Understanding Diabetes – What is Diabetes?

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The term diabetes refers to a group of metabolic diseases and is quite prevalent all over the world [2]. Medically, known as Diabetes Mellitus, the disorder is also spreading quite rapidly. Diabetes is caused due to an increased level of blood sugar or glucose in the blood stream, which in turn can be caused by a number of different factors, most primarily, the role of the hormone insulin in the body.

Diabetes

 

There are three major types of diabetes [5] which include:

  • Type I Diabetes, in which the body is unable to produce the required amount of the hormone insulin. It is a rare form of diabetes and is prevalent in less than 10% of people with diabetes, mainly with children.
  • Type II Diabetes, which is the most common type of diabetes, in which the body cells show resistance to the insulin hormone. Type II diabetes is also known as Non-Insulin Dependent Diabetes Mellitus (NIDDM). It is the most prevalent form of diabetes accounting for almost 90% of the total number of people with diabetes.
  • Gestational Diabetes is another type of diabetes which is exclusively found in pregnant women. This is a much rarer form of diabetes.

 

Diabetes types

There is also another condition known as Prediabetes which is often diagnosed in individuals. In this condition, the glucose levels in the blood prove to be higher than normal, but the levels are not high enough for the condition to be classified under Type II Diabetes.

While Type I and Type II Diabetes prove to be chronic and long lasting conditions, both gestational diabetes and prediabetes are reversible conditions which can be treated completely by following adequate remedies and methods of treatment.

Diabetics by country

Type I Diabetes



Type I Diabetes occurs when body’s own immune system destroys the insulin-producing beta cells of the pancreas. This results in complete deficiency of insulin. It is suspected that heredity and genes have a major role to play in an individual encountering Type I Diabetes as it is passed on from one generation to another. It may also be triggered by environmental factors like diet, viruses, and some specific toxins.

Type II Diabetes



In Type II diabetes, either the body produces insufficient amounts of the hormone insulin, or the body develops a resistance to the action of insulin. This results in the body cells being unable to effectively use up glucose, consequently leading to an increased concentration of sugar in the blood stream. While this is the most common type of diabetes in individuals, the actual causes of Type II Diabetes are yet to be known. The disorder is most commonly found in elderly and obese people. Various factors that may trigger Type II Diabetes include dietary habits, lifestyle and genetic susceptibility.

Diabetes day Nov 14

Gestational Diabetes



Gestational diabetes may be defined as hyperglycemia with its first presentation or onset during pregnancy. Approximately 2-6% women suffer from Gestational Diabetes. The human placental lactogenic hormone also known as Human Chorionic Somatomammotropin, which is released during the gestational period, reduces the insulin sensitivity in mothers and it may lead to an increased level of blood glucose. While the body systems of most women counter this by increasing the production of insulin, some women are susceptible to the disorder. If left uncontrolled, this condition may soon lead to Gestational Diabetes. This type of diabetes causes complications for both the mother and the developing fetus.

Understanding what causes Diabetes

Signs and Symptoms of Diabetes



There are a number of symptoms which may help you to diagnose the presence of this metabolic disease.

  • Frequent urination: Also known as polyuria, this proves to be one of the most common symptoms of diabetes, wherein the sufferer feels an urge to urinate several times in a day and over 2.5 liters of urine is excreted per day. The phenomenon is more noticeable during the night.
  • Increased thirst: Sufferers feel an increased urge of thirst in order to compensate for excessive fluid loss due to urination.
  • Increased hunger: Also known as polyphagia, this condition is also noticed in diabetic patients. If cases of increased hunger coexist along with above two symptoms in a sufferer, diabetes is said to be diagnosed.
  • Fatigue: Increased tiredness and fatigue are other important symptoms in a diabetic patient. This is caused due to an impaired production and utilization of calories by the body. This may also result in the wasting of muscles.
  • Slow healing: Slow healing of wounds is also an important feature that is seen quite commonly in diabetic patients. This condition affects almost all diabetic individuals and is considered to be one of the easiest ways of diagnosing if diabetes has affected an individual.
  • Abnormal sensation: There may be occurrences of numbness or tingling sensation felt in the limbs in diabetic. In some cases, a person may feel a loss of sensation in the hands or the feet.
  • Increased risk to infections: A diabetic person is more prone to an infectious disease as compared to a normal person.
  • Miscellaneous: There are some other symptoms of diabetes which may include a blurring of the vision, unexplained loss of weight, lack of interest and concentration while working or studying.

Diabetes signs

If these symptoms are not taken care of, and treatment of diabetes is neglected, it may result in a number of complications such as:

  • Diabetic neuropathy: The excess sugar levels present in the blood stream can prove to cause damage to the blood vessels and capillaries. This can eventually lead to damage of the nerves and loss of sensation in particular regions of the body such as the fingers and the toes.
  • Diabetic nephropathy and diabetic ketoacidosis: Damage can be caused to the kidneys due to the excess glucose present in the blood in diabetics. There is also a high presence of ketones in the urine which is caused by deamination of some amino acids and also the improper breakdown of fatty acids.
  • Diabetic retinopathy: Diabetes can also cause damage to the blood vessels surrounding the retina of the eye. While this may result in some eye conditions such as glaucoma and cataract, over longer periods, it can also lead to permanent blindness.
  • Cardiovascular or macro vascular diseases like stroke or peripheral vascular disease: The risk of encountering cardiovascular diseases is greatly increased in diabetics. These include potentially serious conditions and diseases such as a heart attack, a stroke, pain in the chest and also a constriction of the arteries in the body.
  • Muscle wasting and weakness: Due to the cells being unable to effectively absorb glucose, diabetic individuals cannot efficiently or effectively use their body muscles. While this causes general fatigue and tiredness, over longer periods it may lead to a gradual wasting of the muscle tissues.
  • Diabetic coma: While it is known that diabetic patients suffer from increased risk to nerve damage, in some extreme cases, this nerve damage can also lead to a condition of a coma.
  • Others: There are many other complications which can be associated with diabetes and these include damage caused to the limbs, infectious skin diseases and conditions, an impairment of hearing and also the development of Alzheimer’s disease is some individuals.

Diagnosis for Diabetes



Some tests are used for the diagnosis of diabetes [5]:

  • Fasting Plasma Glucose Test: This test measures blood glucose levels after going for at least 8 hours of fasting. This test is used to detect diabetes or prediabetes.
  • Oral Glucose Tolerance Test: This test is used to measure the blood sugar level. The test should be taken after at least eight hours of fasting and two hours after drinking a glucose containing liquid. This test is also be used to diagnose diabetes as well as prediabetes.
  • Random Plasma Glucose Test: In this test, the doctor checks the blood sugar level without observing to the last meal. This test helps in assessment of symptoms and for diagnosing diabetes, but it does not diagnose prediabetes.
Diabetes OGT test Diabetes HbA1c test

Treatment of Diabetes



Treatment of diabetes include use of medications [3] or correcting the underlying causes such as diet and exercise [4].

  • Diet: A diabetic should always take a balanced nutrition to maintain the short-term as well as long-term blood glucose levels under control. Following a diabetic diet is a necessary aspect for diabetics.
  • Physical activity: It is another important and effective method of treating as well as preventing diabetes especially in Type II Diabetes mellitus caused due to obesity or overweight.
  • Medications: Type I Diabetes can be treated with the insulin therapy where combinations of NPH and regular insulin or synthetic insulin analogues are administered to the patients with diabetes. Type II Diabetes can be treated effectively with the use of oral hypoglycemic medication like metformin. There are other medications as well which include angiotensin converting enzyme inhibitors (ACEIs) or the angiotensin receptor blockers (ARBs).

Whatever the method of treatment for diabetes may be, care must be taken to periodically monitor the sugar levels in the blood stream of diabetics. While the treatment methods may prove to be effective on their own, diabetes should always ensure to monitor their glucose levels. This is the most effective way to ensure that targets are being met and that the medications or treatment remedies are proving to be effective.

Diabetes reduce risks

There are also a number of home remedies and lifestyle tips that can be used to provide relief to the symptoms of diabetes. These include:

  • Making an active commitment to combat the disease. This is the first and foremost step and sufferers must ensure that they collect as much information about the condition as possible.
  • Following a healthy diet and maintaining a healthy weight.
  • Getting adequate physical activity every day.
  • Identifying the specific type of diabetes as Type I and Type II need to be differentiated.
  • Taking vaccinations on time to combat the increased risk of infections. Flu shots are recommended to be taken every year.
  • Keeping a check on the blood pressure and on bad cholesterol levels. While regular exercise and diet can help in keeping these in check, measurements need to be taken regularly in order to avoid complications.
  • Taking care of the gums and the teeth. Diabetes can have dire consequences on the gums and the teeth and regular brushing and flossing of the teeth should always be done.
  • Avoiding the exertion of unnecessary pressure on the feet. The toes and the feet can very easily get damaged in diabetics. Any problems in the feet should be referred to medical practitioners immediately.
  • Drinking alcohol responsibly and within recommended daily limits. The recommended limits are one drink of alcohol a day for women and two drinks a day for men. Carbohydrates on the consumptions of excess alcohol can upset the balance that is required in the dietary plan.
  • Smokers should cease smoking immediately. Smokers who also have diabetes have an extremely high risk of developing cardiovascular diseases and the smoking and other forms of tobacco should be stopped at the earliest. If addiction is a problem, consult medical practitioners for alternatives to smoking.
  • Stress and strain on the body should be considered very seriously as they may adversely affect a diabetic. Prolonged stress can prove to be very harmful to the tiny blood vessels and can lead to serious complications such as a stroke. Plenty of sleep is recommended for diabetics.
  • Regular visits to the doctor and frequent eye checkups are required to be a part of a diabetic’s life.

Diabetes Treatment

While diabetes cannot be cured completely, following proper medication which is coupled with a healthy lifestyle with lots of physical activity can provide relief to sufferers. Following an effective treatment plan with a well-maintained lifestyle can help keep symptoms in check and can help diabetics lead a closer to normal life. However, diabetics must make sure to understand the fact that complications related to the disorder can spring up at any time and they need to always maintain a high level of care in order to keep symptoms in check. Diabetic sufferers do not have an easy time, but integrating a new lifestyle and adopting healthy measures as daily habits can greatly help in managing the symptoms of this disorder.

 

References




[1] Diagnosis of Diabetes, Silvio E. Inzucchi, M.D., N Engl J Med 2012; 367:542-550 – August 9, 2012 – DOI: 10.1056/NEJMcp1103643: www.nejm.org/doi/full/10.1056/NEJMcp1103643


[2] Diabetes and oral health, Joanathan A. Ship; Volume 134, Supplement 1, Pages 4S-10S – October, 2003 – DOI: 10.14219/jada.archive.2003.0367, http://jada.ada.org/article/S0002-8177(14)65193-X/abstract?cc=y


[3] The Patient-Provider Relationship: Attachment Theory and Adherence to Treatment in Diabetes, Paul S. Cjechanowski, M.D., M.P.H.; Wayne J. Katon, M.D.; Joan E. Russo, Ph.D.; Edward A. Walker, M.D., Volume 158 Issue 1, 29-35 – January 2001, – DOI: 10.1176/appi.ajp.158.1.29, http://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.158.1.29


[4] Using Bitter Melon to Treat Diabetes, Kathy Abascal, Eric Yarnell; 11(4): 179-184 – August 11, 2005 – doi:10.1089/act.2005.11.179, http://online.liebertpub.com/doi/abs/10.1089/act.2005.11.179


[5] Diabetes Knowledge, Health Belief, and Diabetes Management Among the Igala, Nigeria, Samuel OjimaAdejoh; 26 June 2014 – DOI: 1177/2158244014539966, http://sgo.sagepub.com/content/4/2/2158244014539966.abstract

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