Diabetes is a chronic condition resulting after the pancreas either generates insufficient amounts of insulin or when the body cannot properly utilize the insulin that it produces. The hormone insulin controls blood sugar levels. Uncontrolled diabetes frequently results in hyperglycemia, also known as high blood glucose or raised blood sugar. Over time causes significant harm to several bodily systems, including the neurons and blood vessels.
Diabetes is also directly responsible for 1.5 million fatalities annually. In low- and middle-income nations, where the bulk of those with diabetes reside, around 422 million people have been reported to possess the disease. Over the past decades, there’s been a consistent rise in the frequency and number of cases of diabetes. how to test for Diabetes is treated with diet, exercise, reduced blood sugar levels, and other recognized risk factors that harm blood vessels.
Understanding Diabetes Mellitus | How is it Different From Diabetes Type 1 And Type 2?
When the body can’t absorb glucose (sugar) into its cells and utilize it as fuel, it develops into diabetes. The additional sugar in the bloodstream builds up as a result of this. Diabetes mellitus is the most common kind of diabetes and is often curable and controlled due to its wide distribution.
The pancreas, an organ located beneath the stomach that makes digestive enzymes, releases the hormone insulin, which regulates the quantity of glucose in the blood. The pancreas is stimulated to create insulin when glucose is in the blood. Glucose is transported from the blood into the cells with insulin. The glucose is either quickly used as energy as it enters the cells or stored as fat or starch glycogen until it is required.
Every day, there are typical variations in blood glucose levels. Within two hours after eating, they increase following a meal and drop to their pre-meal levels. Insulin production falls off after blood glucose levels return to where they were before a meal. Blood glucose levels in healthy individuals typically fluctuate within a small range, between 70 and 110 milligrams per deciliter (mg/dL) or 3.9 and 6.1 millimoles per liter (mmol/L) of blood. If they consume a lot of carbs, the levels may rise much higher. The levels are often slightly higher in people over 65, particularly after eating.
The signs and complications of diabetes are brought on by a combination of high blood glucose levels and insufficient glucose levels in the cells. This occurs when the body doesn’t produce enough insulin to transport the glucose into the cells or when the cells stop responding normally to insulin (a condition known as insulin resistance).
Diabetes Insipidus is a rare disease. It is caused when there are problems related to ADH (Anti Diuretic Hormone). A person with diabetes insipidus experiences frequent urination. Unlike diabetes mellitus, there is no rise in blood glucose levels. The disease has to be diagnosed using several tests. Chronic renal disease and kidney damage may result from the disorder if it is not managed.
The person has increased thirst due to frequent urination, which leads to excessive fluid intake. Dehydration is a possibility for patients.
The most typical form of diabetes is diabetes mellitus. In the blood, it results in higher than normal sugar levels. The body converts food into glucose, which cells use as energy for their routine metabolic functions. Amputations, renal failure, eyesight loss, and other major health consequences can result from the body’s inability to digest this glucose properly, which causes blood sugar levels to become dangerously high.
Two kinds of diabetes mellitus exist:
Type 1 diabetes is characterized by insufficient insulin synthesis in the pancreas, the organ responsible for producing the hormone. High glucose levels are a result of this.
In Type 2 Diabetes, the body develops an immunity to the insulin already there, making it impossible for the cells to utilize it.
Environmental and genetic variables have a role in its occurrence. Most persons with type diabetes start to have symptoms after they become 40. These types of diabetes cases are predominant.
Diabetes is first discovered in pregnant women and is known as gestational diabetes (gestation). Gestational diabetes alters how the cells utilize sugar, much like other diabetes (glucose). High blood sugar levels brought on by gestational diabetes may negatively affect the health of both you and your unborn child. When you give birth to your baby, the blood sugar usually recovers to normal if you had gestational diabetes while pregnant. The chance of developing type 2 diabetes increases if you have had gestational diabetes earlier.
Symptoms Of Diabetes Mellitus
In type 2 diabetes, the symptoms of elevated blood sugar often develop over time. Not everyone will experience symptoms at first, but they might develop with time.
If symptoms do manifest, they can include the following:
- Frequent urination and increased thirst: The kidneys cannot reabsorb glucose when blood levels get too high. Water from the body is removed together with the extra glucose by the body and excreted in the urine. As a result, you can get overly thirsty and feel the urge to drink and urinate more frequently.
- Loss of weight: The body may use fat and muscle for energy without insulin. Weight loss results from this.
- Fatigue: The body feels fatigued when cells don’t have enough glucose. When someone has type 2 diabetes, fatigue can affect daily living.
- Blurred eyesight: Due to swelling and temporary visual impairment brought on by removing fluid from the eye lenses due to high blood glucose levels.
- Rash and infections: A person could experience frequent Candida infections or irritation in the vagina or around the penis. Diabetes affects blood circulation, which may make it harder for infections and wounds to heal.
Someone with these symptoms must make an appointment to see a doctor. Numerous dangerous consequences from diabetes are possible. A person’s chances of avoiding issues are improved the earlier they begin controlling their blood sugar levels.
The Complications Caused Due To Diabetes Mellitus
Your medical team may refer to two categories of problems related to diabetes: acute complications, which can occur at any time; and chronic complications, which are dangerous and develop over time. Chronic problems are long-term issues that can progressively worsen and cause significant harm if left unregulated and untreated.
The most common chronic irregularities would be:
- Eye conditions (retinopathy): Diabetic retinopathy is an eye condition that some diabetics acquire and can impair vision. If retinopathy is identified, often done during an eye screening exam, it can be treated, and vision loss avoided.
- Issues with the feet: If left untreated, major foot complications from diabetes might result in amputation. Your feet’s sense of touch may be impacted by nerve damage, and high blood sugar levels may harm your circulation, slowing the healing of wounds and sores. So, if you detect any changes in the appearance or sensation of your feet, it’s crucial to inform your doctor.
- A heart attack or stroke: Blood vessel damage can occur when you have diabetes as a result of prolonged high blood sugar levels. A heart attack or stroke may result from this sometimes.
- Renal issues (nephropathy): It may take longer for your kidneys to remove excess fluid and waste from your body if you have diabetes, which can harm them over time. High blood sugar and blood pressure are the causes of this. Renal disease or diabetic nephropathy are the terms used to describe it.
- Damaged nerves (neuropathy): Due to the consequences of high blood sugar levels, certain diabetics may experience nerve damage. As a result, the nerve’s ability to transmit signals from the brain to every area of our body may be hampered, impacting how we see, hear, feel, and move.
- Dental issues: Salivary sugar levels might increase if you have an excessive blood sugar level. The blood vessels in your gums are also susceptible to injury, which increases the risk of gum infection.
- Cancer Related Issues: Diabetes increases your chance of getting some types of cancer. Additionally, certain cancer therapies might influence your diabetes and make it more difficult to maintain blood sugar control.
- Women’s sexual health issues: You may lose some feeling in your genital organs if blood flow to those areas is restricted due to blood vessel and nerve damage. You are more prone to get a urinary tract infection (UTI) if you have high blood sugar.
- Men’s sexual health issues: Your ability to become aroused may be hindered by a restriction in the blood supply to your sexual organs. Impotence, sometimes known as erectile dysfunction, may result from it.
These are prone to occur at any moment and can result in chronic or long-term consequences.
The most common acute irregularities would be:
- Blood sugar levels that are excessively low or high are referred to as hypos and hypers, respectively.
- Hyperosmolar Hyperglycaemic State (HHS), a situation in which life is in danger, exclusively affects patients with type 2 diabetes. It is caused by extreme dehydration and extremely high blood sugar levels.
- Diabetic ketoacidosis (DKA) is a potentially fatal emergency when a buildup of ketones is caused by a lack of insulin and high blood sugar levels.
How Can A Doctor Diagnose Diabetes Mellitus?
Your doctor can use blood tests to determine if you have diabetes, prediabetes, or gestational diabetes. Blood tests allow you to determine if the blood sugar level is greater than what is considered healthy. You can determine the kind of diabetes you have with the use of blood testing.
What Tests Are Used To Diagnose Diabetes?
Diagnosing diabetes and prediabetes requires a range of tests from doctors. Your doctor may advise a different test depending on whether you have symptoms or if you are pregnant.
Blood glucose test when fasting
The fasting plasma glucose (FPG) test determines your blood glucose level using a single point-in-time measurement. Your doctor will administer the test in the morning after you fast for at least 8 hours to get accurate results. If you’re fasting, you may consume water in small amounts.
The A1C test, a blood test, reveals your average blood glucose levels over three months. The A1C test is also called as the glycated hemoglobin test, the hemoglobin A1C test, and the glycosylated hemoglobin test.
Specific forms of hemoglobin or hemoglobin variations can impact the measurement of A1C levels. The most prevalent variations have little impact on most A1C tests used in the US. Your doctor should consider the possibility that the A1C test may not be a trustworthy test for you if the results of your A1C test and blood glucose levels do not match.
Random plasma glucose test
When a patient has diabetes symptoms, and a doctor does not want to wait until the patient has fasted for eight hours, they will occasionally utilize the random plasma glucose test to diagnose the condition. This blood test can be performed whenever you choose.
Challenge Test for Glucose
Your doctor may perform a glucose challenge test on you when you are pregnant to check for gestational diabetes. This examination is also known as a glucose screening test. A medical practitioner will draw a blood sample for this test one hour after consuming a sugary beverage containing glucose. You can do this test without fasting. If your blood sugar level is too high—135 mg/dL to 140 mg/dL or higher—you might need to return for an oral glucose tolerance test while fasting.
Oral test for glucose tolerance
Doctors can identify gestational diabetes, type 2 diabetes, and prediabetes with the oral glucose tolerance test (OGTT). On the other hand, the OGTT is more difficult to administer and costly than the FPG and glucose challenge tests.
Refer to the following chart to get a clearer idea about the results that these tests may declare:
|Fasting Plasma Glucose
|Oral Glucose Tolerance Test
|Random Plasma Glucose Test
|99 mg/dL or below
|139 mg/dL or below
|Pre-Diabetes||5.7% to 6.4%
|100 to 125 mg/dL
|140 to 199 mg/dL
|Diabetes||6.5% or above
|126 mg/dL or above
|200 mg/dL or above
|200 mg/dL or above
Treatment And Medication For Diabetes Mellitus | Diabetes Management
The whole body becomes influenced when diabetes develops. The best way to manage diabetes is to make efforts to manage your risk factors, such as
- Maintain normal blood glucose levels by following a nutrition plan, taking prescribed medication, and increasing your level of exercise.
- Try to keep your triglyceride and blood cholesterol levels as close to your normal limits as possible (HDL and LDL levels).
- Keep an eye on your blood pressure. Blood pressure levels shouldn’t be more than 140/90 mmHg.
To Control Your Diabetes | Diet and Lifestyle Changes
- Plan your meals and stick to them religiously: Adopt a Dash or Mediterranean diet (vegetables, whole grains, legumes, fruits, healthy fats, minimal sugar). Low in fats and calories, these diets are also strong in fiber and nutrients. For guidance on meal planning and nutrition, see a qualified dietitian.
- Regularly working out: On most days of the week, make an effort to work out for at least 30 minutes. Find a fun activity to do, go for a walk, or go swimming.
- Home blood pressure and blood glucose monitoring and maintaining all scheduled meetings with your healthcare providers and completing laboratory tests your doctor orders.
The Food and Drug Administration has authorized more than 40 drugs to treat diabetes.
Medication classes used to treat diabetes include:
|Sulfonylureas||These medications increase the pancreas’ production of insulin, lowering blood sugar.|
|Glinides (also known as meglitinides)||These medications reduce blood sugar by encouraging pancreas to produce more insulin.
|Biguanides||These medications lessen the amount of glucose the liver produces. Additionally, it enhances the function of insulin in the body and delays the breakdown of carbs into sugar.
|Alpha-glucosidase inhibitors||These medications reduce blood sugar levels by delaying the breakdown of carbohydrates and decreasing the small intestine’s glucose absorption.
|Thiazolidinediones||By enabling more glucose to reach the muscles, fat, and liver, these medications enhance the way insulin functions in the body.
|GLP-1 analogs (also known as incretin mimics or glucagon-like peptide-1 receptor agonists)||These medications enhance insulin release, lower the amount of glucose produced by the liver after meals, and postpone the stomach’s emptying of food.
|DPP-4 inhibitors, also known as dipeptidyl peptidase-4 inhibitors||It encourages your pancreas to produce more insulin after meals. Additionally, they decrease the liver’s production of glucose.|
|SGLT2 inhibitors, also known as sodium-glucose cotransporter 2 inhibitors||These medications influence your kidneys to help you eliminate glucose from your body through urine. Drugs called bile acid sequestrants to reduce cholesterol and blood sugar levels.
|Agonists for dopamine||These drugs reduce the amount of glucose the liver releases.
There is no recognized treatment for type 2 diabetes. But you can maintain your health by maintaining a healthy lifestyle and using medication as needed.
As of 2014, 8.5% of adults (18 years of age and above) had diabetes. A total of 1.5 million fatalities in 2019 were directly related to diabetes, and 48% of these deaths occurred in those under 70. Diabetes contributed to an additional 460 000 renal disease deaths, and elevated blood glucose is responsible for 20% of cardiovascular fatalities. Age-standardized diabetes mortality rates rose by 3% between 2000 and 2019. The death rate from diabetes climbed 13% in lower-middle-income nations.
One can win over any ailment by taking proper care of yourself with a healthy diet and proper medications. As for diabetes, the World Health Organisation continues to bring forth resolutions on enhancing diabetes prevention and management, as approved by its Assembly. It urges action in areas including fostering convergence and harmonization of regulatory standards for insulin and other medications and healthcare goods used in treating diabetes and expanding access to insulin.