DIABETES

                                   USEFUL INFORMATION ABOUT DIABETES                                                                                                             

                                                                                                    - Collection  by:

                                                                                                      CHITRA SHIVKUMAR

Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced.The way of body uses digested food for growth and energy. Most of the food people eat is broken down into glucose, a form of sugar in the blood. Glucose is the main source of fuel for the body.

After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.

When people eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into the cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body in the urine. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

What are the types of diabetes?              

The three main types of diabetes are

  • Type 1 diabetes
  • Type 2 diabetes
  • Gestational diabetes

Type 1 Diabetes

Type 1 diabetes is an autoimmune disease. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. The pancreas then produces little or no insulin. A person who has type 1 diabetes must take insulin daily to live.

Type 1 diabetes accounts for about 5 to 10 percent of diagnosed diabetes .It develops most often in children and young adults but can appear at any age.

 

Symptoms:

Symptoms of type 1 diabetes usually develop over a short period, although beta cell destruction can begin years earlier. Symptoms may include.

What are the symptoms of type 1 diabetes (T1D)?
The symptoms may occur suddenly, and include one or more of the following:

  • Extreme thirst
  • Frequent urination
  • Drowsiness, lethargy
  • Sugar in urine
  • Sudden vision changes
  • Increased appetite
  • Sudden weight loss
  • Fruity, sweet, or wine-like odor on breath
  • Heavy, labored breathing
  • Stupor, unconsciousness

If not diagnosed and treated with insulin, a person with type 1 diabetes can lapse into a life-threatening diabetic coma, also known as diabetic

Type 2 Diabetes

The most common form of diabetes is type 2 diabetes. About 90 to 95 percent of people with diabetes have type 2. This form of diabetes is most often associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and certain ethnicities. About 80 percent of people with type 2 diabetes are overweight.

Type 2 diabetes is increasingly being diagnosed in children and adolescents. When type 2 diabetes is diagnosed, the pancreas is usually producing enough insulin, but for unknown reasons the body cannot use the insulin effectively, a condition called insulin resistance. After several years, insulin production decreases.

The symptoms of type 2 diabetes develop gradually. Their onset is not as sudden as in type 1 diabetes. Symptoms may include fatigue, frequent urination, increased thirst and hunger, weight loss, blurred vision, and slow healing of wounds or sores. Some people have no symptoms.

Risk factors for type 2 diabetes:

  1. Obesity
  2. Poor diet
  3. Sedentary lifestyle
  4. Increased age - 21% of people over 60 have diabetes
  5. Family history - Diabetes tends to run in families
  6. Ethnicity - Diabetes is more common in the African-American, Native American, Latino, Pacific Islander and Asian-American populations
  7. History of metabolic syndrome
  8. History of gestational diabetes

Gestational Diabetes

Some women develop gestational diabetes late in pregnancy. Although this form of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes have a 40 to 60 percent chance of developing type 2 diabetes within 5 to 10 years. Maintaining a reasonable body weight and being physically active may help prevent development of type 2 diabetes. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin.

When and What to Eat:

For diabetes, when you eat is as important as what you eat. Eating meals that are approximately the same size and combination of carbohydrates and fats at the same time everyday helps to keep blood sugar regular and predictable. The best diet is one that is low in fat, low in salt and low in added sugars. Complex carbohydrates such as whole grains, fruits and vegetables are preferable over simple carbohydrates like sugary soft drinks and and candy.

Diagnosis:

Insulin and Blood Sugar:

Someone who has Type 1 diabetes must take insulin everyday to survive. The person with diabetes has to check their blood sugar levels often and then inject themselves with the correct amount of insulin to counteract the amount of sugar. This mimics the action of the pancreas.

Diagnosing Type 2 Diabetes in Children

Diagnosis of childhood type 2 diabetes can be difficult because it often develops without symptoms. The usual symptoms include increased urination, increased thirst and weight loss, but a majority of kids who have type 2 don't show these signs. A simple urinalysis test performed at the pediatrician's office will show increased glucose in the urine, but often will not show the elevated ketones that would be present in an adult.

 

Testing Blood Sugar:

Frequently testing blood sugar levels helps to let you know how much insulin you will need to keep your levels as near to normal as possible. The usual times to test are: before meals, before bedtime and maybe one to two hours after meals or a big snack. Also test before you exercise because exercise will lower blood sugar also, and you don't want your blood sugar to drop too low either.

 

Blood tests:

  • Fasting blood glucose level-- diabetes is diagnosed if it is higher than 126 mg/dL twice. Levels between 100 and 126 mg/dL are called impaired fasting glucose or pre-diabetes. These levels are risk factors for type 2 diabetes.
  • Hemoglobin A1c test --
    • Normal: Less than 5.7%
    • Pre-diabetes: 5.7% - 6.4%
    • Diabetes: 6.5% or higher
  • Oral glucose tolerance test-- diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours. (This test is used more often for type 2 diabetes.)

A urine analysis may be used to look for high blood sugar. However, a urine test alone does not diagnose diabetes.

Your health care provider may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL. To confirm the diagnosis, one or more of the following tests must be done.

Treatment

  1. Medications - oral antihyperglycemic agents, injectable antihyperglycemics, insulin
  2. Blood glucose monitoring
  3. Keeping excess weight off
  4. Dietary changes - more vegetables and fruits, complex carbs and whole grains, fewer over-processed, fatty, starchy, sugary choices
  5. Daily exercise

Diabetes without proper treatments can cause many complications. Acute complications include hypoglycemia, diabetic ketoacidosis, or non ketotic hyperosmolar coma. Serious long-term complications include cardiovascular disease, chronic renal failure, and retinal damage. Adequate treatment of diabetes is thus important, as well as blood pressure control and lifestyle factors such as smoking cessation and maintaining a healthy body weight. 

 
  
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