Diabetes
What is Diabetes?
Diabetes is a disease where there is too much glucose in the blood. During digestion, the body changes food into a simple sugar called glucose. The glucose is absorbed into the blood and the body uses it for energy. In a normal person, a hormone called insulin helps glucose in the blood to enter the body cells where it is turned into energy or stored for future use. Insulin is made by the pancreas, a gland found behind the stomach.
In a person with diabetes, the insulin released is either inadequate or not able to do its work of absorbing the glucose from the blood into the cells. As a result, the glucose cannot enter the body cells and it remains in the blood, giving rise to a high glucose level in the blood.
What causes Diabetes?
There are two main types of diabetes: Type 1 diabetes (insulin-dependent) and Type 2 diabetes (non-insulin-dependent). Extra demands on the pancreas cause some women to develop diabetes during pregnancy, known as gestational diabetes.
People with type 1 diabetes have high blood glucose levels because the pancreas is not able to produce enough insulin. Type 2 diabetes (non insulin-dependent) is the more common type of diabetes. It is estimated that more than 90% of people with diabetes have this type of diabetes. People with type 2 diabetes are able to produce some insulin but this may not be effective in keeping the blood glucose level normal.
The causes of type 1 diabetes appear to be different from those for type 2 diabetes, though the exact mechanisms for developing both diseases are unknown. Type 1 diabetes seems to appear following an exposure to an "environmental trigger," such as an unidentified virus, stimulating an immune attack against the beta cells of the pancreas (that produce insulin) in some genetically predisposed people. Type 2 diabetes is more lifestyle related and obesity is a risk factor in this type of diabetes.
Are you at Risk?
Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, and past history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity.
The risk factors are less well defined for type 1 diabetes but autoimmune, genetic, and environmental factors are involved in developing this type of diabetes.
Gestational diabetes occurs more frequently in certain ethnic groups, and in people with a family history of diabetes. Obesity is also associated with higher risk. Women who have had gestational diabetes are at increased risk for developing type 2 diabetes later in life.
How can you tell if you have Diabetes?
You may have the following signs and symptoms:
- Frequent passing of urine
- Increased thirst
- Weight loss despite good appetite
- Hunger
- General weakness and fatigue
- Blurred vision
- Reduced feelings in hands or feet
- Itchy skin, especially in the genital areas
- Slow healing of cuts and wounds
However, symptoms are sometimes mild and many people with diabetes also do not experience any of the symptoms until the disease is at a last stage. Hence, anyone who is at risk of diabetes should go for regular checks of their blood glucose levels.
The following tests are used for diagnosis:
- A fasting blood glucose test measures your blood glucose after you have gone at least 8 hours without eating. This test is used to detect diabetes or pre-diabetes.
- An oral glucose tolerance test measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a glucose-containing beverage. This test can be used to diagnose diabetes or pre-diabetes.
- In a random blood glucose test, your doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of symptoms, is used to diagnose diabetes but not pre-diabetes.
Positive test results should be confirmed by repeating the fasting blood glucose test or the oral glucose tolerance test on a different day.
What happens when you have Diabetes?
Untreated or uncontrolled diabetes leads to serious complications. Diabetes can affect the blood vessels and the heart – causing heart disease, stroke and problems due to poor blood circulation. A persistent high blood glucose level damages the small vessels in the body, particularly in the eyes, kidneys and nerves.
Diabetes can therefore cause blindness, kidney disease, loss of sensation in the hands and feet, and impotence. Such people with diabetes often injure themselves without realising it and the wounds or infection take a long time to heal.
Good diabetes control will reduce the risk or delay the onset of these complications.
How can Diabetes be prevented?
A number of studies have shown that regular physical activity can significantly reduce the risk of developing type 2 diabetes. Type 2 diabetes also appears to be associated with obesity. So, living a healthy lifestyle and maintaining a healthy weight will help reduce the chances of developing type 2 diabetes.
How can Diabetes be treated?
Healthy eating, physical activity and insulin injections are the basic therapies for type 1 diabetes. The amount of insulin taken must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose testing.
Healthy eating, physical activity, and blood glucose testing are the basic therapies for type 2 diabetes. In addition, many people with type 2 diabetes require oral medication, insulin, or both to control their blood glucose levels.
People with diabetes must take responsibility for their day-to-day care, and keep blood glucose levels from going too low or too high. They should see a health care provider who will monitor their diabetes control and help them learn to manage their diabetes. In addition, people with diabetes may see endocrinologists, who may specialise in diabetes care; ophthalmologists for eye examinations; podiatrists for routine foot care; and dietitians and diabetes educators who teach the skills needed for daily diabetes management.
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