Diabetes mellitus, commonly called diabetes, is a metabolic disease that causes high blood glucose levels . Glucose plays an essential role in providing energy to body cells. The hormone insulin moves sugar from blood into the cells to be stored/used for energy. With diabetes, either the body does not make enough insulin or cannot effectively use the insulin it does make. More than a normal sugar level can cause serious health conditions and can damage your nerves, eyes, kidneys, and other organs.
What is diabetes?
Diabetes mellitus (DM) is a medical condition characterized by hyperglycemia , a more than normal sugar level. It is due to the deficiency of the insulin hormone.
What are the types of diabetes?
Diabetes is broadly divided into the following types:
Pre-diabetes: occurs when your blood sugar is higher than normal, but it’s not high enough for a diagnosis of type 2 diabetes.
1. Type I diabetes: This type is an autoimmune disease. The immune system attacks and destroys cells inside the pancreas, where insulin is produced.
2. Type 2 diabetes occurs when the body becomes resistant to insulin, and sugar builds up in the blood.
3. Gestational diabetes: This is a condition, characterized by higher than normal blood sugar levels, is developed for the first time during the pregnancy and resolves after delivery .
What are the symptoms of diabetes?
Symptoms of diabetes vary from one person to another, depending on severity and the level of glucose in the blood . Symptoms tend to come early in those with type I diabetes and at a later stage for others.
Some common signs and symptoms of type I and type II diabetes are:
● Frequent urge to drink water or increase in thirst.
● Weight loss due to no known reason.
● Ketonuria – Presence of ketone bodies in urine.
● Polyuria and frequent urination.
● Fatigue and irritability.
● Blurring vision.
● Increase in hunger.
● Susceptible to infections and slow healing of sores.
When to see a doctor?
The following conditions require you to see and consult a doctor:
● If you are experiencing the above-mentioned signs and symptoms
● For follow-up visits. It is important to review your treatment until you reach and maintain your normal sugar level.
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What causes diabetes?
The underlying cause of diabetes is the abnormal functioning of the pancreas and insulin production from the special cells in the pancreas . It can occur due to any of the following:
● If your pancreas is not producing insulin.
● If your pancreas is producing insufficient insulin, which is unable to meet the body’s demand.
● If the pancreas is producing sufficient insulin, but your body is unable to respond to it, known as insulin resistance.
Type I diabetes
Insulin is produced by the β (beta) cells of the pancreas, and its destruction leads to type I diabetes. It is believed that the immune system attacks and destroys the insulin-secreting cells..
Pre-diabetes and Type II diabetes
Pre-diabetes can lead to type II diabetes where the body does not respond to the insulin secreted. Being overweight has a direct link to type II diabetes.
The hormones produced during pregnancy makes cells resistant to the hormone insulin. Though the pancreas in such conditions secretes an additional amount of insulin to maintain normal sugar level, in some cases, it cannot keep up with the extra production. This leads to the buildup of glucose in the bloodstream rather than the cells.
What is the diagnostic test for diabetes?
Type I, type II, and pre-diabetes
The tests performed to diagnose type I, type II, and pre-diabetes are:
#1 Glycated hemoglobin (A1C) test
It is a blood test that does not require you to fast. The test is performed to indicate the average sugar level for the past 2-3 months. It functions by measuring the percentage of blood sugar attached to the protein that carries oxygen – hemoglobin.
Interpretation of the glycated hemoglobin test is as follows:
● Normal A1C: Below 5.7%
● Pre diabetes A1C: 5.7% – 6.4%
● Diabetes A1C: 6.5% or higher
#2 Random blood sugar (RBS) test
A random blood sample is taken at any time before or after a meal and is analyzed for blood sugar levels.
Interpretation of the RBS test is as follows:
● Diabetes: Blood sugar level of 11.1 mmol/L (200 mg/dL) or higher
#3 Fasting blood sugar test
Your doctor will take a blood sample after you perform overnight fasting.
Interpretation of the test is as follows:
● Normal: Less than 5.6 mmol/L (100 mg/dL)
● Pre-diabetes: 5.6 – 6.9 mmol/L (100 – 125 mg/dL)
● Diabetes: 7 mmol/L (126 mg/dL) or higher
#4 Oral glucose tolerance test (OGTT)
Your doctor will take 2 blood samples. One is taken after an overnight fast and the other after intake of 75g of glucose with 300 ml of water.
Interpretation of OGTT ,two hours after drinking the glucose solution is as follows :
● Normal blood glucose level is below 7.8 mmol/L (140 mg/dL).
● Blood glucose level between 7.8 and 11 mmol/L (140 and 199 mg/dL) is considered impaired glucose tolerance, or prediabetes.
● A blood glucose level of 11.1 mmol/L (200 mg/dL) or higher may indicate diabetes.
Your doctor is likely to perform a test to detect ketone bodies in urine
What are the complications of diabetes?
Diabetes is a lifestyle disorder that is chronic. The more you delay getting it diagnosed and treated, the higher are the chances of developing severe complications. They are as follows:
● Cardiovascular diseases like coronary artery diseases, chest pains, stroke, atherosclerosis (narrowing arteries of the heart), and heart attack.
● Nerve damage like an injury to the nerves, numbness, tingling sensations in your legs, erectile dysfunction in men, and chronic pain at the tips of fingers and toes
● Damage to the kidneys can hamper with the filtering system. This can cause irreversible end-stage kidney disease that requires a kidney transplant or dialysis.
● Damage to the eyes leading to blindness. It can cause serious conditions like cataracts , retinal damage and glaucoma. It also causes hearing damage.
● Bacterial and fungal skin problems.
● Alzheimer’s disease and depression
Gestational diabetes can cause severe complications in you and your child. They are:
● Large babies due to excess growth. This can cause you to undergo a C-section ,
● Your child can develop low blood sugar after birth.
● Your baby is susceptible to obesity and type II diabetes.
● Untreated gestational diabetes can result in the baby’s death.
● Preeclampsia: High blood pressure accompanied by abnormal amounts of protein in the urine and swelling in feet and legs.
What is the treatment for diabetes?
Blood sugar monitoring, oral medications, and insulin therapy, along with healthy eating and regular physical activity, play an essential role in treating pre-diabetes or any type of diabetes.
Treating type I and type II diabetes
There are some differences in treating the two types of diabetes:
● Type I diabetes treatment
It involves using insulin pumps or injections and frequent checks of the blood sugar levels. They primarily need insulin to survive.
● Type II diabetes treatment
It is treated by focusing on lifestyle modification, blood sugar level monitoring, diabetic medicines, and insulin therapies. In addition to monitoring your blood sugar level every day, your doctor is likely to recommend glycated hemoglobin (A1C) testing.
● Insulin therapy
Your doctor will provide you with long-acting insulin, rapid-acting insulin, or other intermediate options depending upon the severity and its need. Insulin cannot be consumed orally, it is injected to attain normal sugar levels.
● Oral medications
Some diabetes medications stimulate your pancreas to produce and release more insulin. Others inhibit the production and release of glucose from your liver, which means you need less insulin to transport sugar into your cells.
Still others block the action of stomach or intestinal enzymes that break down carbohydrates or make your tissues more sensitive to insulin.
Metformin is commonly prescribed for type II diabetic patients.
● Pancreas transplantation
● Bariatric surgery is done to reduce the body weight by making alterations in your digestive system.
Treating gestational diabetes
Your doctor will advise you to keep a check on your blood sugar level and report any changes to avoid serious complications. Your treatment plan is likely to include a healthy diet, regular exercise, blood sugar level monitoring, and insulin or medication. Your doctor will also record your blood sugar level at the time of delivery to be aware of any consequences.
How to prevent diabetes?
No matter how strict and healthy your lifestyle has been, type I diabetes cannot be prevented. Nevertheless, various lifestyle modifications and choices can prevent pre-diabetes, type II diabetes, and gestational diabetes. They are:
● Make sure to choose healthy food items that are low in calories and high in fiber.
● Ensure your body is getting at least 30 minutes of physical activity daily.
● You should lose excess weight if you are overweight. Weight-loss programs can help you tackle and reduce the risk of getting affected.
Diabetes, also known as diabetes mellitus (DM), is a metabolic disorder that leads to higher glucose concentrations in the blood. Type I, type II, and gestational diabetes are the types of diabetes a person can encounter in their lifetime. It is a chronic condition and must be managed with care . With proper care and management, you can tackle diabetes and keep it under control.
Frequently asked questions (FAQs)
1. What are the signs of trouble in diabetes?
Problems like hyperglycemia (high blood sugar), diabetic ketoacidosis (presence of an increased amount of ketone bodies in your urine), and hypoglycemia (low blood sugar) require immediate care. A life-threatening condition known as a hyperglycemic hyperosmolar nonketotic syndrome, characterized by vision loss, hallucinations, dry mouth, drowsiness, and confusion, must be treated urgently.
2. What are some lifestyle modifications to benefit the treatment of diabetes?
Doing physical exercises, eating healthy , getting a regular eye checkup, keeping your blood pressure and cholesterol levels under control, avoiding tobacco consumption and smoking, and managing stress are some important lifestyle modifications to help you with your treatment plan for diabetes.
3. What should I do if someone near me is having a diabetic emergency ?
Hypoglycemia (low blood sugar), hyperglycemia (high blood sugar), diabetic ketoacidosis (DKA), are all emergency situations.
In diabetic hypoglycemia , the person needs to be given something sugary to eat or drink as their blood sugar levels can drop instantly. Make sure the person has regained their consciousness and seek medical care if under any doubt.
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