Basic knowledge on diabetes

Why should we care about Diabetes?

Diabetes is a very common disorder to an extent that up to 12% of population in Delhi is diabetic and another 15-20 % is pre-diabetic. Diabetes is a disorder with very serious consequences if not treated well. And it is very costly to treat diabetic complications than to prevent them. The problem with diabetes is that it affects quality of life much more than quantity of life.

What causes Diabetes?

Diabetes occurs when the pancreas, a gland behind the stomach, does not produce enough of the hormone insulin, or the body can’t use insulin properly due resistance to its action.

What is pre-diabetes?

In Pre-diabetes, person's blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. Pre-diabetes is also known as Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG)

What are different types of Diabetes Mellitus?

Type 1

Diabetes occurs when the pancreas makes very little or no insulin. This form of the disease is most often seen in children. 

Type 2

Body is resistant to the action of insulin, meaning it cannot use insulin properly, so it cannot carry sugar into the cells.

Other types

Gestational Diabetes (occurring in pregnant females) and secondary forms of diabetes like pancreatic DM.

What are the Risk factors for developing Diabetes Mellitus?

Main risk factors for developing diabetes are:

• Being overweight
• Sedentary lifestyle
• Family history of diabetes
• History of gestational diabetes
• Age
• Ethnic/racial background
• African
• Hispanic/Latino
• Native American
• Asian

What are the symptoms that should alert you to see your doctor?

• Increased thirst
• Increased urination
• Constant hunger
• Weight loss
• Blurred vision
• Fatigue, or a feeling of being tired
• Frequent fungal infections
• Very slow healing of wounds or sores

What can be the serious long-term problems due to diabetes?

Diabetes can affect your entire organ systems including:

• Eyes: Decreased vision and even blindness.
• Kidney disease: Change in size and function of kidneys which can result in decrease in urine output and swelling of body.
• Nervous system: Diabetes can result in stroke (weakness of some part of body like left/right hand or leg), abnormal sensation in both feet which can extend to arms also and eventually lead to complete loss of sensations.
• Heart: Diabetes, if uncontrolled, can lead to heart attacks.
• Diabetic foot: Diabetes is leading cause of non-traumatic foot amputations. A combination of loss of sensation and decreased blood supply to your feet make it more prone to trauma and subsequent infection.

Why should I treat my Diabetes?

Keeping your glucose levels close to normal will greatly lower your chances of developing long-term complications.

If you already have complications, keeping your glucose levels close to normal will help keep these problems from getting worse.

What are goals of Diabetes Treatment?

Goals of treatment in Diabetes are two-fold

• Control of your blood sugar, so that you do not have symptoms like weight loss, increased urination etc.
• Early identification and treatment of diabetic complications like eye disease, heart disease and kidney disease

What is HbA1c?

HbA1c stands for Glycosalated haemoglobin or Glycated haemoglobin. HbA1c is also called as the blood test with a memory. It gives a person’s average blood glucose control for 2-3 month period before the test.

What are the tests that are required to monitor Diabetes progression?

Tests for Diabetes can be divided into three tiers according to frequency^*:

• On Daily basis: Blood sugar with glucometer
• Every Three Monthly: HbA1c, Blood glucose from lab, Lipid profile
• Every yearly: Haemogram, LFTs, KFTs, Urine evaluation, HbA1c, Lipid Profile, Eye checkups, foot examination

* Frequency can vary as per your doctor’s discretion.

How should I manage my Diabetes?

Management of diabetes involves three main components.

• Diet
• Exercise
• Medication (oral or insulin