Diabetes – Some Facts, It’s Types and Diagnosis

What is Diabetes?

Diabetes mellitus is a group of metabolic diseases characterized by high blood sugar (glucose) levels as a result of defects in insulin secretion, or its action, or both. Diabetes mellitus, commonly referred to as diabetes was at first identified as a disease associated with “sweet urine,” and excessive muscle loss. Since there is an elevated level of blood glucose (hyperglycemia),  it leads to the spillage of glucose into the urine, hence the term sweet urine.

Normally, insulin, a hormone produced by the pancreas, controls the blood glucose levels. 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 by absorbing glucose into body cells. In patients with diabetes, the absence of insufficient production of or lack of response to insulin causes hyperglycemia. Diabetes is a chronic medical condition, which means that although it can be controlled, it lasts a lifetime.

 

Some facts about diabetes

  • Diabetes is a long-term condition that causes high blood sugar levels.
  • In 2013 it was estimated that over 382 million people throughout the world had diabetes (Source: Williams textbook of endocrinology).
  • Type 1 Diabetes – the body does not produce insulin. Approximately 10% of all diabetes cases are type 1.
  • Type 2 Diabetes – the body does not produce enough insulin for proper function. Approximately 90% of all cases of diabetes worldwide are of this type.
  • Gestational Diabetes – this type affects females during pregnancy.
  • The most common diabetes symptoms include frequent urination, intense thirst and hunger, weight gain, unusual weight loss, fatigue, cuts and bruises that do not heal, male sexual dysfunction, numbness and tingling in hands and feet.
  • If you have Type 1 and follow a healthy eating plan, do adequate exercise, and take insulin, you can lead a normal life.
  • Type 2 patients need to eat healthily, be physically active and test their blood glucose. They may also need to take oral medication, and/or insulin to control blood glucose levels.
  • As the risk of cardiovascular disease is much higher for a diabetic, it is crucial that blood pressure and cholesterol levels are monitored regularly.
  • As smoking might have a serious effect on cardiovascular health, diabetics should stop smoking.
  • Hypoglycemia – low blood glucose – can have a bad effect on the patient. Hyperglycemia – when blood glucose is too high – can also have a bad effect on the patient.

 

What is Type 1 Diabetes?

 

The more severe form of diabetes is type 1, or insulin-dependent diabetes. It’s sometimes called as “juvenile” diabetes, because type 1 diabetes usually develops in children and teenagers, though it can develop at any age.  

Immune System Attacks

With type 1 diabetes, the body’s immune system attacks part of its own pancreas. But the immune system mistakenly sees the insulin-producing cells in the pancreas as foreign, and destroys them. This attack is known as “autoimmune” disease.

These cells – called “islets” (pronounced as EYE-lets) – are the ones that sense glucose in the blood and, in response, produce the necessary amount of insulin to normalize blood sugars. Insulin serves as a “key” to open your cells, to allow the glucose to enter — and allow you to use the glucose for energy. Without insulin, there is no “key.”   So, the sugar stays — and builds up– in the blood. The result: the body’s cells starve from the lack of glucose. And, if left untreated, the high level of “blood sugar” can damage eyes, kidneys, nerves, and the heart, and can also lead to coma and death.

 

Insulin Therapy

So, a person with type 1 treats the disease by taking insulin injections. This outside source of insulin now serves as the “key” — bringing glucose to the body’s cells.

The challenge with this treatment is that it’s often not possible to know precisely how much insulin to take. The amount is based on many factors, including:

  • Food
  • Exercise
  • Stress
  • Emotions and general health

These factors fluctuate greatly throughout every day. So, deciding on what dose of insulin to take is difficult to judge.  

If you take too much, then your body burns too much glucose — and your blood sugar can drop to a dangerously low level. This is a condition called hypoglycemia, which, if untreated, can be potentially life-threatening.  

If you take too little insulin, your body can again be starved of the energy it needs, and your blood sugar can rise to a dangerously high level — a condition called hyperglycemia. This also increases the chance of long-term complications.

 

Type 2 Diabetes

The most common form of diabetes is called type 2, or non-insulin dependent diabetes. This is also called “adult onset” diabetes since it typically develops after age 35. However, a growing number of younger people are now developing type 2 diabetes.  People with type 2 are able to produce some of their own insulin. Often, it’s not enough. And sometimes, the insulin will try to serve as the “key” to open the body’s cells, to allow the glucose to enter. But the key won’t work. The cells won’t open. This is called insulin resistance.  

Treatment

Often, type 2 is tied to people who are overweight, with a sedentary lifestyle. Treatment focuses on diet and exercise. If blood sugar levels are still high, oral medications are used to help the body use its own insulin more efficiently. In some cases, insulin injections are necessary.

Oral glucose tolerance test are recommended to people who show signs of diabetes. Glucose tolerance tests may lead to one of the following diagnoses:

  • Normal response: A person is said to have a normal response when the 2-hour glucose level is less than 140 mg/dl, and all values between 0 and 2 hours are less than 200 mg/dl.
  • Impaired glucose tolerance (prediabetes): A person is said to have impaired glucose tolerance when the fasting plasma glucose is less than 126 mg/dl and the 2-hour glucose level is between 140 and 199 mg/dl.
  • Diabetes: A person has diabetes when two diagnostic tests done on different days show that the blood glucose level is high.
  • Gestational diabetes: A pregnant woman has gestational diabetes when she has any two of the following:, a fasting plasma glucose of 92 mg/dl or more, a 1-hour glucose level of 180 mg/dl or more, or a 2-hour glucose level of 153 mg/dl, or more.

Diabetes is not always curable, however, medication and the right treatment and approach can keep it in check.

In case you want to have a preventive health check up on diabetes, feel free to send us a query or walk in for a consultation. Our consultants will always suggest you the best treatment depending on your diagnosis.



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