Diabetes mellitus is commonly known as “diabetes” is a group of metabolic disorders, defined by a high blood sugar level for a long period of time. Glucose(blood sugar) is the main source of energy for the body. The food we eat provides energy in the form of glucose and its breakdown is necessary for energy conversion. If glucose is not breakdown due to some reason it can increase in blood and causes diabetes.
The body is made up of millions of cells. To get energy, the cells need food in a very simple form. Whatever we eat or drink, it has to breakdown into a simple sugar called glucose. The glucose or sugar has to transport to cells where it required, it cannot go itself to the cells. The blood vessels or blood are the mode of transport for sugar. It is either taken in the stomach, manufactured in the liver, to the cells where it is used muscles and where it is stored as fat.
The cause of diabetes varies by type. No matter what type of diabetes you have, it can lead to an increase in sugar in your blood. A huge amount of sugar in your blood can lead to serious health problems.
Role of Glucose:
Glucose is a source of energy for the cells that make up muscles and other tissues.
- The two major sources of glucose are food and liver.
- Sugar is absorbed into the blood and enters in the cells with the help of insulin.
- The liver can make and store glucose in the form of glycogen.
- When glucose levels are low, the liver breaks down stored glycogen into glucose to keep glucose level within a normal range.
What is Insulin and How it works?
Insulin is a hormone made by the pancreas that allows your body to use glucose for energy. Insulin helps in maintaining the blood glucose level so that it cannot increase so high and not even decrease too low.
The pancreas secretes a low level of insulin into the blood, this amount increases as the blood glucose rises. Similarly, as the blood glucose falls the insulin secreted by the pancreas goes down.
Types of Diabetes Mellitus
There are two main types of diabetes or Chronic diabetes conditions include:
- Type I diabetes: This diabetes occurs due to the damage in insulin-producing cells in the pancreas. These cells are known as beta cells. In this pancreas produce very little or no insulin, that’s why glucose does not breakdown to produce energy and sugar cannot get into the cell. Very few people are diagnosed with this type of diabetes but it can occur at any age.
- Type II diabetes: In this type of diabetes the pancreas produces insulin, but it either produces very less or not enough, or it may not work properly. This type of diabetes occurs in many numbers of people mostly with the age of 40years but can occur even in childhood.
Other types are also present they are:
Prediabetes: In this, the blood sugar level is higher than normal but not that much high to be classified as diabetes.
Gestational diabetes: It occurs during pregnancy due to the developing baby has a greater need for glucose. Hormone changes during pregnancy affect the action of insulin, which can lead to high blood glucose levels. It resolves after giving birth.
Causes of Diabetes:
Type I diabetes: The exact cause of this diabetes is not known. In this diabetes immune system gets affected by the harmful bacteria or virus and that destroys the insulin-producing cells(beta cells) in the pancreas. In this, there is no or very little insulin production. It does not transport into the cells rather accumulate in the bloodstream.
Two main factors genetic susceptibility and environmental factors are considered in this type of diabetes, though exactly what the factors are still unclear.
Type II diabetes: In this type of diabetes, insulin is not able to work properly or cells become resistant to the action of insulin. The pancreas is unable to make enough insulin to overcome this resistance. Instead of insulin moving into cells it builds up in the bloodstream.
The factors responsible for this type of diabetes are an environment, genetic susceptibility, and overweight.
Gestational diabetes: During pregnancy, the placenta produces hormones to sustain your pregnancy. These hormones make your cells resistant to insulin. Pregnant women who have a greater risk of developing gestational diabetes are:
- over 35 years old
- Family history of diabetes
- History of polycystic ovarian syndrome
Diabetes symptoms vary depending on how much your blood sugar is increased. Some people, especially those with type 2 diabetes, may not experience symptoms at the onset of diabetes. In type 1 diabetes, symptoms tend to appear quickly and become more severe. Some of the signs and symptoms of diabetes are:
- Increased thirst and extreme hunger(especially after eating)
- Dry mouth
- Frequent urination, Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there’s not enough available insulin)
- Weight loss
- Blurred vision
- Slow-healing sores or cuts
- Dry and itchy skin
- Frequent infections
Type 1 diabetes can develop at any age, though it often appears during childhood or adolescence. Type 2 diabetes, the more common type, can develop at any age, though it’s more common in people older than 40.
Diagnosis and Tests:
Diabetes is diagnosed with fasting sugar blood tests, also known as glycated hemoglobin tests. A fasting blood sugar test is performed after you have had nothing to eat or drink for at least eight hours. You do not have to be fasting for an A1c blood test. Normal fasting blood sugar is less than 100 mg/dl. The diagnostic chart is given below:
- Fasting Glucose Test
- Normal: Less than 100
- Pre-diabetes: 100-125
- Diabetes: 126 or higher
- Random Glucose Test
- Normal: Less than 140
- Pre-diabetes: 140-199
- Diabetes: 200 or higher
- HbA1c Test
- Normal: Less than 5.7%
- Prediabetes: 5.7 – 6.4%
- Diabetes: 6.5% or higher
The doctor may use the following screening tests for gestational diabetes:
Initial glucose challenge test. You’ll begin the glucose challenge test by drinking a glucose solution. After one hour you’ll have a blood test to measure your blood sugar level. If your blood sugar level is below the range is usually considered normal on a glucose challenge test, although the range may vary at specific clinics or labs.
If your blood sugar level is higher than normal, it means you have a higher risk of gestational diabetes.
Glucose tolerance testing: For the follow-up glucose tolerance test, you’ll be asked to not eat anything overnight and then have your fasting blood sugar level measured. After measuring blood sugar you have to drink another sweet solution this one containing a higher concentration of glucose. After drinking it your blood sugar level will be checked every hour for a period of three hours.
There is no cure for diabetes, but it can be treated and controlled. Depending upon what types of diabetes you have various treatment procedures available from medication to surgery.
Treatment of type I and Type II diabetes:
- Monitoring your blood sugar level: Depending on your treatment plan, monitoring of blood sugar level is important and you may check or record your blood sugar as many as four times a day. People who are taking insulin have to monitor regularly and carefully. Careful monitoring is the only way to make sure that your blood sugar level remains within your normal range. People who aren’t taking insulin generally check their blood sugar much less frequently.
- Insulin: Type I diabetes people need insulin to survive. Many people with type 2 diabetes or gestational diabetes also need insulin treatment. There are many types of insulin are available including rapid-acting insulin, long-acting insulin, and intermediate options. Depending on your severeness of disease, your doctor may prescribe a type of insulin for use throughout the day and night.
Insulin cannot be taken orally because stomach enzymes interfere with its action. Insulin is injected using a fine needle and syringe. An insulin pump also may be an option. It helps in maintaining the blood sugar level.
- Medications: Sometimes other oral medications are prescribed as well. Some medications stimulate your pancreas to produce and release more insulin. Other medications inhibit the production and release of glucose from the liver, which means less insulin is required to transport sugar into your cells.
- Bariatric surgery: It is not specifically considered a treatment for type 2 diabetes if people with type 2 diabetes are obese and have a body mass index higher than 35 may benefit from this surgery.
- Keep your blood glucose levels as near to normal by balancing food intake and doing physical activity.
- Maintain your blood cholesterol and lipid levels as near the normal ranges as possible.
- Control your blood pressure. Your blood pressure should be in the normal range that is 140/90.
You can also manage your diabetes by:
- Planning what you eat and taking a balanced diet plan.
- Exercise regularly
- Taking medication properly
- Monitoring your blood glucose and blood pressure levels at home.
Diabetes risk factors like family history cannot be changed, but there are some other risk factors that you can control over. Implementing some of the healthy lifestyle habits can improve risk factors and help to decrease your chances of diabetes.
- Eating a healthy or a high fiber diet
- Being physically active
- Lowering your stress
- Limiting alcohol intake
- Getting enough sleep
- Quit smoking
- Drink much water
- Lose weight if you are overweight
- Optimize vitamin D levels
- Drink coffee or tea
- Taking natural herbs like curcumin or berberine
- Family history
- Environmental factors
- Damaged immune system cells
- Geographic location
- High blood pressure
- Polycystic ovary syndrome
The longer you have diabetes, the higher the risk of complications. Some complications include:
- Cardiovascular disease
- Neuropathy(nerve damage)
- Kidney Damage
- Eye Damage
- Hearing impairment
- Alzheimer’s disease
- Skin problems
Diabetes is a serious and common disease which is increasing day by day, especially in developing countries. It is a costly disease too. However, there are many ways of preventing or controlling it. Awareness of the risk factors and symptoms of diabetes is important for its prevention and control.