Don’t Allow Diabetes to Let You Down

Diabetes is a chronic condition in which blood sugar (also called glucose) accumulates in your blood. The full name of the disease, diabetes mellitus, literally means “honey diabetes.” Since the time of ancient Greece, people have noticed a sweet or honeyed smell in the urine of those affected by the disease.

There is no cure for diabetes. However, diabetes can be controlled. Controlling diabetes means keeping your blood sugar at levels that are the same as—or close to—those of a person who does not have diabetes.

There are two primary kinds of diabetes, and the cause of your elevated blood sugar depends on which kind of diabetes you have.

TYPE-1 DIABETES

Type 1 diabetes used to be called “juvenile diabetes” because it normally occurs in people under the age of 30. If you have type-1 diabetes, your pancreas no longer produces insulin, a vital hormone that helps your body turn sugar into energy. Without this essential hormone, the sugar in your system accumulates in your blood. Type 1 diabetes is considered to be an “auto-immune” disease. It occurs when the immune system mistakenly attacks the pancreas and destroys its ability to make insulin.

Although family history plays a role in the development of type 1 diabetes, 90 percent of the people who get it have no family history of the disease at all. No one knows for sure why it strikes some people and not others. People with type 1 diabetes have to take insulin to control their blood sugar. Consultation with diabetologists is particularly helpful because of their expertise in diagnosing diabetic patients. 

TYPE-2 DIABETES

Type 2 diabetes used to be called “adult onset” because it normally occurs in people over the age of 30.

Type 2 diabetes is more likely if you have a family history of diabetes. It is closely related to excess weight and a lack of physical activity. African-Americans, Latinos, Pacific Islanders, Asians, and Native Americans are all at high risk for type 2 diabetes.

Although type 2 diabetes normally strikes people over the age of 30, it is on the rise among children. Diabetologists think this is directly related to a lack of physical activity and the increase in obesity among the young.

If you have type 2 diabetes, your pancreas still makes insulin. But it may not make enough, or your body may have become resistant to it. The first line of treatment for type 2 diabetes is exercise and weight loss—many people can control their blood sugar levels with exercise and diet alone. There are also oral medications that can be used to treat the disease. Type-2 diabetes tends to be progressive and a substantial number of people with type 2 diabetes ultimately need to take insulin to control their blood sugar.

  

Diabetes Mellitus: Everything you want to know

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

How should I manage my Diabetes?

Management of diabetes involves three main components:

• Diet
• Exercise
• Medication (oral or insulin)