BASICS OF DIABETES

What is Diabetes?

Diabetes is a condition when someone not able to maintain a healthy levels of glucose or sugars in the blood. Glucose is the main source of energy for our body. A hormone called insulin helps to allow the body to use glucose for energy and control the blood glucose levels in the body. In diabetes, either body doesn’t make enough insulin or can’t use its own insulin as well as it should. Over a period of time presence of too much glucose in the blood may lead to serious health problems.

  • What is insulin and what happens in Diabetes?
  • What are the different types of diabetes?
  • What are the causes of diabetes?
  • Who are at higher risk of developing Type 2 Diabetes?
  • What are the common symptoms of diabetes?
  • What are the chances of developing diabetes if there is a family history of diabetes?
  • How can diabetes be prevented?
  • Can medications be stopped if someone with type 2 diabetes controls their diet and exercise?
  • Can natural or herbal therapies alone treat or manage Diabetes?
  • Who all are there who can help a person with diabetes in managing the condition?
  • What should I need to do or keep in mind to manage my diabetes better?
What is insulin and what happens in Diabetes?

Insulin is a hormone produced by the pancreas; serves as a “key” to open the cells, to allow the glucose enter into the cells — and use the glucose for energy.

However, In DIABETES the pancreas is no longer able to:

  • make any insulin*
  • or not make enough insulin*
  • or the insulin* that is produced does not work properly (known as insulin* resistance)

When there is no insulin the glucose stays in the blood, keeping the blood sugar levels high. This is called hyperglycaemia (high blood sugar).

What are the different types of diabetes?

Type 1: Type 1 diabetes is usually diagnosed in children and young adults, and accounts for 5-10% of total cases of diabetes. People with type 1 diabetes usually are thin or normal weight It occurs when insulin-making cells in pancreas are destroyed by the body. In type 1 diabetes, the body does not produce insulin. And, people with type 1 diabetes requires lifelong insulin injections for survival.

Type 2: Type 2 diabetes is commonly diagnosed in adults but now even younger people are getting it. Type 2 diabetes, accounts for 85-90% of total cases. Being overweight and poor lifestyle are the major causes. In type 2 diabetes either the body does not produce enough insulin or the cells cannot effectively utilize the insulin. It usually managed with lifestyle changes like healthy diet and increased physical activity initially. But due to its progressive nature medication and/or insulin are often required.

Pre-Diabetes: Pre-diabetes is often called borderline diabetes or pre-diagnosis of diabetes, which is an intermediate condition between normality and diabetes. Some people may have impaired fasting glucose (IFT), higher than normal fasting levels, or impaired glucose tolerance (IGT), or have higher than normal sugar levels following eating, or both. But in both the conditions blood glucose level (blood sugar levels) are higher than normal, but it’s not high enough to be considered diabetes. People with pre-diabetes are at high risk of developing to diabetes. Although it can be reversible if appropriate lifestyle measures are taken on time.

Gestational Diabetes Mellitus: Pregnant women who have never had diabetes before but who have high blood sugar (glucose) levels during pregnancy are said to have gestational diabetes. Pregnancy hormones cause the body to become resistant to insulin leading to higher blood sugar levels. It is often controlled with a specific meal plan, lifestyle changes but may also require insulin. It’s a temporary condition and usually disappears after the baby is born. However, In future, both mother and baby are at higher risk of developing diabetes.

What are the causes of diabetes?

The exact cause of type 1 diabetes is still unknown. It is believed that our immune system which normally fights with harmful bacteria and viruses, attacks the beta cells of pancreas. This reduces and finally stops the production of insulin which ultimately leads to increase in blood sugars. It is believed that a combination of some genetic and environmental factors are responsible.

In type 2 diabetes, our cells become resistant to the action of insulin and also the pancreas is not able to make enough insulin. This leads to increase in blood sugar level. Exact cause is unknown, however genetic and environmental factors like extra body weight, poor diet, physical inactivity etc. are believed to play a role in the development of type 2 diabetes.

Gestational diabetes usually occur because of the hormonal changes taking place during pregnancy which make the cells resistant to the action of insulin. In normal conditions the pancreas produces more insulin to overcome such resistance, however in some people it cannot keep up with the increased demand and ultimately leads to increase in blood sugar level.

Who are at higher risk of developing Type 2 Diabetes?

The people who are above 30 years of age, with a family history of diabetes, overweight or obese, who do not exercise regularly, have deranged cholesterol levels or have high blood pressure are at higher risk. Also, women who have had a baby weighing more than 4 kg or has history of PCOS may greater risk of having diabetes.

What are the common symptoms of diabetes?

The symptoms of Diabetes may vary depending on the blood sugar levels. Some people with type 2 diabetes may not experience the symptoms initially that’s why it may remain undiagnosed for long period. However, the development of type 1 diabetes is usually sudden and severe.

Some of the signs and symptoms of type 1 and type 2 diabetes are:

  • Frequent urination and thirst
  • Extreme hunger
  • Fatigue (feeling tired) and irritability
  • Frequent skin, gum, or bladder infections
  • Blurred vision
  • Unusual or sudden weight loss
  • Wounds that are slow to heal
  • Tingling or numbness in the hands and feet
  • Sexual problems

 

What are the chances of developing diabetes if there is a family history of diabetes?

Having a family history of diabetes is a strong risk factor for getting diabetes, however it is also influenced by environmental factors and lifestyle. Individuals with a family history of diabetes should get a blood glucose test done routinely to watch out for the risk and detect diabetes in early stages.

How can diabetes be prevented?

Research has shown that type 2 diabetes can be prevented or delayed in people at risk for the disease. With modest weight loss (8-10% of ideal body weight), eating healthy and balanced diet, managing stress and doing moderate physical activity (at least 30-60 minutes per day) people with high risk and family history of diabetes can delay or prevent the onset of type 2 diabetes.

Can medications be stopped if someone with type 2 diabetes controls their diet and exercise?

Lifestyle modification including a balanced diet and moderate physical activity is definitely beneficial. However, management of diabetes require a combination of healthy lifestyle and medication. One should talk to their health care provider regarding the dosage of medicines and management, which depends upon the severity of the disease.

Can natural or herbal therapies alone treat or manage Diabetes?

There are numerous marketing gimmicks about natural remedies to treat diabetes but one should not follow such claims blindly. The natural formulas might aid in managing your sugars up to certain extent. However there is limited clinical or research data, trials and evidence in managing diabetes. They can also have unknown side-effects or might interfere or alter action of your current diabetes treatment. That’s why it’s highly recommended that one should NEVER start any such formula without consulting their diabetes doctor.

Who all are there who can help a person with diabetes in managing the condition?

It is a team of skilled health professionals who will help patient to manage their diabetes and get the most out of the healthcare system.

The patient is the most important member of DIABETES CARE TEAM. Others members of Diabetes Care Team are:

  • Diabetologist/Endocrinologist
  • Diabetes Educator
  • Dietitian
  • Eye doctor
  • Foot doctor
  • Specialized doctor for heart and kidney
  • Dentist
  • Nurse
  • Pharmacist
  • Mental health counselor
  • Family and friends
  • Social support group
What should I need to do or keep in mind to manage my diabetes better?

Managing your diabetes, making changes and fitting the demands of diabetes into your lifestyle can be challenging at times. But for effective diabetes management you need to work closely with your diabetes care team and it’s important for you to learn the skills you will need to take care of yourself.

  • Work with your healthcare team to learn more about diabetes and self-management.
  • Discuss with your doctor what diabetes target numbers are best for you like before and after meal sugars, HbA1c, cholesterol numbers and blood pressure; keep a track of your numbers.
  • Discuss and understand the effects of medication, diet or exercise on your sugar levels.
  • Learn to check your blood glucose (sugar) at home as advised as it is the best tool to know your diabetes is under control and maintain a log-book.
  • Learn how to manage your sugars at home; if go too high or low.
  • Discuss how your medications work for you; also ask how to take, possible side effects and take them as advised.
  • Make more healthy food choices; and get a personalized diet plan for you from your nutritionist.
  • Be more active but take opinion from your doctor before getting started and get customized exercise plan suits your needs and disease condition.
  • Stay at a healthy weight by using your meal plan and moving more.
  • Stop smoking and limit alcohol intake. Ask for help to quit.
  • Learn to cope with stress; a counselor, support group, friend or a family member can help.
  • Learn about complications of diabetes and how it affects your eyes, heart, nerves, kidney, feet and overall body.
  • Learn daily care for your skin, mouth, feet and other parts of your body.
  • Make sure you get your diabetes tests done periodically as advised to prevent diabetes complications.
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