Diabetes, also known as Diabetes mellitus (DM), is a medical condition that results in high levels of sugar in the blood. The food an individual consumes is turned into glucose, which is used as energy making glucose an important source of energy for the body. Insulin is a hormone produced by a gland called the pancreas and it helps glucose to be delivered to the cells of the body such as muscles and other tissues. This function of insulin does not take place in Diabetes. Thus, instead of getting absorbed in the body, glucose piles up in the bloodstream leading to high blood sugar levels.
Diabetes is a chronic condition and is not a medical emergency but it can lead to various serious health problems.
There are two types of Diabetes. They are:
Type 1 Diabetes: A condition in which the immune system destroys insulin-making cells in the body. This type occurs in children and adolescents, and the body does not produce insulin.
Type 2 Diabetes: A chronic condition that causes high blood sugar levels, insulin resistance, and inadequate production of insulin. In this type, the body does not respond to insulin as the way it should, and also it does not make enough insulin.
PreDiabetes: This is a condition when the blood sugar level is higher than it should be, but not high enough to be diagnosed as Diabetes. In other words, it is an initial stage before turning into Diabetes.
The exact cause of Diabetes is not known. In type 1, the immune system attacks and destroys insulin-making cells. The reason behind this is not exactly known. In type 2, the cells become resistant to insulin and the pancreas does not produce enough insulin. The reason behind this is also not exactly clear. Nevertheless, genetics and environmental factors contribute to the development of the condition.
Factors that increase the probability of developing Diabetes include:
Signs and symptoms of Diabetes are not recognized immediately. The symptoms develop slowly and they include:
Investigation tests for Diabetes are:
Glycated hemoglobin (A1C) test: This test measures the average blood sugar level for the past two to three months.
Random blood sugar test: A blood sample is collected irrespective of the food consumed. The blood sugar level of 200 mg/dL (11.1 mmol/L) or above suggests Diabetes.
Fasting blood sugar test: A blood sample is collected after an overnight fast.
Urinary glucose testing: High glucose levels in the urine during pregnancy also suggest gestational Diabetes. Increased glomerular filtration rates during pregnancy contribute to high glucose levels in the urine.
After the diagnosis of Diabetes is confirmed, additional tests such as blood tests and urine tests are also done to distinguish between type 1 and type 2 Diabetes as the treatment differs for both types.
After being diagnosed positive for Diabetes, the A1C level is checked every few months. The change of the A1C level indicates a change in medication and diet plans. Blood and urine tests are also performed periodically to check cholesterol, thyroid, liver, and kidney functions. Eye checkup is also recommended to identify any Diabetes-induced eye disorders.
Diagnosis of Diabetes is done considering the results of the investigation tests.
There is no cure for Diabetes. Treatment focuses on keeping the sugar levels in control and taking steps to avoid further complications. Steps required to control sugar levels include:
Diabetes can be controlled with diet and exercise; however, in a few cases, blood sugar levels could not be controlled with diet and exercise alone. They require medications to keep blood sugar levels in control. The following medications may be used
Insulin Therapy: Individuals with type 1 diabetes need insulin therapy to survive. Individuals with type 2 diabetes or gestational diabetes also need insulin therapy. Insulin is available in different forms.
Depending upon the requirement, dosage and mixture of insulin types are prescribed by the physician. Insulin can be taken through different methods. They include:
Surgical interventions for the treatment of high blood sugar include:
Pancreas Transplantation: Some individuals may benefit from pancreas transplantation. Insulin therapy may not be required if pancreas transplantation is successful. However, immune-suppressing drugs may be needed to prevent organ rejection.
Bariatric Surgery: High blood sugar that is caused due to obesity may need a weight loss reduction procedure called Bariatric surgery. This surgery improves blood sugar levels.
Preventive measures and lifestyle modifications for type 2 Diabetes include:
In Diabetes, glucose builds up in the blood instead of being absorbed by cells. Thus, cells get starved for energy. This leads to various complications affecting many major organs like the heart, kidneys, eyes, blood vessels, and nerves. Some of them are listed below.
The prognosis of Diabetes varies between individuals. It depends upon how well the sugar levels are maintained. Regardless, Diabetes can lead to complications of other organs and could be life-threatening.
Medical consultation is recommended after noticing any signs and symptoms of Diabetes such as frequent urination, excessive thirst, and unexplained weight loss.
Hospitalization is required in individuals with uncontrolled sugar levels and for any vascular complications that may arise.
Screening is recommended in the following instances: