Your Guide to Diabetes Mellitus

Diabetes mellitus, often simply referred to as diabetes, is a chronic disease characterised by abnormally high blood sugar levels, a condition called hyperglycemia.

This happens when the body is unable to produce sufficient insulin or cannot utilize insulin effectively. Consequently, high blood sugar levels can cause damage to various parts of the body.

The pancreas is responsible for releasing insulin, which aids in the storage and use of sugar (and fat) from food. However, when the pancreas doesn’t generate enough insulin, or cells become unresponsive to insulin, it results in insulin resistance.

Diabetes can lead to severe health complications, including heart disease, vision loss, and kidney failure. Unmanaged diabetes can also harm nerves and blood vessels.

Both type 1 and type 2 diabetes typically require long-term treatment and appropriate medical care.

Although diabetes cannot be cured, it can be managed and controlled through proper weight management and healthy dietary choices.

Types of Diabetes

There are three primary types of diabetes: Type 1, Type 2, and Gestational.

Additionally, there is a condition called Prediabetes, which may progress to type 2 diabetes.

Type 1

In this form of diabetes, the body ceases to produce insulin. The immune system attacks and destroys the beta cells in the pancreas responsible for insulin production. Over time, the pancreas loses its ability to produce the necessary amount of insulin for regulating the body’s energy supply.

Type 1 diabetes typically affects individuals under the age of 20, but it can develop at any age.

Currently, there is no known method of prevention.

Type 2

This type of diabetes involves insulin resistance and elevated blood sugar levels. Type 2 diabetes is the most prevalent form, accounting for about 90% to 95% of diabetes cases.

Type 2 diabetes can be prevented through lifestyle changes, such as achieving weight loss and engaging in physical activity.

Symptoms may not always be present, so regular blood sugar level testing is recommended.

Gestational Diabetes

This type of diabetes affects some pregnant women who have never experienced diabetes before. Gestational diabetes typically resolves after the baby is born.

However, both the mother and child are at a higher risk of developing type 2 diabetes later in life if gestational diabetes was present during pregnancy.

Prediabetes

Prediabetes occurs when blood glucose levels are higher than normal but not high enough for a diabetes diagnosis. Individuals with prediabetes have an increased risk of developing type 2 diabetes and cardiovascular disease.

Prediabetes results from insulin resistance, which means cells no longer respond effectively to insulin. However, prediabetes can be reversed through lifestyle changes, including healthier eating, regular exercise, and weight loss.

Symptoms of Diabetes

Common symptoms associated with diabetes include:

• Frequent urination, particularly at night
• Excessive thirst
• Blurred vision
• Recurring infections, such as skin and gum infections
• Slow-healing sores
• Vaginal dryness
• Extreme fatigue and weakness
• Increased hunger
• Unintentional weight loss
• Elevated ketone levels in urine
• Mood swings and irritability
• Dry skin
• Dry mouth

Type 1 Diabetes Symptoms

Symptoms may include stomach pain, vomiting, or nausea. These symptoms usually develop relatively quickly, within weeks or months.

Type 1 diabetes primarily affects individuals below the age of 20, but it can also occur at any age.

Type 2 Diabetes Symptoms

Symptoms related to type 2 diabetes may take years to develop and may not always be noticeable.

Type 2 diabetes typically occurs in adults, but increasing evidence suggests that children and teens are also being diagnosed with this condition.

Gestational Diabetes Symptoms

While gestational diabetes may develop during pregnancy, symptoms may not always be present. Therefore, it is important to test your blood sugar levels during pregnancy, especially between the 24th and 28th weeks.

Frequent urination and excessive thirst may be indicative of gestational diabetes.

Less Common Types

Other less common types of diabetes include monogenic, cystic fibrosis-related, and drug-induced diabetes, which are rare occurrences.

Causes

The primary cause of diabetes is having excessive glucose in the blood. In other words, uncontrolled spikes in blood sugar levels can lead to the development of diabetes.

However, the exact cause for the various types of diabetes remains unclear.

Possible causes include:

• Insufficient insulin production by the pancreas
• Genetic, environmental, and geographic factors
• Family history (a family member with type 1 or type 2 diabetes)
• Race or ethnicity

Complications of Diabetes

Diabetes complications can be severe, life-threatening, and include:

• Cardiovascular disease
• Nerve damage (Peripheral neuropathy)
• Kidney disease (Diabetic nephropathy)
• Vision loss (Diabetic retinopathy)
• Hearing loss
• Foot damage (due to damage to the feet or poor blood flow to them)
• Skin conditions (bacterial and fungal infections)
• Alzheimer’s disease
• Depression

Complications related to gestational diabetes include premature birth, larger-than-average birth weight, stillbirth, jaundice, and hypoglycemia.

Risk Factors

The following factors may increase the risk of developing diabetes:

Type 1 Diabetes Risk Factors

• Viral illnesses
• Pancreatic injury due to infection, accident, surgery, etc.
• Family history (sibling or parent diagnosed with type 1 diabetes)
• Autoimmune disease

Type 2 Diabetes Risk Factors

• Smoking
• Family history (sibling or parent diagnosed with type 2 diabetes)
• Hypertension (high blood pressure)
• High triglyceride levels
• Physical inactivity
• Previous gestational diabetes
• History of stroke or cardiovascular disease
• Individuals aged 45 or older
• Hormonal conditions (PCOS)

Gestational Diabetes Risk Factors

• Family history (sibling or parent diagnosed with type 2 diabetes)
• Obesity before pregnancy
• Individuals aged 25 or older

In India, gestational diabetes affects approximately five million women every year. Research data indicates that both prediabetes and diabetes affect over six million births in India, with 90% of cases resulting from gestational diabetes.

Diagnosis and Tests for Diabetes

To determine whether you have diabetes, your blood sugar levels must be tested.

Your doctor may perform the following tests to diagnose type 1, type 2, gestational, or prediabetes:

• Fasting Blood Sugar Test: Performed in the morning after an overnight fast (only water allowed)
• Random Blood Sugar Test: Can be performed at any time, without fasting
• A1C Test: Measures average blood glucose levels over two to three months by examining the amount of glucose attached to hemoglobin proteins in red blood cells. No fasting is required for this test.
• Glucose Tolerance Test: Requires drinking a glucose solution and testing blood sugar levels at one, two, and three-hour intervals. Overnight fasting is required for this test.
• Gestational Diabetes Tests: Blood sugar levels are tested during pregnancy, especially between the 24th and 28th weeks. No fasting is needed before testing. If blood sugar levels are higher than normal early in pregnancy, type 1 or type 2 diabetes may be more likely than gestational diabetes.

Type 1 diabetes: Blood and urine samples are tested. Blood tests look for autoantibodies, while urine tests check for the presence of ketones. The presence of both could indicate type 1 diabetes.

Treatment

Treatment for diabetes depends on early detection and diagnosis. Your doctor will determine the appropriate treatment based on the type of diabetes, your current health, and your blood sugar levels.

Type 1: Treatment focuses on blood glucose control, requiring daily insulin injections since the pancreas does not produce enough insulin.

Type 2: As the body becomes insulin-resistant, medications for insulin production may be prescribed. Additionally, lifestyle changes such as weight reduction, healthy eating, and physical activity are necessary.

Gestational diabetes: A diet specifically designed for your condition will be recommended, along with regular exercise. If these measures are not effective, medications or insulin may be prescribed to lower blood sugar levels until they return to normal.

Prediabetes: Treatment addresses risk factors that could lead to diabetes, including a healthy diet and regular exercise. Following your doctor’s advice can help prevent the development of diabetes.

Prevention of Diabetes

Diabetes occurs when blood sugar levels become excessively high, affecting glucose intake and how efficiently the body uses glucose for energy.

The following four steps can help treat and prevent this condition.

Monitor Your Blood Sugar Levels

Testing your blood sugar at least three times daily helps monitor levels. Additionally, checking blood sugar before meals and after exercise is essential.

Eat a Balanced Diet

Consuming a healthy, customised diet, along with frequent blood sugar monitoring, can help manage diabetes effectively.

Exercise Regularly

Regular exercise helps control blood glucose levels by increasing insulin sensitivity, improving cardiovascular function, and lowering blood pressure. It also reduces stress and anxiety, which can positively impact mood.

Follow Medication Instructions

If prescribed medication for diabetes, follow the instructions carefully and consult your doctor before taking any additional medications. Tracking your progress with your treatment plan can help identify necessary changes.

By implementing these steps, you can successfully treat and prevent diabetes while maintaining a healthy lifestyle.

Blog originally published at https://www.nugenomics.in/a-laymans-guide-to-diabetes/