Diabetes Clinic

What is Diabetes?

Diabetes is a lifelong chronic metabolic disorder characterised by high blood sugar (or glucose) levels in the blood. This is called hyperglycaemia.

Glucose is usually regulated by the hormone insulin, produced in the pancreas within the abdomen.

It is vitally essential for a person suspected of having diabetes to attend the practice urgently.

Anatomy of Diabetes

The pancreas is a leaf-shaped organ located just below the stomach and responsible for regulating glucose levels in the blood. This is done by the secretion of insulin hormone by tiny clusters of cells called Islets of Langerhans, which are present in the pancreas.

After a meal, the blood glucose level rises, causing beta cells (which form part of the Islets) to release insulin into the blood. This instigates body cells to absorb glucose to be used as fuel.

When the diabetes disorder exists, one of two things can occur, either little or no insulin is produced by the pancreas, or the body cells are resistant to the action of insulin, causing increased blood glucose levels (hyperglycemia).

How Does Diabetes Impact Your Health?

Diabetes can have several negative impacts on the body and overall health. High blood sugar levels can damage blood vessels and nerves, leading to complications such as cardiovascular disease, kidney damage, and nerve damage (neuropathy). It can also lead to eye problems, including cataracts and diabetic retinopathy, which can cause blindness. Diabetes is also a significant risk factor for amputations due to poor circulation and nerve damage in the feet and legs.

Long-term high blood sugar levels can also damage the body's ability to produce insulin, making it more difficult to control blood sugar levels over time. This can lead to complications such as diabetic ketoacidosis (a serious, life-threatening condition) and nonketotic hyperosmolar coma (severe dehydration that can lead to unconsciousness).

In addition, diabetes can also affect a person's mental health, leading to feelings of depression and anxiety.

Diabetes is a severe chronic disease, and it's necessary to take care of it with regular check-ups, monitoring blood sugar levels, and taking medications as prescribed by the doctor.

What are the Types of Diabetes?

Type 1 Diabetes

Also known as insulin-dependent diabetes, this type of diabetes is an autoimmune disorder in which the body's immune system attacks and destroys the cells that produce insulin. As a result, the body cannot produce enough insulin to regulate blood sugar levels, and people with type 1 diabetes must take insulin injections to survive.

Type 2 Diabetes

This is the most common form of diabetes, and it is characterised by insulin resistance, in which the body's cells do not respond appropriately to insulin. This can lead to high blood sugar levels and is often associated with obesity and a sedentary lifestyle. People with type 2 diabetes may be able to manage their condition with lifestyle changes such as diet and exercise, but many will eventually need medication, including insulin.

Gestational Diabetes

This type of diabetes develops during pregnancy when the body's cells become less responsive to insulin. It usually goes away after giving birth, but women with gestational diabetes have a higher risk of developing type 2 diabetes later in life.

Who is Most at Risk for Diabetes?

Anyone can develop diabetes, but certain factors can increase a person's risk. Some of the significant risk factors for type 2 diabetes include:

  • Obesity: Excess weight, particularly around the waist, increases the risk of insulin resistance and diabetes.
  • Age: The risk of type 2 diabetes increases as people get older, especially after the age of 45.
  • Family history: A parent or sibling with type 2 diabetes increases a person's risk of developing the condition.
  • Race and ethnicity: Some ethnic groups, such as Hispanic and some Asian nationals, have a higher risk of developing type 2 diabetes.
  • Low physical activity: A sedentary lifestyle and lack of physical activity can increase the risk of diabetes.
  • High blood pressure: High blood pressure is a risk factor for diabetes and cardiovascular disease.
  • High cholesterol: High cholesterol, exceptionally high triglycerides, and low HDL cholesterol are risk factors for diabetes.
  • History of gestational diabetes or giving birth to a baby weighing more than 9 pounds: Women who have had gestational diabetes or given birth to a large baby are at increased risk of developing type 2 diabetes later in life.

While type 1 diabetes is not caused by lifestyle factors and is not preventable, specific genetic markers may be associated with a higher risk of type 1 diabetes. Still, it's unclear how much these genetic factors contribute to the overall risk of type 1 diabetes.

What Causes Diabetes?

The causes of diabetes vary depending on the type of diabetes.

Type 1 diabetes is caused by an autoimmune disorder in which the body's immune system attacks and destroys the cells that produce insulin. The exact reason this happens is not yet understood, but it is believed to be a combination of genetic and environmental factors.

Type 2 diabetes, on the other hand, is caused by a combination of factors, including:

  • Insulin resistance: As the body becomes resistant to the effects of insulin, the pancreas produces more insulin to try to compensate. Over time, the pancreas cannot meet the body's needs, and blood sugar levels rise.
  • Beta cell dysfunction: The cells in the pancreas that produce insulin (beta cells) may not be functioning correctly, which can lead to a decrease in insulin production.
  • Genetics: A family history of diabetes can increase a person's risk of developing the condition.
  • Lifestyle factors: A diet high in sugar and saturated fat, lack of physical activity, and being overweight or obese can increase the risk of developing type 2 diabetes.

Gestational diabetes is caused by the hormonal changes of pregnancy, which can make it harder for the body to use insulin. It is not yet understood why some women develop gestational diabetes, and others do not.

Symptoms of Diabetes

The symptoms of diabetes can vary depending on the type of diabetes and the severity of the condition. Some of the most common symptoms of diabetes include:

  • Increased thirst and frequent urination
  • Fatigue
  • Hunger
  • Blurred vision
  • Slow-healing wounds or frequent infections
  • Numbness or tingling in the hands and feet
  • Dry, itchy skin 

As the loss of insulin production progresses, a patient may develop the following:

  • Stomach pain
  • Vomiting
  • Become very ill

How is Diabetes Diagnosed?

Diabetes is typically diagnosed through a combination of blood tests. The most common tests used to diagnose diabetes include:

  • A fasting blood sugar test (FBS) measures the sugar level in the blood after an overnight fast. An average fasting blood sugar level is less than 100 milligrams per deciliter (mg/dL). A 126 mg/dL or higher on two separate tests indicates diabetes.
  • The oral glucose tolerance test (OGTT) measures the body's ability to process sugar. After an overnight fast, a person drinks a solution containing a specific amount of glucose, and their blood sugar levels are measured at regular intervals over the next two hours. An average two-hour blood sugar level is less than 140 mg/dL. A level of 200 mg/dL or higher on two separate tests indicates diabetes.
  • The Haemoglobin A1c test measures the average blood sugar level over the past two to three months. An A1c level of 6.5% or higher indicates diabetes.
  • Random blood sugar test measures the sugar level at any time of the day regardless of when the person last ate. An arbitrary blood sugar level of 200 mg/dL or higher, along with symptoms of diabetes, such as increased thirst or frequent urination, can indicate diabetes.

If your test results are positive for diabetes, your doctor may recommend additional tests, such as a urine test or an eye exam, to check for complications of diabetes.

Is Diabetes Curable?

Currently, diabetes does not have a cure. Treatment will have to be continued throughout life to control the symptoms of the disease.

Timely treatment and lifestyle changes can help control the condition and its symptoms and prevent serious complications.

What are the Treatments for Diabetes?

Treatment for diabetes aims to keep blood sugar levels within a target range and prevent or delay the development of diabetes-related complications. The specific treatment plan will depend on the type of diabetes, the individual's age, overall health, and personal preferences.

The most common treatments for diabetes include:

  • Medications: People with type 2 diabetes may need to take one or more oral medications or insulin to help control their blood sugar levels. These medications work by increasing the body's sensitivity to insulin, stimulating the pancreas to produce more insulin, or slowing the absorption of sugar from the gut.
  • Lifestyle changes: Eating a healthy diet, staying physically active, and losing weight (if overweight) can help improve blood sugar control and prevent or delay the development of diabetes-related complications.
  • Monitoring: People with diabetes must monitor their blood sugar levels at home and adjust their treatment plan as needed. This may include adjusting medications and meal plans and increasing physical activity.
  • Insulin: People with type 1 diabetes and some with type 2 diabetes will need insulin injections to help control their blood sugar levels.
  • Bariatric Surgery: This is an option for some people with type 2 diabetes who are severely overweight and cannot control their blood sugar levels with lifestyle changes and medications.

Work closely with your doctor to develop a treatment plan for you. Regular check-ups and monitoring for diabetes-related complications are also essential for managing diabetes and maintaining overall health.

What if Diabetes is Untreated?

If diabetes is left untreated, it can lead to severe and potentially life-threatening complications. High blood sugar levels can damage the blood vessels and nerves, leading to several health problems. Some of the most common complications of untreated diabetes include:

  • Cardiovascular disease
  • Kidney damage
  • Nerve damage
  • Eye damage.
  • Skin complications
  • Dental problems
  • Sexual dysfunction
  • Amputations

Many of these complications can be prevented or delayed with proper management of diabetes. This includes regular check-ups, monitoring blood sugar levels, taking medications as prescribed, eating a healthy diet, and staying physically active.

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