Immune thrombocytopenia (ITP) | disease | symptoms
Types Of Diabetes Mellitus
Diabetes mellitus, also called diabetes, is a term for several conditions involving how your body turns food into energy. The term comes from the Greek word "diabetes," which means to siphon or to pass through, and the Latin word "mellitus," which means sweet. In 2021, 529 million people worldwide and 38.4 million in the U.S. Had diabetes.
When you eat a carbohydrate, your body turns it into a sugar called glucose and sends that to your bloodstream. Your pancreas releases insulin, a hormone that helps move glucose from your blood into your cells, which use it for energy.
When you have diabetes and don't get treatment, your body doesn't use insulin like it should. Too much glucose stays in your blood, a condition usually called high blood sugar. This can cause health problems that may be serious or even life-threatening.
There's no cure for diabetes. But with treatment and lifestyle changes, you can live a long, healthy life.
Diabetes comes in different forms, depending on the cause.
Prediabetes is when your blood sugar is higher than it should be but not high enough for your doctor to diagnose it as diabetes. Normal blood sugar levels are between 70 mg/dL and 99 mg/dL. Blood sugar levels in people with prediabetes are between 110 mg/dL and 125 mg/dL.
Prediabetes often has no symptoms. More than a third of people in the U.S. Have it, but about 90% don't know. If you have prediabetes, you might notice darkened skin on areas like your neck, armpits, and groin.
Rarely, you may have other symptoms like:
Over 70% of people with prediabetes later develop type 2 diabetes. You're also likely to start having heart, kidney, and nerve damage.
You can lower these risks and potentially reverse prediabetes by:
Your doctor might recommend medications like acarbose and metformin if you can't follow these lifestyle changes or you're at a very high risk of having type 2 diabetes.
Type 1 diabetes is also called insulin-dependent diabetes. It used to be called juvenile-onset diabetes because it was thought to start more often in childhood. However, more research has shown it happens as frequently in children and adults.
Type 1 diabetes is an organ-specific autoimmune condition. It happens when your body attacks your pancreas with antibodies. The organ is damaged and doesn't make insulin. It affects 2 million people, including about 304,000 children and teens in the U.S.
Your genes might cause this type of diabetes. It could also happen because of problems with cells in your pancreas that make insulin. Type 1 diabetes cannot be prevented.
Type 1 diabetes symptoms happen quickly, in a few days to weeks. They include:
About 30% of people with type 1 diabetes have a life-threatening condition that causes loss of consciousness, called diabetic coma, as their first symptom.
Get medical help immediately if you or your child show any of these symptoms:
Many of the health problems that can come with type 1 happen because of damage to tiny blood vessels in your eyes (diabetic retinopathy), nerves (diabetic neuropathy), and kidneys (diabetic nephropathy). People with type 1 also have a higher risk of heart disease and stroke.
A doctor may use a test called random plasma glucose (RPG) to check how much sugar you have in your blood when diagnosing type 1 diabetes. They may also use an A1c blood test to estimate your blood sugar levels over the last 3 months. Your doctor uses it to see how well your blood sugar is controlled. That helps them know your risk of complications.
Treatment for type 1 diabetes involves injecting insulin into the fatty tissue just under your skin. You might use:
If you have type 1 diabetes, you'll need to make changes, including:
Type 2 diabetes used to be called non-insulin-dependent or adult-onset diabetes. But it's become more common in children and teens over the past 20 years, largely because more young people are overweight or obese. About 90% of people with diabetes have type 2.
When you have type 2 diabetes, your pancreas usually creates some insulin. But either it's not enough or your body doesn't use it like it should. Insulin resistance, when your cells don't respond to insulin, usually happens in fat, liver, and muscle cells.
Type 2 diabetes is often milder than type 1. But it can still cause major health complications, especially in the tiny blood vessels in your kidneys, nerves, and eyes. Type 2 also raises your risk of heart disease and stroke.
People who have obesity -- more than 20% over their target body weight for their height -- have an especially high risk of type 2 diabetes and the health problems that can follow. Obesity often causes insulin resistance, so your pancreas has to work harder to make more insulin. But it's still not enough to keep your blood sugar levels where they should be.
Treatment for type 2 diabetes involves keeping a healthy weight, eating right, and exercising. Some people need medication, too.
Your doctor might do an A1c test a few times a year to see how well you've been controlling your blood sugar.
Pregnancy usually causes some form of insulin resistance. If this becomes diabetes, it's called gestational. Doctors often spot it in 2%-10% of pregnancies. You may be diagnosed in the middle or late pregnancy with a:
It usually causes no or mild symptoms like feeling thirstier or peeing more often. It goes away after giving birth. But people who have had gestational diabetes are 8-10 times more likely to develop type 2 diabetes and have twice the risk of developing heart disease compared to those who have not had it.
If you've had gestational diabetes, you'll need to be tested for type 2 diabetes every 3 years for the rest of your life.
If you get gestational diabetes while pregnant, your symptoms should go away once you have your baby. (Photo Credit: iStock/Getty Images)
Gestational diabetes is more of a risk for the baby than the mother. Because your blood sugars travel through their placenta to the baby, it's important to control gestational diabetes to protect the baby's growth and development.
A baby might have unusual weight gain before birth, trouble breathing at birth, or a higher risk of obesity and diabetes later in life. You might need a cesarean section because of an overly large baby, or they might have damage to their heart, kidney, nerves, and eyes.
Gestational diabetes treatment involves:
Rarely, diabetes can happen due to changes in a single gene that can affect how much insulin the body can produce. When this is the case, it is called monogenic diabetes.
The gene mutation is often passed down from one or both parents. However, gene mutations may also happen unexpectedly.
In the U.S., monogenic diabetes happens in 1% to 4% of all diabetes cases.
The two main types of monogenic diabetes are
Many times, doctors mistake monogenic diabetes for type 2 diabetes. But a doctor might suspect monogenic diabetes if:
Then, they recommend genetic testing to confirm it and determine which specific type you have. They might also test your family members to see if they have it.
You may get diabetes medicines you take by mouth or insulin injections to treat it.
Secondary diabetes is a type of diabetes that happens because of another primary condition, which may include:
Medications like steroids may also trigger secondary diabetes.
Treatment may involve managing the underlying cause, making lifestyle changes, and taking insulin and other medications to control your blood sugar levels.
Type 1 and type 2 diabetes are the most common types of diabetes. Type 1 diabetes affects 1.3 million people in the U.S., and type 2 diabetes occurs in 37 million people.
Type 1 diabetes happens when the immune system mistakenly attacks your pancreas, causing it to stop producing insulin. Both genetic and environmental factors play a role in causing this immune response.
Type 2 diabetes is a hormonal condition that happens when your body doesn't respond well to insulin, which leads to high blood sugar levels. With time, the pancreas in people with type 2 diabetes may stop working as well as it should until it stops being able to produce insulin.
Type 1 diabetes symptoms usually happen suddenly within a few days to a week. Type 2 diabetes symptoms take a while, about a year, to develop.
People with type 1 diabetes need insulin medicine because the body can't make it anymore. People with type 2 diabetes only need insulin when their pancreas stops making it.
Diabetes is a group of conditions that affect how well your body turns food into energy. It causes high blood sugar levels that can lead to serious health issues like heart disease, eye damage, dementia, stroke, and kidney damage. Your doctor will manage it depending on the type you have. You may need insulin injections and antidiabetic medicines. They'll also recommend following lifestyle changes like eating a healthy diet and exercising.
Is type 2 diabetes manageable?
Yes, type 2 diabetes is manageable with medicines and healthy lifestyle changes.
What causes diabetes mellitus?
What causes diabetes will depend on the type. It may be related to your genes, lifestyle, and family history. But all forms of diabetes cause you to have high blood sugar levels.
What are diabetes mellitus types 1 and 2?
Types 1 and 2 diabetes are the most common type of diabetes. Type 1 diabetes happens when your immune system attacks and damages your pancreas, causing it to stop making enough insulin. Type 2 diabetes occurs when your body stops using insulin well.
Type II Error: Definition, Example, Vs. Type I Error
What Is a Type II Error? A type II error is a statistical term used within the context of hypothesis testing that describes the error that occurs when one fails to reject a null hypothesis that is actually false. A type II error produces a false negative, also known as an error of omission. For example, a test for a disease may report a negative result when the patient is infected. This is a type II error because we accept the conclusion of the test as negative, even though it is incorrect. A type II error can be contrasted with a type I error, where researchers incorrectly reject a true null hypothesis. A type II error happens when one fails to reject a null hypothesis that is actually false. A type I error produces a false positive. Key Takeaways A type II error is defined as the probability of incorrectly failing to reject the null hypothesis, when in fact it is not applicable to the entire population. A type II error is essentially a false negative. A type II error can be made less likely by making more stringent criteria for rejecting a null hypothesis, although this increases the chances of a false positive. The sample size, the true population size, and the preset alpha level influence the magnitude of risk of an error. Analysts need to weigh the likelihood and impact of type II errors with type I errors. Understanding a Type II Error A type II error, also known as an error of the second kind or a beta error, confirms an idea that should have been rejected—for instance, claiming that two observances are the same, despite them being different. A type II error does not reject the null hypothesis, even though the alternative hypothesis is actually correct. In other words, a false finding is accepted as true. The likelihood of a type II error can be reduced by making more stringent criteria for rejecting a null hypothesis (H0). For example, if an analyst is considering anything that falls within the +/- bounds of a 95% confidence interval as statistically insignificant (a negative result), then by decreasing that tolerance to +/- 90%, and subsequently narrowing the bounds, you will get fewer negative results, and thus reduce the chances of a false negative. Taking these steps, however, tends to increase the chances of encountering a type I error—a false-positive result. When conducting a hypothesis test, the probability or risk of making a type I error or type II error should be considered. The steps taken to reduce the chances of encountering a type II error tend to increase the probability of a type I error. Type I Errors vs. Type II Errors The difference between a type II error and a type I error is that a type I error rejects the null hypothesis when it is true (i.E., a false positive). The probability of committing a type I error is equal to the level of significance that was set for the hypothesis test. Therefore, if the level of significance is 0.05, there is a 5% chance that a type I error may occur. The probability of committing a type II error is equal to one minus the power of the test, also known as beta. The power of the test could be increased by increasing the sample size, which decreases the risk of committing a type II error. Some statistical literature will include overall significance level and type II error risk as part of the report's analysis. For example, a 2021 meta-analysis of exosome in the treatment of spinal cord injury recorded an overall significance level of 0.05 and a type II error risk of 0.1. Example of a Type II Error Assume a biotechnology company wants to compare how effective two of its drugs are for treating diabetes. The null hypothesis states the two medications are equally effective. A null hypothesis, H0, is the claim that the company hopes to reject using the one-tailed test. The alternative hypothesis, Ha, states that the two drugs are not equally effective. The alternative hypothesis, Ha, is the state of nature that is supported by rejecting the null hypothesis. The biotech company implements a large clinical trial of 3,000 patients with diabetes to compare the treatments. The company randomly divides the 3,000 patients into two equally sized groups, giving one group one of the treatments and the other group the other treatment. It selects a significance level of 0.05, which indicates it is willing to accept a 5% chance it may reject the null hypothesis when it is true or a 5% chance of committing a type I error. Assume the beta is calculated to be 0.025, or 2.5%. Therefore, the probability of committing a type II error is 97.5%. If the two medications are not equal, the null hypothesis should be rejected. However, if the biotech company does not reject the null hypothesis when the drugs are not equally effective, then a type II error occurs. What Is the Difference Between Type I and Type II Errors? A type I error occurs if a null hypothesis is rejected that is actually true in the population. This type of error is representative of a false positive. Alternatively, a type II error occurs if a null hypothesis is not rejected that is actually false in the population. This type of error is representative of a false negative. What Causes Type II Errors? A type II error is commonly caused if the statistical power of a test is too low. The higher the statistical power, the greater the chance of avoiding an error. It's often recommended that the statistical power should be set to at least 80% prior to conducting any testing. What Factors Influence the Magnitude of Risk for Type II Errors? As the sample size of a study increases, the risk of type II errors should decrease. As the true population effect size increases, the probability of a type II error should also decrease. Finally, the preset alpha level set by the research influences the magnitude of risk. As the alpha level set decreases, the risk of a type II error increases. How Can a Type II Error Be Minimized? It is not possible to fully prevent committing a type II error, but the risk can be minimized by increasing the sample size. However, doing so will also increase the risk of committing a type I error instead. The Bottom Line In statistics, a type II error results in a false negative—meaning that there is a finding, but it has been missed in the analysis (or that the null hypothesis is not rejected when it ought to have been). A type II error can occur if there is not enough power in statistical tests, often resulting from sample sizes that are too small. Increasing the sample size can help reduce the chances of committing a type II error. Type II errors can be contrasted with type I errors, which are false positives.May-Thurner Syndrome
May-Thurner syndrome, also known as iliac vein compression syndrome or Cockett's syndrome, affects two blood vessels that go to your legs. It could make you more likely to have a DVT (deep vein thrombosis) in your left leg.
Your blood vessels carry blood to every part of your body. Your arteries move blood away from your heart, and your veins bring it back. Sometimes, arteries and veins cross over each other. Normally, that's not a problem. But it is if you have May-Thurner syndrome.
This condition involves your right iliac artery, which carries blood to your right leg, and the left iliac vein, which brings blood out of your left leg toward your heart.
In May-Thurner syndrome, the right iliac artery squeezes the left iliac vein when they cross each other in your pelvis. Because of that pressure, blood can't flow as freely through the left iliac vein. It's a bit like stepping partway down on a hose.
The result: You're more likely to get a deep vein thrombosis (DVT) in your left leg. A DVT is a type of blood clot that can be very serious. It's not just that it can block blood flow in your leg. It can also break off and cause a clot in your lung. That's called a pulmonary embolism, and it can be life-threatening.
May-Thurner syndrome is random. It isn't something in your genes that you get from your parents.
The crossover of those blood vessels is normal. But in some cases, they are positioned in a way that the right iliac artery presses the left iliac vein against the spine. That added pressure leaves a narrower opening. It can also lead to scars in the vein.
You're more likely to get May-Thurner syndrome if you:
You likely won't even know you have it unless you get a DVT. You might get pain or swelling in your leg, but usually, there aren't any warning signs.
With a DVT, your left leg may show symptoms such as:
If the DVT breaks off and forms a clot in your lungs, you may notice:
Call 911 if you have any of these symptoms.
Your doctor will first do a physical exam to look for symptoms of a DVT. From there, you may need lab tests or imaging tests, such as:
There are two goals: to treat any clots you already have and to keep new ones from forming.
Your doctor may talk to you about several options, including:
Angioplasty and a stent. This is a common treatment for May-Thurner syndrome. First, your doctor uses a small balloon to expand the left iliac vein. Then, you get a device called a stent. It's a tiny cylinder, made of metal mesh, that keeps the vein open wide so blood can flow normally. The doctor may also use intravascular ultrasound to help put the stent in place.
Blood thinners. These drugs are often used to treat DVT. They can prevent new clots and keep ones you already have from getting bigger. Your doctor may call these medicines anticoagulants.
Bypass surgery. Your doctor builds a new path for blood to flow. You can think of it as a detour around the part of the left iliac vein that's getting squeezed.
Clot busters. Doctors may use these to treat more serious clots. You might also hear this treatment called thrombolytic therapy. Your doctor uses a thin tube, called a catheter, to send the medication right to the site of the clot. The drug breaks it down in anywhere from a few hours to a few days.
Compression stockings. If your symptoms are mild and the doctor doesn't think you need more treatment, they may suggest you wear these tight stockings that go from toes to knee. They put pressure on your lower legs that eases swelling and improves blood flow. You may have heard them called support hose.
Surgery to move the right iliac artery. This operation shifts the position of the artery so it sits behind the left iliac vein and no longer presses on it.
Surgical thrombectomy. This procedure to remove the clot is reserved for very large clots or those that are causing severe tissue damage.
Tissue sling. With this surgery, you get extra tissue put in that acts as a cushion between the two blood vessels.
Vena cava filter. You might get this if you can't take blood thinners or if they don't work well for you. Your doctor places a filter in your vena cava, a large vein in your belly. Although the filter won't prevent clots from forming, it will catch them before they end up in your lungs.
DVT is the primary complication of May-Thurner syndrome, but you could also get:
Pulmonary embolism: If the clot or part of the clot breaks loose, it could move to your lungs. Once there it might block an artery. This condition can be life-threatening.
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