What is diabetes?
Diabetes mellitus is a metabolic disorder characterized by dysfunctional carbohydrate metabolism which leads to hyperglycemia (high blood sugar).
When we eat food, it is broken down into simple sugars (glucose). Insulin, a hormone produced by pancreas, is responsible for lowering the blood sugar levels by increasing the glucose uptake by body cells. In diabetes, either there is not enough insulin being produced by the pancreas or the body cells are not responsive to insulin which in turn leads to high levels of glucose in the blood.
Diabetes can lead to a number of complications such as blindness (diabetic retinopathy), kidney failure (nephropathy), nerve damage (neuropathy), heart attack, and heart stroke if not managed properly.
There are different types of diabetes according to their pathology namely type 1 diabetes, type 2 diabetes, and gestational diabetes. However, they all have one thing in common – high blood sugar. We will discuss them in detail in the next section.
Type 1 diabetes
Type 1 diabetes is an autoimmune disease in which the immune system starts attacking the beta cells of pancreas. The beta cells are responsible for producing insulin. Hence damage to these cells leads to insufficient or no production of insulin at all which in turn causes blood sugar levels to rise.
Type 1 diabetes was previously known as juvenile onset diabetes or insulin-dependent diabetes. Type 1 diabetes has an early onset although it can occur at any age. The exact cause is unknown however genetics and some environmental factors such as an infection are thought to play a role. The management of type 1 diabetes is life-long insulin injections.
Type 2 diabetes
Type 2 diabetes, also known as adult-onset or non-insulin dependant diabetes, is the most common type of diabetes. It occurs due to insulin resistance. The cells in your body become resistant to insulin. The secretion of insulin by beta cells is normal mostly but they try to produce more and more insulin in order to overcome the resistance until eventually they get exhausted.
This is known as ‘beta cell exhaustion’ due to which the beta cells fail to secrete sufficient amounts of insulin.
Type 2 diabetes usually has a late onset. It is common among middle aged and older people but there is a rise in type 2 diabetes amongst children and adolescents due to their sedentary lifestyle. Type 2 diabetes is often linked to obesity and sedentary lifestyle although it can occur in non-obese people as well. Type 2 diabetes can be managed by diet modification, healthy lifestyle and certain medication.
Gestational diabetes is a type of diabetes that occurs during pregnancy. Female body undergoes multiple changes during pregnancy. It is normal to gain weight during pregnancy. This weight gain can lead to insulin resistance which in turn leads to high blood sugar levels.
Gestational diabetes can lead to certain complications such as a baby larger than average (fetal macrosomia) which makes the delivery very difficult. Gestational diabetes usually resolves on its own after delivery however these women are at an increased risk of developing type 2 diabetes later in life.
What is prediabetes?
Prediabetes is a condition that usually occurs before type 2 diabetes. In this condition, the blood sugar levels are higher than normal. However they are not high enough to be diagnosed as diabetes. There are certain lifestyle changes that one can opt for in order to prevent type 2 diabetes.
The general symptoms of type 1 and type 2 diabetes are as follows:
- Increased thirst
- Frequent urination
- Weight loss
- Blurry vision
- Frequent infections
- Increased hunger
- Sores that heal very slowly or not at all
Type 1 diabetes symptoms
The symptoms of type 1 diabetes can develop over a few weeks or months and can also occur suddenly. They also tend to be severe. In addition to the symptoms listed above, type 1 diabetes symptoms can include upset stomach and vomiting.
Type 2 diabetes symptoms
The symptoms of type 2 diabetes develop gradually over a long period of time. Due to this, a type 2 diabetic may not experience any symptoms at all. The symptoms can also go unnoticed because they are usually not that severe.
Gestational diabetes is usually not accompanied by any symptoms. Rarely, some women may experience increased thirst and frequent urination. Since most women do not experience any symptoms, doctors test the blood glucose levels between 24th to 28th weeks of pregnancy.
Diabetes has no cure but it can be managed by controlling the blood sugar levels through diet modifications, monitoring blood sugar levels regularly, physical activity, insulin and other medications.
Type 1 diabetes treatment
Since insulin is not produced in sufficient amounts or not at all in type 1 diabetics, the mainstay of treatment of type 1 diabetes is insulin. Insulin is available in the form of injections, pumps and insulin pens. There are different types of insulin depending on their onset and how long their effectiveness lasts.
- Rapid-acting insulin
- Short-acting insulin
- Intermediate-acting insulin
- Long-acting insulin
Your doctor can prescribe you a combination of these depending on various factors such as your age, blood sugar levels, physical activity and your diet. Sometimes, type 2 diabetics also require insulin as a part of their treatment.
Type 2 diabetes treatment
Type 2 diabetes can be managed by making changes to the diet and opting for healthy lifestyle choices such as introducing cardio in your daily routine.
Type 2 diabetics should cut down on carbohydrates and saturated fats. You should eat more fruits, vegetables and lean protein such as chicken.
Doctors can prescribe oral medication to type 2 diabetics. Sometimes insulin may also be required if oral medication alone is not enough. The following oral medications have different mechanisms of action but they all help lower blood sugar levels in one way or the other.
- Metformin (Glucophage)
- Alpha-glucosidase inhibitors
- DPP-4 inhibitors
- Glucagon-like peptides
- SGLT2 inhibitors
The management of gestational diabetes is to check the blood sugar levels regularly and keep them in control through diet and physical activity. If the lifestyle changes do not seem to be working or if the blood sugar levels are too high, then insulin might be required to avoid further complications.
The bottom line
Diabetes is a chronic metabolic disorder leading to high blood sugar levels. There are different types of diabetes depending on the cause but they all have raised blood sugar levels in common. Uncontrolled long standing cases of raised blood sugar levels can lead to a bunch of complications. Currently, there is no cure for diabetes but it can be managed by opting for a healthier lifestyle, diet modifications, insulin and oral medications.