Thirst, frequent urination, blurred vision and fatigue after meals may be symptoms of diabetes, and according to the American Diabetes Association, the underlying causes of the illness remain a medical mystery.

Diabetes affects more than 23 million children and adults, and only about 18 million of those cases have been diagnosed. The remaining six million are unaware they suffer from one of the leading causes of death and disability in the United States.

In 2006, diabetes ranked seventh on the list of causes of fatality, but it is likely to be underreported as the underlying cause on death certificates.

Tawnia Jones, diabetes clinical coordinator at Our Lady of Bellefonte Hospital, said many states have conceded that such underreporting does occur, but oftentimes it is not with bad intentions.

“Diabetes often goes underreported because it is an underlying factor.” Jones said. “The actual cause of death might be a cardiac event or something that was brought on by diabetes.”

Jones added that in addition to cardiac complications, many diabetes deaths are camouflaged by kidney damage, eye disease and nerve damage that are typically recorded on death certificates.

Sometimes as a result of diabetes, limb amputations can lead to death.

“(Amputations) have a very difficult time healing,” Jones said. “I think the statistic is that 50 percent of amputees will require further amputations.”

Diabetes is instigated when the body does not properly produce insulin, a hormone that converts sugar, starches and other foods into energy. The pancreas produces insulin to assist glucose into the bloodstream, and without the imperative insulin, excess glucose overflows into the urine where it leaves the body.

The illness can be present in the body through one of three forms: gestational, Type 2 and Type 1.

Gestational diabetes typically occurs during pregnancies when women who have never had diabetes develop high blood sugar. This type of diabetes affects about 4 percent of every pregnancy, according to the American Diabetes Association.

Type 2 is the most common form of diabetes, and the culprit is the insulin. In Type 2, the body either does not produce enough insulin or the cells reject it. As a result of the lack of insulin, the body will be starved of energy, and over time, high glucose levels could cause serious damage to kidneys, eyes, nerves and the heart.

Hemerle said Type 2 diabetes is preventable through a healthy lifestyle.

“You want to keep your children as active as possible,” she said. “Bake and grill your foods, and have (your children) eat as healthy as possible.”

But treating and preventing Type 1 diabetes is not as simple.

Also known as juvenile diabetes, Type 1 is typically the most frightening form of the illness. In this type of diabetes, most often found in children and young adults, the body does not produce insulin, and the patient is often required to undergo dialysis.

“Treatment of Type 1 diabetes includes insulin,” Hemerle said. “A lot of children are on insulin pumps. As they grow, it is adjusted. They always need more as they age.”

Despite the frightening aspect of the illness, it is possible to continue a long, healthy life while battling diabetes.

“Children with diabetes are able to live normal lives without complications if they are treated properly,” Hemerle said.

And the American Diabetes Association reiterates Hemerle’s advice to keep active and healthy to overcome the illness.