Diabetes or diabetes mellitus is a group of metabolic disorders characterized by high levels of sugar in the blood for a considerable period of time. It’s a common health condition all over the world. Over 30 million people have been diagnosed with diabetes in India alone.
Diabetes or diabetes mellitus is a group of metabolic disorders characterized by high levels of sugar in the blood for a considerable period of time. It’s a common health condition all over the world. Over 30 million people have been diagnosed with diabetes in India alone. It is believed that a combination of factors such as sedentary lifestyle, lack of balanced diet, tobacco, fast urbanization, and increasing life expectancy are significant reasons behind increasing prevalence of diabetes in India.
In a healthy condition, pancreas in the human body produces the hormone called insulin that helps to maintain the level of glucose in the bloodstream. The cells in our body need food for energy but in a very simple form such as glucose. During digestion, the complex food nutrients are broken down into simpler sugars. These are then carried via blood to different cells in the body. The insulin produced by the pancreas helps to let this sugar into the cells for use as energy. When this sugar leaves the bloodstream and enters the cells the blood sugar level lowers down Diabetes occurs either of the two ways: the pancreas does not produce enough insulin in the body or when the body is not able to effectively use the insulin produced. Based on this there are two types of diabetes seen namely Type1 and Type2 Diabetes mellitus.
Type 1 Diabetes
In this the beta cells in the pancreas that secrete insulin are damaged due to which little or no insulin is produced. It is the most common form of diabetes in people under 30yrs age. Only 10 percent of people with diabetes are diagnosed with type1 diabetes.
Type 2 Diabetes
Also called adult-onset diabetes, it occurs more commonly in people above 40yrs age. Nine out of 10 diabetics have type2 diabetes. In this, the pancreas makes insulin, which is either not enough or does not work correctly.
Apart from these two, there is Gestational Diabetes, which occurs when there is a high blood glucose level during pregnancy and generally returns to normal after childbirth.
The cause of diabetes is not well-established. However it has been attributed to several risk factors like family history of diabetes, age, being overweight, stress both mental and physical like surgery or illness, high blood pressure, autoimmune disorders, smoking, high blood cholesterol, history of gestational diabetes and certain medication like steroids. In addition, gestational diabetes is more commonly found in pregnant women who are exposed to risk factors like age above 35yrs, being overweight, family history of diabetes or a personal history of PCOD.
The various symptoms of diabetes are dry mouth and increased thirst, increased hunger, increased frequency of urination, weight loss despite eating well, frequent infection in body like UTI, boils and abscesses, slow healing of injury, vision blurred, slow healing of cuts and injuries and constant weak and tired feeling.
Blood tests like fasting and postprandial blood sugar tests and HbA1c also known as glycosylated hemoglobin tests are used for diagnosing diabetes. For fasting blood sugar test one has to avoid eating or drinking anything for at least eight hours before the test. Patient is diagnosed with diabetes if one of the following conditions is met with that is
Fasting blood sugar level is equal or greater than 126mg/dl.
Two random blood sugar tests are over 200g mg/dl with symptoms as mentioned above
Oral glucose tolerance test is over 200mg/dl.
A1c test is greater than 6.5 percent on two separate days.
Diabetes is found to result in various serious complications. Years of poorly controlled hyperglycemias lead to vascular complications by affecting both small blood vessels (microvascular) and large blood vessels (macrovascular) or both. The microvascular damage in turn is the major reason behind 3 common and serious manifestations of diabetes that is
Retinopathy- It is a leading cause of blindness and there are no early signs and symptoms. It is characterized by retinal capillary microaneurysm, neovascularization and macular oedema. It leads to eventually focal blurring, vitreous or retinal detachment and eventually partial or total vision loss. Therefore retinal examination should be done regularly (mostly annually)in both Type1 and Type2 diabetes.
Nephropathy- It is a leading cause of chronic kidney disease. It is characterized by glomerular basement membrane thickening, glomerular sclerosis and mesangial expansion. It leads to glomerular hypertension and progressive decline in glomerular filtration rate. This disease has no sign and symptoms until nephrotic syndrome and renal failure develops. Therefore urine albumin levels must be monitored regularly (usually annually).
Neuropathy- This involves impaired nerve function due to nerve ischemia from microvascular disease, direct effect of hyperglycemia on neuron and intracellular metabolic disease. This can lead to symmetric polyneuropathy, cranial neuropathy, mononeuropathy, autonomic neuropathy and radiculopathy.
This microvascular damage also impairs skin healing, so that even minor cuts in skin develop into deeper ulcers and become easily infected especially in the lower extremities. These complications can be tackled by proper treatment and management of increased blood sugar but once established they may not reverse.
On the other hand macrovascular damage due to diabetes leads to complications such as angina pectoris and even myocardial infarction, transient ischemic attacks and strokes and peripheral arterial disease. Impaired immunity due to direct adverse effect of hyperglycemia on cellular immunity is another major complication of diabetes mellitus making the diabetic more prone to bacterial and fungal infections.
One can decrease the chances to get diabetes especially Type 2 by observing some healthy lifestyle habits such as eating healthy, nutritious and balanced diet, being physically active, lowering stress, limiting alcohol intake, getting adequate sleep and quitting smoking.