Diabetes

What is it?

Symptoms

Causes

Diagnosis

Treatment

Prevention

What is it?

Diabetes is a disorder in which the body can not regulate the amount of sugar (glucose) in the blood. Glucose is produced by the liver from the foods we eat and is the main source of energy for the body.

In a healthy person, the blood glucose level is regulated by several hormones, one of which is insulin. Insulin allows glucose to move from the blood into our cells where it is utilised for growth and energy.

Persons with diabetes produce little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose then builds up in the blood, overflowing into the urine and passing out of the body, reducing the amount of energy the body can produce. In addition, the high levels of glucose in the blood can damage cells and organs.

There are three(3) types of diabetes:

Type 1

The body stops producing insulin or produces too little insulin to regulate blood glucose level. This type is typically recognized in childhood or adolescence. Persons living with type 1 diabetes generally require daily treatment of insulin.

Type 2

The body is partially or completely unable to use insulin that is produced. This type accounts for about 90% of cases of diabetes and is typically recognized in adulthood, usually after age 45 years. Type 2 diabetes is usually controlled with diet, weight loss, exercise, and oral medications

Gestational diabetes

A form of diabetes that occurs during the second half of pregnancy, which typically goes away after delivery. However, women who have gestational diabetes are more likely than other women to develop type 2 diabetes later in life.

Symptoms

• Excessive thirst and appetite
• Increased urination (sometimes as often as every hour)
• Unusual weight loss or gain
• Fatigue
• Nausea, perhaps vomiting
• Blurred vision
• In women, frequent vaginal infections
• In men and women, yeast infections
• Dry mouth
• Slow-healing sores or cuts
• Itching skin, especially in the groin or vaginal area

Causes

Type 1 diabetes is believed to be an autoimmune disease. The body's immune system attacks the cells in the pancreas that produce insulin.

• A predisposition to develop type 1 diabetes may run in families but much less so than for type 2.
  
• Environmental factors, such as certain types of viral infections, may also contribute.
  
• Type 1 diabetes is slightly more common in men than in women.

Type 2 diabetes is believed to have a strong genetic link, meaning that it tends to run in families. Several genes are being studied that may be related to the cause of type 2 diabetes. Risk factors for developing type 2 diabetes include the following:

• High blood pressure
  
• High blood triglyceride (fat) levels
  
• Gestational diabetes or giving birth to a baby weighing more than 9 pounds
  
• High-fat diet
  
• High alcohol intake
  
• Sedentary lifestyle
  
• Obesity or being overweight
  
• Aging: Increasing age is a significant risk factor for type 2 diabetes. Risk begins to rise significantly at about age 45 years, and rises considerably after age 65 years.

Diagnosis

Fingerstick blood glucose

This is a rapid screening test that may be performed at a medical office or at a hospital emergency department.

• A fingerstick blood glucose test is not as accurate as testing your blood in the laboratory but is easy to perform, and the result is available right away.
  
• The test involves sticking your finger for a blood sample, which is then placed on a strip. The strip goes into a machine that reads the blood sugar level. These machines are only accurate to within about 10% of actual laboratory values.
  
• Fingerstick blood glucose values may be inaccurate at very high or very low levels, so this test is only a preliminary screening study. This is the way most diabetics monitor their blood sugar levels at home.

Fasting plasma glucose

You will be asked to eat or drink nothing for 8 hours before having your blood drawn (usually first thing in the morning). If the blood glucose level is greater than or equal to 126 mg/dL without eating anything, you probably have diabetes.

• If the result is abnormal, the fasting plasma glucose test may be repeated on a different day to confirm the result, or you may undergo an oral glucose tolerance test or a glycosylated hemoglobin test (often nicknamed "hemoglobin A1c") as a confirmatory test.
  
• If your fasting plasma glucose level is greater than 100 but less than 126 mg/dL, then you have what is called impaired fasting glucose or IFG. This is a prediabetes condition. You do not have diabetes, but you are at high risk of developing diabetes in the near future.

Oral glucose tolerance test

This test involves drawing blood for a fasting plasma glucose test and then drawing blood for a second test 2 hours after you drink a very sweet drink containing 75 grams of sugar.

• If the blood sugar level after the sugar drink is greater than or equal to 200 mg/dL, you are probably diabetic.
  
  
• If the blood glucose level is between 140 and 199, then you probably have impaired glucose tolerance, which is also a prediabetic condition.

Treatment

Self Care

If you have diabetes, you would be wise to make healthful lifestyle choices in diet, exercise, and other health habits. These will help to improve glycemic (blood sugar) control and prevent or minimize complications of diabetes.

Diet
A healthy diet is key to controlling blood sugar levels and preventing diabetes complications.

Exercise
Regular exercise, in any form, can help reduce the risk of developing diabetes. Activity can also reduce the risk of developing complications of diabetes such as heart disease, stroke, kidney failure, blindness, and leg ulcers.

Alcohol use
Moderate or eliminate your consumption of alcohol. Try to have no more than 7 alcoholic drinks in a week and never more than 2-3 in an evening. One drink is considered 1.5 ounces of liquor, 6 ounces of wine, or 12 ounces of beer. Excessive alcohol use is a known risk factor for type 2 diabetes. Alcohol consumption can cause low or high blood sugar levels, nerve pain called neuritis, and increase in triglycerides, which is a type of fat in our blood.

Smoking
If you have diabetes, and you smoke cigarettes or use any other form of tobacco, you are raising your risks markedly for nearly all of the complications of diabetes. Smoking damages blood vessels and contributes to heart disease, stroke, and poor circulation in the limbs. If you need help quitting, talk to your health care provider.

Self-monitored blood glucose
Check your blood sugar levels frequently, at least before meals and at bedtime, and record the results in a logbook.

Medical Treatment

Treatment of Type 1 diabetes almost always involves the daily injection of insulin, usually a combination of short-acting insulin

For Type 2 diabetes, depending on how elevated your blood sugar and glycosylated hemoglobin are at the time of your diagnosis, you may be given a chance to lower your blood sugar level without medication. If this does not happen, then you will be given oral medication.

Prevention

There are not any known ways of preventing Type 1 diabetes, Type 2 diabetes, however, can be prevented in some cases.

• Control weight to normal or near-normal levels by eating a healthy low-fat, high-fiber diet.
  
• Regular exercise is crucial to the prevention of type 2 diabetes.
  
• Keep alcohol consumption low.
  
• Quit smoking.
  
• If you have high blood fat levels (such as high cholesterol) or high blood pressure, take your medication as directed.

Sources: WebMD, eMedicineHealth