Diabetes is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime. Diabetes Mellitus is a group of metabolic diseases characterized by high blood sugar (glucose) levels that result from defects in insulin secretion, or action, or both.
Diabetes Mellitus, commonly referred to as diabetes was first identified as a disease associated with “sweet urine” and excessive muscle loss in the ancient world. Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the urine, hence the term sweet urine. Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level. In patients with diabetes, the absence or insufficient production of insulin causes hyperglycemia.
Causes of Diabetes
Type 1 diabetes: Type 1 diabetes is believed to be an Autoimmune Disease. The body’s immune system specifically attacks the cells in the pancreas that produce insulin.
- A predisposition to develop Type 1 Diabetes may run in families, but genetic causes are much more common for Type 2 Diabetes.
- Environmental Factors, including common unavoidable viral infections, may also contribute to Type 1 Diabetes.
Type 2 diabetes: Type 2 Diabetes tends to run in families. Several genes have been identified, and more are under study which may relate to the causes of Type 2 Diabetes. Risk factors for developing Type 2 Diabetes include the following:-
- High blood pressure
- High blood triglyceride (fat) levels
- Gestational diabetes or giving birth to a baby weighing more than 9 pounds
- High-fat diet
- High alcohol intake
- Sedentary lifestyle
- Obesity or being overweight
- Aging: Increasing age is a significant risk factor for Type 2 Diabetes. Risk begins to rise significantly at about age 45 years, and rises considerably after age 65 years.
Symptoms of Diabetes
- Fatigue. The body is inefficient and sometimes unable to use glucose for fuel. The body switches over to metabolizing fat, partially or completely, as a fuel source. This process requires the body to use more energy. The end result is feeling fatigued or constantly tired.
- Unexplained weight loss: People with diabetes are unable to process many of the calories in the foods they eat. Thus, they may lose weight even though they eat an apparently appropriate or even an excessive amount of food.
- Excessive thirst (polydipsia): A person with diabetes develops high blood sugar levels, which overwhelms the kidney’s ability to reabsorb the sugar as the blood is filtered to make urine. Excessive urine is made as the kidney spills the excess sugar. The body tries to counteract this by sending a signal to the brain to dilute the blood, which translates into thirst.
- Excessive urination (polyuria): Another way the body tries to rid the body of the extra sugar in the blood is to excrete it in the urine. This can also lead to dehydration because a large amount of water is necessary to excrete the sugar.
- Excessive eating (polyphagia): If the body is able, it will secrete more insulin in order to try to manage the excessive blood sugar levels. Moreover, the body is resistant to the action of insulin in type 2 diabetes. One of the functions of insulin is to stimulate hunger.
- Poor wound healing: High blood sugar levels prevent white blood cells, which are important in defending the body against bacteria and also in cleaning up dead tissue and cells, from functioning normally. When these cells do not function properly, wounds take much longer to heal and become infected more frequently. Long-standing diabetes also is associated with thickening of blood vessels, which prevents good circulation, including the delivery of enough oxygen and other nutrients to body tissues.
- Infections: Certain infections, such as frequent yeast infections of the genitals, skin infections, and frequent urinary tract infections, may result from suppression of the immune system by diabetes and by the presence of glucose in the tissues, which allow bacteria to grow.
- Altered mental status: Agitation, unexplained irritability, inattention, extreme lethargy, or confusion can all be signs of very high blood sugar, ketoacidosis, hyperosmolar hyperglycemia nonketotic syndrome, or hypoglycemia (low sugar).
- Blurry vision: Blurry vision is not specific for diabetes but is frequently present with high blood sugar levels.
Diagnosis of Diabetes
- Fasting plasma glucose: The patient will be asked to eat or drink nothing for 8 hours before having blood drawn (usually first thing in the morning). If the blood glucose level is greater than or equal to 126 mg/dL (without eating anything), they probably have diabetes.
- Finger stick blood glucose: This is a rapid screening test that may be performed anywhere.
- Oral glucose tolerance test: This test involves drawing blood for a fasting plasma glucose test, then drawing blood for a second test at two hours after drinking a very sweet drink containing up to 75 grams of sugar.
- Glycosylated hemoglobin or hemoglobin A1c: This test is a measurement of how high the blood sugar levels have been over approximately the last 120 days.
Prevention of Diabetes
Diabetes can be prevented in some cases.
- Control weight to normal or near-normal levels by eating a healthy low-fat, high-fiber diet.
- Regular exercise is crucial to the prevention of type 2 diabetes.
- Keep alcohol consumption low.
- Quit smoking.
- If a person has high blood fat levels (such as high cholesterol) or high blood pressure, take all medications as directed.
- Lifestyle modifications and/or certain medications can be used in people with prediabetes to prevent progression to diabetes. Prediabetes can be diagnosed by checking fasting glucose and 2 hours after ingesting up to 75 grams of glucose
Treatment of Diabetes
If a person has diabetes, healthful lifestyle choices in diet, exercise, and other health habits will help to improve glycemic (blood sugar) control and prevent or minimize complications of diabetes. Before insulin was discovered in 1921 Diabetes Type 1 was a fatal disease – most patients would die within a few years of onset. Things have changed a great deal since then. You can lead a normal life , If you have Type 1 and follow a healthy eating plan, do adequate exercise, and take insulin, you can lead a normal life
- Diabetes Diet: A healthy diet is key to controlling blood sugar levels and preventing diabetes complications.
- Exercise: Regular exercise, in any form, can help reduce the risk of developing diabetes. Activity can also reduce the risk of developing complications of diabetes such as heart disease, stroke, kidney failure, blindness, and leg ulcers.
- Alcohol use. Moderate or eliminate consumption of alcohol. Try to have no more than seven alcoholic drinks in a week and never more than one or two drinks in an evening.
- Smoking. If the patient has diabetes, and smokes cigarettes or use any other form of tobacco, they are raising the risks markedly for nearly all of the complications of diabetes.
- Self-monitored blood glucose. Check blood sugar levels frequently, at least before meals and at bedtime, then record the results in a logbook.
- Diabetes Management The main aim of diabetes management is to keep the following under control:-
- Blood glucose levels
- Blood pressure
- Cholesterol levels
- Lack Of Guidance For Patients Newly Diagnosed With Diabetes (medicalnewstoday.com)