What is Diabetes?

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood glucose. Hyperglycaemia, also called raised blood glucose or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body’s systems, especially the nerves and blood vessels.

How common is diabetes?

Diabetes is common. Approximately 37.3 million people in the United States have diabetes, which is about 11% of the population. Type 2 diabetes is the most common form, representing 90% to 95% of all diabetes cases.

About 537 million adults across the world have diabetes. Experts predict this number will rise to 643 million by 2030 and 783 million by 2045.

Types of diabetes

Type 1 diabetes

Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is characterized by deficient insulin production and requires daily administration of insulin. In 2017 there were 9 million people with type 1 diabetes; the majority of them live in high-income countries. Neither its cause nor the means to prevent it are known.

Prediabetes

This type is the stage before Type 2 diabetes. Your blood glucose levels are higher than normal but not high enough to be officially diagnosed with Type 2 diabetes.

Type 2 diabetes

Type 2 diabetes affects how your body uses sugar (glucose) for energy. It stops the body from using insulin properly, which can lead to high levels of blood sugar if not treated.Over time, type 2 diabetes can cause serious damage to the body, especially nerves and blood vessels.

Type 2 diabetes is often preventable. Factors that contribute to developing type 2 diabetes include being overweight, not getting enough exercise, and genetics.Early diagnosis is important to prevent the worst effects of type 2 diabetes. The best way to detect diabetes early is to get regular check-ups and blood tests with a healthcare provider.

Symptoms of type 2 diabetes can be mild. They may take several years to be noticed.  Symptoms may be similar to those of type 1 diabetes but are often less marked. As a result, the disease may be diagnosed several years after onset, after complications have already arisen.

More than 95% of people with diabetes have type 2 diabetes. Type 2 diabetes was formerly called non-insulin dependent, or adult onset. Until recently, this type of diabetes was seen only in adults but it is now also occurring increasingly frequently in children.

Gestational diabetes

This type develops in some people during pregnancy. Gestational diabetes usually goes away after pregnancy. However, if you have gestational diabetes, you’re at a higher risk of developing Type 2 diabetes later in life.Gestational diabetes occurs when the body cannot produce enough insulin to meet the increased demands of pregnancy. While gestational diabetes usually resolves after childbirth, women who have had gestational diabetes are at increased risk of developing type 2 diabetes later in life. Managing gestational diabetes typically involves dietary changes, monitoring blood sugar levels, and, in some cases, insulin therapy.

In addition to these main types, there are other forms of diabetes, including:

  • Monogenic Diabetes: This rare form of diabetes is caused by mutations in a single gene and is usually diagnosed in infancy or early adulthood.
  • Secondary Diabetes: Diabetes can also develop as a result of other medical conditions or factors such as pancreatitis, certain medications (e.g., corticosteroids), hormonal disorders, and genetic syndromes.

Causes of diabetes

Too much glucose circulating in your bloodstream causes diabetes, regardless of the type. However, the reason why your blood glucose levels are high differs depending on the type of diabetes.

  1. Genetics: Family history plays a significant role in the development of type 1 and type 2 diabetes. If you have a parent or sibling with diabetes, you’re at higher risk.
  2. Lifestyle Factors: Poor diet, lack of physical activity, and obesity are major contributors to type 2 diabetes. Eating too much sugar and processed foods can lead to insulin resistance, where your body’s cells don’t respond effectively to insulin.
  3. Autoimmune Response: In type 1 diabetes, the body’s immune system mistakenly attacks and destroys insulin-producing cells in the pancreas. The exact cause of this autoimmune response is still unknown, but genetic and environmental factors likely play a role.
  4. Insulin Resistance: In type 2 diabetes, the body becomes resistant to the effects of insulin or doesn’t produce enough insulin to maintain normal blood sugar levels. Excess body weight, particularly around the abdomen, increases the risk of insulin resistance.
  5. Pancreatic Conditions: Diseases of the pancreas, such as pancreatitis, can impair insulin production and lead to diabetes.
  6. Age: The risk of type 2 diabetes increases with age, especially after age 45.
  7. Ethnicity: Certain ethnic groups, including African Americans, Hispanic/Latino Americans, Native Americans, Asian Americans, and Pacific Islanders, are at higher risk of developing type 2 diabetes.
  8. Gestational Diabetes: Some women develop high blood sugar levels during pregnancy, known as gestational diabetes. This condition increases the risk of developing type 2 diabetes later in life.
  9. Medications and Other Health Conditions: Certain medications, such as corticosteroids, can increase blood sugar levels and contribute to diabetes. Other health conditions, such as polycystic ovary syndrome (PCOS) and high blood pressure, are associated with an increased risk of diabetes.

Symptoms

Symptoms of diabetes may occur suddenly. In type 2 diabetes, the symptoms can be mild and may take many years to be noticed.

Symptoms of diabetes include:

  • feeling very thirsty
  • needing to urinate more often than usual
  • blurred vision
  • feeling tired
  • Slow Healing of Wounds
  • Unexplained Weight Loss
  • Tingling or Numbness in Hands or Feet
  • Frequent Infections

Over time, diabetes can damage blood vessels in the heart, eyes, kidneys and nerves.

People with diabetes have a higher risk of health problems including heart attack, stroke and kidney failure.

Diabetes can cause permanent vision loss by damaging blood vessels in the eyes.

Many people with diabetes develop problems with their feet from nerve damage and poor blood flow. This can cause foot ulcers and may lead to amputation.

Treatments

  1. Lifestyle Changes:
    • Healthy Diet: Eating a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats can help manage blood sugar levels. Monitoring carbohydrate intake and avoiding sugary and processed foods is crucial.
    • Regular Exercise: Engaging in regular physical activity, such as walking, swimming, or cycling, helps improve insulin sensitivity and can lower blood sugar levels. Aim for at least 150 minutes of moderate-intensity exercise per week, as recommended by health guidelines.
    • Weight Management: For individuals with overweight or obesity, losing weight can improve insulin sensitivity and glycemic control. Even modest weight loss can have significant benefits for people with type 2 diabetes.
    • Stress Management: Stress can affect blood sugar levels, so incorporating stress-reduction techniques such as mindfulness, meditation, yoga, or deep breathing exercises can be helpful.
  2. Medications
    • Insulin Therapy: People with type 1 diabetes always require insulin therapy to survive. Some people with type 2 diabetes may also need insulin therapy if other treatments are not sufficient to control blood sugar levels.
    • Oral Medications: There are several classes of oral medications available to treat type 2 diabetes, including metformin, sulfonylureas, meglitinides, thiazolidinediones, dipeptidyl peptidase-4 (DPP-4) inhibitors, sodium-glucose cotransporter-2 (SGLT2) inhibitors, and glucagon-like peptide-1 (GLP-1) receptor agonists. These medications work in various ways to lower blood sugar levels.
    • Other Injectable Medications: In addition to insulin, some injectable medications, such as GLP-1 receptor agonists and amylin analogs, may be prescribed to help control blood sugar levels in type 2 diabetes.
  1. Blood Sugar Monitoring: Regular monitoring of blood sugar levels is essential for managing diabetes effectively. This may involve self-monitoring using a blood glucose meter or continuous glucose monitoring (CGM) systems.
  2. Regular Medical Check-ups: Regular visits to healthcare providers are important for monitoring diabetes control, assessing complications, and adjusting treatment plans as needed.
  3. Education and Support: Diabetes self-management education (DSME) programs provide valuable information and support to help individuals learn how to manage their diabetes effectively. These programs cover topics such as blood sugar monitoring, medication management, meal planning, exercise, and coping strategies.
  4. Treatment of Complications: Diabetes can lead to various complications over time, including cardiovascular disease, kidney disease, nerve damage, and eye problems. Managing blood sugar levels and addressing risk factors for complications, such as high blood pressure and high cholesterol, are important parts of diabetes treatment.

"Living with diabetes requires vigilance, but with proper management, it doesn't define me; I define it."

Written by Satya