Diabetes

What Is Diabetes?

Diabetes or diabetes mellitus is a condition that affects how your body uses blood glucose or blood sugar. Glucose is an important source of energy for the cells in the body, and it is the main source of fuel of the brain. There are many types of diabetes depending on the cause, but all types increase the blood sugar levels. Excess sugar can affect organs in the body and can also result in heart attacks and stroke.

What Is the Role of Glucose in the Body?

Glucose is an important source of energy for the cells. The two major sources of glucose for your body is from the food you eat and your liver. With the help of insulin, this glucose is absorbed from the intestine to the blood and into the cells. Glucose is also stored and made in the liver, which is broken down and released into the blood when you fast or do not eat for in a while.

The normal fasting blood sugar levels are between 70 and 99 mg/dL, and normal blood glucose 2 hours after a meal should be below 140 mg/dL.

What Are the Types of Diabetes?

The types of diabetes are:

1. Prediabetes - Prediabetes or borderline diabetes is when blood sugar is 100 to 125 mg/dL. Here, the blood glucose is higher than usual, but not so high to diagnose it as diabetes.

2. Type 1 diabetes or Juvenile diabetes - Here, the body fails to produce insulin. As such patients do not have insulin production, they must take Insulin shots throughout their life.

3. Type 2 diabetes - Type 2 diabetes is the most common type of diabetes, and it impairs the way the body uses insulin. Here, the cells in the body do not respond to insulin effectively, even after the body produces it.

4. Gestational diabetes - Diabetes that affects pregnant woman, as the body becomes less sensitive to insulin, is gestational diabetes.

The other less common types of diabetes are monogenic diabetes and cystic fibrosis-related diabetes.

What Are the Causes of Diabetes?

• Type 1 diabetes - The exact cause is still not known, but it is believed that the immune system attacks and destroys the cells in the pancreas that produce insulin. This results in less or no insulin production. In the absence of insulin, glucose is not transported to the cells and builds up in the blood. This type of diabetes is believed to be caused by both genetic and environmental factors.

• Prediabetes and type 2 diabetes - As prediabetes increases the risk of type 2 diabetes, the causes are almost the same. Here, your cells become resistant to the action of insulin, and the pancreas is unable to produce enough insulin, which results in sugar build up in the blood. Obesity is believed to be the primary cause of this type of diabetes.

• Gestational diabetes - The hormones produced by the placenta during pregnancy makes the cells more resistant to insulin. This is usually compensated by pancreas producing more insulin, but if it does not, it results in gestational diabetes.

What Are the Symptoms of Diabetes?

The symptoms vary depending on the level of blood sugar. Prediabetes and type 2 diabetes usually do not cause any symptoms early on. Some of the signs and symptoms of diabetes are:

Common Symptoms:

• Feeling extremely thirsty.

• Frequent urination.

• Increased hunger.

• Unintentional weight loss.

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  Diabetes

• Ketones in urine.

• Tiredness.

• Irritability.

• Vision problems.

• Slow wound healing.

• Frequent skin and vaginal infections.

Symptoms in Men:

• Reduced sex drive.

• Erectile dysfunction.

• Muscle weakness.

Symptoms in Women:

• Vaginal yeast infection.

• Urinary tract infections.

• Dry and itchy skin.

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What Are the Risk Factors for Diabetes?

The risk factors for prediabetes and type 2 diabetes are:

• Obesity.

• Family history.

• Sedentary lifestyle.

• Increasing age.

• Pregnancy.

• Hypertension.

• High cholesterol and triglyceride levels.

• Polycystic ovary syndrome (PCOS).

What Are the Complications of Diabetes?

The complications of diabetes develop if your blood sugar level is left uncontrolled from a long period. These complications can be life-threatening. The complications include:

• Heart disease - It increases the risk of heart problems like angina, heart attack, stroke, and atherosclerosis.

• Neuropathy - Diabetes damages the tiny blood vessels that supply the nerves in the limbs, which results in tingling, numbness, and pain at the tips of the toes or fingers.

• Nephropathy - The kidney function is affected when excess sugar damages the tiny blood vessel in the kidneys. It can also lead to kidney failure or irreversible end-stage kidney disease.

• Retinopathy - It is when the blood vessels of the retina get damaged, resulting in blurred vision, and blindness. It can also cause cataracts and glaucoma.

• Foot infections - Poor blood supply and nerve damage results in sores and blisters to form on the toes. If left untreated, it can get infected and cause gangrene, which might require amputation of the affected toe, foot or leg.

• Skin infections - Diabetes makes the skin susceptible to many fungal and bacterial infections.

• Hearing problems - Increases the risk of hearing problems.

• Memory problems - It increases the risk of dementia or Alzheimer's disease.

• Mental problems - It can result in depression.

What Are the Complications of Gestational Diabetes?

Gestational diabetes can affect both the mother and her baby.

The complications in the baby are:

• Macrosomia - Excess sugar in the mother’s blood can reach the baby through the placenta, which results in the production of excess insulin by the baby's pancreas. This results in the baby growing too big, which requires birth by cesarian.

• Hypoglycemia - The blood sugar level drops in some babies shortly after birth due to the high production of insulin, which requires prompt treatment.

• Obesity - Babies are at higher risk of being overweight later in life if the mother had gestational diabetes.

• Death - Gestational diabetes if left untreated, can result in fetal death.

The complications in the mother are:

• Preeclampsia - It is a life-threatening condition, which causes high blood pressure, protein in the urine, and swelling in the legs and feet.

• Risk of gestational diabetes again - It increases the risk of you having gestational diabetes in the next pregnancy.

How Is Diabetes Diagnosed?

If you are experiencing the symptoms of diabetes, it is best you get the following tests done:

• Glycated hemoglobin test (HbA1c) test - This indicates the average blood sugar level for the past three months, by measuring the percentage of blood sugar attached to hemoglobin.

• Random blood sugar test - Here, blood is collected and glucose level is checked at any time. If the random blood sugar level is 200 mg/dL or higher, it indicates diabetes.

• Fasting blood sugar test - Here, blood is collected and glucose level is checked after fasting overnight. A fasting blood sugar level between 100 and 125 mg/dL is considered prediabetes, and if it is 126 mg/dL or higher, it is diabetes.

• Oral glucose tolerance test - After the fasting blood sugar level is measured, you are supposed to drink a sugary liquid, and the doctor will check the blood sugar levels for the next two hours. Blood sugar level less than 140 mg/dL is normal, and more than 200 mg/dL, indicates diabetes.

What Are the Treatment Options for Diabetes?

The treatment options include:

Insulin - Insulin is used to control blood sugar levels in type 1 diabetes and type 2 diabetes that is not controlled by medicines. The types of diabetes are:

• Rapid-acting insulin - starts working in 15 minutes and lasts for 3 to 4 hours.

• Short-acting insulin - starts working in 30 minutes and lasts for 6 to 8 hours.

• Intermediate-acting insulin - starts working in 1 to 2 hours and lasts for 12 to 18 hours.

• Long-acting insulin - starts working some hours after injection and lasts for a day or longer.

Medications - The drugs that lower the blood glucose levels are:

• Alpha-glucosidase inhibitors - Acarbose, Miglitol.

• Biguanides - Metformin.

• DPP-4 inhibitors - Linagliptin, Saxagliptin.

• Meglitinides - Nateglinide, Repaglinide.

• Sulfonylureas - Glipizide, Glimepiride.

• SGLT2 inhibitors - Canagliflozin, Dapagliflozin.

• Thiazolidinedione - Rosiglitazone.

How to Prevent Diabetes?

Ways to prevent diabetes are:

• Consume a diet low in fat and high in fiber.

• Exercise for at least 30 minutes every day.

• Weight reduction.

• Avoid eating trans and saturated fat.

• Eat fruits, vegetables, and whole grains.

Consult a diabetologist online, to know if you are at risk of developing diabetes, and ways to prevent it.

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