Diabetes

Diabetes, also called Diabetes mellitus, is a chronic disease that occurs when your blood glucose (sugar) level is too high. Glucose is a form of sugar and is the major source of energy that comes from the food we eat. Insulin, a hormone made by the pancreas, regulates the amount of glucose in the blood. Insulin acts as a key that allows the cells to use glucose. With Diabetes, the body is unable to produce enough insulin or doesn’t efficiently use the insulin it produces.

How does diabetes develop?

When we eat, our body breaks down the carbohydrates into glucose, which gets absorbed into the bloodstream. Glucose provides the energy that our body needs to perform daily activities. In order to use the glucose, our body needs insulin. Glucose stimulates the blood to produce insulin. It is the insulin that allows the glucose from the blood to move into the cells. When glucose leaves the bloodstream, the blood sugar level is lowered. Inside the cell, it is converted into energy, or is stored as fat. Sometimes our body doesn’t make enough insulin or doesn’t use the insulin properly. As a result, glucose stays and builds up in the blood. This causes sugar to rise. Eventually, high blood glucose level leads to Diabetes.

Diabetes is a serious condition which effects the entire body. Diabetes may damage the eyes, kidneys, blood vessels, brain or heart. People with diabetes are up to two times more likely to develop heart disease and stroke. So, the blood sugar must be regulated carefully to ensure that the body functions properly. There are 3 main types of Diabetes:

Type 1 Diabetes

Type 1 Diabetes or Insulin dependent Diabetes is the most common form of diabetes in people who are under the age of 30. It is an autoimmune disease, which means that the immune system attacks the body’s own healthy cells. Hence, in type 1 diabetes, your immune system attacks insulin producing cells of the pancreas. The cause of this is still unknown. It is sometimes called “juvenile” diabetes because it usually develops in children. However, it can also develop in adults. If left untreated, it can prove to be fatal, putting the undiagnosed patient in coma.

People with type1 diabetes are insulin-dependent. They must take daily insulin injections or other medications to keep their blood glucose levels from becoming high. They should limit the amount of Carbohydrates and should get the right balance of proteins, fat and carbohydrates.

Treatment

Type 1 Diabetes is managed by taking insulin, which is usually injected or infused via a pump.

Type 2 Diabetes

Type 2 Diabetes, also known as non- insulin dependent diabetes, is the most common type of Diabetes. People with type 2 diabetes produce insulin, but their body does not respond to it as it should, which is known as insulin resistance. After eating a meal, the blood sugar increases because the insulin does not move the glucose out of the bloodstream. To maintain normal blood sugar, body produces more and more insulin and over time the pancreas wears out and loses its ability to produce insulin.

The symptoms of type 2 diabetes take a long time to develop. In most cases, the symptoms go unnoticed. It usually occurs in people who are over forty, overweight, or have a family history of diabetes. Now that children are being overweight, leading a sedentary lifestyle and have unhealthy eating habits, type 2 Diabetes is becoming common among children and adolescents too.

Treatment

Type 2 diabetes can be managed with regular exercise and healthy eating. If lifestyle changes aren’t enough, you may require medications or insulin.

Gestational Diabetes

This type of diabetes occurs in women during pregnancy. Pregnant women produce large amount of hormone, due to which body becomes resistant to the effect of insulin. It usually develops during the second trimester of pregnancy and disappears after delivery. However, mother & fetus are at increased risk of getting Type 2 diabetes later in life.

Prediabetes

It is a condition in which blood glucose level is too high to be considered normal but not high enough to be called Diabetes. The range of blood sugar for prediabetes is 100-125mg/dl. People with prediabetes have a higher risk of developing Type 2 diabetes.

Risk factors of Diabetes

• Obesity: Obesity is the major risk factor for developing type 2 diabetes.
• Age: More than 45 years
• Medications: Certain medications like steroids may lead to diabetes
• Family history
• High cholesterol
• Physical inactivity
• Smoking

Symptoms

The symptoms of diabetes include:

• Unusual thirst
• Increased hunger
• Frequent urination
• Unexplained weight loss
• Blurred vision
• Nausea
• Dry Mouth

Diagnosis

Your healthcare provider may use any one or more of the following tests for the diagnosis of diabetes:

• Fasting Blood Glucose Testing: Diabetes can be diagnosed by measuring the level of glucose in blood. In this test, blood is drawn from the patient after 8 hours of fasting. A person with diabetes will have a fasting blood glucose level of more than 126mg/dl.
• Random blood test: It is a simple-in office test which your healthcare provider performs by taking a drop of blood from the finger. A level of 200mg/dL or above may indicate that a person is diabetic. It can be done at any time of the day.
• Oral Glucose Tolerance Test (OGTT): Oral glucose tolerance test, also known as Glucose tolerance test (GTT) is a test in which blood glucose level is measured before and after a sugary drink is taken. It requires a person not to eat or drink for 8 hours. After overnight fasting, the fasting blood glucose level of the patient is measured. Then a sugary liquid is given to the patient, and blood sugar levels are tested periodically for the next two hours. A level of 200 mg/dL or above indicates Diabetes.
• HbA1c Test: It is also referred as A1c or Glycated Hemoglobin and does not require fasting. This test measures the percentage of hemoglobin that is bound to the glucose over the last 2-3 months. The higher the level of glucose in blood, the more Glycated hemoglobin is formed. It is measured in percentage and units of mmol/mol. The normal HbA1c result is between 15-42 mmol/mol (below 5.7%). Whereas, 48 mmol/mol (6.5%) or higher is diagnostic of diabetes.

Treatment

Diabetes has no cure; however, it can be managed. People with diabetes need to work with a team of health care professionals. They should discuss and take steps to treat and manage diabetes and prevent its complications.

Diet

Avoid simple sugar, limit carbohydrate rich and protein food. Add dietary fiber in the diet.

Exercise

Exercise can help people control their weight and increase the sensitivity of insulin receptors to insulin.

Smoking

Quit smoking. Since smoking narrows the blood vessels, it could be dangerous.

Medications

Type 1 diabetes

People with type1 diabetes require insulin injections or an insulin pump to lower blood glucose level. Insulin is not present in pill form because stomach enzyme interferes with insulin action. They are of 4 types:

• Rapid-Acting Insulin: It is usually taken just before the meal to minimize the rise in blood sugar from eating. Its action lasts for 3-5 hours.
• Short-Acting Insulin: It is injected 30 minutes before the meal and lasts for 6-8 hours.
• Intermediate-Acting Insulin: It has an onset of 1-4 hours and lasts for 12 hours or longer.
• Long-Acting Insulin- It has an onset of 1 hour and duration of 20-26 hours.

Type 2 diabetes

If diet and exercise aren’t sufficient to control type 2 diabetes, then your doctor may prescribe a medication to you. Metformin is a very common medication prescribed for type 2 diabetes.

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