zaharat" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-qu mw-list-item"><a href="https://qu.wikipedia.org/wiki/Misk%27i_unquy" title="Misk'i unquy – Quechua" lang="qu" hreflang="qu" data-title="Misk'i unquy" data-language-autonym="Runa Simi" data-language-local-name="Quechua" class="interlanguage-link-target"><span>Runa Simi</span></a></li><li class="interlanguage-link interwiki-rue mw-list-item"><a href="https://rue.wikipedia.org/wiki/%D0%A6%D1%83%D0%BA%D1%80%D1%91%D0%B2%D1%8B%D0%B9_%D0%B4%D1%96%D0%B0%D0%B1%D0%B5%D1%82" title="Цукрёвый діабет – Rusyn" lang="rue" hreflang="rue" data-title="Цукрёвый діабет" data-language-autonym="Русиньскый" data-language-local-name="Rusyn" class="interlanguage-link-target"><span>Русиньскый</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%A1%D0%B0%D1%85%D0%B0%D1%80%D0%BD%D1%8B%D0%B9_%D0%B4%D0%B8%D0%B0%D0%B1%D0%B5%D1%82" title="Сахарный диабет – Russian" lang="ru" hreflang="ru" data-title="Сахарный диабет" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sah mw-list-item"><a href="https://sah.wikipedia.org/wiki/%D0%A1%D0%B0%D1%85%D0%B0%D1%80%D0%BD%D0%B0%D0%B9_%D0%B4%D0%B8%D0%B0%D0%B1%D0%B5%D1%82" title="Сахарнай диабет – Yakut" lang="sah" hreflang="sah" data-title="Сахарнай диабет" data-language-autonym="Саха тыла" data-language-local-name="Yakut" class="interlanguage-link-target"><span>Саха тыла</span></a></li><li class="interlanguage-link interwiki-sa mw-list-item"><a href="https://sa.wikipedia.org/wiki/%E0%A4%AE%E0%A4%A7%E0%A5%81%E0%A4%AE%E0%A5%87%E0%A4%B9%E0%A4%83" title="मधुमेहः – Sanskrit" lang="sa" hreflang="sa" data-title="मधुमेहः" data-language-autonym="संस्कृतम्" data-language-local-name="Sanskrit" class="interlanguage-link-target"><span>संस्कृतम्</span></a></li><li class="interlanguage-link interwiki-sq mw-list-item"><a href="https://sq.wikipedia.org/wiki/Diabeti" title="Diabeti – Albanian" lang="sq" hreflang="sq" data-title="Diabeti" data-language-autonym="Shqip" data-language-local-name="Albanian" class="interlanguage-link-target"><span>Shqip</span></a></li><li class="interlanguage-link interwiki-si mw-list-item"><a href="https://si.wikipedia.org/wiki/%E0%B6%AF%E0%B7%92%E0%B6%BA%E0%B7%80%E0%B7%90%E0%B6%A9%E0%B7%92%E0%B6%BA%E0%B7%8F%E0%B7%80" title="දියවැඩියාව – Sinhala" lang="si" hreflang="si" data-title="දියවැඩියාව" data-language-autonym="සිංහල" data-language-local-name="Sinhala" class="interlanguage-link-target"><span>සිංහල</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Simple English" lang="en-simple" hreflang="en-simple" data-title="Diabetes mellitus" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sd mw-list-item"><a href="https://sd.wikipedia.org/wiki/%D8%B0%D9%8A%D8%A7%D8%A8%D9%8A%D8%B7%D8%B3_(%D8%B4%D9%88%DA%AF%D8%B1)" title="ذيابيطس (شوگر) – Sindhi" lang="sd" hreflang="sd" data-title="ذيابيطس (شوگر)" data-language-autonym="سنڌي" data-language-local-name="Sindhi" class="interlanguage-link-target"><span>سنڌي</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Slovak" lang="sk" hreflang="sk" data-title="Diabetes mellitus" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Sladkorna_bolezen" title="Sladkorna bolezen – Slovenian" lang="sl" hreflang="sl" data-title="Sladkorna bolezen" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-so mw-list-item"><a href="https://so.wikipedia.org/wiki/Sokorow" title="Sokorow – Somali" lang="so" hreflang="so" data-title="Sokorow" data-language-autonym="Soomaaliga" data-language-local-name="Somali" class="interlanguage-link-target"><span>Soomaaliga</span></a></li><li class="interlanguage-link interwiki-ckb mw-list-item"><a href="https://ckb.wikipedia.org/wiki/%D8%B4%DB%95%DA%A9%D8%B1%DB%95" title="شەکرە – Central Kurdish" lang="ckb" hreflang="ckb" data-title="شەکرە" data-language-autonym="کوردی" data-language-local-name="Central Kurdish" class="interlanguage-link-target"><span>کوردی</span></a></li><li class="interlanguage-link interwiki-sr badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://sr.wikipedia.org/wiki/%D0%A8%D0%B5%D1%9B%D0%B5%D1%80%D0%BD%D0%B0_%D0%B1%D0%BE%D0%BB%D0%B5%D1%81%D1%82" title="Шећерна болест – Serbian" lang="sr" hreflang="sr" data-title="Шећерна болест" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Dijabetes" title="Dijabetes – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Dijabetes" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-su mw-list-item"><a href="https://su.wikipedia.org/wiki/Diab%C3%A9tes_m%C3%A9litus" title="Diabétes mélitus – Sundanese" lang="su" hreflang="su" data-title="Diabétes mélitus" data-language-autonym="Sunda" data-language-local-name="Sundanese" class="interlanguage-link-target"><span>Sunda</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Diabetes" title="Diabetes – Finnish" lang="fi" hreflang="fi" data-title="Diabetes" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Diabetes" title="Diabetes – Swedish" lang="sv" hreflang="sv" data-title="Diabetes" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Diyabetes" title="Diyabetes – Tagalog" lang="tl" hreflang="tl" data-title="Diyabetes" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target"><span>Tagalog</span></a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%A8%E0%AF%80%E0%AE%B0%E0%AE%BF%E0%AE%B4%E0%AE%BF%E0%AE%B5%E0%AF%81_%E0%AE%A8%E0%AF%8B%E0%AE%AF%E0%AF%8D" title="நீரிழிவு நோய் – Tamil" lang="ta" hreflang="ta" data-title="நீரிழிவு நோய்" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target"><span>தமிழ்</span></a></li><li class="interlanguage-link interwiki-shi mw-list-item"><a href="https://shi.wikipedia.org/wiki/Addyabi%E1%B9%AD%E1%B9%AD" title="Addyabiṭṭ – Tachelhit" lang="shi" hreflang="shi" data-title="Addyabiṭṭ" data-language-autonym="Taclḥit" data-language-local-name="Tachelhit" class="interlanguage-link-target"><span>Taclḥit</span></a></li><li class="interlanguage-link interwiki-tt mw-list-item"><a href="https://tt.wikipedia.org/wiki/%D0%A8%D0%B8%D0%BA%D3%99%D1%80_%D0%B0%D0%B2%D1%8B%D1%80%D1%83%D1%8B" title="Шикәр авыруы – Tatar" lang="tt" hreflang="tt" data-title="Шикәр авыруы" data-language-autonym="Татарча / tatarça" data-language-local-name="Tatar" class="interlanguage-link-target"><span>Татарча / tatarça</span></a></li><li class="interlanguage-link interwiki-shn mw-list-item"><a href="https://shn.wikipedia.org/wiki/%E1%80%9A%E1%80%B5%E1%80%9D%E1%80%BA%E1%82%88%E1%80%9D%E1%81%A2%E1%81%BC%E1%80%BA" title="ယဵဝ်ႈဝၢၼ် – Shan" lang="shn" hreflang="shn" data-title="ယဵဝ်ႈဝၢၼ်" data-language-autonym="ၽႃႇသႃႇတႆး " data-language-local-name="Shan" class="interlanguage-link-target"><span>ၽႃႇသႃႇတႆး </span></a></li><li class="interlanguage-link interwiki-te mw-list-item"><a href="https://te.wikipedia.org/wiki/%E0%B0%AE%E0%B0%A7%E0%B1%81%E0%B0%AE%E0%B1%87%E0%B0%B9%E0%B0%82" title="మధుమేహం – Telugu" lang="te" hreflang="te" data-title="మధుమేహం" data-language-autonym="తెలుగు" data-language-local-name="Telugu" class="interlanguage-link-target"><span>తెలుగు</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B9%80%E0%B8%9A%E0%B8%B2%E0%B8%AB%E0%B8%A7%E0%B8%B2%E0%B8%99" title="เบาหวาน – Thai" lang="th" hreflang="th" data-title="เบาหวาน" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-din mw-list-item"><a href="https://din.wikipedia.org/wiki/Tuaany%C3%AB%C5%8Beeiab%C3%AFk" title="Tuaanyëŋeeiabïk – Dinka" lang="din" hreflang="din" data-title="Tuaanyëŋeeiabïk" data-language-autonym="Thuɔŋjäŋ" data-language-local-name="Dinka" class="interlanguage-link-target"><span>Thuɔŋjäŋ</span></a></li><li class="interlanguage-link interwiki-tg mw-list-item"><a href="https://tg.wikipedia.org/wiki/%D0%91%D0%B5%D0%BC%D0%BE%D1%80%D0%B8%D0%B8_%D2%9B%D0%B0%D0%BD%D0%B4" title="Бемории қанд – Tajik" lang="tg" hreflang="tg" data-title="Бемории қанд" data-language-autonym="Тоҷикӣ" data-language-local-name="Tajik" class="interlanguage-link-target"><span>Тоҷикӣ</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Diyabet" title="Diyabet – Turkish" lang="tr" hreflang="tr" data-title="Diyabet" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-tk mw-list-item"><a href="https://tk.wikipedia.org/wiki/S%C3%BC%C3%BDj%C3%BClik_(kesel)" title="Süýjülik (kesel) – Turkmen" lang="tk" hreflang="tk" data-title="Süýjülik (kesel)" data-language-autonym="Türkmençe" data-language-local-name="Turkmen" class="interlanguage-link-target"><span>Türkmençe</span></a></li><li class="interlanguage-link interwiki-kcg mw-list-item"><a href="https://kcg.wikipedia.org/wiki/Zwan_shuga" title="Zwan shuga – Tyap" lang="kcg" hreflang="kcg" data-title="Zwan shuga" data-language-autonym="Tyap" data-language-local-name="Tyap" class="interlanguage-link-target"><span>Tyap</span></a></li><li class="interlanguage-link interwiki-uk badge-Q17437798 badge-goodarticle mw-list-item" title="good article badge"><a href="https://uk.wikipedia.org/wiki/%D0%A6%D1%83%D0%BA%D1%80%D0%BE%D0%B2%D0%B8%D0%B9_%D0%B4%D1%96%D0%B0%D0%B1%D0%B5%D1%82" title="Цукровий діабет – Ukrainian" lang="uk" hreflang="uk" data-title="Цукровий діабет" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-ur mw-list-item"><a href="https://ur.wikipedia.org/wiki/%D8%B0%DB%8C%D8%A7%D8%A8%DB%8C%D8%B7%D8%B3" title="ذیابیطس – Urdu" lang="ur" hreflang="ur" data-title="ذیابیطس" data-language-autonym="اردو" data-language-local-name="Urdu" class="interlanguage-link-target"><span>اردو</span></a></li><li class="interlanguage-link interwiki-ug mw-list-item"><a href="https://ug.wikipedia.org/wiki/%D8%AF%D9%89%D8%A6%D8%A7%D8%A8%DB%90%D8%AA_%D9%83%DB%90%D8%B3%D9%89%D9%84%D9%89" title="دىئابېت كېسىلى – Uyghur" lang="ug" hreflang="ug" data-title="دىئابېت كېسىلى" data-language-autonym="ئۇيغۇرچە / Uyghurche" data-language-local-name="Uyghur" class="interlanguage-link-target"><span>ئۇيغۇرچە / Uyghurche</span></a></li><li class="interlanguage-link interwiki-za mw-list-item"><a href="https://za.wikipedia.org/wiki/Oknyouhdiemz" title="Oknyouhdiemz – Zhuang" lang="za" hreflang="za" data-title="Oknyouhdiemz" data-language-autonym="Vahcuengh" data-language-local-name="Zhuang" class="interlanguage-link-target"><span>Vahcuengh</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/%C4%90%C3%A1i_th%C3%A1o_%C4%91%C6%B0%E1%BB%9Dng" title="Đái tháo đường – Vietnamese" lang="vi" hreflang="vi" data-title="Đái tháo đường" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-fiu-vro mw-list-item"><a href="https://fiu-vro.wikipedia.org/wiki/Tsukrut%C3%B5bi" title="Tsukrutõbi – Võro" lang="vro" hreflang="vro" data-title="Tsukrutõbi" data-language-autonym="Võro" data-language-local-name="Võro" class="interlanguage-link-target"><span>Võro</span></a></li><li class="interlanguage-link interwiki-war mw-list-item"><a href="https://war.wikipedia.org/wiki/Diabetes_mellitus" title="Diabetes mellitus – Waray" lang="war" hreflang="war" data-title="Diabetes mellitus" data-language-autonym="Winaray" data-language-local-name="Waray" class="interlanguage-link-target"><span>Winaray</span></a></li><li class="interlanguage-link interwiki-wuu mw-list-item"><a href="https://wuu.wikipedia.org/wiki/%E7%B3%96%E5%B0%BF%E7%97%85" title="糖尿病 – Wu" lang="wuu" hreflang="wuu" data-title="糖尿病" data-language-autonym="吴语" data-language-local-name="Wu" class="interlanguage-link-target"><span>吴语</span></a></li><li class="interlanguage-link interwiki-yi mw-list-item"><a href="https://yi.wikipedia.org/wiki/%D7%A6%D7%95%D7%A7%D7%A2%D7%A8%D7%A7%D7%A8%D7%A2%D7%A0%D7%A7" title="צוקערקרענק – Yiddish" lang="yi" hreflang="yi" data-title="צוקערקרענק" data-language-autonym="ייִדיש" data-language-local-name="Yiddish" class="interlanguage-link-target"><span>ייִדיש</span></a></li><li class="interlanguage-link interwiki-zh-yue mw-list-item"><a href="https://zh-yue.wikipedia.org/wiki/%E7%B3%96%E5%B0%BF" title="糖尿 – Cantonese" lang="yue" hreflang="yue" data-title="糖尿" data-language-autonym="粵語" data-language-local-name="Cantonese" class="interlanguage-link-target"><span>粵語</span></a></li><li class="interlanguage-link interwiki-bat-smg mw-list-item"><a href="https://bat-smg.wikipedia.org/wiki/Sokraus_diabets" title="Sokraus diabets – Samogitian" lang="sgs" hreflang="sgs" data-title="Sokraus diabets" data-language-autonym="Žemaitėška" data-language-local-name="Samogitian" class="interlanguage-link-target"><span>Žemaitėška</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E7%B3%96%E5%B0%BF%E7%97%85" title="糖尿病 – Chinese" lang="zh" hreflang="zh" data-title="糖尿病" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q12206#sitelinks-wikipedia" title="Edit interlanguage links" class="wbc-editpage">Edit links</a></span></div> </div> </div> </div> </header> <div class="vector-page-toolbar"> <div class="vector-page-toolbar-container"> <div id="left-navigation"> <nav aria-label="Namespaces"> <div id="p-associated-pages" class="vector-menu vector-menu-tabs mw-portlet mw-portlet-associated-pages" > <div class="vector-menu-content"> <ul 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div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">This article is about the common insulin disorder. For the urine hyper-production disorder, see <a href="/wiki/Diabetes_insipidus" title="Diabetes insipidus">Diabetes insipidus</a>. For other uses, see <a href="/wiki/Diabetes_(disambiguation)" class="mw-disambig" title="Diabetes (disambiguation)">Diabetes (disambiguation)</a>.</div> <p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Diabetes</th></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span typeof="mw:File"><a href="/wiki/File:Blue_circle_for_diabetes.svg" class="mw-file-description"><img alt="A hollow circle with a thick blue border and a clear centre" src="//upload.wikimedia.org/wikipedia/commons/thumb/4/43/Blue_circle_for_diabetes.svg/250px-Blue_circle_for_diabetes.svg.png" decoding="async" width="250" height="250" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/43/Blue_circle_for_diabetes.svg/375px-Blue_circle_for_diabetes.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/43/Blue_circle_for_diabetes.svg/500px-Blue_circle_for_diabetes.svg.png 2x" data-file-width="240" data-file-height="240" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">Universal blue circle symbol for diabetes<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Pronunciation</th><td class="infobox-data"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style><div class="plainlist"><ul><li><span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="/ˌ/: secondary stress follows">ˌ</span><span title="'d' in 'dye'">d</span><span title="/aɪ/: 'i' in 'tide'">aɪ</span><span title="/./: syllable break">.</span><span title="/ə/: 'a' in 'about'">ə</span><span title="/ˈ/: primary stress follows">ˈ</span><span title="'b' in 'buy'">b</span><span title="/iː/: 'ee' in 'fleece'">iː</span><span title="'t' in 'tie'">t</span><span title="/iː/: 'ee' in 'fleece'">iː</span><span title="'z' in 'zoom'">z</span></span>,<span class="wrap"> </span>-<span style="border-bottom:1px dotted"><span title="'t' in 'tie'">t</span><span title="/ɪ/: 'i' in 'kit'">ɪ</span><span title="'s' in 'sigh'">s</span></span>/</a></span></span> </li></ul></div></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Endocrinology" title="Endocrinology">Endocrinology</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li><a href="/wiki/Polyuria" title="Polyuria">Frequent urination</a></li> <li><a href="/wiki/Polydipsia" title="Polydipsia">Increased thirst</a></li> <li><a href="/wiki/Polyphagia" title="Polyphagia">Increased hunger</a></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li>Metabolic imbalances</li> <li>Cardiovascular diseases</li> <li><a href="/wiki/Myocardial_infarction" title="Myocardial infarction">Myocardial infarction</a></li> <li>Nerve and brain damage</li> <li>Kidney failure</li> <li>Gastrointestinal changes<sup id="cite_ref-WHO2022_2-0" class="reference"><a href="#cite_note-WHO2022-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ADA2009_3-0" class="reference"><a href="#cite_note-ADA2009-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Sa2016_5-0" class="reference"><a href="#cite_note-Sa2016-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label">Duration</th><td class="infobox-data">Remission may occur, but diabetes is often life-long</td></tr><tr><th scope="row" class="infobox-label">Types</th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li>Type 1 diabetes</li> <li>Type 2 diabetes</li> <li>Gestational diabetes</li></ul> </div></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data">Insulin insufficiency or gradual resistance</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li><b>Type 1</b>: <a href="/wiki/Heredity" title="Heredity">genetics</a> and environmental factors<sup id="cite_ref-NIH2014Cause_6-0" class="reference"><a href="#cite_note-NIH2014Cause-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></li> <li><b>Type 2</b>: <a href="/wiki/Obesity" title="Obesity">Obesity</a>, family history, non-alcoholic fatty liver disease, past pregnancy with gestational diabetes, lack of exercise, <a href="/wiki/Heredity" title="Heredity">genetics</a><sup id="cite_ref-WHO2022_2-1" class="reference"><a href="#cite_note-WHO2022-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NIH2014Cause_6-1" class="reference"><a href="#cite_note-NIH2014Cause-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li>High <a href="/wiki/Blood_sugar" class="mw-redirect" title="Blood sugar">blood sugar</a></li> <li>Increased <a href="/wiki/HbA1c" class="mw-redirect" title="HbA1c">HbA1c</a><sup id="cite_ref-WHO2022_2-2" class="reference"><a href="#cite_note-WHO2022-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Differential_diagnosis" title="Differential diagnosis">Differential diagnosis</a></th><td class="infobox-data"><a href="/wiki/Diabetes_insipidus" title="Diabetes insipidus">diabetes insipidus</a></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li><a href="/wiki/Lifestyle_causes_of_type_2_diabetes" title="Lifestyle causes of type 2 diabetes">Lifestyle changes</a></li> <li><a href="/wiki/Diabetes_medication" title="Diabetes medication">Diabetes medication</a><sup id="cite_ref-WHO2022_2-3" class="reference"><a href="#cite_note-WHO2022-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medication" title="Medication">Medication</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li><a href="/wiki/Insulin_(medication)" title="Insulin (medication)">Insulin</a></li> <li><a href="/wiki/Anti-diabetic_medication" class="mw-redirect" title="Anti-diabetic medication">Anti-hyperglycemics</a><sup id="cite_ref-WHO2022_2-4" class="reference"><a href="#cite_note-WHO2022-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-AFP09_7-0" class="reference"><a href="#cite_note-AFP09-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">463 million (5.7%)<sup id="cite_ref-IDF2019_9-0" class="reference"><a href="#cite_note-IDF2019-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Deaths</th><td class="infobox-data">4.2 million (2019)<sup id="cite_ref-IDF2019_9-1" class="reference"><a href="#cite_note-IDF2019-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup></td></tr></tbody></table> <p><b>Diabetes</b>, also known as <b>diabetes mellitus</b>, is a group of common <a href="/wiki/Endocrine_disease" title="Endocrine disease">endocrine diseases</a> characterized by sustained <a href="/wiki/Hyperglycemia" title="Hyperglycemia">high blood sugar levels</a>.<sup id="cite_ref-:3_10-0" class="reference"><a href="#cite_note-:3-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-msd_11-0" class="reference"><a href="#cite_note-msd-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Diabetes is due to either the <a href="/wiki/Pancreas" title="Pancreas">pancreas</a> not producing enough of the hormone <a href="/wiki/Insulin" title="Insulin">insulin</a>, or the cells of the body becoming unresponsive to insulin's effects.<sup id="cite_ref-Green2011_12-0" class="reference"><a href="#cite_note-Green2011-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> Classic symptoms include <a href="/wiki/Polydipsia" title="Polydipsia">polydipsia</a> (excessive thirst), <a href="/wiki/Polyuria" title="Polyuria">polyuria</a> (excessive urination), <a href="/wiki/Polyphagia" title="Polyphagia">polyphagia</a> (excessive hunger), weight loss, and <a href="/wiki/Blurred_vision" title="Blurred vision">blurred vision</a>. If left untreated, the disease can lead to various health complications, including disorders of the <a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">cardiovascular system</a>, <a href="/wiki/Diabetic_retinopathy" title="Diabetic retinopathy">eye</a>, <a href="/wiki/Diabetic_nephropathy" title="Diabetic nephropathy">kidney</a>, and <a href="/wiki/Diabetic_neuropathy" title="Diabetic neuropathy">nerves</a>.<sup id="cite_ref-ADA2009_3-1" class="reference"><a href="#cite_note-ADA2009-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Diabetes accounts for approximately 4.2 million deaths every year,<sup id="cite_ref-IDF2019_9-2" class="reference"><a href="#cite_note-IDF2019-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> with an estimated 1.5 million caused by either untreated or poorly treated diabetes.<sup id="cite_ref-:3_10-1" class="reference"><a href="#cite_note-:3-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p><p>The major types of diabetes are <a href="/wiki/Type_1_diabetes" title="Type 1 diabetes">type 1</a> and <a href="/wiki/Type_2_diabetes" title="Type 2 diabetes">type 2</a>.<sup id="cite_ref-niddk_13-0" class="reference"><a href="#cite_note-niddk-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> The most common treatment for type 1 is <a href="/wiki/Insulin_replacement_therapy" class="mw-redirect" title="Insulin replacement therapy">insulin replacement therapy</a> (insulin injections), while <a href="/wiki/Diabetes_medication" title="Diabetes medication">anti-diabetic medications</a> (such as <a href="/wiki/Metformin" title="Metformin">metformin</a> and <a href="/wiki/Semaglutide" title="Semaglutide">semaglutide</a>) and <a href="/wiki/Lifestyle_medicine" title="Lifestyle medicine">lifestyle modifications</a> can be used to manage type 2. <a href="/wiki/Gestational_diabetes" title="Gestational diabetes">Gestational diabetes</a>, a form that arises during <a href="/wiki/Pregnancy" title="Pregnancy">pregnancy</a> in some women, normally resolves shortly after delivery. Type 1 diabetes is an autoimmune condition where the body's immune system attacks the <a href="/wiki/Beta_cell" title="Beta cell">beta cells</a> in the pancreas, preventing the production of insulin. This condition is typically present from birth or develops early in life. Type 2 diabetes occurs when the body becomes resistant to insulin, meaning the cells do not respond effectively to it, and thus, glucose remains in the bloodstream instead of being absorbed by the cells.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>The number of people diagnosed as living with diabetes has increased sharply in recent decades, from 200 million in 1990 to 830 million by 2022.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> It affects one in seven of the adult population, with type 2 diabetes accounting for more than 95% of cases. These numbers have already risen beyond earlier projections of 783 million adults by 2045.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> The prevalence of the disease continues to increase, most dramatically in low- and middle-income nations.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> Rates are similar in women and men, with diabetes being the seventh leading cause of death globally.<sup id="cite_ref-Vos2012_19-0" class="reference"><a href="#cite_note-Vos2012-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> The global expenditure on diabetes-related healthcare is an estimated US$760 billion a year.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> </p> <style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Main_symptoms_of_diabetes.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/01/Main_symptoms_of_diabetes.svg/330px-Main_symptoms_of_diabetes.svg.png" decoding="async" width="330" height="337" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/01/Main_symptoms_of_diabetes.svg/495px-Main_symptoms_of_diabetes.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/01/Main_symptoms_of_diabetes.svg/660px-Main_symptoms_of_diabetes.svg.png 2x" data-file-width="1029" data-file-height="1052" /></a><figcaption>Overview of the most significant symptoms of diabetes</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Diabetes_complications.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/bc/Diabetes_complications.jpg/220px-Diabetes_complications.jpg" decoding="async" width="220" height="124" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/bc/Diabetes_complications.jpg/330px-Diabetes_complications.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/bc/Diabetes_complications.jpg/440px-Diabetes_complications.jpg 2x" data-file-width="1920" data-file-height="1080" /></a><figcaption>Retinopathy, nephropathy, and neuropathy are potential complications of diabetes</figcaption></figure><p>Common symptoms of diabetes include increased thirst, frequent urination, extreme hunger, and unintended weight loss.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:5_23-0" class="reference"><a href="#cite_note-:5-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> Several other non-specific signs and symptoms may also occur, including fatigue, blurred vision, sweet smelling urine/semen and genital itchiness due to <a href="/wiki/Candidiasis" title="Candidiasis"><i>Candida</i> infection</a>.<sup id="cite_ref-:5_23-1" class="reference"><a href="#cite_note-:5-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> About half of affected individuals may also be asymptomatic.<sup id="cite_ref-:5_23-2" class="reference"><a href="#cite_note-:5-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> Type 1 presents abruptly following a pre-clinical phase, while type 2 has a more insidious onset; patients may remain asymptomatic for many years.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Diabetic_ketoacidosis" title="Diabetic ketoacidosis">Diabetic ketoacidosis</a> is a medical emergency that occurs most commonly in type 1, but may also occur in type 2 if it has been longstanding or if the individual has significant β-cell dysfunction.<sup id="cite_ref-:6_25-0" class="reference"><a href="#cite_note-:6-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> Excessive production of <a href="/wiki/Ketone_bodies" title="Ketone bodies">ketone bodies</a> leads to signs and symptoms including nausea, vomiting, abdominal pain, the smell of <a href="/wiki/Acetone" title="Acetone">acetone</a> in the breath, deep breathing known as <a href="/wiki/Kussmaul_breathing" title="Kussmaul breathing">Kussmaul breathing</a>, and in severe cases <a href="/wiki/Altered_level_of_consciousness" title="Altered level of consciousness">decreased level of consciousness</a>.<sup id="cite_ref-:6_25-1" class="reference"><a href="#cite_note-:6-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Hyperosmolar_hyperglycemic_state" title="Hyperosmolar hyperglycemic state">Hyperosmolar hyperglycemic state</a> is another emergency characterized by dehydration secondary to severe hyperglycemia, with resultant <a href="/wiki/Hypernatremia" title="Hypernatremia">hypernatremia</a> leading to an altered mental state and possibly <a href="/wiki/Coma" title="Coma">coma</a>.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Hypoglycemia" title="Hypoglycemia">Hypoglycemia</a> is a recognized complication of insulin treatment used in diabetes.<sup id="cite_ref-:7_27-0" class="reference"><a href="#cite_note-:7-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> An acute presentation can include mild symptoms such as <a href="/wiki/Perspiration" title="Perspiration">sweating</a>, trembling, and <a href="/wiki/Palpitations" title="Palpitations">palpitations</a>, to more serious effects including <a href="/wiki/Delirium" title="Delirium">impaired cognition</a>, confusion, <a href="/wiki/Seizure" title="Seizure">seizures</a>, <a href="/wiki/Coma" title="Coma">coma</a>, and rarely death.<sup id="cite_ref-:7_27-1" class="reference"><a href="#cite_note-:7-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> Recurrent hypoglycemic episodes may lower the glycemic threshold at which symptoms occur, meaning mild symptoms may not appear before cognitive deterioration begins to occur.<sup id="cite_ref-:7_27-2" class="reference"><a href="#cite_note-:7-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Long-term_complications">Long-term complications</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=2" title="Edit section: Long-term complications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Complications_of_diabetes" title="Complications of diabetes">Complications of diabetes</a></div> <p>The major long-term complications of diabetes relate to damage to <a href="/wiki/Blood_vessel" title="Blood vessel">blood vessels</a> at both <a href="/wiki/Macrovascular_disease" title="Macrovascular disease">macrovascular</a> and <a href="/wiki/Microvascular_disease" class="mw-redirect" title="Microvascular disease">microvascular</a> levels.<sup id="cite_ref-:8_28-0" class="reference"><a href="#cite_note-:8-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> Diabetes doubles the risk of <a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">cardiovascular disease</a>, and about 75% of deaths in people with diabetes are due to <a href="/wiki/Coronary_artery_disease" title="Coronary artery disease">coronary artery disease</a>.<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> Other macrovascular morbidities include <a href="/wiki/Stroke" title="Stroke">stroke</a> and <a href="/wiki/Peripheral_artery_disease" title="Peripheral artery disease">peripheral artery disease</a>.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </p><p>Microvascular disease affects the <a href="/wiki/Eye" title="Eye">eyes</a>, <a href="/wiki/Kidney" title="Kidney">kidneys</a>, and <a href="/wiki/Nerve" title="Nerve">nerves</a>.<sup id="cite_ref-:8_28-1" class="reference"><a href="#cite_note-:8-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> Damage to the retina, known as <a href="/wiki/Diabetic_retinopathy" title="Diabetic retinopathy">diabetic retinopathy</a>, is the most common cause of blindness in people of working age.<sup id="cite_ref-:5_23-3" class="reference"><a href="#cite_note-:5-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> The eyes can also be affected in other ways, including development of <a href="/wiki/Cataract" title="Cataract">cataract</a> and <a href="/wiki/Glaucoma" title="Glaucoma">glaucoma</a>.<sup id="cite_ref-:5_23-4" class="reference"><a href="#cite_note-:5-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> It is recommended that people with diabetes visit an <a href="/wiki/Optometrist" class="mw-redirect" title="Optometrist">optometrist</a> or <a href="/wiki/Ophthalmologist" class="mw-redirect" title="Ophthalmologist">ophthalmologist</a> once a year.<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Diabetic_nephropathy" title="Diabetic nephropathy">Diabetic nephropathy</a> is a major cause of <a href="/wiki/Chronic_kidney_disease" title="Chronic kidney disease">chronic kidney disease</a>, accounting for over 50% of patients on <a href="/wiki/Kidney_dialysis" title="Kidney dialysis">dialysis</a> in the United States.<sup id="cite_ref-:9_33-0" class="reference"><a href="#cite_note-:9-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Diabetic_neuropathy" title="Diabetic neuropathy">Diabetic neuropathy</a>, damage to nerves, manifests in various ways, including <a href="/wiki/Sensory_loss" title="Sensory loss">sensory loss</a>, <a href="/wiki/Neuropathic_pain" title="Neuropathic pain">neuropathic pain</a>, and <a href="/wiki/Autonomic_dysfunction" class="mw-redirect" title="Autonomic dysfunction">autonomic dysfunction</a> (such as <a href="/wiki/Orthostatic_hypotension" title="Orthostatic hypotension">postural hypotension</a>, <a href="/wiki/Diarrhea" title="Diarrhea">diarrhoea</a>, and <a href="/wiki/Erectile_dysfunction" title="Erectile dysfunction">erectile dysfunction</a>).<sup id="cite_ref-:5_23-5" class="reference"><a href="#cite_note-:5-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> Loss of pain sensation predisposes to trauma that can lead to <a href="/wiki/Diabetic_foot" title="Diabetic foot">diabetic foot problems</a> (such as <a href="/wiki/Ulcer" title="Ulcer">ulceration</a>), the most common cause of non-traumatic lower-limb <a href="/wiki/Amputation" title="Amputation">amputation</a>.<sup id="cite_ref-:5_23-6" class="reference"><a href="#cite_note-:5-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Hearing_loss_in_diabetes" title="Hearing loss in diabetes">Hearing loss</a> is another long-term complication associated with diabetes.<sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> </p><p>Based on extensive data and numerous cases of gallstone disease, it appears that a causal link might exist between type 2 diabetes and gallstones. People with diabetes are at a higher risk of developing gallstones compared to those without diabetes.<sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p><p>There is a link between <a href="/wiki/Cognitive_deficit" class="mw-redirect" title="Cognitive deficit">cognitive deficit</a> and diabetes; studies have shown that diabetic individuals are at a greater risk of cognitive decline, and have a greater rate of decline compared to those without the disease.<sup id="cite_ref-cognitive_36-0" class="reference"><a href="#cite_note-cognitive-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> Diabetes increases the risk of dementia, and the earlier that one is diagnosed with diabetes, the higher the risk becomes.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> The condition also predisposes to <a href="/wiki/Falls_in_older_adults" title="Falls in older adults">falls in the elderly</a>, especially those treated with <a href="/wiki/Insulin" title="Insulin">insulin</a>.<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Types">Types</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=3" title="Edit section: Types"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <table class="wikitable" style="float:right; margin:10px"> <caption>Comparison of type 1 and 2 diabetes<sup id="cite_ref-Will2011_39-0" class="reference"><a href="#cite_note-Will2011-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> </caption> <tbody><tr> <th>Feature</th> <th>Type 1 diabetes</th> <th>Type 2 diabetes </th></tr> <tr> <th>Onset </th> <td>Sudden</td> <td>Gradual, Insidious </td></tr> <tr> <th>Age at onset </th> <td>Any age; average age at diagnosis being 24.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup></td> <td>Mostly in adults </td></tr> <tr> <th>Body size </th> <td>Thin or normal<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup></td> <td>Often <a href="/wiki/Obese" class="mw-redirect" title="Obese">obese</a> </td></tr> <tr> <th><a href="/wiki/Diabetic_ketoacidosis" title="Diabetic ketoacidosis">Ketoacidosis</a> </th> <td>Common</td> <td>Rare </td></tr> <tr> <th><a href="/wiki/Autoantibodies" class="mw-redirect" title="Autoantibodies">Autoantibodies</a> </th> <td>Usually present</td> <td>Absent </td></tr> <tr> <th>Endogenous insulin </th> <td>Low or absent</td> <td>Normal, decreased<br /> or increased </td></tr> <tr> <th>Heritability </th> <td>0.69 to 0.88<sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup></td> <td>0.47 to 0.77<sup id="cite_ref-45" class="reference"><a href="#cite_note-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <th>Prevalence <p>(age standardized) </p> </th> <td><2 per 1,000<sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup></td> <td>~6% (men), ~5% (women)<sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> </td></tr></tbody></table> <p>Diabetes is classified by the <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> into six categories: <a href="/wiki/Type_1_diabetes" title="Type 1 diabetes">type 1 diabetes</a>, <a href="/wiki/Type_2_diabetes" title="Type 2 diabetes">type 2 diabetes</a>, hybrid forms of diabetes (including <a href="/wiki/Latent_autoimmune_diabetes_of_adults" class="mw-redirect" title="Latent autoimmune diabetes of adults">slowly evolving, immune-mediated diabetes of adults</a> and <a href="/wiki/Ketosis-prone_diabetes" title="Ketosis-prone diabetes">ketosis-prone type 2 diabetes</a>), hyperglycemia first detected during pregnancy, "other specific types", and "unclassified diabetes".<sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> Diabetes is a more variable disease than once thought, and individuals may have a combination of forms.<sup id="cite_ref-Tuomi2014_49-0" class="reference"><a href="#cite_note-Tuomi2014-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Type_1">Type 1</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=4" title="Edit section: Type 1"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Type_1_diabetes" title="Type 1 diabetes">Type 1 diabetes</a></div><p> Type 1 accounts for 5 to 10% of diabetes cases and is the most common type of diabetes diagnosed in patients under 20 years;<sup id="cite_ref-:10_50-0" class="reference"><a href="#cite_note-:10-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> however, the older term "juvenile-onset diabetes" is no longer used as onset in adulthood is possible.<sup id="cite_ref-:9_33-1" class="reference"><a href="#cite_note-:9-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> The disease is characterized by loss of the insulin-producing <a href="/wiki/Beta_cell" title="Beta cell">beta cells</a> of the <a href="/wiki/Pancreatic_islets" title="Pancreatic islets">pancreatic islets</a>, leading to severe insulin deficiency, and can be further classified as <a href="/wiki/Immune-mediated" class="mw-redirect" title="Immune-mediated">immune-mediated</a> or <a href="/wiki/Idiopathic_disease" title="Idiopathic disease">idiopathic</a> (without known cause).<sup id="cite_ref-:10_50-1" class="reference"><a href="#cite_note-:10-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> The majority of cases are immune-mediated, in which a <a href="/wiki/T_cell" title="T cell">T cell</a>-mediated <a href="/wiki/Autoimmunity" title="Autoimmunity">autoimmune</a> attack causes loss of beta cells and thus insulin deficiency.<sup id="cite_ref-Rother_51-0" class="reference"><a href="#cite_note-Rother-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> Patients often have irregular and unpredictable blood sugar levels due to very low insulin and an impaired counter-response to hypoglycemia.<sup id="cite_ref-merck1_52-0" class="reference"><a href="#cite_note-merck1-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> </p><figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Type_1_Diabetes_Mellitus.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d7/Type_1_Diabetes_Mellitus.jpg/220px-Type_1_Diabetes_Mellitus.jpg" decoding="async" width="220" height="124" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d7/Type_1_Diabetes_Mellitus.jpg/330px-Type_1_Diabetes_Mellitus.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d7/Type_1_Diabetes_Mellitus.jpg/440px-Type_1_Diabetes_Mellitus.jpg 2x" data-file-width="1920" data-file-height="1080" /></a><figcaption>Autoimmune attack in type 1 diabetes.</figcaption></figure> <p>Type 1 diabetes is partly <a href="/wiki/Genetic_disorder" title="Genetic disorder">inherited</a>, with multiple genes, including certain <a href="/wiki/Human_leukocyte_antigen" title="Human leukocyte antigen">HLA genotypes</a>, known to influence the risk of diabetes. In genetically susceptible people, the onset of diabetes can be triggered by one or more <a href="/wiki/Environmental_factor" title="Environmental factor">environmental factors</a>,<sup id="cite_ref-PetzoldSolimena2015_53-0" class="reference"><a href="#cite_note-PetzoldSolimena2015-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> such as a <a href="/wiki/Viral_infection" class="mw-redirect" title="Viral infection">viral infection</a> or diet. Several viruses have been implicated, but to date there is no stringent evidence to support this hypothesis in humans.<sup id="cite_ref-PetzoldSolimena2015_53-1" class="reference"><a href="#cite_note-PetzoldSolimena2015-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ButaliaKaplan2016_54-0" class="reference"><a href="#cite_note-ButaliaKaplan2016-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </p><p>Type 1 diabetes can occur at any age, and a significant proportion is diagnosed during adulthood. <a href="/wiki/Latent_autoimmune_diabetes_of_adults" class="mw-redirect" title="Latent autoimmune diabetes of adults">Latent autoimmune diabetes of adults</a> (LADA) is the diagnostic term applied when type 1 diabetes develops in adults; it has a slower onset than the same condition in children. Given this difference, some use the unofficial term "type 1.5 diabetes" for this condition.<sup id="cite_ref-55" class="reference"><a href="#cite_note-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> Adults with LADA are frequently initially misdiagnosed as having type 2 diabetes, based on age rather than a cause.<sup id="cite_ref-56" class="reference"><a href="#cite_note-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup> LADA leaves adults with higher levels of insulin production than type 1 diabetes, but not enough insulin production for healthy blood sugar levels.<sup id="cite_ref-57" class="reference"><a href="#cite_note-57"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-58" class="reference"><a href="#cite_note-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Type_2">Type 2</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=5" title="Edit section: Type 2"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Type_2_diabetes" title="Type 2 diabetes">Type 2 diabetes</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Type_2_Diabetes_Mellitus.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/5d/Type_2_Diabetes_Mellitus.jpg/220px-Type_2_Diabetes_Mellitus.jpg" decoding="async" width="220" height="124" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/5d/Type_2_Diabetes_Mellitus.jpg/330px-Type_2_Diabetes_Mellitus.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/5d/Type_2_Diabetes_Mellitus.jpg/440px-Type_2_Diabetes_Mellitus.jpg 2x" data-file-width="1920" data-file-height="1080" /></a><figcaption>Reduced insulin secretion or weaker effect of insulin on its receptor leads to high glucose content in the blood.</figcaption></figure> <p>Type 2 diabetes is characterized by <a href="/wiki/Insulin_resistance" title="Insulin resistance">insulin resistance</a>, which may be combined with relatively reduced insulin secretion.<sup id="cite_ref-Green2011_12-1" class="reference"><a href="#cite_note-Green2011-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> The defective responsiveness of body tissues to insulin is believed to involve the <a href="/wiki/Insulin_receptor" title="Insulin receptor">insulin receptor</a>.<sup id="cite_ref-59" class="reference"><a href="#cite_note-59"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup> However, the specific defects are not known. Diabetes mellitus cases due to a known defect are classified separately. Type 2 diabetes is the most common type of diabetes mellitus accounting for 95% of diabetes.<sup id="cite_ref-WHO2022_2-5" class="reference"><a href="#cite_note-WHO2022-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Many people with type 2 diabetes have evidence of <a href="/wiki/Prediabetes" title="Prediabetes">prediabetes</a> (impaired fasting glucose and/or impaired glucose tolerance) before meeting the criteria for type 2 diabetes.<sup id="cite_ref-60" class="reference"><a href="#cite_note-60"><span class="cite-bracket">[</span>60<span class="cite-bracket">]</span></a></sup> The progression of prediabetes to overt type 2 diabetes can be slowed or reversed by lifestyle changes or <a href="/wiki/Anti-diabetic_drug" class="mw-redirect" title="Anti-diabetic drug">medications</a> that improve insulin sensitivity or reduce the <a href="/wiki/Glycogenolysis" title="Glycogenolysis">liver's glucose production</a>.<sup id="cite_ref-pmid30528418_61-0" class="reference"><a href="#cite_note-pmid30528418-61"><span class="cite-bracket">[</span>61<span class="cite-bracket">]</span></a></sup> </p><p>Type 2 diabetes is primarily due to lifestyle factors and genetics.<sup id="cite_ref-Fat2009_62-0" class="reference"><a href="#cite_note-Fat2009-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> A number of lifestyle factors are known to be important to the development of type 2 diabetes, including <a href="/wiki/Obesity" title="Obesity">obesity</a> (defined by a <a href="/wiki/Body_mass_index" title="Body mass index">body mass index</a> of greater than 30), lack of <a href="/wiki/Physical_activity" title="Physical activity">physical activity</a>, poor <a href="/wiki/Diet_(nutrition)" title="Diet (nutrition)">diet</a> such as <a href="/wiki/Western_pattern_diet" title="Western pattern diet">Western Pattern Diet</a>, <a href="/wiki/Stress_(biology)" title="Stress (biology)">stress</a>, and <a href="/wiki/Urbanization" title="Urbanization">urbanization</a>.<sup id="cite_ref-Will2011_39-1" class="reference"><a href="#cite_note-Will2011-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-63" class="reference"><a href="#cite_note-63"><span class="cite-bracket">[</span>63<span class="cite-bracket">]</span></a></sup> Excess body fat is associated with 30% of cases in people of Chinese and Japanese descent, 60–80% of cases in those of European and African descent, and 100% of Pima Indians and Pacific Islanders.<sup id="cite_ref-Green2011_12-2" class="reference"><a href="#cite_note-Green2011-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> Even those who are not obese may have a high <a href="/wiki/Waist%E2%80%93hip_ratio" title="Waist–hip ratio">waist–hip ratio</a>.<sup id="cite_ref-Green2011_12-3" class="reference"><a href="#cite_note-Green2011-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p><p>Dietary factors such as <a href="/wiki/Sugar" title="Sugar">sugar</a>-sweetened drinks are associated with an increased risk.<sup id="cite_ref-SSB2010_64-0" class="reference"><a href="#cite_note-SSB2010-64"><span class="cite-bracket">[</span>64<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-65" class="reference"><a href="#cite_note-65"><span class="cite-bracket">[</span>65<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-66" class="reference"><a href="#cite_note-66"><span class="cite-bracket">[</span>66<span class="cite-bracket">]</span></a></sup> The type of <a href="/wiki/Fat" title="Fat">fats</a> in the diet is also important, with <a href="/wiki/Saturated_fat" title="Saturated fat">saturated fat</a> and <a href="/wiki/Trans_fat" title="Trans fat">trans fats</a> increasing the risk and <a href="/wiki/Polyunsaturated_fat" title="Polyunsaturated fat">polyunsaturated</a> and <a href="/wiki/Monounsaturated_fat" title="Monounsaturated fat">monounsaturated fat</a> decreasing the risk.<sup id="cite_ref-Fat2009_62-1" class="reference"><a href="#cite_note-Fat2009-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> Eating <a href="/wiki/White_rice" title="White rice">white rice</a> excessively may increase the risk of diabetes, especially in Chinese and Japanese people.<sup id="cite_ref-67" class="reference"><a href="#cite_note-67"><span class="cite-bracket">[</span>67<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Adverse_Childhood_Experiences_Study" class="mw-redirect" title="Adverse Childhood Experiences Study">Adverse childhood experiences</a>, including abuse, neglect, and household difficulties, increase the likelihood of type 2 diabetes later in life by 32%, with <a href="/wiki/Neglect" title="Neglect">neglect</a> having the strongest effect.<sup id="cite_ref-68" class="reference"><a href="#cite_note-68"><span class="cite-bracket">[</span>68<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Antipsychotic" title="Antipsychotic">Antipsychotic medication</a>, <a href="/wiki/Selective_serotonin_reuptake_inhibitor" title="Selective serotonin reuptake inhibitor">SSRI</a>, and <a href="/wiki/Serotonin%E2%80%93norepinephrine_reuptake_inhibitor" title="Serotonin–norepinephrine reuptake inhibitor">SNRI</a> side effects (specifically metabolic abnormalities, <a href="/wiki/Dyslipidemia" title="Dyslipidemia">dyslipidemia</a> and weight gain) are also potential risk factors.<sup id="cite_ref-69" class="reference"><a href="#cite_note-69"><span class="cite-bracket">[</span>69<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Gestational_diabetes">Gestational diabetes</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=6" title="Edit section: Gestational diabetes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Gestational_diabetes" title="Gestational diabetes">Gestational diabetes</a></div> <p>Gestational diabetes resembles type 2 diabetes in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness. It occurs in about 2–10% of all <a href="/wiki/Pregnancy" title="Pregnancy">pregnancies</a> and may improve or disappear after delivery.<sup id="cite_ref-NDIC_Stats_70-0" class="reference"><a href="#cite_note-NDIC_Stats-70"><span class="cite-bracket">[</span>70<span class="cite-bracket">]</span></a></sup> It is recommended that all pregnant women get tested starting around 24–28 weeks gestation.<sup id="cite_ref-:2_71-0" class="reference"><a href="#cite_note-:2-71"><span class="cite-bracket">[</span>71<span class="cite-bracket">]</span></a></sup> It is most often diagnosed in the second or third trimester because of the increase in insulin-antagonist hormone levels that occurs at this time.<sup id="cite_ref-:2_71-1" class="reference"><a href="#cite_note-:2-71"><span class="cite-bracket">[</span>71<span class="cite-bracket">]</span></a></sup> However, after pregnancy approximately 5–10% of women with gestational diabetes are found to have another form of diabetes, most commonly type 2.<sup id="cite_ref-NDIC_Stats_70-1" class="reference"><a href="#cite_note-NDIC_Stats-70"><span class="cite-bracket">[</span>70<span class="cite-bracket">]</span></a></sup> Gestational diabetes is fully treatable, but requires careful medical supervision throughout the pregnancy. Management may include dietary changes, blood glucose monitoring, and in some cases, insulin may be required.<sup id="cite_ref-72" class="reference"><a href="#cite_note-72"><span class="cite-bracket">[</span>72<span class="cite-bracket">]</span></a></sup> </p><p>Though it may be transient, untreated gestational diabetes can damage the health of the fetus or mother. Risks to the baby include <a href="/wiki/Macrosomia" class="mw-redirect" title="Macrosomia">macrosomia</a> (high birth weight), <a href="/wiki/Congenital_heart_defect" title="Congenital heart defect">congenital heart</a> and <a href="/wiki/Central_nervous_system" title="Central nervous system">central nervous system</a> abnormalities, and <a href="/wiki/Skeletal_muscle" title="Skeletal muscle">skeletal muscle</a> malformations. Increased levels of insulin in a fetus's blood may inhibit fetal <a href="/wiki/Surfactant" title="Surfactant">surfactant</a> production and cause <a href="/wiki/Infant_respiratory_distress_syndrome" title="Infant respiratory distress syndrome">infant respiratory distress syndrome</a>. A <a href="/wiki/Bilirubin#Hyperbilirubinemia" title="Bilirubin">high blood bilirubin level</a> may result from <a href="/wiki/Hemolysis" title="Hemolysis">red blood cell destruction</a>. In severe cases, perinatal death may occur, most commonly as a result of poor placental perfusion due to vascular impairment. <a href="/wiki/Labor_induction" title="Labor induction">Labor induction</a> may be indicated with decreased placental function. A <a href="/wiki/Caesarean_section" title="Caesarean section">caesarean section</a> may be performed if there is marked <a href="/wiki/Fetal_distress" title="Fetal distress">fetal distress</a><sup id="cite_ref-73" class="reference"><a href="#cite_note-73"><span class="cite-bracket">[</span>73<span class="cite-bracket">]</span></a></sup> or an increased risk of injury associated with macrosomia, such as <a href="/wiki/Shoulder_dystocia" title="Shoulder dystocia">shoulder dystocia</a>.<sup id="cite_ref-74" class="reference"><a href="#cite_note-74"><span class="cite-bracket">[</span>74<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Other_types">Other types</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=7" title="Edit section: Other types"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Maturity_onset_diabetes_of_the_young" class="mw-redirect" title="Maturity onset diabetes of the young">Maturity onset diabetes of the young</a> (MODY) is a rare <a href="/wiki/Dominance_(genetics)" title="Dominance (genetics)">autosomal dominant</a> inherited form of diabetes, due to one of several single-gene mutations causing defects in insulin production.<sup id="cite_ref-75" class="reference"><a href="#cite_note-75"><span class="cite-bracket">[</span>75<span class="cite-bracket">]</span></a></sup> It is significantly less common than the three main types, constituting 1–2% of all cases. The name of this disease refers to early hypotheses as to its nature. Being due to a defective gene, this disease varies in age at presentation and in severity according to the specific gene defect; thus, there are at least 14 subtypes of MODY.<sup id="cite_ref-76" class="reference"><a href="#cite_note-76"><span class="cite-bracket">[</span>76<span class="cite-bracket">]</span></a></sup> People with MODY often can control it without using insulin.<sup id="cite_ref-77" class="reference"><a href="#cite_note-77"><span class="cite-bracket">[</span>77<span class="cite-bracket">]</span></a></sup> </p><p>Some cases of diabetes are caused by the body's tissue receptors not responding to insulin (even when insulin levels are normal, which is what separates it from type 2 diabetes); this form is very uncommon. Genetic mutations (<a href="/wiki/Dominance_(genetics)" title="Dominance (genetics)">autosomal</a> or <a href="/wiki/Mitochondrion" title="Mitochondrion">mitochondrial</a>) can lead to defects in beta cell function. Abnormal insulin action may also have been genetically determined in some cases. Any disease that causes extensive damage to the pancreas may lead to diabetes (for example, <a href="/wiki/Chronic_pancreatitis" title="Chronic pancreatitis">chronic pancreatitis</a> and <a href="/wiki/Cystic_fibrosis" title="Cystic fibrosis">cystic fibrosis</a>). Diseases associated with excessive secretion of <a href="/wiki/Insulin_receptor" title="Insulin receptor">insulin-antagonistic</a> hormones can cause diabetes (which is typically resolved once the <a href="/wiki/Hormone" title="Hormone">hormone</a> excess is removed). Many drugs impair insulin secretion and some toxins damage pancreatic beta cells, whereas others increase <a href="/wiki/Insulin_resistance" title="Insulin resistance">insulin resistance</a> (especially <a href="/wiki/Glucocorticoid" title="Glucocorticoid">glucocorticoids</a> which can provoke "<a href="/wiki/Steroid_diabetes" class="mw-redirect" title="Steroid diabetes">steroid diabetes</a>"). The <a href="/wiki/ICD-10" title="ICD-10">ICD-10</a> (1992) diagnostic entity, <i>malnutrition-related diabetes mellitus</i> (ICD-10 code E12), was deprecated by the <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> (WHO) when the current taxonomy was introduced in 1999.<sup id="cite_ref-WHO1999-DefDiagClass_78-0" class="reference"><a href="#cite_note-WHO1999-DefDiagClass-78"><span class="cite-bracket">[</span>78<span class="cite-bracket">]</span></a></sup> Yet another form of diabetes that people may develop is <a href="/wiki/Double_diabetes" title="Double diabetes">double diabetes</a>. This is when a type 1 diabetic becomes insulin resistant, the hallmark for type 2 diabetes or has a family history for type 2 diabetes.<sup id="cite_ref-79" class="reference"><a href="#cite_note-79"><span class="cite-bracket">[</span>79<span class="cite-bracket">]</span></a></sup> It was first discovered in 1990 or 1991. </p><p>The following is a list of disorders that may increase the risk of diabetes:<sup id="cite_ref-Robbins_80-0" class="reference"><a href="#cite_note-Robbins-80"><span class="cite-bracket">[</span>80<span class="cite-bracket">]</span></a></sup> </p> <style data-mw-deduplicate="TemplateStyles:r1215345927">@media all and (max-width:720px){.mw-parser-output .multicol-float{width:auto!important}}.mw-parser-output .multicol-float{clear:none;float:left}.mw-parser-output .multicol-float-clear{clear:both}</style><div class="multicol-float" style=""> <ul><li>Genetic defects of β-cell function <ul><li><a href="/wiki/Maturity_onset_diabetes_of_the_young" class="mw-redirect" title="Maturity onset diabetes of the young">Maturity onset diabetes of the young</a></li> <li>Mitochondrial DNA mutations</li></ul></li> <li>Genetic defects in insulin processing or insulin action <ul><li>Defects in <a href="/wiki/Proinsulin" title="Proinsulin">proinsulin</a> conversion</li> <li>Insulin gene mutations</li> <li>Insulin receptor mutations</li></ul></li> <li>Exocrine pancreatic defects (see <a href="/wiki/Type_3c_diabetes" title="Type 3c diabetes">Type 3c diabetes</a>, i.e. pancreatogenic diabetes) <ul><li><a href="/wiki/Chronic_pancreatitis" title="Chronic pancreatitis">Chronic pancreatitis</a></li> <li><a href="/wiki/Pancreatectomy" title="Pancreatectomy">Pancreatectomy</a></li> <li><a href="/wiki/Pancreatic_neoplasia" class="mw-redirect" title="Pancreatic neoplasia">Pancreatic neoplasia</a></li> <li><a href="/wiki/Cystic_fibrosis" title="Cystic fibrosis">Cystic fibrosis</a></li> <li><a href="/wiki/Hemochromatosis" class="mw-redirect" title="Hemochromatosis">Hemochromatosis</a></li> <li><a href="/wiki/Fibrocalculous_pancreatopathy" title="Fibrocalculous pancreatopathy">Fibrocalculous pancreatopathy</a></li></ul></li></ul> </div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1215345927"><div class="multicol-float" style=""> <ul><li><a href="/wiki/Endocrinopathies" class="mw-redirect" title="Endocrinopathies">Endocrinopathies</a> <ul><li>Growth hormone excess (<a href="/wiki/Acromegaly" title="Acromegaly">acromegaly</a>)</li> <li><a href="/wiki/Cushing_syndrome" class="mw-redirect" title="Cushing syndrome">Cushing syndrome</a></li> <li><a href="/wiki/Hyperthyroidism" title="Hyperthyroidism">Hyperthyroidism</a></li> <li><a href="/wiki/Hypothyroidism" title="Hypothyroidism">Hypothyroidism</a></li> <li><a href="/wiki/Pheochromocytoma" title="Pheochromocytoma">Pheochromocytoma</a></li> <li><a href="/wiki/Glucagonoma" title="Glucagonoma">Glucagonoma</a></li></ul></li> <li>Infections <ul><li><a href="/wiki/Cytomegalovirus_infection" class="mw-redirect" title="Cytomegalovirus infection">Cytomegalovirus infection</a></li> <li><a href="/wiki/Coxsackie_B4_virus" title="Coxsackie B4 virus">Coxsackievirus B</a></li></ul></li> <li>Drugs <ul><li><a href="/wiki/Glucocorticoids" class="mw-redirect" title="Glucocorticoids">Glucocorticoids</a></li> <li><a href="/wiki/Thyroid_hormone" class="mw-redirect" title="Thyroid hormone">Thyroid hormone</a></li> <li><a href="/wiki/%CE%92-adrenergic_agonist" class="mw-redirect" title="Β-adrenergic agonist">β-adrenergic agonists</a></li> <li><a href="/wiki/Statins" class="mw-redirect" title="Statins">Statins</a><sup id="cite_ref-pmid20167359_81-0" class="reference"><a href="#cite_note-pmid20167359-81"><span class="cite-bracket">[</span>81<span class="cite-bracket">]</span></a></sup></li></ul></li></ul> </div><div class="multicol-float-clear" style=""></div> <div class="mw-heading mw-heading2"><h2 id="Pathophysiology">Pathophysiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=8" title="Edit section: Pathophysiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Suckale08_fig3_glucose_insulin_day.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/4d/Suckale08_fig3_glucose_insulin_day.png/310px-Suckale08_fig3_glucose_insulin_day.png" decoding="async" width="310" height="233" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/4d/Suckale08_fig3_glucose_insulin_day.png/465px-Suckale08_fig3_glucose_insulin_day.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/4d/Suckale08_fig3_glucose_insulin_day.png/620px-Suckale08_fig3_glucose_insulin_day.png 2x" data-file-width="800" data-file-height="600" /></a><figcaption>The fluctuation of <a href="/wiki/Blood_sugar_level" title="Blood sugar level">blood sugar</a> (red) and the sugar-lowering hormone <a href="/wiki/Insulin" title="Insulin">insulin</a> (blue) in humans during the course of a day with three meals. One of the effects of a <a href="/wiki/Sucrose" title="Sucrose">sugar</a>-rich vs a <a href="/wiki/Starch" title="Starch">starch</a>-rich meal is highlighted.</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Glucose-insulin-release.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/05/Glucose-insulin-release.svg/310px-Glucose-insulin-release.svg.png" decoding="async" width="310" height="200" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/05/Glucose-insulin-release.svg/465px-Glucose-insulin-release.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/05/Glucose-insulin-release.svg/620px-Glucose-insulin-release.svg.png 2x" data-file-width="900" data-file-height="580" /></a><figcaption>Mechanism of insulin release in normal pancreatic <a href="/wiki/Beta_cell" title="Beta cell">beta cells</a>. Insulin production is more or less constant within the beta cells. Its release is triggered by food, chiefly food containing absorbable glucose.</figcaption></figure> <p><a href="/wiki/Insulin" title="Insulin">Insulin</a> is the principal hormone that regulates the uptake of <a href="/wiki/Glucose" title="Glucose">glucose</a> from the blood into most cells of the body, especially liver, adipose tissue and muscle, except smooth muscle, in which insulin acts via the <a href="/wiki/IGF-1" class="mw-redirect" title="IGF-1">IGF-1</a>.<sup id="cite_ref-82" class="reference"><a href="#cite_note-82"><span class="cite-bracket">[</span>82<span class="cite-bracket">]</span></a></sup> Therefore, deficiency of insulin or the insensitivity of its <a href="/wiki/Receptor_(biochemistry)" title="Receptor (biochemistry)">receptors</a> play a central role in all forms of diabetes mellitus.<sup id="cite_ref-83" class="reference"><a href="#cite_note-83"><span class="cite-bracket">[</span>83<span class="cite-bracket">]</span></a></sup> </p><p>The body obtains glucose from three main sources: the intestinal absorption of food; the breakdown of <a href="/wiki/Glycogen" title="Glycogen">glycogen</a> (<a href="/wiki/Glycogenolysis" title="Glycogenolysis">glycogenolysis</a>), the storage form of glucose found in the liver; and <a href="/wiki/Gluconeogenesis" title="Gluconeogenesis">gluconeogenesis</a>, the generation of glucose from non-carbohydrate substrates in the body.<sup id="cite_ref-GreenspanEndo_84-0" class="reference"><a href="#cite_note-GreenspanEndo-84"><span class="cite-bracket">[</span>84<span class="cite-bracket">]</span></a></sup> Insulin plays a critical role in regulating glucose levels in the body. Insulin can inhibit the breakdown of glycogen or the process of gluconeogenesis, it can stimulate the transport of glucose into fat and muscle cells, and it can stimulate the storage of glucose in the form of glycogen.<sup id="cite_ref-GreenspanEndo_84-1" class="reference"><a href="#cite_note-GreenspanEndo-84"><span class="cite-bracket">[</span>84<span class="cite-bracket">]</span></a></sup> </p><p>Insulin is released into the blood by beta cells (β-cells), found in the <a href="/wiki/Islets_of_Langerhans" class="mw-redirect" title="Islets of Langerhans">islets of Langerhans</a> in the pancreas, in response to rising levels of blood glucose, typically after eating. Insulin is used by about two-thirds of the body's cells to absorb glucose from the blood for use as fuel, for conversion to other needed molecules, or for storage. Lower glucose levels result in decreased insulin release from the beta cells and in the breakdown of glycogen to glucose. This process is mainly controlled by the hormone <a href="/wiki/Glucagon" title="Glucagon">glucagon</a>, which acts in the opposite manner to insulin.<sup id="cite_ref-GanongsPhys_85-0" class="reference"><a href="#cite_note-GanongsPhys-85"><span class="cite-bracket">[</span>85<span class="cite-bracket">]</span></a></sup> </p><p>If the amount of insulin available is insufficient, or if cells respond poorly to the effects of insulin (<a href="/wiki/Insulin_resistance" title="Insulin resistance">insulin resistance</a>), or if the insulin itself is defective, then glucose is not absorbed properly by the body cells that require it, and is not stored appropriately in the liver and muscles. The net effect is persistently high levels of blood glucose, poor <a href="/wiki/Protein_biosynthesis" title="Protein biosynthesis">protein synthesis</a>, and other metabolic derangements, such as metabolic <a href="/wiki/Acidosis" title="Acidosis">acidosis</a> in cases of complete insulin deficiency.<sup id="cite_ref-GreenspanEndo_84-2" class="reference"><a href="#cite_note-GreenspanEndo-84"><span class="cite-bracket">[</span>84<span class="cite-bracket">]</span></a></sup> </p><p>When there is too much glucose in the blood for a long time, the <a href="/wiki/Kidneys" class="mw-redirect" title="Kidneys">kidneys</a> cannot absorb it all (reach a threshold of <a href="/wiki/Reabsorption" title="Reabsorption">reabsorption</a>) and the extra glucose gets passed out of the body through <a href="/wiki/Urine" title="Urine">urine</a> (<a href="/wiki/Glycosuria" title="Glycosuria">glycosuria</a>).<sup id="cite_ref-86" class="reference"><a href="#cite_note-86"><span class="cite-bracket">[</span>86<span class="cite-bracket">]</span></a></sup> This increases the <a href="/wiki/Osmotic_pressure" title="Osmotic pressure">osmotic pressure</a> of the urine and inhibits reabsorption of water by the kidney, resulting in increased urine production (<a href="/wiki/Polyuria" title="Polyuria">polyuria</a>) and increased fluid loss. Lost blood volume is replaced osmotically from water in body cells and other body compartments, causing <a href="/wiki/Dehydration" title="Dehydration">dehydration</a> and increased thirst (<a href="/wiki/Polydipsia" title="Polydipsia">polydipsia</a>).<sup id="cite_ref-GreenspanEndo_84-3" class="reference"><a href="#cite_note-GreenspanEndo-84"><span class="cite-bracket">[</span>84<span class="cite-bracket">]</span></a></sup> In addition, intracellular glucose deficiency stimulates appetite leading to excessive food intake (polyphagia).<sup id="cite_ref-87" class="reference"><a href="#cite_note-87"><span class="cite-bracket">[</span>87<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=9" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Glycated_hemoglobin" title="Glycated hemoglobin">Glycated hemoglobin</a> and <a href="/wiki/Glucose_tolerance_test" title="Glucose tolerance test">Glucose tolerance test</a></div> <p>Diabetes mellitus is diagnosed with a test for the glucose content in the blood, and is diagnosed by demonstrating any one of the following:<sup id="cite_ref-WHO1999-DefDiagClass_78-1" class="reference"><a href="#cite_note-WHO1999-DefDiagClass-78"><span class="cite-bracket">[</span>78<span class="cite-bracket">]</span></a></sup> </p> <ul><li><a href="/wiki/Fasting_glucose" class="mw-redirect" title="Fasting glucose">Fasting plasma glucose level</a> ≥ 7.0 mmol/L (126 mg/dL). For this test, blood is taken after a period of fasting, i.e. in the morning before breakfast, after the patient had sufficient time to fast overnight or at least 8 hours before the test.</li> <li><a href="/wiki/Plasma_glucose" class="mw-redirect" title="Plasma glucose">Plasma glucose</a> ≥ 11.1 mmol/L (200 mg/dL) two hours after a 75 gram oral glucose load as in a <a href="/wiki/Glucose_tolerance_test" title="Glucose tolerance test">glucose tolerance test</a> (OGTT)</li> <li>Symptoms of high blood sugar and plasma glucose ≥ 11.1 mmol/L (200 mg/dL) either while fasting or not fasting</li> <li><a href="/wiki/Glycated_hemoglobin" title="Glycated hemoglobin">Glycated hemoglobin</a> (HbA<sub>1C</sub>) ≥ 48 mmol/mol (≥ 6.5 <a href="/wiki/Diabetes_control_and_complications_trial" class="mw-redirect" title="Diabetes control and complications trial">DCCT</a> %).<sup id="cite_ref-88" class="reference"><a href="#cite_note-88"><span class="cite-bracket">[</span>88<span class="cite-bracket">]</span></a></sup></li></ul> <table class="wikitable" style="float: right; margin-left:15px; text-align:center"> <caption>WHO diabetes diagnostic criteria<sup id="cite_ref-who2006_89-0" class="reference"><a href="#cite_note-who2006-89"><span class="cite-bracket">[</span>89<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-90" class="reference"><a href="#cite_note-90"><span class="cite-bracket">[</span>90<span class="cite-bracket">]</span></a></sup>  <small class="editlink noprint plainlinks"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Template:OGTT&action=edit">edit</a></small> </caption> <tbody><tr> <th>Condition </th> <th colspan="2">2-hour glucose </th> <th colspan="2">Fasting glucose </th> <th colspan="2">HbA<sub>1c</sub> </th></tr> <tr> <td><i>Unit</i> </td> <td><i>mmol/L</i></td> <td><i>mg/dL</i> </td> <td><i>mmol/L</i></td> <td><i>mg/dL</i> </td> <td><i>mmol/mol</i></td> <td><i>DCCT %</i> </td></tr> <tr> <td width="34%">Normal</td> <td>< 7.8</td> <td>< 140</td> <td>< 6.1</td> <td>< 110</td> <td>< 42</td> <td>< 6.0 </td></tr> <tr> <td><a href="/wiki/Impaired_fasting_glycaemia" class="mw-redirect" title="Impaired fasting glycaemia">Impaired fasting glycaemia</a></td> <td>< 7.8</td> <td>< 140</td> <td>6.1–7.0</td> <td>110–125</td> <td>42–46</td> <td>6.0–6.4 </td></tr> <tr> <td><a href="/wiki/Impaired_glucose_tolerance" class="mw-redirect" title="Impaired glucose tolerance">Impaired glucose tolerance</a></td> <td>≥ 7.8</td> <td>≥ 140</td> <td>< 7.0</td> <td>< 126</td> <td>42–46</td> <td>6.0–6.4 </td></tr> <tr> <td><a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">Diabetes mellitus</a></td> <td>≥ 11.1</td> <td>≥ 200</td> <td>≥ 7.0</td> <td>≥ 126</td> <td>≥ 48</td> <td>≥ 6.5 </td></tr></tbody></table> <p>A positive result, in the absence of unequivocal high blood sugar, should be confirmed by a repeat of any of the above methods on a different day. It is preferable to measure a fasting glucose level because of the ease of measurement and the considerable time commitment of formal glucose tolerance testing, which takes two hours to complete and offers no prognostic advantage over the fasting test.<sup id="cite_ref-91" class="reference"><a href="#cite_note-91"><span class="cite-bracket">[</span>91<span class="cite-bracket">]</span></a></sup> According to the current definition, two fasting glucose measurements at or above 7.0 mmol/L (126 mg/dL) is considered diagnostic for diabetes mellitus. </p><p>Per the WHO, people with fasting glucose levels from 6.1 to 6.9 mmol/L (110 to 125 mg/dL) are considered to have <a href="/wiki/Impaired_fasting_glycemia" class="mw-redirect" title="Impaired fasting glycemia">impaired fasting glucose</a>.<sup id="cite_ref-92" class="reference"><a href="#cite_note-92"><span class="cite-bracket">[</span>92<span class="cite-bracket">]</span></a></sup> People with plasma glucose at or above 7.8 mmol/L (140 mg/dL), but not over 11.1 mmol/L (200 mg/dL), two hours after a 75 gram oral glucose load are considered to have <a href="/wiki/Impaired_glucose_tolerance" class="mw-redirect" title="Impaired glucose tolerance">impaired glucose tolerance</a>. Of these two prediabetic states, the latter in particular is a major risk factor for progression to full-blown diabetes mellitus, as well as cardiovascular disease.<sup id="cite_ref-93" class="reference"><a href="#cite_note-93"><span class="cite-bracket">[</span>93<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/American_Diabetes_Association" title="American Diabetes Association">American Diabetes Association</a> (ADA) since 2003 uses a slightly different range for impaired fasting glucose of 5.6 to 6.9 mmol/L (100 to 125 mg/dL).<sup id="cite_ref-94" class="reference"><a href="#cite_note-94"><span class="cite-bracket">[</span>94<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Glycated_hemoglobin" title="Glycated hemoglobin">Glycated hemoglobin</a> is better than <a href="/wiki/Fasting_glucose" class="mw-redirect" title="Fasting glucose">fasting glucose</a> for determining risks of cardiovascular disease and death from any cause.<sup id="cite_ref-95" class="reference"><a href="#cite_note-95"><span class="cite-bracket">[</span>95<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=10" title="Edit section: Prevention"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Prevention_of_type_2_diabetes" title="Prevention of type 2 diabetes">Prevention of type 2 diabetes</a></div> <p>There is no known <a href="/wiki/Preventive_healthcare" title="Preventive healthcare">preventive</a> measure for type 1 diabetes.<sup id="cite_ref-WHO2022_2-6" class="reference"><a href="#cite_note-WHO2022-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> However, islet autoimmunity and multiple antibodies can be a strong predictor of the onset of type 1 diabetes.<sup id="cite_ref-96" class="reference"><a href="#cite_note-96"><span class="cite-bracket">[</span>96<span class="cite-bracket">]</span></a></sup> Type 2 diabetes—which accounts for 85–90% of all cases worldwide—can often be prevented or delayed<sup id="cite_ref-97" class="reference"><a href="#cite_note-97"><span class="cite-bracket">[</span>97<span class="cite-bracket">]</span></a></sup> by maintaining a <a href="/wiki/Normal_body_weight" class="mw-redirect" title="Normal body weight">normal body weight</a>, engaging in physical activity, and eating a <a href="/wiki/Healthy_diet" title="Healthy diet">healthy diet</a>.<sup id="cite_ref-WHO2022_2-7" class="reference"><a href="#cite_note-WHO2022-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Higher levels of physical activity (more than 90 minutes per day) reduce the risk of diabetes by 28%.<sup id="cite_ref-BMJ2016_98-0" class="reference"><a href="#cite_note-BMJ2016-98"><span class="cite-bracket">[</span>98<span class="cite-bracket">]</span></a></sup> Dietary changes known to be effective in helping to prevent diabetes include maintaining a diet rich in <a href="/wiki/Whole_grain" title="Whole grain">whole grains</a> and <a href="/wiki/Dietary_fiber" title="Dietary fiber">fiber</a>, and choosing good fats, such as the <a href="/wiki/Polyunsaturated_fat" title="Polyunsaturated fat">polyunsaturated fats</a> found in nuts, vegetable oils, and fish.<sup id="cite_ref-HarvardNutrition_99-0" class="reference"><a href="#cite_note-HarvardNutrition-99"><span class="cite-bracket">[</span>99<span class="cite-bracket">]</span></a></sup> Limiting sugary beverages and eating less red meat and other sources of <a href="/wiki/Saturated_fat" title="Saturated fat">saturated fat</a> can also help prevent diabetes.<sup id="cite_ref-HarvardNutrition_99-1" class="reference"><a href="#cite_note-HarvardNutrition-99"><span class="cite-bracket">[</span>99<span class="cite-bracket">]</span></a></sup> Tobacco smoking is also associated with an increased risk of diabetes and its complications, so <a href="/wiki/Smoking_cessation" title="Smoking cessation">smoking cessation</a> can be an important preventive measure as well.<sup id="cite_ref-100" class="reference"><a href="#cite_note-100"><span class="cite-bracket">[</span>100<span class="cite-bracket">]</span></a></sup> </p><p>The relationship between type 2 diabetes and the main modifiable risk factors (excess weight, unhealthy diet, physical inactivity and tobacco use) is similar in all regions of the world. There is growing evidence that the underlying determinants of diabetes are a reflection of the major forces driving social, economic and cultural change: <a href="/wiki/Globalization" title="Globalization">globalization</a>, urbanization, population aging, and the general <a href="/wiki/Health_policy" title="Health policy">health policy</a> environment.<sup id="cite_ref-101" class="reference"><a href="#cite_note-101"><span class="cite-bracket">[</span>101<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Comorbidity">Comorbidity</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=11" title="Edit section: Comorbidity"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Diabetes patients' comorbidities have a significant impact on medical expenses and related costs. It has been demonstrated that patients with diabetes are more likely to experience respiratory, urinary tract, and skin infections, develop atherosclerosis, hypertension, and chronic kidney disease, putting them at increased risk of infection and complications that require medical attention.<sup id="cite_ref-102" class="reference"><a href="#cite_note-102"><span class="cite-bracket">[</span>102<span class="cite-bracket">]</span></a></sup> Patients with diabetes mellitus are more likely to experience certain infections, such as COVID-19, with prevalence rates ranging from 5.3 to 35.5%.<sup id="cite_ref-103" class="reference"><a href="#cite_note-103"><span class="cite-bracket">[</span>103<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-104" class="reference"><a href="#cite_note-104"><span class="cite-bracket">[</span>104<span class="cite-bracket">]</span></a></sup> Maintaining adequate glycemic control is the primary goal of diabetes management since it is critical to managing diabetes and preventing or postponing such complications.<sup id="cite_ref-105" class="reference"><a href="#cite_note-105"><span class="cite-bracket">[</span>105<span class="cite-bracket">]</span></a></sup> </p><p>People with type 1 diabetes have higher rates of <a href="/wiki/Autoimmune_disorders" class="mw-redirect" title="Autoimmune disorders">autoimmune disorders</a> than the general population. An analysis of a type 1 diabetes registry found that 27% of the 25,000 participants had other autoimmune disorders.<sup id="cite_ref-Williams_Textbook_106-0" class="reference"><a href="#cite_note-Williams_Textbook-106"><span class="cite-bracket">[</span>106<span class="cite-bracket">]</span></a></sup> Between 2% and 16% of people with type 1 diabetes also have <a href="/wiki/Celiac_disease" class="mw-redirect" title="Celiac disease">celiac disease</a>.<sup id="cite_ref-Williams_Textbook_106-1" class="reference"><a href="#cite_note-Williams_Textbook-106"><span class="cite-bracket">[</span>106<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Management">Management</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=12" title="Edit section: Management"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Diabetes_management" title="Diabetes management">Diabetes management</a></div> <p>Diabetes management concentrates on keeping blood sugar levels close to normal, without causing low blood sugar.<sup id="cite_ref-niddk16_107-0" class="reference"><a href="#cite_note-niddk16-107"><span class="cite-bracket">[</span>107<span class="cite-bracket">]</span></a></sup> This can usually be accomplished with dietary changes,<sup id="cite_ref-108" class="reference"><a href="#cite_note-108"><span class="cite-bracket">[</span>108<span class="cite-bracket">]</span></a></sup> exercise, weight loss, and use of appropriate medications (insulin, oral medications).<sup id="cite_ref-niddk16_107-1" class="reference"><a href="#cite_note-niddk16-107"><span class="cite-bracket">[</span>107<span class="cite-bracket">]</span></a></sup> </p><p>Learning about the disease and actively participating in the treatment is important, since complications are far less common and less severe in people who have well-managed blood sugar levels.<sup id="cite_ref-niddk16_107-2" class="reference"><a href="#cite_note-niddk16-107"><span class="cite-bracket">[</span>107<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-109" class="reference"><a href="#cite_note-109"><span class="cite-bracket">[</span>109<span class="cite-bracket">]</span></a></sup> The goal of treatment is an A1C level below 7%.<sup id="cite_ref-niddka1c_110-0" class="reference"><a href="#cite_note-niddka1c-110"><span class="cite-bracket">[</span>110<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-111" class="reference"><a href="#cite_note-111"><span class="cite-bracket">[</span>111<span class="cite-bracket">]</span></a></sup> Attention is also paid to other health problems that may accelerate the negative effects of diabetes. These include <a href="/wiki/Smoking" title="Smoking">smoking</a>, <a href="/wiki/Hypertension" title="Hypertension">high blood pressure</a>, <a href="/wiki/Metabolic_syndrome" title="Metabolic syndrome">metabolic syndrome</a> <a href="/wiki/Obesity" title="Obesity">obesity</a>, and lack of regular <a href="/wiki/Exercise" title="Exercise">exercise</a>.<sup id="cite_ref-niddk16_107-3" class="reference"><a href="#cite_note-niddk16-107"><span class="cite-bracket">[</span>107<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NICE66_112-0" class="reference"><a href="#cite_note-NICE66-112"><span class="cite-bracket">[</span>112<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Diabetic_shoe" title="Diabetic shoe">Specialized footwear</a> is widely used to reduce the risk of <a href="/wiki/Diabetic_foot_ulcer" title="Diabetic foot ulcer">diabetic foot ulcers</a> by relieving the pressure on the foot.<sup id="cite_ref-113" class="reference"><a href="#cite_note-113"><span class="cite-bracket">[</span>113<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-114" class="reference"><a href="#cite_note-114"><span class="cite-bracket">[</span>114<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-115" class="reference"><a href="#cite_note-115"><span class="cite-bracket">[</span>115<span class="cite-bracket">]</span></a></sup> Foot examination for patients living with diabetes should be done annually which includes sensation testing, foot <a href="/wiki/Biomechanics" title="Biomechanics">biomechanics</a>, vascular integrity and foot structure.<sup id="cite_ref-116" class="reference"><a href="#cite_note-116"><span class="cite-bracket">[</span>116<span class="cite-bracket">]</span></a></sup> </p><p>Concerning those with severe <a href="/wiki/Mental_disorder" title="Mental disorder">mental illness</a>, the efficacy of <a href="/wiki/Type_2_diabetes" title="Type 2 diabetes">type 2 diabetes</a> self-management interventions is still poorly explored, with insufficient scientific evidence to show whether these interventions have similar results to those observed in the general population.<sup id="cite_ref-117" class="reference"><a href="#cite_note-117"><span class="cite-bracket">[</span>117<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Lifestyle">Lifestyle</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=13" title="Edit section: Lifestyle"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Diet_in_diabetes" title="Diet in diabetes">Diet in diabetes</a></div> <p>People with diabetes can benefit from education about the disease and treatment, dietary changes, and exercise, with the goal of keeping both short-term and long-term blood glucose levels <a href="/wiki/Diabetes_management#Glycemic_control" title="Diabetes management">within acceptable bounds</a>. In addition, given the associated higher risks of cardiovascular disease, lifestyle modifications are recommended to control blood pressure.<sup id="cite_ref-118" class="reference"><a href="#cite_note-118"><span class="cite-bracket">[</span>118<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-119" class="reference"><a href="#cite_note-119"><span class="cite-bracket">[</span>119<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Weight_loss" title="Weight loss">Weight loss</a> can prevent progression from prediabetes to <a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">diabetes type 2</a>, decrease the risk of cardiovascular disease, or result in a partial remission in people with diabetes.<sup id="cite_ref-ADA2019_120-0" class="reference"><a href="#cite_note-ADA2019-120"><span class="cite-bracket">[</span>120<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ADA2018_121-0" class="reference"><a href="#cite_note-ADA2018-121"><span class="cite-bracket">[</span>121<span class="cite-bracket">]</span></a></sup> No single dietary pattern is best for all people with diabetes.<sup id="cite_ref-Em2015_122-0" class="reference"><a href="#cite_note-Em2015-122"><span class="cite-bracket">[</span>122<span class="cite-bracket">]</span></a></sup> Healthy dietary patterns, such as the <a href="/wiki/Mediterranean_diet" title="Mediterranean diet">Mediterranean diet</a>, <a href="/wiki/Low-carbohydrate_diet" title="Low-carbohydrate diet">low-carbohydrate diet</a>, or <a href="/wiki/DASH_diet" title="DASH diet">DASH diet</a>, are often recommended, although evidence does not support one over the others.<sup id="cite_ref-ADA2019_120-1" class="reference"><a href="#cite_note-ADA2019-120"><span class="cite-bracket">[</span>120<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ADA2018_121-1" class="reference"><a href="#cite_note-ADA2018-121"><span class="cite-bracket">[</span>121<span class="cite-bracket">]</span></a></sup> According to the ADA, "reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia", and for individuals with type 2 diabetes who cannot meet the glycemic targets or where reducing anti-glycemic medications is a priority, <a href="/wiki/Low-carbohydrate_diet" title="Low-carbohydrate diet">low or very-low carbohydrate diets</a> are a viable approach.<sup id="cite_ref-ADA2018_121-2" class="reference"><a href="#cite_note-ADA2018-121"><span class="cite-bracket">[</span>121<span class="cite-bracket">]</span></a></sup> For overweight people with type 2 diabetes, any diet that achieves weight loss is effective.<sup id="cite_ref-Em2015_122-1" class="reference"><a href="#cite_note-Em2015-122"><span class="cite-bracket">[</span>122<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-123" class="reference"><a href="#cite_note-123"><span class="cite-bracket">[</span>123<span class="cite-bracket">]</span></a></sup> </p><p>A 2020 Cochrane systematic review compared several non-nutritive sweeteners to sugar, placebo and a nutritive low-calorie sweetener (<a href="/wiki/Tagatose" title="Tagatose">tagatose</a>), but the results were unclear for effects on HbA1c, body weight and adverse events.<sup id="cite_ref-:4_124-0" class="reference"><a href="#cite_note-:4-124"><span class="cite-bracket">[</span>124<span class="cite-bracket">]</span></a></sup> The studies included were mainly of very low-certainty and did not report on health-related quality of life, diabetes complications, all-cause mortality or socioeconomic effects.<sup id="cite_ref-:4_124-1" class="reference"><a href="#cite_note-:4-124"><span class="cite-bracket">[</span>124<span class="cite-bracket">]</span></a></sup> </p><p>Exercise has demonstrated to impact people’s lives for a better health outcome. However, fear of hypoglycemia can negatively impact exercise view on youth that have been diagnosed with diabetes. Managing insulin, carbohydrate intake, and physical activity becomes a task that drive youth away benefitting from enjoying exercises. With different studies, an understanding of what can be done and applied to the youth population diagnosed with Type 1 Diabetes has been conducted. A study’s aim was to focus on the impact of an exercise education on physical activity. During the length of a 12-month program, youth and their parents participated in 4 education sessions learning about the benefits, safe procedures, glucose control, and physical activity. With a survey conducted in the beginning, youth and parents demonstrated their fear of hypoglycemia. At the end of the program, most of the youth and parents showed confidence on how to manage and handle situations regarding hypoglycemia. In some instances, youth provided feedback that a continuation of the sessions would be beneficial. In two other studies, exercise was the aim to investigate on how it affects adolescents with T1D. In one of those studies, the impact was assessed in the changes of glucose in exercise by how many minutes per day, intensity, duration, and heart rate. Also, glucose was monitored to see changes during exercise, post exercise, and overnight. The other study investigated how types of exercises can affect glucose levels. The exercise types were continuous moderate exercise and interval-high-intensity exercise. Both types consisted of 2 sets of 10-minute work at different pedaling paces. The continuous pedaled at a 50% and had a 5-minute passive recovery. The high-intensity pedaled at 150% for 15 seconds and was intermixed with a 30-second passive recovery.<sup id="cite_ref-125" class="reference"><a href="#cite_note-125"><span class="cite-bracket">[</span>125<span class="cite-bracket">]</span></a></sup> So, when studies finished collecting data and were able to analyze it, the following were the results. For the studies comparing the different intensities, it was seen that insulin and carbohydrate intake did not have a significant difference before or after exercise. In regards of glucose content, there was a greater drop of blood glucose post exercise in the high intensity (-1.47mmol/L). During recovery, the continuous exercise showed a greater decrease in blood glucose. With all these, continuous exercise resulted in being more favorable for managing blood glucose levels. In the other study, it is mentioned that exercise also contributed to a notable impact on glucose levels. Post-exercise measurements, there was a low mean glucose level that occurred 12 to 16 hours after exercising. Although, with participants exercising for longer sessions (≥90 minutes), hypoglycemia rates were higher. With all these, participants showed well-managed glucose control by intaking proper carbohydrates amount without any insulin adjustments.<sup id="cite_ref-126" class="reference"><a href="#cite_note-126"><span class="cite-bracket">[</span>126<span class="cite-bracket">]</span></a></sup> Lastly, the study, that educated youth and parents about exercise important and management of hypoglycemia, showed many youths feeling confident to continue to exercise regularly and being able to manage their glucose levels.<sup id="cite_ref-127" class="reference"><a href="#cite_note-127"><span class="cite-bracket">[</span>127<span class="cite-bracket">]</span></a></sup> Therefore, as important as exercising is, showing youth and parents that being physical active is possible. That can be done in specific intensities and with proper understanding on how to handle glucose control over time. </p> <div class="mw-heading mw-heading3"><h3 id="Diabetes_and_youth">Diabetes and youth</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=14" title="Edit section: Diabetes and youth"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Youth dealing with diabetes face unique challenges. These can include the emotional, psychological, and social implications as a result of managing a chronic condition at such a young age. Both forms of diabetes can have long-term risks for complications like cardiovascular disease, kidney damage, and nerve damage. This is why early intervention and impactful management important to improving long-term health. Physical activity plays a vital role in managing diabetes, improving glycemic control, and enhancing the overall quality of life for children and adolescents. </p><p>Younger children and adolescents with T1D tend to be more physically active compared to older individuals. This possibly because of the more demanding schedules and sedentary lifestyles of older adolescents, who are often in high school or university. This age-related decrease in physical activity is a potential challenge to keeping up with the ideal healthy lifestyle. <sup id="cite_ref-128" class="reference"><a href="#cite_note-128"><span class="cite-bracket">[</span>128<span class="cite-bracket">]</span></a></sup> People who have had T1D for a longer amount of time also have a tendency to be less active. As diabetes progresses, people may face more barriers to engaging in physical activity. Examples of this could include anxiety about experiencing hypoglycemic events during exercise or the physical challenges posed by the long-term complications that diabetes cause. Increased physical activity in youth with T1D can be associated with improved health. These outcomes can include better lipid profiles (higher HDL-C and lower triglycerides), healthier body composition (reduced waist circumference and BMI), and improved overall physical health. These benefits are especially important during childhood and adolescence because this is when proper growth and development are occurring. </p><p>Younger people with type 2 diabetes have a tendency to have lower levels of physical activity and CRF compared to their peers without diabetes. This contributes to their poorer overall health and increases the risk of cardiovascular and metabolic complications.<sup id="cite_ref-129" class="reference"><a href="#cite_note-129"><span class="cite-bracket">[</span>129<span class="cite-bracket">]</span></a></sup> Despite recommendations for physical activity as part of diabetes management, many youth and young adolesents with type 2 diabetes do not meet the guidelines, hindering their ability to effectively manage blood glucose levels and improve their health. CRF is a key health indicator. Higher levels of CRF is associated with better health outcomes. This means that increasing CRF through exercise can provide important benefits for managing type 2 diabetes. There is a need for targeted interventions that promote physical activity and improve CRF in youth with type 2 diabetes to help reduce the risk of long-term complications. </p><p>When it comes to resistance training, it is found to have no significant effect on insulin sensitivity in children and adolescents, despite it having positive trends. <sup id="cite_ref-130" class="reference"><a href="#cite_note-130"><span class="cite-bracket">[</span>130<span class="cite-bracket">]</span></a></sup> Intervention length, training intensity, and the participants' physical maturation might explain the mixed results. Longer and higher-intensity programs showed more promising results. Future research could focus on more dire metabolic conditions like type II diabetes, investigate the role of physical maturation, and think about including longer intervention periods. While resistance training complements aerobic exercise, its standalone effects on insulin sensitivity remain unclear. </p> <div class="mw-heading mw-heading3"><h3 id="Medications">Medications</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=15" title="Edit section: Medications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Diabetes_medication" title="Diabetes medication">Diabetes medication</a></div> <div class="mw-heading mw-heading4"><h4 id="Glucose_control">Glucose control</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=16" title="Edit section: Glucose control"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Anti-diabetic_medication" class="mw-redirect" title="Anti-diabetic medication">Anti-diabetic medication</a></div> <p>Most medications used to treat diabetes act by lowering <a href="/wiki/Glucose" title="Glucose">blood sugar levels</a> through different mechanisms. There is broad consensus that when people with diabetes maintain tight glucose control – keeping the glucose levels in their blood within normal ranges – they experience fewer complications, such as <a href="/wiki/Diabetic_nephropathy" title="Diabetic nephropathy">kidney problems</a> or <a href="/wiki/Diabetic_retinopathy" title="Diabetic retinopathy">eye problems</a>.<sup id="cite_ref-131" class="reference"><a href="#cite_note-131"><span class="cite-bracket">[</span>131<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-132" class="reference"><a href="#cite_note-132"><span class="cite-bracket">[</span>132<span class="cite-bracket">]</span></a></sup> There is, however, debate as to whether this is appropriate and <a href="/wiki/Cost_effective" class="mw-redirect" title="Cost effective">cost effective</a> for people later in life in whom the risk of hypoglycemia may be more significant.<sup id="cite_ref-Pozzilli2014_133-0" class="reference"><a href="#cite_note-Pozzilli2014-133"><span class="cite-bracket">[</span>133<span class="cite-bracket">]</span></a></sup> </p><p>There are a number of different classes of anti-diabetic medications. Type 1 diabetes requires treatment with <a href="/wiki/Insulin" title="Insulin">insulin</a>, ideally using a "basal bolus" regimen that most closely matches normal insulin release: long-acting insulin for the <a href="/wiki/Basal_rate" title="Basal rate">basal rate</a> and short-acting insulin with meals.<sup id="cite_ref-NICENG17_134-0" class="reference"><a href="#cite_note-NICENG17-134"><span class="cite-bracket">[</span>134<span class="cite-bracket">]</span></a></sup> Type 2 diabetes is generally treated with medication that is taken by mouth (e.g. <a href="/wiki/Metformin" title="Metformin">metformin</a>) although some eventually require injectable treatment with insulin or <a href="/wiki/GLP-1_agonist" class="mw-redirect" title="GLP-1 agonist">GLP-1 agonists</a>.<sup id="cite_ref-NICENG28_135-0" class="reference"><a href="#cite_note-NICENG28-135"><span class="cite-bracket">[</span>135<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Metformin" title="Metformin">Metformin</a> is generally recommended as a first-line treatment for type 2 diabetes, as there is good evidence that it decreases mortality.<sup id="cite_ref-AFP09_7-1" class="reference"><a href="#cite_note-AFP09-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> It works by decreasing the liver's production of glucose, and increasing the amount of glucose stored in peripheral tissue.<sup id="cite_ref-Drugs2005_136-0" class="reference"><a href="#cite_note-Drugs2005-136"><span class="cite-bracket">[</span>136<span class="cite-bracket">]</span></a></sup> Several other groups of drugs, mainly oral medication, may also decrease blood sugar in type 2 diabetes. These include agents that increase insulin release (<a href="/wiki/Sulfonylurea" title="Sulfonylurea">sulfonylureas</a>), agents that decrease absorption of sugar from the intestines (<a href="/wiki/Acarbose" title="Acarbose">acarbose</a>), agents that inhibit the enzyme dipeptidyl peptidase-4 (DPP-4) that inactivates incretins such as GLP-1 and GIP (<a href="/wiki/Sitagliptin" title="Sitagliptin">sitagliptin</a>), agents that make the body more sensitive to insulin (<a href="/wiki/Thiazolidinedione" title="Thiazolidinedione">thiazolidinedione</a>) and agents that increase the excretion of glucose in the urine (<a href="/wiki/SGLT2_inhibitor" title="SGLT2 inhibitor">SGLT2 inhibitors</a>).<sup id="cite_ref-Drugs2005_136-1" class="reference"><a href="#cite_note-Drugs2005-136"><span class="cite-bracket">[</span>136<span class="cite-bracket">]</span></a></sup> When insulin is used in type 2 diabetes, a long-acting formulation is usually added initially, while continuing oral medications.<sup id="cite_ref-AFP09_7-2" class="reference"><a href="#cite_note-AFP09-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>Some severe cases of type 2 diabetes may also be treated with insulin, which is increased gradually until glucose targets are reached.<sup id="cite_ref-AFP09_7-3" class="reference"><a href="#cite_note-AFP09-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-137" class="reference"><a href="#cite_note-137"><span class="cite-bracket">[</span>137<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Blood_pressure_lowering">Blood pressure lowering</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=17" title="Edit section: Blood pressure lowering"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">Cardiovascular disease</a> is a serious complication associated with diabetes, and many international guidelines recommend blood pressure treatment targets that are lower than 140/90 mmHg for people with diabetes.<sup id="cite_ref-138" class="reference"><a href="#cite_note-138"><span class="cite-bracket">[</span>138<span class="cite-bracket">]</span></a></sup> However, there is only limited evidence regarding what the lower targets should be. A 2016 systematic review found potential harm to treating to targets lower than 140 mmHg,<sup id="cite_ref-139" class="reference"><a href="#cite_note-139"><span class="cite-bracket">[</span>139<span class="cite-bracket">]</span></a></sup> and a subsequent systematic review in 2019 found no evidence of additional benefit from blood pressure lowering to between 130 – 140mmHg, although there was an increased risk of adverse events.<sup id="cite_ref-140" class="reference"><a href="#cite_note-140"><span class="cite-bracket">[</span>140<span class="cite-bracket">]</span></a></sup> </p><p>2015 American Diabetes Association recommendations are that people with diabetes and albuminuria should receive an inhibitor of the renin-angiotensin system to reduce the risks of progression to end-stage renal disease, cardiovascular events, and death.<sup id="cite_ref-:0_141-0" class="reference"><a href="#cite_note-:0-141"><span class="cite-bracket">[</span>141<span class="cite-bracket">]</span></a></sup> There is some evidence that <a href="/wiki/Angiotensin_converting_enzyme_inhibitors" class="mw-redirect" title="Angiotensin converting enzyme inhibitors">angiotensin converting enzyme inhibitors</a> (ACEIs) are superior to other inhibitors of the renin-angiotensin system such as <a href="/wiki/Angiotensin_receptor_blockers" class="mw-redirect" title="Angiotensin receptor blockers">angiotensin receptor blockers</a> (ARBs),<sup id="cite_ref-142" class="reference"><a href="#cite_note-142"><span class="cite-bracket">[</span>142<span class="cite-bracket">]</span></a></sup> or <a href="/wiki/Aliskiren" title="Aliskiren">aliskiren</a> in preventing cardiovascular disease.<sup id="cite_ref-143" class="reference"><a href="#cite_note-143"><span class="cite-bracket">[</span>143<span class="cite-bracket">]</span></a></sup> Although a more recent review found similar effects of ACEIs and ARBs on major cardiovascular and renal outcomes.<sup id="cite_ref-:1_144-0" class="reference"><a href="#cite_note-:1-144"><span class="cite-bracket">[</span>144<span class="cite-bracket">]</span></a></sup> There is no evidence that combining ACEIs and ARBs provides additional benefits.<sup id="cite_ref-:1_144-1" class="reference"><a href="#cite_note-:1-144"><span class="cite-bracket">[</span>144<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Aspirin">Aspirin</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=18" title="Edit section: Aspirin"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The use of <a href="/wiki/Aspirin" title="Aspirin">aspirin</a> to prevent cardiovascular disease in diabetes is controversial.<sup id="cite_ref-:0_141-1" class="reference"><a href="#cite_note-:0-141"><span class="cite-bracket">[</span>141<span class="cite-bracket">]</span></a></sup> Aspirin is recommended by some in people at high risk of cardiovascular disease; however, routine use of aspirin has not been found to improve outcomes in uncomplicated diabetes.<sup id="cite_ref-145" class="reference"><a href="#cite_note-145"><span class="cite-bracket">[</span>145<span class="cite-bracket">]</span></a></sup> 2015 American Diabetes Association recommendations for aspirin use (based on expert consensus or clinical experience) are that low-dose aspirin use is reasonable in adults with diabetes who are at intermediate risk of cardiovascular disease (10-year cardiovascular disease risk, 5–10%).<sup id="cite_ref-:0_141-2" class="reference"><a href="#cite_note-:0-141"><span class="cite-bracket">[</span>141<span class="cite-bracket">]</span></a></sup> National guidelines for England and Wales by the <a href="/wiki/National_Institute_for_Health_and_Care_Excellence" title="National Institute for Health and Care Excellence">National Institute for Health and Care Excellence</a> (NICE) recommend against the use of aspirin in people with type 1 or type 2 diabetes who do not have confirmed cardiovascular disease.<sup id="cite_ref-NICENG17_134-1" class="reference"><a href="#cite_note-NICENG17-134"><span class="cite-bracket">[</span>134<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NICENG28_135-1" class="reference"><a href="#cite_note-NICENG28-135"><span class="cite-bracket">[</span>135<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Surgery">Surgery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=19" title="Edit section: Surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Bariatric_surgery" title="Bariatric surgery">Weight loss surgery</a> in those with <a href="/wiki/Obesity" title="Obesity">obesity</a> and type 2 diabetes is often an effective measure.<sup id="cite_ref-Picot2009_146-0" class="reference"><a href="#cite_note-Picot2009-146"><span class="cite-bracket">[</span>146<span class="cite-bracket">]</span></a></sup> Many are able to maintain normal blood sugar levels with little or no medications following surgery<sup id="cite_ref-147" class="reference"><a href="#cite_note-147"><span class="cite-bracket">[</span>147<span class="cite-bracket">]</span></a></sup> and long-term mortality is decreased.<sup id="cite_ref-Schum2009_148-0" class="reference"><a href="#cite_note-Schum2009-148"><span class="cite-bracket">[</span>148<span class="cite-bracket">]</span></a></sup> There is, however, a short-term mortality risk of less than 1% from the surgery.<sup id="cite_ref-149" class="reference"><a href="#cite_note-149"><span class="cite-bracket">[</span>149<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Body_mass_index" title="Body mass index">body mass index</a> cutoffs for when surgery is appropriate are not yet clear.<sup id="cite_ref-Schum2009_148-1" class="reference"><a href="#cite_note-Schum2009-148"><span class="cite-bracket">[</span>148<span class="cite-bracket">]</span></a></sup> It is recommended that this option be considered in those who are unable to get both their weight and blood sugar under control.<sup id="cite_ref-150" class="reference"><a href="#cite_note-150"><span class="cite-bracket">[</span>150<span class="cite-bracket">]</span></a></sup> </p><p>A <a href="/wiki/Pancreas_transplant" class="mw-redirect" title="Pancreas transplant">pancreas transplant</a> is occasionally considered for people with type 1 diabetes who have severe complications of their disease, including <a href="/wiki/Chronic_kidney_disease" title="Chronic kidney disease">end stage kidney disease</a> requiring <a href="/wiki/Kidney_transplantation" title="Kidney transplantation">kidney transplantation</a>.<sup id="cite_ref-151" class="reference"><a href="#cite_note-151"><span class="cite-bracket">[</span>151<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Diabetic_neuropathy" title="Diabetic neuropathy">Diabetic peripheral neuropathy</a> (DPN) affects 30% of all diabetes patients.<sup id="cite_ref-152" class="reference"><a href="#cite_note-152"><span class="cite-bracket">[</span>152<span class="cite-bracket">]</span></a></sup> When DPN is superimposed with <a href="/wiki/Nerve_compression_syndrome" title="Nerve compression syndrome">nerve compression</a>, DPN may be treatable with multiple <a href="/wiki/Nerve_decompression" title="Nerve decompression">nerve decompressions</a>.<sup id="cite_ref-153" class="reference"><a href="#cite_note-153"><span class="cite-bracket">[</span>153<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:11_154-0" class="reference"><a href="#cite_note-:11-154"><span class="cite-bracket">[</span>154<span class="cite-bracket">]</span></a></sup> The theory is that DPN predisposes <a href="/wiki/Peripheral_nervous_system" title="Peripheral nervous system">peripheral nerves</a> to compression at anatomical sites of narrowing, and that the majority of DPN symptoms are actually attributable to nerve compression, a treatable condition, rather than DPN itself.<sup id="cite_ref-155" class="reference"><a href="#cite_note-155"><span class="cite-bracket">[</span>155<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:12_156-0" class="reference"><a href="#cite_note-:12-156"><span class="cite-bracket">[</span>156<span class="cite-bracket">]</span></a></sup> The surgery is associated with lower <a href="/wiki/Pain_scale" title="Pain scale">pain scores</a>, higher <a href="/wiki/Two-point_discrimination" title="Two-point discrimination">two-point discrimination</a> (a measure of sensory improvement), lower rate of <a href="/wiki/Ulcer" title="Ulcer">ulcerations</a>, fewer falls (in the case of lower extremity decompression), and fewer <a href="/wiki/Amputation" title="Amputation">amputations</a>.<sup id="cite_ref-:12_156-1" class="reference"><a href="#cite_note-:12-156"><span class="cite-bracket">[</span>156<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-157" class="reference"><a href="#cite_note-157"><span class="cite-bracket">[</span>157<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-158" class="reference"><a href="#cite_note-158"><span class="cite-bracket">[</span>158<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:11_154-1" class="reference"><a href="#cite_note-:11-154"><span class="cite-bracket">[</span>154<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Self-management_and_support">Self-management and support</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=20" title="Edit section: Self-management and support"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In countries using a <a href="/wiki/General_practitioner" title="General practitioner">general practitioner</a> system, such as the United Kingdom, care may take place mainly outside hospitals, with hospital-based specialist care used only in case of complications, difficult blood sugar control, or research projects. In other circumstances, general practitioners and specialists share care in a team approach. Evidence has shown that social prescribing led to slight improvements in blood sugar control for people with type 2 diabetes.<sup id="cite_ref-159" class="reference"><a href="#cite_note-159"><span class="cite-bracket">[</span>159<span class="cite-bracket">]</span></a></sup> Home <a href="/wiki/Telehealth" title="Telehealth">telehealth</a> support can be an effective management technique.<sup id="cite_ref-Polisena_160-0" class="reference"><a href="#cite_note-Polisena-160"><span class="cite-bracket">[</span>160<span class="cite-bracket">]</span></a></sup> </p><p>The use of <a href="/wiki/Technology" title="Technology">technology</a> to deliver educational programs for adults with type 2 diabetes includes computer-based self-management interventions to collect for tailored responses to facilitate self-management.<sup id="cite_ref-pal_161-0" class="reference"><a href="#cite_note-pal-161"><span class="cite-bracket">[</span>161<span class="cite-bracket">]</span></a></sup> There is no adequate evidence to support effects on <a href="/wiki/Cholesterol" title="Cholesterol">cholesterol</a>, <a href="/wiki/Blood_pressure" title="Blood pressure">blood pressure</a>, <a href="/wiki/Behavior_change_(public_health)" title="Behavior change (public health)">behavioral change</a> (such as <a href="/wiki/Physical_activity" title="Physical activity">physical activity</a> levels and dietary), <a href="/wiki/Depression_(mood)" title="Depression (mood)">depression</a>, weight and <a href="/wiki/Quality_of_life_(healthcare)" title="Quality of life (healthcare)">health-related quality of life</a>, nor in other biological, cognitive or emotional outcomes.<sup id="cite_ref-pal_161-1" class="reference"><a href="#cite_note-pal-161"><span class="cite-bracket">[</span>161<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-162" class="reference"><a href="#cite_note-162"><span class="cite-bracket">[</span>162<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=21" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Epidemiology_of_diabetes" title="Epidemiology of diabetes">Epidemiology of diabetes</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Prevalence_of_Diabetes_by_Percent_of_Country_Population_(2014)_Gradient_Map.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/52/Prevalence_of_Diabetes_by_Percent_of_Country_Population_%282014%29_Gradient_Map.png/310px-Prevalence_of_Diabetes_by_Percent_of_Country_Population_%282014%29_Gradient_Map.png" decoding="async" width="310" height="169" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/52/Prevalence_of_Diabetes_by_Percent_of_Country_Population_%282014%29_Gradient_Map.png/465px-Prevalence_of_Diabetes_by_Percent_of_Country_Population_%282014%29_Gradient_Map.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/52/Prevalence_of_Diabetes_by_Percent_of_Country_Population_%282014%29_Gradient_Map.png/620px-Prevalence_of_Diabetes_by_Percent_of_Country_Population_%282014%29_Gradient_Map.png 2x" data-file-width="862" data-file-height="471" /></a><figcaption>Rates of diabetes worldwide in 2014. The worldwide prevalence was 9.2%.</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Diabetes_mellitus_world_map-Deaths_per_million_persons-WHO2012.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/44/Diabetes_mellitus_world_map-Deaths_per_million_persons-WHO2012.svg/310px-Diabetes_mellitus_world_map-Deaths_per_million_persons-WHO2012.svg.png" decoding="async" width="310" height="137" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/44/Diabetes_mellitus_world_map-Deaths_per_million_persons-WHO2012.svg/465px-Diabetes_mellitus_world_map-Deaths_per_million_persons-WHO2012.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/44/Diabetes_mellitus_world_map-Deaths_per_million_persons-WHO2012.svg/620px-Diabetes_mellitus_world_map-Deaths_per_million_persons-WHO2012.svg.png 2x" data-file-width="940" data-file-height="415" /></a><figcaption>Mortality rate of diabetes worldwide in 2012 per million inhabitants <style data-mw-deduplicate="TemplateStyles:r1184024115">.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}</style><div class="div-col div-col-small" style="column-width: 10em;"><style data-mw-deduplicate="TemplateStyles:r981673959">.mw-parser-output .legend{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .legend-color{display:inline-block;min-width:1.25em;height:1.25em;line-height:1.25;margin:1px 0;text-align:center;border:1px solid black;background-color:transparent;color:black}.mw-parser-output .legend-text{}</style><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffff20; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 28–91</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffe820; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 92–114</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffd820; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 115–141</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffc020; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 142–163</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffa020; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 164–184</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ff9a20; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 185–209</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#f08015; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 210–247</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#e06815; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 248–309</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#d85010; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 310–404</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#d02010; color:white;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 405–1879</div></div></figcaption></figure> <p>An estimated 382 million people worldwide had diabetes in 2013<sup id="cite_ref-Shi2014_163-0" class="reference"><a href="#cite_note-Shi2014-163"><span class="cite-bracket">[</span>163<span class="cite-bracket">]</span></a></sup> up from 108 million in 1980.<sup id="cite_ref-WHO2016_164-0" class="reference"><a href="#cite_note-WHO2016-164"><span class="cite-bracket">[</span>164<span class="cite-bracket">]</span></a></sup> Accounting for the shifting age structure of the global population, the prevalence of diabetes is 8.8% among adults, nearly double the rate of 4.7% in 1980.<sup id="cite_ref-IDF2017_165-0" class="reference"><a href="#cite_note-IDF2017-165"><span class="cite-bracket">[</span>165<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-WHO2016_164-1" class="reference"><a href="#cite_note-WHO2016-164"><span class="cite-bracket">[</span>164<span class="cite-bracket">]</span></a></sup> Type 2 makes up about 90% of the cases.<sup id="cite_ref-Vos2012_19-1" class="reference"><a href="#cite_note-Vos2012-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Will2011_39-2" class="reference"><a href="#cite_note-Will2011-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> Some data indicate rates are roughly equal in women and men,<sup id="cite_ref-Vos2012_19-2" class="reference"><a href="#cite_note-Vos2012-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> but male excess in diabetes has been found in many populations with higher type 2 incidence, possibly due to sex-related differences in insulin sensitivity, consequences of obesity and regional body fat deposition, and other contributing factors such as high blood pressure, tobacco smoking, and alcohol intake.<sup id="cite_ref-166" class="reference"><a href="#cite_note-166"><span class="cite-bracket">[</span>166<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-167" class="reference"><a href="#cite_note-167"><span class="cite-bracket">[</span>167<span class="cite-bracket">]</span></a></sup> </p><p>The WHO estimates that diabetes resulted in 1.5 million deaths in 2012, making it the 8th leading cause of death.<sup id="cite_ref-WHO2013Top10_168-0" class="reference"><a href="#cite_note-WHO2013Top10-168"><span class="cite-bracket">[</span>168<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-WHO2016_164-2" class="reference"><a href="#cite_note-WHO2016-164"><span class="cite-bracket">[</span>164<span class="cite-bracket">]</span></a></sup> However, another 2.2 million deaths worldwide were attributable to high blood glucose and the increased risks of cardiovascular disease and other associated complications (e.g. kidney failure), which often lead to premature death and are often listed as the underlying cause on death certificates rather than diabetes.<sup id="cite_ref-WHO2016_164-3" class="reference"><a href="#cite_note-WHO2016-164"><span class="cite-bracket">[</span>164<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-169" class="reference"><a href="#cite_note-169"><span class="cite-bracket">[</span>169<span class="cite-bracket">]</span></a></sup> For example, in 2017, the <a href="/wiki/International_Diabetes_Federation" title="International Diabetes Federation">International Diabetes Federation</a> (IDF) estimated that diabetes resulted in 4.0 million deaths worldwide,<sup id="cite_ref-IDF2017_165-1" class="reference"><a href="#cite_note-IDF2017-165"><span class="cite-bracket">[</span>165<span class="cite-bracket">]</span></a></sup> using modeling to estimate the total number of deaths that could be directly or indirectly attributed to diabetes.<sup id="cite_ref-IDF2017_165-2" class="reference"><a href="#cite_note-IDF2017-165"><span class="cite-bracket">[</span>165<span class="cite-bracket">]</span></a></sup> </p><p>Diabetes occurs throughout the world but is more common (especially type 2) in more developed countries. The greatest increase in rates has, however, been seen in low- and middle-income countries,<sup id="cite_ref-WHO2016_164-4" class="reference"><a href="#cite_note-WHO2016-164"><span class="cite-bracket">[</span>164<span class="cite-bracket">]</span></a></sup> where more than 80% of diabetic deaths occur.<sup id="cite_ref-170" class="reference"><a href="#cite_note-170"><span class="cite-bracket">[</span>170<span class="cite-bracket">]</span></a></sup> The fastest prevalence increase is expected to occur in Asia and Africa, where most people with diabetes will probably live in 2030.<sup id="cite_ref-Wild2004_171-0" class="reference"><a href="#cite_note-Wild2004-171"><span class="cite-bracket">[</span>171<span class="cite-bracket">]</span></a></sup> The increase in rates in developing countries follows the trend of urbanization and lifestyle changes, including increasingly sedentary lifestyles, less physically demanding work and the global nutrition transition, marked by increased intake of foods that are high energy-dense but nutrient-poor (often high in sugar and saturated fats, sometimes referred to as the "Western-style" diet).<sup id="cite_ref-WHO2016_164-5" class="reference"><a href="#cite_note-WHO2016-164"><span class="cite-bracket">[</span>164<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Wild2004_171-1" class="reference"><a href="#cite_note-Wild2004-171"><span class="cite-bracket">[</span>171<span class="cite-bracket">]</span></a></sup> The global number of diabetes cases might increase by 48% between 2017 and 2045.<sup id="cite_ref-IDF2017_165-3" class="reference"><a href="#cite_note-IDF2017-165"><span class="cite-bracket">[</span>165<span class="cite-bracket">]</span></a></sup> </p><p>As of 2020, 38% of all US adults had prediabetes.<sup id="cite_ref-CDC_2018_172-0" class="reference"><a href="#cite_note-CDC_2018-172"><span class="cite-bracket">[</span>172<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Prediabetes" title="Prediabetes">Prediabetes</a> is an early stage of diabetes. </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=22" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/History_of_diabetes" title="History of diabetes">History of diabetes</a></div> <p>Diabetes was one of the first diseases described,<sup id="cite_ref-173" class="reference"><a href="#cite_note-173"><span class="cite-bracket">[</span>173<span class="cite-bracket">]</span></a></sup> with an <a href="/wiki/Ancient_Egypt" title="Ancient Egypt">Egyptian</a> manuscript from <abbr title="circa">c.</abbr> 1500 <a href="/wiki/Common_Era" title="Common Era">BCE</a> mentioning "too great emptying of the urine."<sup id="cite_ref-History2010_174-0" class="reference"><a href="#cite_note-History2010-174"><span class="cite-bracket">[</span>174<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Ebers_papyrus" class="mw-redirect" title="Ebers papyrus">Ebers papyrus</a> includes a recommendation for a drink to take in such cases.<sup id="cite_ref-Roberts_175-0" class="reference"><a href="#cite_note-Roberts-175"><span class="cite-bracket">[</span>175<span class="cite-bracket">]</span></a></sup> The first described cases are believed to have been type 1 diabetes.<sup id="cite_ref-History2010_174-1" class="reference"><a href="#cite_note-History2010-174"><span class="cite-bracket">[</span>174<span class="cite-bracket">]</span></a></sup> Indian physicians around the same time identified the disease and classified it as <i>madhumeha</i> or "honey urine", noting the urine would attract ants.<sup id="cite_ref-History2010_174-2" class="reference"><a href="#cite_note-History2010-174"><span class="cite-bracket">[</span>174<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Roberts_175-1" class="reference"><a href="#cite_note-Roberts-175"><span class="cite-bracket">[</span>175<span class="cite-bracket">]</span></a></sup> </p><p>The term "diabetes" or "to pass through" was first used in 230 BCE by the Greek <a href="/wiki/Apollonius_(physician)" class="mw-redirect" title="Apollonius (physician)">Apollonius of Memphis</a>.<sup id="cite_ref-History2010_174-3" class="reference"><a href="#cite_note-History2010-174"><span class="cite-bracket">[</span>174<span class="cite-bracket">]</span></a></sup> The disease was considered rare during the time of the <a href="/wiki/Roman_empire" class="mw-redirect" title="Roman empire">Roman empire</a>, with <a href="/wiki/Galen" title="Galen">Galen</a> commenting he had only seen two cases during his career.<sup id="cite_ref-History2010_174-4" class="reference"><a href="#cite_note-History2010-174"><span class="cite-bracket">[</span>174<span class="cite-bracket">]</span></a></sup> This is possibly due to the diet and lifestyle of the ancients, or because the clinical symptoms were observed during the advanced stage of the disease. Galen named the disease "diarrhea of the urine" (diarrhea urinosa).<sup id="cite_ref-Laios_176-0" class="reference"><a href="#cite_note-Laios-176"><span class="cite-bracket">[</span>176<span class="cite-bracket">]</span></a></sup> </p><p>The earliest surviving work with a detailed reference to diabetes is that of <a href="/wiki/Aretaeus_of_Cappadocia" title="Aretaeus of Cappadocia">Aretaeus of Cappadocia</a> (2nd or early 3rd<span class="nowrap"> </span>century CE). He described the symptoms and the course of the disease, which he attributed to the moisture and coldness, reflecting the beliefs of the "<a href="/wiki/Pneumatic_school" class="mw-redirect" title="Pneumatic school">Pneumatic School</a>". He hypothesized a correlation between diabetes and other diseases, and he discussed differential diagnosis from the snakebite, which also provokes excessive thirst. His work remained unknown in the West until 1552, when the first Latin edition was published in Venice.<sup id="cite_ref-Laios_176-1" class="reference"><a href="#cite_note-Laios-176"><span class="cite-bracket">[</span>176<span class="cite-bracket">]</span></a></sup> </p><p>Two types of diabetes were identified as separate conditions for the first time by the Indian physicians <a href="/wiki/Sushruta" title="Sushruta">Sushruta</a> and <a href="/wiki/Charaka" title="Charaka">Charaka</a> in 400–500 CE with one type being associated with youth and another type with being overweight.<sup id="cite_ref-History2010_174-5" class="reference"><a href="#cite_note-History2010-174"><span class="cite-bracket">[</span>174<span class="cite-bracket">]</span></a></sup> Effective treatment was not developed until the early part of the 20th century when Canadians <a href="/wiki/Frederick_Banting" title="Frederick Banting">Frederick Banting</a> and <a href="/wiki/Charles_Best_(medical_scientist)" title="Charles Best (medical scientist)">Charles Best</a> isolated and purified insulin in 1921 and 1922.<sup id="cite_ref-History2010_174-6" class="reference"><a href="#cite_note-History2010-174"><span class="cite-bracket">[</span>174<span class="cite-bracket">]</span></a></sup> This was followed by the development of the long-acting insulin <a href="/wiki/NPH_insulin" title="NPH insulin">NPH</a> in the 1940s.<sup id="cite_ref-History2010_174-7" class="reference"><a href="#cite_note-History2010-174"><span class="cite-bracket">[</span>174<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Etymology">Etymology</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=23" title="Edit section: Etymology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The word <i>diabetes</i> (<span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="/ˌ/: secondary stress follows">ˌ</span><span title="'d' in 'dye'">d</span><span title="/aɪ/: 'i' in 'tide'">aɪ</span><span title="/./: syllable break">.</span><span title="/ə/: 'a' in 'about'">ə</span><span title="/ˈ/: primary stress follows">ˈ</span><span title="'b' in 'buy'">b</span><span title="/iː/: 'ee' in 'fleece'">iː</span><span title="'t' in 'tie'">t</span><span title="/iː/: 'ee' in 'fleece'">iː</span><span title="'z' in 'zoom'">z</span></span>/</a></span></span> or <span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="/ˌ/: secondary stress follows">ˌ</span><span title="'d' in 'dye'">d</span><span title="/aɪ/: 'i' in 'tide'">aɪ</span><span title="/./: syllable break">.</span><span title="/ə/: 'a' in 'about'">ə</span><span title="/ˈ/: primary stress follows">ˈ</span><span title="'b' in 'buy'">b</span><span title="/iː/: 'ee' in 'fleece'">iː</span><span title="'t' in 'tie'">t</span><span title="/ɪ/: 'i' in 'kit'">ɪ</span><span title="'s' in 'sigh'">s</span></span>/</a></span></span>) comes from <a href="/wiki/Latin" title="Latin">Latin</a> <span title="Latin-language text"><i lang="la">diabētēs</i></span>, which in turn comes from <a href="/wiki/Ancient_Greek" title="Ancient Greek">Ancient Greek</a> <span title="Ancient Greek (to 1453)-language text"><span lang="grc-Grek" style="font-style: normal;"><a href="https://en.wiktionary.org/wiki/%CE%B4%CE%B9%CE%B1%CE%B2%CE%AE%CF%84%CE%B7%CF%82" class="extiw" title="wikt:διαβήτης">διαβήτης</a></span></span> (<span title="Ancient Greek (to 1453)-language text"><i lang="grc-Latn">diabētēs</i></span>), which literally means "a passer through; a <a href="/wiki/Siphon" title="Siphon">siphon</a>".<sup id="cite_ref-OED_diabetes_177-0" class="reference"><a href="#cite_note-OED_diabetes-177"><span class="cite-bracket">[</span>177<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Ancient_Greece" title="Ancient Greece">Ancient Greek</a> physician <a href="/wiki/Aretaeus_of_Cappadocia" title="Aretaeus of Cappadocia">Aretaeus of Cappadocia</a> (<a href="/wiki/Floruit" title="Floruit">fl.</a> 1st<span class="nowrap"> </span>century <a href="/wiki/Common_Era" title="Common Era">CE</a>) used that word, with the intended meaning "excessive discharge of urine", as the name for the disease.<sup id="cite_ref-OnlineEtymology_diabetes_178-0" class="reference"><a href="#cite_note-OnlineEtymology_diabetes-178"><span class="cite-bracket">[</span>178<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-179" class="reference"><a href="#cite_note-179"><span class="cite-bracket">[</span>179<span class="cite-bracket">]</span></a></sup> Ultimately, the word comes from Greek <span title="Greek-language text"><span lang="el" style="font-style: normal;">διαβαίνειν</span></span> (<span title="Greek-language text"><i lang="el-Latn">diabainein</i></span>), meaning "to pass through",<sup id="cite_ref-OED_diabetes_177-1" class="reference"><a href="#cite_note-OED_diabetes-177"><span class="cite-bracket">[</span>177<span class="cite-bracket">]</span></a></sup> which is composed of <span title="Greek-language text"><span lang="el" style="font-style: normal;">δια</span></span>- (<span title="Greek-language text"><i lang="el-Latn">dia</i></span>-), meaning "through" and <span title="Greek-language text"><span lang="el" style="font-style: normal;">βαίνειν</span></span> (<span title="Greek-language text"><i lang="el-Latn">bainein</i></span>), meaning "to go".<sup id="cite_ref-OnlineEtymology_diabetes_178-1" class="reference"><a href="#cite_note-OnlineEtymology_diabetes-178"><span class="cite-bracket">[</span>178<span class="cite-bracket">]</span></a></sup> The word "diabetes" is first recorded in English, in the form <i>diabete</i>, in a medical text written around 1425. </p><p>The word <i><a href="https://en.wiktionary.org/wiki/mellitus" class="extiw" title="wikt:mellitus">mellitus</a></i> (<span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="'m' in 'my'">m</span><span title="/ə/: 'a' in 'about'">ə</span><span title="/ˈ/: primary stress follows">ˈ</span><span title="'l' in 'lie'">l</span><span title="/aɪ/: 'i' in 'tide'">aɪ</span><span title="'t' in 'tie'">t</span><span title="/ə/: 'a' in 'about'">ə</span><span title="'s' in 'sigh'">s</span></span>/</a></span></span> or <span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="/ˈ/: primary stress follows">ˈ</span><span title="'m' in 'my'">m</span><span title="/ɛ/: 'e' in 'dress'">ɛ</span><span title="'l' in 'lie'">l</span><span title="/ɪ/: 'i' in 'kit'">ɪ</span><span title="'t' in 'tie'">t</span><span title="/ə/: 'a' in 'about'">ə</span><span title="'s' in 'sigh'">s</span></span>/</a></span></span>) comes from the classical Latin word <span title="Latin-language text"><i lang="la">mellītus</i></span>, meaning "mellite"<sup id="cite_ref-OED_mellite_180-0" class="reference"><a href="#cite_note-OED_mellite-180"><span class="cite-bracket">[</span>180<span class="cite-bracket">]</span></a></sup> (i.e. sweetened with honey;<sup id="cite_ref-OED_mellite_180-1" class="reference"><a href="#cite_note-OED_mellite-180"><span class="cite-bracket">[</span>180<span class="cite-bracket">]</span></a></sup> honey-sweet<sup id="cite_ref-MyEtymology_mellitus_181-0" class="reference"><a href="#cite_note-MyEtymology_mellitus-181"><span class="cite-bracket">[</span>181<span class="cite-bracket">]</span></a></sup>). The Latin word comes from <span title="Latin-language text"><i lang="la">mell</i></span>-, which comes from <span title="Latin-language text"><i lang="la">mel</i></span>, meaning "honey";<sup id="cite_ref-OED_mellite_180-2" class="reference"><a href="#cite_note-OED_mellite-180"><span class="cite-bracket">[</span>180<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-MyEtymology_mellitus_181-1" class="reference"><a href="#cite_note-MyEtymology_mellitus-181"><span class="cite-bracket">[</span>181<span class="cite-bracket">]</span></a></sup> sweetness;<sup id="cite_ref-MyEtymology_mellitus_181-2" class="reference"><a href="#cite_note-MyEtymology_mellitus-181"><span class="cite-bracket">[</span>181<span class="cite-bracket">]</span></a></sup> pleasant thing,<sup id="cite_ref-MyEtymology_mellitus_181-3" class="reference"><a href="#cite_note-MyEtymology_mellitus-181"><span class="cite-bracket">[</span>181<span class="cite-bracket">]</span></a></sup> and the suffix -<span title="Latin-language text"><i lang="la">ītus</i></span>,<sup id="cite_ref-OED_mellite_180-3" class="reference"><a href="#cite_note-OED_mellite-180"><span class="cite-bracket">[</span>180<span class="cite-bracket">]</span></a></sup> whose meaning is the same as that of the English suffix "-ite".<sup id="cite_ref-OED_-ite_182-0" class="reference"><a href="#cite_note-OED_-ite-182"><span class="cite-bracket">[</span>182<span class="cite-bracket">]</span></a></sup> It was <a href="/wiki/Thomas_Willis" title="Thomas Willis">Thomas Willis</a> who in 1675 added "mellitus" to the word "diabetes" as a designation for the disease, when he noticed the urine of a person with diabetes had a sweet taste (glycosuria). This sweet taste had been noticed in urine by the ancient Greeks, Chinese, Egyptians, and Indians.<sup id="cite_ref-183" class="reference"><a href="#cite_note-183"><span class="cite-bracket">[</span>183<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=24" title="Edit section: Society and culture"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/List_of_films_featuring_diabetes" title="List of films featuring diabetes">List of films featuring diabetes</a></div> <p>The 1989 "<a href="/wiki/St._Vincent_Declaration" title="St. Vincent Declaration">St. Vincent Declaration</a>"<sup id="cite_ref-184" class="reference"><a href="#cite_note-184"><span class="cite-bracket">[</span>184<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-185" class="reference"><a href="#cite_note-185"><span class="cite-bracket">[</span>185<span class="cite-bracket">]</span></a></sup> was the result of international efforts to improve the care accorded to those with diabetes. Doing so is important not only in terms of quality of life and life expectancy but also economically – expenses due to diabetes have been shown to be a major drain on health – and productivity-related resources for healthcare systems and governments. </p><p>Several countries established more and less successful national diabetes programmes to improve treatment of the disease.<sup id="cite_ref-EO005-Dubois&Bankauskaite_186-0" class="reference"><a href="#cite_note-EO005-Dubois&Bankauskaite-186"><span class="cite-bracket">[</span>186<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Diabetes_stigma">Diabetes stigma</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=25" title="Edit section: Diabetes stigma"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Diabetes stigma describes the negative attitudes, judgment, discrimination, or prejudice against people with diabetes. Often, the stigma stems from the idea that diabetes (particularly Type 2 diabetes) resulted from poor lifestyle and unhealthy food choices rather than other causal factors such as genetics and social determinants of health.<sup id="cite_ref-187" class="reference"><a href="#cite_note-187"><span class="cite-bracket">[</span>187<span class="cite-bracket">]</span></a></sup> Manifestation of stigma can be seen throughout different cultures and contexts. Scenarios include diabetes statuses affecting marriage proposals, workplace-employment, and social standing in communities.<sup id="cite_ref-188" class="reference"><a href="#cite_note-188"><span class="cite-bracket">[</span>188<span class="cite-bracket">]</span></a></sup> </p><p>Stigma is also seen internally, as people with diabetes can also have negative beliefs about themselves. Often these cases of self-stigma are associated with higher diabetes-specific distress, lower self-efficacy, higher rates of depression, and poorer provider-patient interactions during diabetes care.<sup id="cite_ref-189" class="reference"><a href="#cite_note-189"><span class="cite-bracket">[</span>189<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Racial_and_economic_inequalities">Racial and economic inequalities</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=26" title="Edit section: Racial and economic inequalities"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Racial and ethnic minorities are disproportionately affected with higher prevalence of diabetes compared to non-minority individuals.<sup id="cite_ref-190" class="reference"><a href="#cite_note-190"><span class="cite-bracket">[</span>190<span class="cite-bracket">]</span></a></sup> While US adults overall have a 40% chance of developing type 2 diabetes, Hispanic/Latino adults chance is more than 50%.<sup id="cite_ref-191" class="reference"><a href="#cite_note-191"><span class="cite-bracket">[</span>191<span class="cite-bracket">]</span></a></sup> African Americans also are much more likely to be diagnosed with diabetes compared to White Americans. Asians have increased risk of diabetes as diabetes can develop at lower BMI due to differences in visceral fat compared to other races. For Asians, diabetes can develop at a younger age and lower body fat compared to other groups. Additionally, diabetes is highly underreported in Asian American people, as 1 in 3 cases are undiagnosed compared to the average 1 in 5 for the nation.<sup id="cite_ref-192" class="reference"><a href="#cite_note-192"><span class="cite-bracket">[</span>192<span class="cite-bracket">]</span></a></sup> </p><p>People with diabetes who have neuropathic symptoms such as <a href="/wiki/Paresthesia" title="Paresthesia">numbness or tingling</a> in feet or hands are twice as likely to be <a href="/wiki/Unemployed" class="mw-redirect" title="Unemployed">unemployed</a> as those without the symptoms.<sup id="cite_ref-pmid17563611_193-0" class="reference"><a href="#cite_note-pmid17563611-193"><span class="cite-bracket">[</span>193<span class="cite-bracket">]</span></a></sup> </p><p>In 2010, diabetes-related emergency room (ER) visit rates in the United States were higher among people from the lowest income communities (526 per 10,000 population) than from the highest income communities (236 per 10,000 population). Approximately 9.4% of diabetes-related ER visits were for the uninsured.<sup id="cite_ref-hcup-us.ahrq_194-0" class="reference"><a href="#cite_note-hcup-us.ahrq-194"><span class="cite-bracket">[</span>194<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Naming">Naming</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=27" title="Edit section: Naming"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The term "type 1 diabetes" has replaced several former terms, including childhood-onset diabetes, juvenile diabetes, and insulin-dependent diabetes mellitus. Likewise, the term "type 2 diabetes" has replaced several former terms, including adult-onset diabetes, obesity-related diabetes, and noninsulin-dependent diabetes mellitus. Beyond these two types, there is no agreed-upon standard nomenclature.<sup id="cite_ref-195" class="reference"><a href="#cite_note-195"><span class="cite-bracket">[</span>195<span class="cite-bracket">]</span></a></sup> </p><p>Diabetes mellitus is also occasionally known as "sugar diabetes" to differentiate it from <a href="/wiki/Diabetes_insipidus" title="Diabetes insipidus">diabetes insipidus</a>.<sup id="cite_ref-196" class="reference"><a href="#cite_note-196"><span class="cite-bracket">[</span>196<span class="cite-bracket">]</span></a></sup> Diabetes insipidus is an unrelated disease with symptoms that can mimic diabetes mellitus. </p> <div class="mw-heading mw-heading2"><h2 id="Other_animals">Other animals</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=28" title="Edit section: Other animals"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main articles: <a href="/wiki/Diabetes_in_dogs" title="Diabetes in dogs">Diabetes in dogs</a> and <a href="/wiki/Diabetes_in_cats" title="Diabetes in cats">Diabetes in cats</a></div> <p>Diabetes can occur in mammals or reptiles.<sup id="cite_ref-197" class="reference"><a href="#cite_note-197"><span class="cite-bracket">[</span>197<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-198" class="reference"><a href="#cite_note-198"><span class="cite-bracket">[</span>198<span class="cite-bracket">]</span></a></sup> Birds do not develop diabetes because of their unusually high tolerance for elevated blood glucose levels.<sup id="cite_ref-199" class="reference"><a href="#cite_note-199"><span class="cite-bracket">[</span>199<span class="cite-bracket">]</span></a></sup> There is some indication that amphibians have the ability to develop diabetes.<sup id="cite_ref-200" class="reference"><a href="#cite_note-200"><span class="cite-bracket">[</span>200<span class="cite-bracket">]</span></a></sup> </p><p>In animals, diabetes is most commonly encountered in dogs and cats. Middle-aged animals are most commonly affected. Female dogs are twice as likely to be affected as males, while according to some sources, male cats are more prone than females. In both species, all breeds may be affected, but some small dog breeds are particularly likely to develop diabetes, such as <a href="/wiki/Poodle" title="Poodle">Miniature Poodles</a>.<sup id="cite_ref-Merck_201-0" class="reference"><a href="#cite_note-Merck-201"><span class="cite-bracket">[</span>201<span class="cite-bracket">]</span></a></sup> </p><p>Feline diabetes is strikingly similar to human type 2 diabetes. The <a href="/wiki/Burmese_cat" title="Burmese cat">Burmese</a>, <a href="/wiki/Russian_Blue" title="Russian Blue">Russian Blue</a>, <a href="/wiki/Abyssinian_cat" title="Abyssinian cat">Abyssinian</a>, and <a href="/wiki/Norwegian_Forest_cat" class="mw-redirect" title="Norwegian Forest cat">Norwegian Forest</a> cat breeds are at higher risk than other breeds. Overweight cats are also at higher risk.<sup id="cite_ref-202" class="reference"><a href="#cite_note-202"><span class="cite-bracket">[</span>202<span class="cite-bracket">]</span></a></sup> </p><p>The symptoms may relate to fluid loss and polyuria, but the course may also be insidious. Diabetic animals are more prone to infections. The long-term complications recognized in humans are much rarer in animals. The principles of treatment (weight loss, oral antidiabetics, subcutaneous insulin) and management of emergencies (e.g. ketoacidosis) are similar to those in humans.<sup id="cite_ref-Merck_201-1" class="reference"><a href="#cite_note-Merck-201"><span class="cite-bracket">[</span>201<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=29" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Outline_of_diabetes" title="Outline of diabetes">Outline of diabetes</a></li> <li><a href="/wiki/Diabetic_foot" title="Diabetic foot">Diabetic foot</a></li> <li><a href="/wiki/Blood_glucose_monitoring" title="Blood glucose monitoring">Blood glucose monitoring</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=30" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20070805042346/http://www.diabetesbluecircle.org/">"Diabetes Blue Circle Symbol"</a>. 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National Library of Medicine: <span class="nowrap">1462–</span>1470. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs00125-013-2904-2">10.1007/s00125-013-2904-2</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3671104">3671104</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23613085">23613085</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Diabetologia&rft.atitle=Insulin+resistance+in+type+1+diabetes%3A+what+is+%27double+diabetes%27+and+what+are+the+risks%3F&rft.volume=56&rft.issue=7&rft.pages=%3Cspan+class%3D%22nowrap%22%3E1462-%3C%2Fspan%3E1470&rft.date=2013-07&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3671104%23id-name%3DPMC&rft_id=info%3Apmid%2F23613085&rft_id=info%3Adoi%2F10.1007%2Fs00125-013-2904-2&rft.aulast=Cleland&rft.aufirst=SJ&rft.au=Fisher%2C+BM&rft.au=Colhoun%2C+HM&rft.au=Sattar%2C+N&rft.au=Petrie%2C+JR&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3671104&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiabetes" class="Z3988"></span></span> </li> <li id="cite_note-Robbins-80"><span class="mw-cite-backlink"><b><a href="#cite_ref-Robbins_80-0">^</a></b></span> <span class="reference-text">Unless otherwise specified, reference is: Table 20-5 in <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMitchell,_Richard_SheppardKumar,_VinayAbbas,_Abul_K.Fausto,_Nelson2007" class="citation book cs1">Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson (2007). <i>Robbins Basic Pathology</i> (8th ed.). 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Part B, Biochemistry & Molecular Biology</i>. <b>262</b>: 110778. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.cbpb.2022.110778">10.1016/j.cbpb.2022.110778</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/35817273">35817273</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:250404382">250404382</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Comparative+Biochemistry+and+Physiology.+Part+B%2C+Biochemistry+%26+Molecular+Biology&rft.atitle=Revisiting+glucose+regulation+in+birds+-+A+negative+model+of+diabetes+complications&rft.volume=262&rft.pages=110778&rft.date=2022-07-08&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A250404382%23id-name%3DS2CID&rft_id=info%3Apmid%2F35817273&rft_id=info%3Adoi%2F10.1016%2Fj.cbpb.2022.110778&rft.aulast=Sweazea&rft.aufirst=KL&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiabetes" class="Z3988"></span></span> </li> <li id="cite_note-200"><span class="mw-cite-backlink"><b><a href="#cite_ref-200">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFVeyrencRegnaultSrodaRaveton2022" class="citation journal cs1">Veyrenc, Sylvie; Regnault, Christophe; Sroda, Sophie; Raveton, Muriel; Reynaud, Stéphane (2022-10-15). <a rel="nofollow" class="external text" href="https://www.sciencedirect.com/science/article/abs/pii/S0269749122012234#:~:text=An%20amphibian%20high%20fat%20diet%20model%20(HFD)%20indicates%20that%20diabetes,metabolic%20disruption%20in%20wild%20amphibians.">"An amphibian high fat diet model confirms that endocrine disruptors can induce a metabolic syndrome in wild green frogs (Pelophylax spp. complex)"</a>. <i>Environmental Pollution</i>. <b>311</b>: 120009. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.envpol.2022.120009">10.1016/j.envpol.2022.120009</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0269-7491">0269-7491</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Environmental+Pollution&rft.atitle=An+amphibian+high+fat+diet+model+confirms+that+endocrine+disruptors+can+induce+a+metabolic+syndrome+in+wild+green+frogs+%28Pelophylax+spp.+complex%29&rft.volume=311&rft.pages=120009&rft.date=2022-10-15&rft_id=info%3Adoi%2F10.1016%2Fj.envpol.2022.120009&rft.issn=0269-7491&rft.aulast=Veyrenc&rft.aufirst=Sylvie&rft.au=Regnault%2C+Christophe&rft.au=Sroda%2C+Sophie&rft.au=Raveton%2C+Muriel&rft.au=Reynaud%2C+St%C3%A9phane&rft_id=https%3A%2F%2Fwww.sciencedirect.com%2Fscience%2Farticle%2Fabs%2Fpii%2FS0269749122012234%23%3A~%3Atext%3DAn%2520amphibian%2520high%2520fat%2520diet%2520model%2520%28HFD%29%2520indicates%2520that%2520diabetes%2Cmetabolic%2520disruption%2520in%2520wild%2520amphibians.&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiabetes" class="Z3988"></span></span> </li> <li id="cite_note-Merck-201"><span class="mw-cite-backlink">^ <a href="#cite_ref-Merck_201-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Merck_201-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/40302.htm">"Diabetes mellitus"</a>. <i>Merck Veterinary Manual</i> (9th ed.). 2005. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20110927154816/http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm%2Fbc%2F40302.htm">Archived</a> from the original on 2011-09-27<span class="reference-accessdate">. Retrieved <span class="nowrap">2011-10-23</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Merck+Veterinary+Manual&rft.atitle=Diabetes+mellitus&rft.date=2005&rft_id=http%3A%2F%2Fwww.merckvetmanual.com%2Fmvm%2Findex.jsp%3Fcfile%3Dhtm%2Fbc%2F40302.htm&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiabetes" class="Z3988"></span></span> </li> <li id="cite_note-202"><span class="mw-cite-backlink"><b><a href="#cite_ref-202">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFÖhlund" class="citation book cs1">Öhlund M. <a rel="nofollow" class="external text" href="https://pub.epsilon.slu.se/14746/1/ohlund_m_171123.pdf"><i>Feline diabetes mellitus Aspects on epidemiology and pathogenesis</i></a> <span class="cs1-format">(PDF)</span>. Acta Universitatis agriculturae Sueciae. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-91-7760-067-1" title="Special:BookSources/978-91-7760-067-1"><bdi>978-91-7760-067-1</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20210413223918/https://pub.epsilon.slu.se/14746/1/ohlund_m_171123.pdf">Archived</a> <span class="cs1-format">(PDF)</span> from the original on 2021-04-13<span class="reference-accessdate">. Retrieved <span class="nowrap">2017-12-18</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Feline+diabetes+mellitus+Aspects+on+epidemiology+and+pathogenesis&rft.pub=Acta+Universitatis+agriculturae+Sueciae&rft.isbn=978-91-7760-067-1&rft.aulast=%C3%96hlund&rft.aufirst=M&rft_id=https%3A%2F%2Fpub.epsilon.slu.se%2F14746%2F1%2Fohlund_m_171123.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiabetes" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Diabetes&action=edit&section=31" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 0.9em}.mw-parser-output .side-box-image{padding:2px 0 2px 0.9em;text-align:center}.mw-parser-output .side-box-imageright{padding:2px 0.9em 2px 0;text-align:center}@media(min-width:500px){.mw-parser-output .side-box-flex{display:flex;align-items:center}.mw-parser-output .side-box-text{flex:1;min-width:0}}@media(min-width:720px){.mw-parser-output .side-box{width:238px}.mw-parser-output .side-box-right{clear:right;float:right;margin-left:1em}.mw-parser-output .side-box-left{margin-right:1em}}</style><style data-mw-deduplicate="TemplateStyles:r1250146164">.mw-parser-output .sister-box .side-box-abovebelow{padding:0.75em 0;text-align:center}.mw-parser-output .sister-box .side-box-abovebelow>b{display:block}.mw-parser-output .sister-box .side-box-text>ul{border-top:1px solid #aaa;padding:0.75em 0;width:217px;margin:0 auto}.mw-parser-output .sister-box .side-box-text>ul>li{min-height:31px}.mw-parser-output .sister-logo{display:inline-block;width:31px;line-height:31px;vertical-align:middle;text-align:center}.mw-parser-output .sister-link{display:inline-block;margin-left:4px;width:182px;vertical-align:middle}@media print{body.ns-0 .mw-parser-output .sistersitebox{display:none!important}}@media screen{html.skin-theme-clientpref-night .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-v2.svg"]{background-color:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-v2.svg"]{background-color:white}}</style><div role="navigation" aria-labelledby="sister-projects" class="side-box metadata side-box-right sister-box sistersitebox plainlinks"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"> <div class="side-box-abovebelow"> <b>Diabetes mellitus</b> at Wikipedia's <a href="/wiki/Wikipedia:Wikimedia_sister_projects" title="Wikipedia:Wikimedia sister projects"><span id="sister-projects">sister projects</span></a></div> <div class="side-box-flex"> <div class="side-box-text plainlist"><ul><li><span class="sister-logo"><span class="mw-valign-middle" typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/0/06/Wiktionary-logo-v2.svg/27px-Wiktionary-logo-v2.svg.png" decoding="async" width="27" height="27" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/0/06/Wiktionary-logo-v2.svg/41px-Wiktionary-logo-v2.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/0/06/Wiktionary-logo-v2.svg/54px-Wiktionary-logo-v2.svg.png 2x" data-file-width="391" data-file-height="391" /></span></span></span><span class="sister-link"><a href="https://en.wiktionary.org/wiki/Special:Search/Diabetes" class="extiw" title="wikt:Special:Search/Diabetes">Definitions</a> from Wiktionary</span></li><li><span class="sister-logo"><span class="mw-valign-middle" typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/20px-Commons-logo.svg.png" decoding="async" width="20" height="27" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/30px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/40px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /></span></span></span><span class="sister-link"><a href="https://commons.wikimedia.org/wiki/Diabetes_mellitus" class="extiw" title="c:Diabetes mellitus">Media</a> from Commons</span></li><li><span class="sister-logo"><span class="mw-valign-middle" typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/2/24/Wikinews-logo.svg/27px-Wikinews-logo.svg.png" decoding="async" width="27" height="15" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/24/Wikinews-logo.svg/41px-Wikinews-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/24/Wikinews-logo.svg/54px-Wikinews-logo.svg.png 2x" data-file-width="759" data-file-height="415" /></span></span></span><span class="sister-link"><a href="https://en.wikinews.org/wiki/Special:Search/Diabetes" class="extiw" title="n:Special:Search/Diabetes">News</a> from Wikinews</span></li><li><span class="sister-logo"><span class="mw-valign-middle" typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Wikiquote-logo.svg/23px-Wikiquote-logo.svg.png" decoding="async" width="23" height="27" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Wikiquote-logo.svg/35px-Wikiquote-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Wikiquote-logo.svg/46px-Wikiquote-logo.svg.png 2x" data-file-width="300" data-file-height="355" /></span></span></span><span class="sister-link"><a href="https://en.wikiquote.org/wiki/Special:Search/Diabetes" class="extiw" title="q:Special:Search/Diabetes">Quotations</a> from Wikiquote</span></li><li><span class="sister-logo"><span class="mw-valign-middle" typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/26px-Wikisource-logo.svg.png" decoding="async" width="26" height="27" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/39px-Wikisource-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/51px-Wikisource-logo.svg.png 2x" data-file-width="410" data-file-height="430" /></span></span></span><span class="sister-link"><a href="https://en.wikisource.org/wiki/Special:Search/Diabetes" class="extiw" title="s:Special:Search/Diabetes">Texts</a> from Wikisource</span></li><li><span class="sister-logo"><span class="mw-valign-middle" typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Wikibooks-logo.svg/27px-Wikibooks-logo.svg.png" decoding="async" width="27" height="27" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Wikibooks-logo.svg/41px-Wikibooks-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Wikibooks-logo.svg/54px-Wikibooks-logo.svg.png 2x" data-file-width="300" data-file-height="300" /></span></span></span><span class="sister-link"><a href="https://en.wikibooks.org/wiki/Special:Search/Diabetes" class="extiw" title="b:Special:Search/Diabetes">Textbooks</a> from Wikibooks</span></li><li><span class="sister-logo"><span class="mw-valign-middle" typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/0/0b/Wikiversity_logo_2017.svg/27px-Wikiversity_logo_2017.svg.png" decoding="async" width="27" height="22" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/0b/Wikiversity_logo_2017.svg/41px-Wikiversity_logo_2017.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/0b/Wikiversity_logo_2017.svg/54px-Wikiversity_logo_2017.svg.png 2x" data-file-width="626" data-file-height="512" /></span></span></span><span class="sister-link"><a href="https://en.wikiversity.org/wiki/Special:Search/Diabetes" class="extiw" title="v:Special:Search/Diabetes">Resources</a> from Wikiversity</span></li></ul></div></div> </div> <ul><li><a rel="nofollow" class="external text" href="https://www.diabetes.org">American Diabetes Association</a></li> <li><a rel="nofollow" class="external text" href="https://diabetesatlas.org/">IDF Diabetes Atlas</a></li> <li><a rel="nofollow" class="external text" href="https://www.nei.nih.gov/learn-about-eye-health/resources-for-health-educators/national-eye-health-education-program/nehep-partnership-directory/national-diabetes-education-program">National Diabetes Education Program</a></li> <li><a rel="nofollow" class="external text" href="https://diabetesjournals.org/care/issue/42/Supplement_1">ADA's Standards of Medical Care in Diabetes 2019</a></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFPolonsky2012" class="citation journal cs1">Polonsky KS (October 2012). <a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJMra1110560">"The past 200 years in diabetes"</a>. <i>The New England Journal of Medicine</i>. <b>367</b> (14): <span class="nowrap">1332–</span>1340. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJMra1110560">10.1056/NEJMra1110560</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23034021">23034021</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:9456681">9456681</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+New+England+Journal+of+Medicine&rft.atitle=The+past+200+years+in+diabetes&rft.volume=367&rft.issue=14&rft.pages=%3Cspan+class%3D%22nowrap%22%3E1332-%3C%2Fspan%3E1340&rft.date=2012-10&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A9456681%23id-name%3DS2CID&rft_id=info%3Apmid%2F23034021&rft_id=info%3Adoi%2F10.1056%2FNEJMra1110560&rft.aulast=Polonsky&rft.aufirst=KS&rft_id=https%3A%2F%2Fdoi.org%2F10.1056%252FNEJMra1110560&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiabetes" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://medlineplus.gov/diabetes.html">"Diabetes"</a>. <i>MedlinePlus</i>. U.S. National Library of Medicine.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=MedlinePlus&rft.atitle=Diabetes&rft_id=https%3A%2F%2Fmedlineplus.gov%2Fdiabetes.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADiabetes" class="Z3988"></span></li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 1em;line-height:1.5em;text-align:center}.mw-parser-output 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li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox32" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q12206" class="extiw" title="d:Q12206">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/E10">E10</a>–<a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/E14">E14</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=250">250</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D003920">D003920</a></li><li><b><a href="/wiki/SNOMED_CT" title="SNOMED CT">SNOMED CT</a></b>: <a rel="nofollow" class="external text" href="http://snomed.info/id/73211009">73211009</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></b>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/001214.htm">001214</a></li><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/med/546-overview">med/546</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/emerg/topic134.htm#">emerg/134</a></li><li><b><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a></b>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/management-of-type-1-diabetes">Diabetes</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Diabetes143" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2" style="background-color:turquoise"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Diabetes" title="Template:Diabetes"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Diabetes" title="Template talk:Diabetes"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Diabetes" title="Special:EditPage/Template:Diabetes"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Diabetes143" style="font-size:114%;margin:0 4em"><a class="mw-selflink selflink">Diabetes</a></div></th></tr><tr><th scope="row" class="navbox-group" style="background-color:turquoise;width:1%">Types</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Type_1_diabetes" title="Type 1 diabetes">Type 1</a> (SAID cluster)</li> <li>Type 1 diabetes (<a href="/wiki/Latent_autoimmune_diabetes_in_adults" title="Latent autoimmune diabetes in adults">LADA</a> cluster)</li> <li><a href="/wiki/Type_2_diabetes" title="Type 2 diabetes">Type 2</a> (SIDD, SIRD, MOD and MARD clusters)</li> <li>Type 4 (<a href="/wiki/Gestational_diabetes" title="Gestational diabetes">Gestational diabetes</a>) <ul><li><a href="/wiki/Diabetes_and_pregnancy" title="Diabetes and pregnancy">Diabetes and pregnancy</a></li></ul></li> <li><a href="/wiki/Prediabetes" title="Prediabetes">Prediabetes</a> <ul><li><a href="/wiki/Impaired_fasting_glucose" title="Impaired fasting glucose">Impaired fasting glucose</a></li> <li><a href="/wiki/Impaired_glucose_tolerance" class="mw-redirect" title="Impaired glucose tolerance">Impaired glucose tolerance</a></li></ul></li> <li><a href="/wiki/Insulin_resistance" title="Insulin resistance">Insulin resistance</a></li> <li><a href="/wiki/Ketosis-prone_diabetes" title="Ketosis-prone diabetes">Ketosis-prone diabetes</a> (KPD)</li> <li>Type 3a (<a href="/wiki/Maturity-onset_diabetes_of_the_young" title="Maturity-onset diabetes of the young">MODY</a>) <ul><li><a href="/wiki/MODY_1" title="MODY 1">Type 1</a> <a href="/wiki/MODY_2" title="MODY 2">2</a> <a href="/wiki/MODY_3" title="MODY 3">3</a> <a href="/wiki/MODY_4" title="MODY 4">4</a> <a href="/wiki/MODY_5" class="mw-redirect" title="MODY 5">5</a> <a href="/wiki/MODY_6" title="MODY 6">6</a></li></ul></li> <li><a href="/wiki/Neonatal_diabetes" title="Neonatal diabetes">Neonatal</a> <ul><li><a href="/wiki/Transient_neonatal_diabetes" title="Transient neonatal diabetes">Transient</a></li> <li><a href="/wiki/Permanent_neonatal_diabetes" title="Permanent neonatal diabetes">Permanent</a></li></ul></li> <li><a href="/wiki/Type_3c_diabetes" title="Type 3c diabetes">Type 3c (pancreatogenic)</a></li> <li><a href="/wiki/Type_3_diabetes" title="Type 3 diabetes">Type 3</a></li> <li><a href="/wiki/Diabetes_and_deafness" title="Diabetes and deafness">MIDD</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background-color:turquoise;width:1%"><a href="/wiki/Blood_test" title="Blood test">Blood tests</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Blood_sugar_level" title="Blood sugar level">Blood sugar level</a></li> <li><a href="/wiki/Biomarkers_of_diabetes" title="Biomarkers of diabetes">Biomarkers</a></li> <li><a href="/wiki/Glycated_hemoglobin" title="Glycated hemoglobin">Glycated hemoglobin</a></li> <li><a href="/wiki/Glucose_tolerance_test" title="Glucose tolerance test">Glucose tolerance test</a></li> <li><a href="/wiki/Postprandial_glucose_test" title="Postprandial glucose test">Postprandial glucose test</a></li> <li><a href="/wiki/Fructosamine" title="Fructosamine">Fructosamine</a></li> <li><a href="/wiki/Glucose_test" title="Glucose test">Glucose test</a></li> <li><a href="/wiki/C-peptide" title="C-peptide">C-peptide</a></li> <li><a href="/wiki/Noninvasive_glucose_monitor" title="Noninvasive glucose monitor">Noninvasive glucose monitor</a></li> <li><a href="/wiki/Insulin_tolerance_test" title="Insulin tolerance test">Insulin tolerance test</a></li> <li><a href="/wiki/Metabolic_Score_for_Insulin_Resistance" title="Metabolic Score for Insulin Resistance">Metabolic Score for Insulin Resistance (METS-IR)</a></li> <li><a href="/wiki/Homeostatic_model_assessment" title="Homeostatic model assessment">Homeostatic model assessment</a></li> <li><a href="/wiki/SPINA-GBeta" title="SPINA-GBeta">SPINA-GBeta</a></li> <li><a href="/wiki/SPINA-GR" title="SPINA-GR">SPINA-GR</a></li> <li><a href="/wiki/Disposition_index" title="Disposition index">Disposition index</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background-color:turquoise;width:1%"><a href="/wiki/Diabetes_management" title="Diabetes management">Management</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Prevention_of_type_2_diabetes" title="Prevention of type 2 diabetes">Prevention</a></li> <li>Metabolic assessment and monitoring <ul><li><a href="/wiki/Blood_glucose_monitoring" title="Blood glucose monitoring">Blood glucose monitoring</a></li> <li><a href="/wiki/Ambulatory_glucose_profile" title="Ambulatory glucose profile">Ambulatory glucose profile</a></li></ul></li> <li><a href="/wiki/Diet_in_diabetes" title="Diet in diabetes">Diet in diabetes</a></li> <li><a href="/wiki/Diabetes_medication" title="Diabetes medication">Diabetes medication</a></li> <li><a href="/wiki/Insulin_(medication)" title="Insulin (medication)">Insulin therapy</a> <ul><li><a href="/wiki/Intensive_insulin_therapy" title="Intensive insulin therapy">intensive</a></li> <li><a href="/wiki/Conventional_insulin_therapy" title="Conventional insulin therapy">conventional</a></li> <li><a href="/wiki/Pulsatile_insulin" title="Pulsatile insulin">pulsatile</a></li></ul></li> <li><a href="/wiki/Diabetic_shoe" title="Diabetic shoe">Diabetic shoes</a></li> <li>Cure <ul><li><a href="/wiki/Embryonic_stem_cell" title="Embryonic stem cell">Embryonic stem cells</a></li> <li><a href="/wiki/Automated_insulin_delivery_system" title="Automated insulin delivery system">Artificial pancreas</a></li></ul></li> <li>Other <ul><li><a href="/wiki/Gastric_bypass_surgery#Results_and_health_benefits_of_gastric_bypass" title="Gastric bypass surgery">Gastric bypass surgery</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background-color:turquoise;width:1%"><a href="/wiki/Complications_of_diabetes" title="Complications of diabetes">Complications</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Diabetic_coma" title="Diabetic coma">Diabetic comas</a> <ul><li><a href="/wiki/Diabetic_hypoglycemia" title="Diabetic hypoglycemia">Hypoglycemia</a></li> <li><a href="/wiki/Diabetic_ketoacidosis" title="Diabetic ketoacidosis">Ketoacidosis</a></li> <li><a href="/wiki/Hyperosmolar_hyperglycemic_state" title="Hyperosmolar hyperglycemic state">Hyperosmolar hyperglycemic state</a></li></ul></li> <li><a href="/wiki/Diabetic_foot" title="Diabetic foot">Diabetic foot</a> <ul><li><a href="/wiki/Diabetic_foot_ulcer" title="Diabetic foot ulcer">ulcer</a></li> <li><a href="/wiki/Neuropathic_arthropathy" title="Neuropathic arthropathy">Neuropathic arthropathy</a></li></ul></li> <li>Organs in diabetes <ul><li><a href="/wiki/Diabetic_angiopathy" title="Diabetic angiopathy">Blood vessels</a></li> <li><a href="/wiki/Diabetic_myonecrosis" title="Diabetic myonecrosis">Muscle</a></li> <li><a href="/wiki/Diabetic_nephropathy" title="Diabetic nephropathy">Kidney</a></li> <li><a href="/wiki/Diabetic_neuropathy" title="Diabetic neuropathy">Nerves</a></li> <li><a href="/wiki/Diabetic_retinopathy" title="Diabetic retinopathy">Retina</a></li> <li><a href="/wiki/Diabetic_cardiomyopathy" title="Diabetic cardiomyopathy">Heart</a></li></ul></li> <li><a href="/wiki/Diabetic_dermadrome" title="Diabetic dermadrome">Diabetes-related skin disease</a> <ul><li><a href="/wiki/Diabetic_dermopathy" title="Diabetic dermopathy">Diabetic dermopathy</a></li> <li><a href="/wiki/Diabetic_bulla" title="Diabetic bulla">Diabetic bulla</a></li> <li><a href="/wiki/Diabetic_cheiroarthropathy" title="Diabetic cheiroarthropathy">Diabetic cheiroarthropathy</a></li> <li><a href="/wiki/Diabetic_foot_ulcer" title="Diabetic foot ulcer">Diabetic foot ulcer</a></li></ul></li> <li><a href="/wiki/Hyperglycemia" title="Hyperglycemia">Hyperglycemia</a></li> <li><a href="/wiki/Hypoglycemia" title="Hypoglycemia">Hypoglycemia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background-color:turquoise;width:1%">Advocacy and<br />organizations</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/T1International" title="T1International">T1International</a></li> <li><a href="/wiki/Open_Insulin_Project" title="Open Insulin Project">Open Insulin Project</a></li> <li><a href="/wiki/Breakthrough_T1D" title="Breakthrough T1D">Breakthrough T1D</a></li> <li><a href="/wiki/International_Diabetes_Federation" title="International Diabetes Federation">International Diabetes Federation</a></li> <li><a href="/wiki/World_Diabetes_Day" title="World Diabetes Day">World Diabetes Day</a></li> <li><a href="/wiki/Diabetes_UK" title="Diabetes UK">Diabetes UK</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background-color:turquoise;width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Outline_of_diabetes" title="Outline of diabetes">Outline of diabetes</a></li> <li><a href="/wiki/Glossary_of_diabetes" title="Glossary of diabetes">Glossary of diabetes</a></li> <li><a href="/wiki/Epidemiology_of_diabetes" title="Epidemiology of diabetes">Epidemiology of diabetes</a></li> <li><a href="/wiki/History_of_diabetes" title="History of diabetes">History of diabetes</a></li> <li><a href="/wiki/List_of_people_with_type_1_diabetes" title="List of people with type 1 diabetes">Notable people with type 1 diabetes</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Disease_of_the_pancreas_and_glucose_metabolism226" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Disease_of_the_pancreas_and_glucose_metabolism" title="Template:Disease of the pancreas and glucose metabolism"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Disease_of_the_pancreas_and_glucose_metabolism" title="Template talk:Disease of the pancreas and glucose metabolism"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Disease_of_the_pancreas_and_glucose_metabolism" title="Special:EditPage/Template:Disease of the pancreas and glucose metabolism"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Disease_of_the_pancreas_and_glucose_metabolism226" style="font-size:114%;margin:0 4em">Disease of the <a href="/wiki/Pancreatic_disease" title="Pancreatic disease">pancreas</a> and <a href="/wiki/Glucose_metabolism_disorder" class="mw-redirect" title="Glucose metabolism disorder">glucose metabolism</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">Diabetes</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Types <ul><li><a href="/wiki/Type_1_diabetes" title="Type 1 diabetes">type 1</a></li> <li><a href="/wiki/Type_2_diabetes" title="Type 2 diabetes">type 2</a></li> <li><a href="/wiki/Gestational_diabetes" title="Gestational diabetes">gestational</a></li> <li><a href="/wiki/Maturity_onset_diabetes_of_the_young" class="mw-redirect" title="Maturity onset diabetes of the young">MODY</a> <a href="/wiki/MODY_1" title="MODY 1">1</a> <a href="/wiki/MODY_2" title="MODY 2">2</a> <a href="/wiki/MODY_3" title="MODY 3">3</a> <a href="/wiki/MODY_4" title="MODY 4">4</a> <a href="/wiki/MODY_5" class="mw-redirect" title="MODY 5">5</a> <a href="/wiki/MODY_6" title="MODY 6">6</a></li></ul></li> <li><a href="/wiki/Complications_of_diabetes_mellitus" class="mw-redirect" title="Complications of diabetes mellitus">Complications</a> <ul><li>See <a href="/wiki/Template:Diabetes" title="Template:Diabetes">Template:Diabetes</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Abnormal <a href="/wiki/Blood_glucose" class="mw-redirect" title="Blood glucose">blood glucose</a> levels</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hyperglycemia" title="Hyperglycemia">Hyperglycemia</a> <ul><li><a href="/wiki/Oxyhyperglycemia" title="Oxyhyperglycemia">Oxyhyperglycemia</a></li></ul></li> <li><a href="/wiki/Hypoglycemia" title="Hypoglycemia">Hypoglycemia</a> <ul><li><a href="/wiki/Whipple%27s_triad" title="Whipple's triad">Whipple's triad</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Insulin" title="Insulin">Insulin</a> disorders</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Insulin_resistance" title="Insulin resistance">Insulin resistance</a></li> <li><a href="/wiki/Hyperinsulinism" title="Hyperinsulinism">Hyperinsulinism</a> <ul><li><a href="/wiki/Congenital_hyperinsulinism" title="Congenital hyperinsulinism">Congenital hyperinsulinism</a></li></ul></li> <li><a href="/wiki/Rabson%E2%80%93Mendenhall_syndrome" title="Rabson–Mendenhall syndrome">Rabson–Mendenhall syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other pancreatic disorders and conditions</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pancreatic_beta_cell_function" title="Pancreatic beta cell function">Pancreatic beta cell function</a></li> <li><a href="/wiki/Insulinoma" title="Insulinoma">Insulinoma</a></li> <li><a href="/wiki/Insulitis" title="Insulitis">Insulitis</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r1038841319">.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}</style></div><div role="navigation" class="navbox authority-control" aria-label="Navbox1063" style="padding:3px"><table class="nowraplinks hlist navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a 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