What is diabetes? Diabetes (Diabetes Mellitus-DM) is not one disease, but a heterogeneous group of diseases, all of which occur concurrently. It is characterized by elevated levels of sugar in the blood due to the partial or complete deficiency of insulin.
Symptoms and Complications of Diabetes Mellitus DM
1. Acute Problems
- Polyuria and polydipsia
Excessive urination and increased thirst are the most initial and prominent manifestations of diabetes. Excess blood glucose causes kidneys to produce more urine. Increased urine production dehydrates the body leading to great thirst.
- Weight loss
In diabetes, there is unexplained weight loss with little or no loss of appetite. It is because the body can’t use glucose for energy and instead uses muscle and fat for this purpose. Also, water has weight, so dehydration also causes weight loss.
When the body is unable to use glucose, it uses ketones produced in the liver for energy production. Ketones build up in the blood leading to ketoacidosis. It also affects the nervous and vascular system and may lead to a coma.
- Fatigue, Weakness & Numbness
Cells run out of energy because they can’t use the available glucose. It causes extreme fatigue and numbness and lower limbs. Patients seem to be exhausted and lethargic and may tend to sleep a lot.
2. Chronic Issues
Increased blood glucose levels may damage the kidney’s glomeruli leading to kidney failure. It may cause proteins to leak into the urine leading to proteinuria.
High blood glucose damages the delicate retinal vessels. They may bleed into the eye severing the retina. Initially, patients experience blurred vision. The retinal injury ultimately leads to blindness. Hemorrhage in vitreous humor causes sudden blindness. Cataracts are common.
Numbness is a quite common presentation due to the damage of peripheral nerves due to high blood sugar. Patients may complain of “pins and needles” in feet, tingling, or hypersensitivity of hands and feet. Nervous damage may cause sweating and defecation problems.
Medications for diabetes and insulin may cause hypoglycemia. The person may come across an episode of sudden sweating, extreme headache, trembling with dizziness, and confusion. If the condition is left uncorrected, it may lead to a coma.
- Foot problems
Neural deterioration may present as loss of sense of touch in distal limbs. It may lead to sores and ulcers in feet chiefly big toe, as there is diminished blood flow, decreased temperature, and poor healing in lower extremities. Swelling of feet and legs may lead to gangrene, necessitating amputation.
- Increased risk of heart diseases and strokes and changes in blood vessels
Increased sugar levels lead to hypertension or high blood pressure. It not only damages large and small blood vessels but also leads to strokes due to poor blood circulation.
Diagnosis of Diabetes Mellitus
1. Fasting blood glucose test :
It is clinically written as BSF or fasting blood sugar level test. Blood glucose is tested after overnight fasting (8 hrs.). Normally, it is 70-100 mg%. If it exceeds 126 mg%, diabetes is diagnosed.
2. Random Blood Glucose test :
If blood glucose level exceeds 200 mg% at any time of the day (even after meal), this and other features of diabetes, are the ultimate signs of diabetes.
3. HbA1c :
Excess glucose may combine with blood Hb forming HbA1c. It should be less than 6.4 % in healthy individuals. Levels of 6.5% or higher, are signs of diabetes.
Types of Diabetes
Most cases of DM are into two groups; type 1 diabetes (T1D), previously called Insulin-dependent diabetes, and Type 2 diabetes (T2D), formerly called insulin-independent diabetes.
Type I diabetes
It is an autoimmune disorder where the cells of our immune system attack the beta cells of our pancreas. The stimulus may be genetic or any environmental factor like a viral infection.
- Age of onset
It can occur from childhood to puberty.
- Genetic predisposition
Although the inheritance pattern is unknown, this disease tends to run in families. In identical twins, if one develops DM type1, there are 30-50% chances of the other.
- Insulin status
Due to beta cell destruction, there is an absolute deficiency of insulin. Too little or no insulin is available.
Despite profound research, DM type 1 has no cure. Therefore, the treatment focuses on the prevention of complications by changing lifestyle and diet along with insulin shots.
Type II diabetes
The inability of the pancreas to produce sufficient insulin combined with insulin resistance leads t DM type 2. Insulin lets glucose into the cells. Its deficiency and the unresponsiveness of the cells leads to glucose accumulation in the blood. Genes and lifestyle both take part in the onset. Smoking, poor diet, obesity, and physical inactivity increase the probability.
- Age of onset
It can occur at any time, but most commonly develops middle age or later in life.
The increased prevalence of DM type 2 in recent years is particularly disturbing, especially in children. It is due to obesity and a sedentary lifestyle. Every 1 out of 11 adults has diabetes worldwide, out of which 46% are undiagnosed. 90-95% of the diabetic cases are that of type 2.
- Genetic predisposition
It runs in generations. Lifestyle also plays a part.
- Insulin status
Initially, it is high, but in chronic untreated conditions, it is low to absent.
Cut off sugars from the diet. Physical activity and regular exercise help a lot. Maintain weight within healthy limits. Also, follow a proper diet plan under the dietician’s suggestions.
This type of diabetes develops in pregnancy due to hormonal changes along with genetic factors. The placental hormone released in the third trimester may cause insulin resistance. Many females cope up with this situation very well by increased insulin production. But, obese ladies who gain extra weight during pregnancy may develop gestational diabetes. Babies born are hypoglycemic due to excess insulin and are at higher risk of developing type 2 diabetes.
Preventions of Diabetes and Pre-diabetes
It can only by changing the lifestyle. Quitting smoking and drinking, and following a balanced diet would prevent the risks. Not to forget the extreme importance of healthy sleeping habits and routine exercise.