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Carpal tunnel syndrome is the name for a group of problems that includes numbness, tingling, weakness, or pain in your wrist or hand. It's a very common condition that happens when a nerve in your wrist becomes squeezed.

The carpal tunnel is a narrow opening between the bones in your wrist and the ligament that holds them together. A nerve, called the median nerve, runs from your lower arm through the carpal tunnel and into your hand. This nerve provides feeling to your thumb and first three fingers. It also helps you move your thumb.

Tendons also run from your lower arm, through the carpal tunnel, and into your hand. The tendons connect your finger bones to muscles in your arm, so you can bend your fingers.

If the tendons become swollen or irritated inside the carpal tunnel, they may press on the nerve. The squeezed nerve may not work well, which can lead to numbness, weakness, and other symptoms of carpal tunnel syndrome.

In certain cases, the cause of carpal tunnel syndrome is unknown. But it usually happens from a combination of things that affect the structures in your wrist, such as:

• Injury to your wrist that causes swelling, such as a sprain or broken bone
• Health conditions that can affect your nerves, joints, or other parts of your wrist, for example:
  • Diabetes.
  • Rheumatoid arthritis.
  • A cyst or tumor in your wrist.
  • Changes in certain hormones, which may cause swelling from extra fluid in your body. Examples include an underactive thyroid gland (hypothyroidism), pregnancy and menopause.
  • Problems with the way your wrist is formed.
• Doing the same wrist and hand movements over and over, such as:
  • Assembly line work.
  • Carpentry or using tools that vibrate.
  • Knitting, gardening, or sports, such as golf.

Researchers aren't sure whether long-term typing or computer use leads to carpal tunnel syndrome.

Carpal tunnel syndrome usually happens only in adults. You're more likely to develop it if you:

• Are a woman. Women are three times more likely to have carpal tunnel syndrome than men.
• Have a health condition that may affect structures in your wrist.
• Do activities with repeated hand motions.
• Have had a wrist injury.
• Have a close relative who has had carpal tunnel syndrome, such as a parent, brother or sister.

You may feel numbness, tingling or burning in your fingers, especially in your thumb, index, and middle fingers. Symptoms often affect both hands.

In the early stages, symptoms usually:

• Start slowly in your dominant hand (the one you write with)
• Happen at night if you sleep with your wrists bent

As symptoms get worse, you may notice:

• Tingling, pain, or weakness with certain activities, such as driving or holding a phone
• Difficulty grasping or holding small things
• Feeling like your fingers are swollen when they're not

Without treatment, you could lose feeling in some fingers and have permanent weakness in your thumb. But early diagnosis and treatment can help prevent lasting damage.

To find out if you have carpal tunnel syndrome, your health care provider will:

• Ask about your medical history
• Ask about your family health history
• Do a physical exam
• Order tests if needed, such as:
  • Lab tests to look for diseases that may damage nerves
  • X-rays to look for broken bones or arthritis
  • Tests to measure the electrical activity in your nerves and muscles
  • Ultrasound to check the nerve in the carpal tunnel

It's easier to treat carpal tunnel syndrome early on, so you should start treatment as soon as possible. Your provider will first treat any health conditions you have that may cause your symptoms. The next step would be treatments for carpal tunnel syndrome. They may include:

• Wrist splints (usually worn at night).
• Rest.
• Medicines to reduce swelling and pain:
• Over-the-counter pain relievers, such as aspirin, ibuprofen, and naproxen sodium.
• Prescriptionsteroids, either pills or an injection (shot) into your wrist.
• Other therapies (complementary and integrative medicine). Research shows that yoga may help with pain and weakness. Some people may find acupuncture and chiropractic care helpful, but research hasn't shown that these therapies can improve carpal tunnel syndrome. If you want to try other therapies, talk with your provider first.
• Surgery to make more space in the carpal tunnel. Surgery may be an option if your symptoms are severe and other treatments don't work. It involves cutting the wrist ligament to take pressure off the nerve. Recovery may take months. Carpal tunnel syndrome rarely comes back after surgery, but mild symptoms may last.

You may help prevent carpal tunnel syndrome if you protect your wrists:

• Use good posture to keep your wrists in a natural position.
• Keep your hands warm to keep your muscles flexible. Fingerless gloves may help.
• Take work breaks and vary your tasks.
• Stretch and exercise your hands and wrists.
• Organize your workspace and tools to reduce strain on your hands and wrists.

Celiac disease is a chronic (long-term) digestive and immune disorder that damages your small intestine. The damage may prevent your body from absorbing vitamins, minerals, and other nutrients from the food you eat. This can lead to malnutrition and other serious health problems

Celiac disease is triggered by eating foods that contain gluten. Gluten is a protein found in wheat, barley, rye, and other grains. It may also be in other products like vitamins and supplements, hair and skin products, toothpastes, and lip balm.

Celiac disease is different from gluten sensitivity. Both involve problems with gluten and can cause some of the same symptoms, such as abdominal (belly) pain and fatigue. But gluten sensitivity does not damage the small intestine like celiac disease does.

Wheat allergy, a type of food allergy, is also different. With both celiac disease and wheat allergy, your immune system is reacting to wheat. But with wheat allergy, you can have some different symptoms, such as itchy eyes or trouble breathing. And a wheat allergy will not cause long-term damage to the small intestine.

The exact cause of celiac disease is not known. Research suggests that celiac disease only happens in people who have certain genes and eat food that contains gluten. Researchers are studying other factors that may play a role in causing the disease.

Celiac disease is more common if you:

• Have a family member who has the disease
• Have Down syndrome, Turner syndrome, or Williams syndrome
• Are White
• Are female

The symptoms of celiac disease can be different from person to person. Sometimes the symptoms may come and go. Some people may not notice any symptoms.

Some of the possible symptoms affect your digestive system. Digestive symptoms are more common in children than in adults. The digestive symptoms include:

• Bloating (feeling fullness or swelling in your belly)
• Chronic (long-term) diarrhea or greasy, bulky, unusually bad-smelling stool (poop)
• Constipation
• Gas
• Lactose intolerance because of damage to the small intestine
• Nausea and vomiting
• Pain in the abdomen (belly)
• Weight loss in adults, or not enough weight gain in children

Some people with celiac disease have symptoms that affect other parts of the body, such as:

• Fatigue
• Depression and anxiety
• Irritability (in children)
• Dermatitis herpetiformis, an itchy rash with blisters (mainly in adults)
• Bone or joint pain
• Symptoms involving the mouth, such as canker sores or dry mouth

Over time, celiac disease can cause other health problems, especially if it is not treated. These problems can include:

• Malnutrition
• Anemia, especially iron-deficiency anemia
• Bone loss
• Nervous system problems such as headaches, balance problems, or peripheral neuropathy
• Reproductive problems, such as missed menstrual periods and miscarriages in women and infertility in men and women

If you have symptoms of celiac disease, your health care provider will look for signs that you might have celiac disease. To do this, your provider will get your medical and family history and do a physical exam.

If your provider thinks that you could have celiac disease, you will have some tests. Providers most often use blood tests and biopsies of the small intestine to diagnose celiac disease. The biopsy would be done during an upper gastrointestinal (GI) endoscopy. For this procedure, your provider uses an endoscope (a flexible tube with a camera) to see the lining of your esophagus, stomach, and small intestine. It also allows your provider to take a sample of tissue for a biopsy.

The treatment for celiac disease is following a gluten-free diet for the rest of your life. Sticking with a gluten-free diet will treat or prevent many of the symptoms and other health problems caused by celiac disease. In most cases, it can also heal damage in the small intestine and prevent more damage.

Your provider may refer you to a registered dietician (a nutrition expert) who can help you learn how to eat a healthy diet without gluten. You will also need to avoid all hidden sources of gluten, such as certain supplements, cosmetics, toothpaste, etc. Reading product labels can sometimes help you avoid gluten. If a label doesn't tell you what is in a product, check with the company that makes the product for an ingredients list. Don't just assume that a product is gluten-free if it doesn't mention it.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Childbirth is the process of giving birth to a baby. It includes labor and delivery. Usually everything goes well, but problems can happen. They may cause a risk to the mother, baby, or both. Some of the more common childbirth problems include:

• Preterm (premature) labor, when your labor starts before 37 completed weeks of pregnancy
• Premature rupture of membranes (PROM), when your water breaks too early. If labor does not start soon afterwards, this can raise the risk of infection.
• Problems with the placenta, such as the placenta covering the cervix, separating from the uterus before birth, or being attached too firmly to the uterus
• Labor that does not progress, meaning that labor is stalled. This can happen when
  • Your contractions weaken
  • Your cervix does not dilate (open) enough or is taking too long to dilate
  • The baby is not in the right position
  • The baby is too big or your pelvis is too small for the baby to move through the birth canal
• Abnormal heart rate of the baby. Often, an abnormal heart rate is not a problem. But if the heart rate gets very fast or very slow, it can be a sign that your baby is not getting enough oxygen or that there are other problems.
• Problems with the umbilical cord, such as the cord getting caught on the baby's arm, leg, or neck. It's also a problem if cord comes out before the baby does.
• Problems with the position of the baby, such as breech, in which the baby is going to come out feet first
• Shoulder dystocia, when the baby's head comes out, but the shoulder gets stuck
• Perinatal asphyxia, which happens when the baby does not get enough oxygen in the uterus, during labor or delivery, or just after birth
• Perineal tears, tearing of your vagina and the surrounding tissues
• Excessive bleeding, which can happen when the delivery causes tears to the uterus or if you are not able to deliver the placenta after you give birth to the baby
• Post-term pregnancy, when your pregnancy lasts more than 42 weeks

If you have problems in childbirth, your health care provider may need to give you medicines to induce or speed up labor, use tools to help guide the baby out of the birth canal, or deliver the baby by Cesarean section.

NIH: National Institute of Child Health and Human Development

Chlamydia is a common sexually transmitted disease (STD). It is caused by bacteria called Chlamydia trachomatis. Anyone can get chlamydia. It often doesn't cause symptoms, so people may not know that they have it. Antibiotics can cure it. But if it's not treated, chlamydia can cause serious health problems.

You can get chlamydia during oral, vaginal, or anal sex with someone who has chlamydia. A pregnant person can also pass chlamydia to the baby during childbirth.

If you've had chlamydia and were treated in the past, you can get re-infected if you have unprotected sex with someone who has it.

Chlamydia is more common in young people, especially young women. You are more likely to get infected with chlamydia if you don't consistently use a condom or if you have multiple partners.

Chlamydia doesn't usually cause any symptoms. So you may not realize that you have it. But even if you don't have symptoms, you can still pass the infection to others.

If you do have symptoms, they may not appear until several weeks after you have sex with someone who has chlamydia.

Symptoms in women include:

• Abnormal vaginal discharge, which may have a strong smell
• A burning sensation when urinating

If the infection spreads, you might get lower abdominal (belly) pain, pain during sex, nausea, and fever.

Symptoms in men include:

• Discharge from your penis
• A burning sensation when urinating (peeing)
• Pain and swelling in one or both testicles (although this is less common)

If the chlamydia infects the rectum (in men or women), it can cause rectal pain, discharge, and bleeding.

There are lab tests to diagnose chlamydia. Your health care provider may ask you to provide a urine sample. Or your provider may use (or ask you to use) a cotton swab to get a sample from your vagina to test for chlamydia.

You should go to your provider for a test if you have symptoms of chlamydia or if you have a partner who has an STD. Pregnant people should get a test when they go to their first prenatal visit.

People at higher risk should get checked for chlamydia every year:

• Sexually active women 25 and younger
• Older women who have new or multiple sex partners or a sex partner who has an STD
• Men who have sex with men (MSM)

In women, an untreated infection can spread to your uterus and fallopian tubes, causing pelvic inflammatory disease (PID). PID can cause permanent damage to your reproductive system. This can lead to long-term pelvic pain, infertility, and ectopic pregnancy. Women who have had chlamydia infections more than once are at higher risk of serious reproductive health complications.

Men often don't have health problems from chlamydia. Sometimes it can infect the epididymis (the tube that carries sperm). This can cause pain, fever, and, rarely, infertility.

Both men and women can develop reactive arthritis because of a chlamydia infection. Reactive arthritis is a type of arthritis that happens as a "reaction" to an infection in the body.

Babies born to infected mothers can get eye infections and pneumonia from chlamydia. It may also make it more likely for your baby to be born too early.

Untreated chlamydia may also increase your chances of getting or giving HIV.

Antibiotics will cure the infection. You may get a one-time dose of the antibiotics, or you may need to take medicine every day for 7 days. It is important to take all the medicine that your provider prescribed for you. Antibiotics cannot repair any permanent damage that the disease has caused.

To prevent spreading the disease to your partner, you should not have sex until the infection has cleared up. If you got a one-time dose of antibiotics, you should wait 7 days after taking the medicine to have sex again. If you have to take medicine every day for 7 days, you should not have sex again until you have finished taking all of the doses of your medicine.

It is common to get a repeat infection, so you need to get tested again about three months after treatment.

The only sure way to prevent chlamydia is to not have vaginal, anal, or oral sex.

Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading chlamydia. If your or your partner is allergic to latex, you can use polyurethane condoms.

Centers for Disease Control and Prevention

Congenital heart defects (CHDs) are problems with the structure of the heart. "Congenital" means that that the problems are present at birth. These defects happen when a baby's heart doesn't develop normally during pregnancy. Congenital heart defects are the most common type of birth defect.

Congenital heart defects can change the way the heart pumps blood. They may make blood flow too slowly, go the wrong way, or block it completely.

There are many types of congenital heart defects. They can happen in one or more parts of the heart. The most common types are:

• Septal defects ("hole in the heart") - openings in the wall between the left and right sides of the heart
• Heart valve defects - problems with the valves that control the flow of blood through the heart
• Defects in the large blood vessels that carry blood in and out of the heart

Congenital heart defects can range from very mild problems that never need treatment to life-threatening problems at birth. The most serious congenital heart defects are called critical congenital heart disease. Babies with these defects usually need surgery in the first year of life. But the symptoms of milder heart defects may not show up until childhood or adulthood.

Researchers often don't know what causes congenital heart defects. They do know that changes in a baby's genes sometimes cause a heart defect. The changed genes may come from the parents, or the changes may happen during pregnancy.

Several things may increase the chance that your baby has a congenital heart defect, such as:

• Your health before and during pregnancy, including
  • Having diabetes before pregnancy or developing it in the first 3 months of pregnancy (diabetes that develops later in pregnancy isn't a major risk for heart defects). Carefully controlling your blood sugar before and during pregnancy can lower your baby's risk of congenital heart defects.
  • Having phenylketonuria (PKU), a rare inherited disorder that affects how the body uses a protein in foods. If you have PKU, eating a low-protein diet before getting pregnant can lower your baby's risk of having a congenital heart defect.
  • Having rubella (German measles) during pregnancy.
• Your contact with certain substances during pregnancy, including
  • Smoking or secondhand smoke (breathing smoke from another smoker).
  • Certain medicines, such as angiotensin-converting (ACE) inhibitors for high blood pressure and retinoic acids for acne. If you're pregnant or plan to get pregnant, talk with your health care provider about all the medicines you take.
• Your family history and genetics. In most cases, congenital heart defects don't run in families. But your chance of having a baby with a congenital heart defect does go up if you or the other parent has a congenital heart defect, or if you already have a child with a congenital heart defect.

Congenital heart defects don't cause pain. The signs and symptoms are different, depending on the type and number of defects and how serious they are.

Common signs and symptoms of congenital heart defects include:

• Cyanosis - a bluish color to the skin, lips, and fingernails. It happens when there isn't enough oxygen in the blood
• Fatigue - your baby may be unusually sleepy and may become very tired during feedings
• Poor blood flow
• Fast or difficult breathing
• Heart murmur - an unusual sound between heartbeats

Congenital heart defects don't always cause other problems. If they do, which problems you have would depend on the type and number of defects and how serious the defects are.

Children with congenital heart defects are more likely to:

• Be smaller than other children
• Have problems or delays in mental, and emotional growth, and behavior, such as:
  • Speech and language problems
  • Attention deficit hyperactivity disorders (ADHD)

People with congenital heart defects may develop other health conditions, including:

• Endocarditis - an infection of lining of the heart and valves
• Arrhythmia - a problem with the rate or rhythm of your heartbeat
• Heart failure - when your heart can't pump enough blood to the body
• Pulmonary hypertension - high blood pressure in your lungs
• Kidney and liver disease

• Before a baby is born, your provider may use ultrasound pictures of the baby's heart to look for heart defects. This is called a fetal echocardiogram. It's done between weeks 18 and 22 of pregnancy.
• During the first few days after birth, all newborns are checked for congenital heart defects. A pulse oximeter is clipped to your baby's hands or feet to measure blood oxygen. If it shows low levels of blood oxygen, more tests will be needed to find out if your baby has a heart defect.
• To diagnose congenital heart defects in babies, children, and adults, a provider may use many tools, including:
  • A physical exam.
  • Certain heart tests to see how the heart is working.
  • Genetic testing to see if certain gene problems caused the defect.

Treatment depends on the type of congenital heart defect and how serious it is. Possible treatments include:

• Cardiac catheterization to repair simple defects, such as a small hole in the inside wall of the heart. A catheterization uses a thin tube guided through a vein and into the heart.
• Heart surgery may be needed to:
  • Repair defects in the heart and blood vessels.
  • Repair or replace a heart valve.
  • Place a device in the chest to help the heart pump blood.
  • Do a heart transplant.
• Medicine is often used if your baby has a specific type of congenital heart defect called patent ductus arteriosus.

All children and adults who have congenital heart defects need regular follow-up care from a cardiologist (a doctor who specializes in heart diseases) throughout their life, even if their defect was repaired.

Some people may need several heart surgeries or catheterizations over the years. They may also need to take medicines to help their hearts work as well as possible.

NIH: National Heart, Lung, and Blood Institute

COVID-19 (coronavirus disease 2019) is an illness caused by a virus. This virus is a coronavirus called SARS-CoV-2. It spreads when a person who has the infection breathes out droplets and very small particles that contain the virus. On this page, you'll find links to resources on important issues such as symptoms, risks, and how you can protect yourself and your family.

We also have pages on:

• COVID-19 testing
• COVID-19 vaccines
• Post-COVID conditions (long COVID)

Delirium is a mental state in which you are confused, disoriented, and not able to think or remember clearly. It usually starts suddenly. It is often temporary and treatable.

There are three types of delirium:

• Hypoactive, when you are not active and seem sleepy, tired, or depressed
• Hyperactive, when you are restless or agitated
• Mixed, when you change back and forth between being hypoactive and hyperactive

There are many different problems that can cause delirium. Some of the more common causes include:

• Advanced cancer.
• Alcohol or drugs, either from intoxication or withdrawal. This includes a serious type of alcohol withdrawal syndrome called delirium tremens. It usually happens to people who stop drinking after years of alcohol use disorder (AUD).
• Dehydration and electrolyte imbalances.
• Dementia.
• Hospitalization, especially in intensive care.
• Infections, such as urinary tract infections, pneumonia, and the flu.
• Medicines. This could be a side effect of a medicine, such as sedatives or opioids. Or it could be from withdrawal after stopping a medicine.
• Metabolic disorders.
• Organ failure, such as kidney or liver failure.
• Poisoning.
• Serious illnesses.
• Severe pain.
• Sleep deprivation.
• Surgeries, including reactions to anesthesia.

Certain factors put you at risk for delirium, including:

• Being in a hospital or nursing home
• Having dementia
• Having a serious illness or more than one illness
• Having an infection
• Older age
• Having surgery
• Taking medicines that affect the mind or behavior
• Taking high doses of pain medicines, such as opioids

The symptoms of delirium usually start suddenly, over a few hours or a few days. They often come and go. The most common symptoms include:

• Changes in alertness (usually more alert in the morning, less at night)
• Changing levels of consciousness
• Confusion
• Disorganized thinking, talking in a way that doesn't make sense
• Disrupted sleep patterns, sleepiness
• Emotional changes: anger, agitation, depression, irritability, overexcitement
• Hallucinations and delusions
• Memory problems, especially with short-term memory
• Trouble concentrating

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• Physical and neurological exams
• Mental status testing, which checks for problems with your thinking and alertness
• Lab and diagnostic imaging tests

Delirium and dementia have similar symptoms, so it can be hard to tell them apart. You can also have both at the same time. The differences between them are that:

• Delirium starts suddenly and can cause hallucinations. It is mainly a problem with attention and staying alert. The symptoms may get better or worse and can last for hours or weeks.
• Dementia develops slowly and does not cause hallucinations. It usually starts with memory loss. The symptoms don't change often, like they can with delirium. Dementia almost never gets better.

Treatment of delirium focuses on the causes and symptoms of delirium. The first step is to identify the cause. Often, treating the cause will lead to a full recovery. The recovery may take some time - weeks or sometimes even months. In the meantime, there may be treatments to manage the symptoms, such as:

• Controlling the environment, which includes making sure that the room is quiet and well-lit, having clocks or calendars in view, and having family members around
• Medicines, including those that control aggression or agitation and pain relievers if there is pain
• If needed, making sure that the person has a hearing aid, glasses, or other devices for communication

Treating the conditions that can cause delirium may reduce the risk of getting it. Hospitals can help lower the risk of delirium by avoiding sedatives and making sure that hospital rooms are kept quiet, calm, and well-lit. It can also help to have family members around and to have the same staff members treat the person each day (if possible).

Dengue is a viral infection. It can be caused by four related viruses. You can get it if an infected mosquito bites you. It is common in warm, wet areas of the world. Although rare, it can be found in some parts of the United States. Outbreaks are more common during rainy seasons.

Dengue spreads to people through the bite of an infected mosquito. It does not spread directly from person to person. However, a pregnant person can pass the infection on to the baby. In rare cases, it can spread through a blood transfusion, organ transplant, or needle stick injury (an accidental injury from a used needle)..

About one in four people infected with dengue will get sick. For those who do get sick, the infection can be mild or severe. The symptoms of dengue include:

• A high fever
• Nausea and vomiting
• Rash
• Aches and pains (eye pain, usually behind the eyes, and pain in the muscles, joints, or bones)

The symptoms usually last two to seven days.

Severe dengue is a serious form of the illness. About 1 in 20 people who get sick with dengue will develop severe dengue. It can cause shock, internal bleeding, and even death. People are more likely to develop severe dengue if they have had dengue before, are pregnant, or are infants.

Watch for signs and symptoms of severe dengue. Warning signs usually begin about 24 - 48 hours after your fever has gone away. If you or your family member have these signs, get immediate medical care:

• Severe abdominal (belly) pain and tenderness
• Vomiting at least 3 times in 24 hours
• Bleeding from the nose or gums
• Vomiting blood, or blood in the stool (poop)
• Feeling tired, restless, or irritable

There is a blood test which can show if you have been infected with dengue.

There is no specific medicine to treat dengue. Most people will get better after about a week. But if you think you might have dengue:

• See a health care provider and mention any recent travel.
• Rest as much as possible.
• Take acetaminophen to control fever and relieve pain. But do not take aspirin or ibuprofen.
• Drink plenty of fluids to prevent dehydration.

Severe dengue often requires care at a hospital.

In the United States, a dengue vaccine is approved for children who are ages 9 - 16. They must also have previously had dengue and live in areas where dengue is common.

You can also help prevent dengue by avoiding mosquito bites:

• Wear insect repellent with DEET or another U.S. Environmental Protection Agency (EPA)-registered insect repellent. Make sure to follow the instructions for using the repellant.
• Wear clothes that cover your arms, legs and feet.
• Close unscreened doors and windows.

Centers for Disease Control and Prevention

Type 2 diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose is your main source of energy. It comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy. If you have diabetes, your body doesn't make enough insulin or doesn't use insulin well. The glucose then stays in your blood and not enough goes into your cells.

Over time, having too much glucose in your blood can cause health problems. But you can take steps to manage your diabetes and try to prevent these health problems.

Type 2 diabetes may be caused by a combination of factors:

• Being overweight or having obesity
• Not being physically active
• Genetics and family history

Type 2 diabetes usually starts with insulin resistance. This is a condition in which your cells don't respond normally to insulin. As a result, your body needs more insulin to help the glucose enter your cells. At first, your body makes more insulin to try to get cells to respond. But over time, your body can't make enough insulin, and your blood glucose levels rise.

You are at higher risk of developing type 2 diabetes if you:

• Are over age 45. Children, teenagers, and younger adults can get type 2 diabetes, but it is more common in middle-aged and older people.
• Have prediabetes, which means that your blood sugar is higher than normal but not high enough to be called diabetes
• Had diabetes in pregnancy or gave birth to a baby weighing 9 pounds or more.
• Have a family history of diabetes
• Are overweight or have obesity
• Are Black or African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander
• Are not physically active
• Have other conditions such as high blood pressure, heart disease, stroke, polycystic ovary syndrome (PCOS), or depression
• Have low HDL (good) cholesterol and high triglycerides
• Have acanthosis nigricans - dark, thick, and velvety skin around your neck or armpits

Many people with type 2 diabetes have no symptoms at all. If you do have them, the symptoms develop slowly over several years. They might be so mild that you do not notice them. The symptoms can include:

• Increased thirst and urination
• Increased hunger
• Feeling tired
• Blurred vision
• Numbness or tingling in the feet or hands
• Sores that do not heal
• Unexplained weight loss

Your health care provider will use blood tests to diagnose type 2 diabetes. The blood tests include:

• A1C test, which measures your average blood sugar level over the past 3 months
• Fasting plasma glucose (FPG) test, which measures your current blood sugar level. You need to fast (not eat or drink anything except water) for at least 8 hours before the test.
• Random plasma glucose (RPG) test, which measures your current blood sugar level. This test is used when you have diabetes symptoms and the provider does not want to wait for you to fast before having the test.

Treatment for type 2 diabetes involves managing your blood sugar levels. Many people are able to do this by living a healthy lifestyle. Some people may also need to take medicine.:

• A healthy lifestyle includes following a healthy eating plan and getting regular physical activity. You need to learn how to balance what you eat and drink with physical activity and diabetes medicine, if you take any.
• Medicines for diabetes include oral medicines, insulin, and other injectable medicines. Over time, some people will need to take more than one type of medicine to control their diabetes.
• You will need to check your blood sugar regularly. Your health care provider will tell you how often you need to do it.
• It's also important to keep your blood pressure and cholesterol levels close to the targets your provider sets for you. Make sure to get your screening tests regularly.

You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. If you have a condition which raises your risk for type 2 diabetes, managing that condition may lower your risk of getting type 2 diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose builds up in your blood and causes high blood sugar levels.

Diabetic heart disease is a term for heart disease in people who have diabetes. If you have diabetes, you are much more likely to develop heart disease or have a stroke than people who don't have diabetes. And you may start having these problems at a younger age.

Over time, the effects of high blood sugar from diabetes can include damage to the blood vessels and nerves in your heart. This damage increases your chance of developing heart diseases, including:

• Coronary artery disease (CAD). It happens slowly as a sticky material called plaque builds up in the arteries that supply your heart muscle with blood.
• Heart failure. With this condition, your heart can't pump enough oxygen-rich blood to meet the needs of your body.
• Cardiomyopathy. This is a group of diseases in which the heart muscle may become thick or stiff.

Diabetes puts you at serious risk for heart disease. It also makes you more likely to develop other conditions that raise your risk even more, including:

• High blood pressure
• High blood levels of LDL "bad" cholesterol
• High triglycerides (a type of fat in your blood) with low blood levels of HDL "good" cholesterol

Your risk for heart disease is also higher if you

• Are male
• Smoke
• Have obesity
• Have too much belly fat around your waist, even though you're at a healthy weight:
  • For men, that's a waist more than 40 inches
  • For women, that's a waist more than 35 inches
• Have a family history of heart disease
• Have chronic kidney disease

In the early stages, heart disease usually doesn't have any symptoms. But if your heart disease worsens, you can have symptoms. Your symptoms will depend on the type of heart disease you have. They might include:

• Shortness of breath
• Fatigue
• Dizziness or fainting
• Arrhythmia (problem with the rate or rhythm of your heartbeat)
• Swollen feet and ankles
• Chest pain

It's important to know that people with diabetes may not feel chest pain. That's because diabetes can damage the nerves in your heart. If you have any symptoms that could be heart disease, talk with your health care provider.

To find out if you have diabetic heart disease, your provider will:

• Ask about your medical history, including your symptoms and other health conditions you may have
• Ask about your family history, to find out if you have relatives who have or had heart disease
• Do a physical exam
• Likely run some tests to help understand your personal risk for heart disease, including:
  • Blood tests to check your cholesterol, triglycerides, and blood sugar levels
  • A blood-pressure check
  • Heart tests, if needed

Depending on your risk level, your provider may send you to a cardiologist (a doctor who specializes in heart diseases) for care. If you do have heart disease, treatment will depend on the type of heart disease you have.

You may be able to prevent heart disease or keep it from getting worse by working with your provider to:

• Control your blood sugar levels
• Manage other conditions you may have that can raise your risk for heart disease
• Take any medicines your provider prescribed
• Make heart-healthy habits part of your daily life
• Follow a healthy eating plan for diabetes

NIH: National Institute of Diabetes and Digestive and Kidney Diseases