Diabetes

Did you know that diabetes affects millions of people worldwide? This chronic condition influences how the body processes glucose, the primary energy source for our tissues and cells. Diabetes can have a big impact on daily life, requiring careful management of blood sugar levels and lifestyle choices. Understanding the types of diabetes, their causes, normal diabetes levels and available treatments is crucial for those living with the condition and their loved ones. In this article, we'll explore the various types of diabetes, as well as its symptoms, diagnosis, and treatment. 

What is Diabetes?

It is a chronic condition that occurs when blood sugar levels become too high. It develops when the pancreas fails to produce enough insulin, or any at all, or when the body doesn't respond properly to insulin's effects. Insulin, a hormone synthesised by the pancreas, acts as a key to help glucose enter cells for energy use.

Types of Diabetes

Diabetes manifests in several forms, each with distinct characteristics. The three main diabetes types are type 1, type 2, and gestational diabetes.

• Type 1 diabetes, an autoimmune condition, occurs when the immune system attacks & destroys insulin-producing cells in the pancreas. It often develops quickly and can cause symptoms like weight loss. 
• Type 2 diabetes is the most common form. It develops when the body can't use insulin effectively resistant or produce enough of it. 
• Gestational diabetes develops during pregnancy & gets resolved after childbirth, though it increases the risk of type 2 diabetes later in life.
• Another common type include Maturity-onset Diabetes of the Young (MODY), a rare genetic form, and Latent Autoimmune Diabetes in Adults (LADA), which shares features of both type 1 & type 2 diabetes. Other rare forms include neonatal diabetes, diagnosed in infants under six months, and type 3c diabetes, caused by pancreatic damage from conditions like pancreatitis or cystic fibrosis.

Symptoms of Diabetes

Diabetes disease symptoms may vary in accordance with the blood sugar levels & the type of diabetes. 

• Common signs & symptoms include increased thirst, frequent urination, and fatigue. 
• People may also experience blurred vision, unexplained weight loss, and slow-healing sores. 
• Numbness or tingling in hands or feet and frequent skin or vaginal yeast fungal infections can occur.
• Gestational diabetes typically shows no noticeable symptoms. Doctors test for this condition between 24 and 28 weeks of pregnancy.
• Children with type 1 diabetes may exhibit extreme hunger or thirst, increased urination (including bed-wetting), and tiredness. 
• Behavioural changes and vaginal yeast fungal infections, irritability, pain in abd and growth retardation in prepubescent girls can also occur. 
• In type 2 diabetes, acanthosis can be seen in children similar symptoms, with skin darkening around the neck, groin, and armpits being a distinctive sign.

Diagnosis of Diabetes

Doctors use various blood tests to diagnose diabetes, prediabetes, and gestational diabetes. These tests measure blood glucose levels to determine if they are higher than the healthy range. The most common tests include:

• Fasting Plasma Glucose (FPG) Test: This test measures the glucose level in a person's blood after fasting for at least 8 hours.
• A1C Test: It provides average blood glucose levels over the past three months.
• Random Plasma Glucose Test: Used when immediate diagnosis is needed, regardless of when the patient last ate
• Oral Glucose Tolerance Test (OGTT): Helps detect type 2 diabetes, prediabetes, and gestational diabetes.

Treatment for Diabetes

Doctors manage diabetes through a combination of lifestyle changes and medication. 

• Healthy eating plays a crucial role. There's no specific diabetes diet, but focusing on regular meal schedules, smaller portions, and high-fibre foods is essential. Patients should eat fewer refined grains and sweets and choose healthy cooking oils like olive or canola oil.
• Physical activity is equally important. Adults should aim for half an hour of moderate aerobic exercise most days or at least 150 minutes weekly. Resistance exercise, like weightlifting or yoga, should be done 2-3 times a week. Breaking up long periods of inactivity also helps control blood sugar levels.
• If lifestyle changes aren't enough, doctors may prescribe diabetes medications or insulin therapy. 

Risk Factors for Diabetes

Several factors influence a person's likelihood of developing diabetes, such as:

• The age of a person plays a major role, with the risk of type 2 diabetes increasing after 30. 
• Family history also contributes, as having a parent or sibling with diabetes raises one's chances.
• Obesity increases the likelihood of developing the condition.
• Physical inactivity contributes to diabetes risk. 
• High blood pressure & smoking also raise the risk of diabetes and its complications.
• Other risk factors include prediabetes, non-alcoholic fatty liver disease, or polycystic ovary syndrome. 
• Sedentary lifestyle

Complications of Diabetes

Diabetes can lead to serious health and medical issues if blood sugar levels remain high for extended periods, such as:

• Eye problems, known as diabetic retinopathy, can develop and affect eyesight. 
• Foot problems are another serious complication that can lead to amputation if left untreated. 
• Nerve damage can decrease sensation in the feet, while poor circulation slows the healing of sores, how people see, hear, feel, and move
• High blood sugar levels in the blood can damage blood vessels, increasing the susceptibility towards heart attacks & strokes. 
• Kidney problems, or diabetic nephropathy, can occur due to long-term damage from high blood sugar and blood pressure. 
• Nerve damage, or neuropathy, 
• Gum disease and other mouth problems may develop due to increased sugar in saliva. 
• People with diabetes also face a higher risk of certain cancers and sexual problems in both men and women.
• Immunity and risk of Infection
• Life threatening complications like DKA, Hyperosmolar

When to See a Doctor

It Is vital to seek medical attention for any unusual symptoms or concerns. Early treatment of diabetes-related issues proves more effective. Developing a sick day plan with your healthcare team helps manage illness-related blood glucose fluctuations.

Remember, your doctor wants to stay informed about your health. If you're unsure whether to make an appointment, it's best to reach out. A simple discussion can address potential problems and improve blood sugar control. Don't hesitate to contact your endocrinologist if you have any questions or concerns about your disease management.

Home Remedies for Diabetes

People with diabetes often explore alternative therapies and natural remedies to complement their treatment. These approaches range from supplements to relaxation techniques. 

• Biofeedback makes patients become more aware of their body's response to pain, emphasising relaxation and stress reduction.
• Guided imagery, another relaxation technique, encourages people to visualise peaceful mental images or imagine controlling their condition. Some find this method helpful in managing their diabetes. 
• Chromium, necessary for glucose tolerance factor production, has shown some promise in improving diabetes control. 
• Vanadium, a compound found in small amounts in plants and animals, has shown potential in normalising blood sugar levels.
• Sugar intake and Fiber in Diet 

Prevention

Preventing type 2 diabetes, the most common form of the disease, is crucial, especially for those at increased risk due to excess weight, high cholesterol, or family history. 

• Lifestyle alterations play a pivotal role in diabetes prevention and can delay or stall the onset of diabetes in those with prediabetes.
• Losing weight reduces the risk of diabetes. Studies show that people who lost about 7% of their body weight through exercise and diet changes reduced their risk by nearly 60%. 
• Regular exercise helps with weight loss, lowers blood sugar, and boosts insulin sensitivity, keeping blood sugar levels within a normal range. 
• A diet rich in fibre promotes weight loss and lowers diabetes risk. Incorporating unsaturated fats, both monounsaturated and polyunsaturated, supports healthy blood cholesterol levels & good heart health.
• Routine screening is recommended for adults over 45 & those with risk factors such as obesity, family history, or a history of gestational diabetes. 

Conclusion

Diabetes is a complex condition that has a significant impact on millions of lives worldwide. Staying informed and working closely with doctors are key to controlling diabetes and preventing complications. Regular checkups, adopting healthy lifestyle habits, and following prescribed treatments can help people with diabetes lead fulfilling lives. As research continues to advance, new treatments and management strategies offer hope for improved outcomes and quality of life for those affected by this chronic condition.

FAQ's

1. Can diabetes be cured?

Currently, there is no permanent treatment for diabetes. However, people can achieve remission through proper medication and lifestyle changes. 

2. How does diabetes affect life?

Diabetes has a significant impact on various aspects of life. Many people report negative effects on their physical, emotional, social, and financial health. It can influence future planning, self-confidence, and success at work or school. 

3. How does diabetes damage the body?

Diabetes can affect whole body from head to toe, leading to various complications. It affects the heart, brain, eyes, kidneys, nerves, and feet. High blood sugar levels reduce blood vessel elasticity, impeding blood flow & increasing the risk of high blood pressure. This damage can result in heart attacks, strokes, vision problems, kidney disease, and nerve issues.

4. Is 200 blood sugar very high?

A blood sugar level of 200 mg/dL or higher is considered high and suggests diabetes, especially when accompanied by symptoms like frequent urination and extreme thirst. Levels between 180 mg/dL and 250 mg/dL are considered hyperglycaemia. Readings above 250 mg/dL are dangerous and require immediate medical attention.

5. How often should one go for a blood sugar checkup?

The frequency of blood sugar checks depends on the type of diabetes and individual treatment plans. People using insulin may need to test several times daily, often before meals and bedtime. Those managing type 2 diabetes with non-insulin medications or lifestyle changes might not need daily testing. 

Dr. Vaibhav Agrawal

MBBS, MD
Ganga CARE Hospital Limited, Nagpur

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