DIABETES: SIMPLE AND IMPORTANT FACTS YOU SHOULD KNOW

Diabetes mellitus is a metabolic disorder that affects your body’s blood glucose ( sugar ) metabolism. Glucose is vital to your health because it’s an important source of energy for the cells that make up your muscles and tissues. It’s also your brain’s main source of fuel. Prevalence of diabetes  has been rising more rapidly. 

WHAT EXACTLY HAPPENING

Insulin is a hormone that regulates blood glucose. Diabetes occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. As a result there will be raised blood glucose  level in your blood , condition  also called hyperglycaemia.

TYPES

Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is characterized by deficient insulin production and requires daily administration of insulin.

Type 2 diabetes (formerly called non-insulin-dependent or adult-onset) results from the body’s ineffective use of insulin. Type 2 diabetes comprises most people with diabetes around the world   and is largely the result of excess body weight and physical inactivity.

Gestational diabetes is hyperglycaemia with blood glucose values above normal but below those diagnostics of diabetes, occurring during pregnancy. Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery.

They and their children are also at increased risk of type 2 diabetes in the future.

Impaired glucose tolerance (IGT) and Impaired fasting glycaemia (IFG) are intermediate conditions in the transition between normality and diabetes. People with IGT or IFG are at high risk of progressing to type 2 diabetes, although this is not unavoidable.

RISK FACTORS

The risk factors can be either Non modifiable ( can’t change) or  Modifiable ( can change).

Non modifiable factors

1. Family history:Some factors that increase the risk of diabetes are inherited from our parents or close biological relatives. If you have a blood relative with diabetes, your risk for developing it is significantly increased.
2. Race or ethnic background: People belongs to certain racehave a greater chance of developing diabetes like African American, Asian-American, Pacific-Islander descent etc.
3. Age:The older you are, the higher your risk for prediabetes and Type 2 diabetes. Type 2 diabetes generally occurs in middle-aged adults, most frequently after age 40. Now a days incidents are more common in young adult and children also.
4. Gestational diabetes:As we earlier said, If you developed diabetes during pregnancy, you are at increased risk of developing diabetes again later in life.

Modifiable risk factors

You can reduce your risk for diabetes or delay its development by making healthy changes:

1. Weight:Being overweight or obese increases your risk of developing diabetes. So, it is important to maintain an ideal BMI.If you having higher BMI losing 5% to 10% of your body weight along with a regular physical activity can significantly reduce your risk of developing diabetes.
2. Physical activity:Physical inactivity is a key modifiable risk factor for prediabetes and Type 2 diabetes. Regular physical activity helps lower insulin resistance. This means your body can use its own insulin more effectively.
   1. At least 150 minutes per week of moderate-intensity aerobic physical activity.
   2. Muscle-strengthening exercise at least two days per week.
3. Blood pressure:In addition to causing damage to the cardiovascular system, untreated high blood pressure has been linked to complications from diabetes. People with diabetes and HBP should maintain a blood pressure of less than 130/80 mm Hg. Normal blood pressure is below 120/80 mm Hg.
4. Cholesterol (lipid) levels: Low HDL “good” cholesterol and or high triglycerides can increase the risk for Type 2 diabetes and cardiovascular disease.
5. Smoking:It can increase the risk of developing diabetes. There are a number of tools, medications and online resources that you can use to help you quit.
6. Diet:It’s important to eat healthy foods in the right amounts. Diet is one of the most important modifiable risk factors for prediabetes and Type 2 diabetes.
7. Alcohol:Heavy use of alcohol can cause inflammation in the pancreas and limit its ability to produce enough insulin. Alcohol can cause liver damage and adds more sugar and starch to your diet that must either be used or stored as fat. Moderate your alcohol intake. That means no more than one drink per day for women or two drinks per day for men.
8. Stress and well-being:Managing the stress in our lives is an important part of healthy living, not only for diabetes but for heart disease and many other conditions.
9. Sleep: Adults should get seven to nine hours of sleep a night. Sleep benefits your whole body, including your heart and brain. It improves mood, memory and reasoning. Research also has shown that too little or too much sleep is linked to a high A1C in people with Type 2 diabetes. If you have trouble going to sleep or waking up too soon or sleep apnoea (problems breathing while asleep) try to get medical attention as early as possible.

SYMPTOMS

Not all patients experience the same, but these are some of symptoms that prediabetic and diabetic patient will have.

• Urinate (pee) a lot, often at night.
• Are very thirsty.
• Lose weight without trying.
• Are very hungry.
• Have blurry vision.
• Have numb or tingling hands or feet.
• Feel very tired.
• Have very dry skin.
• Have wounds that heals slowly.

COMPLICATIONS

• Low blood sugar (hypoglycaemia)
• Ketoacidosis     When your cells don’t get enough glucose, they start to burn fat for energy, which makes things called ketones. High ketone levels signal that your diabetes is out of control or that you’re getting sick. This can lead to diabetic ketoacidosis(DKA), a dangerous complication.
• Eye problems.A complication of diabetes where blood vessels in the eye are damaged. This may be with no symptoms initially but eventually may notice vision problems
• Diabetic kidney disease
• Over time, high blood sugar levels can affect your kidneys’ ability to filter waste out of your body. When this happens, substances such as protein may incorrectly pass into your urine. This progressive damage to your kidneys is called diabetic nephropathy
• Diabetic Neuropathyover time, diabetes can cause nerve damage that produces symptoms of numbness, burning, or pain in your hands, feet, or legs.
• Heart Disease, Stroke: Heart disease is one of the most common diabetes complications

• Foot and skin problems

DIABETES SCREENING, DIAGNOSIS & TREATMENT

• Early diagnosis can be accomplished through relatively inexpensive testing of blood glucose.
• A screening test is advisable if you have any of the symptoms of diabetes.
• Screening for type 2 diabetes can be by either fasting blood sugar, haemoglobin (A1C), glucose tolerance testing, and random plasma sugar.
• Urine glucose may be useful, but it is an inferior test to screen for diabetes.

 Treatment of diabetes involves diet and physical activity along with lowering of blood glucose and the levels of other known risk factors that damage blood vessels.

Blood glucose control,

Particularly in type 1 diabetes, People with type 1 diabetes require insulin, people with type 2 diabetes can be treated with oral medication but may also require insulin.

• Blood pressure control
• Foot care(patient self-care by maintaining foot hygiene; wearing appropriate footwear; seeking professional care for ulcer management; and regular examination of feet by health professionals).
• Screening and treatment for retinopathy(which causes blindness) In people with type 1 diabetes, these annual exams should start within three to five years of diabetes once the patient is age 10 or older. People with type 2 diabetes should have their first eye exam once they are diagnosed. Those with eye complications may need to see their ophthalmologist more frequently.
• Blood lipid control (to regulate cholesterol levels).
• Screening for early signs of diabetes-related kidney disease and treatment.