Diabetes Mellitus - All You Should Know!

It is imperative to maintain optimum levels of nutrients, hormones, gases, ions, enzymes, and pretty much everything in the blood. To achieve this, the human body maintains homeostatic mechanisms to ensure the concentrations of different substances are kept within precise limits.

However, some conditions can cause these homeostatic paths to be disrupted. This is what happens in diabetes mellitus.

Usually, excess glucose is taken up by our body's cells to keep blood glucose levels under a set limit. Patients diagnosed with diabetes mellitus have abnormally high blood glucose levels. This can cause mild to severe levels of symptoms that can be life-threatening.

By the end of this thread, you will be fully educated about this highly prevalent cardio metabolic disorder and possible lifestyle changes that you might have to undertake going forward for both prevention and treatment.

 

What is Diabetes Mellitus?

The pancreas, an organ located just behind the stomach, secretes the hormone insulin. Insulin travels via the bloodstream to specific target cells and stimulates changes in such a way as to increase the uptake of excess glucose by the cells.

Diabetes occurs due to pathophysiological changes

1. either the beta cells of the pancreas don't produce enough insulin, or

2. our body cells don't respond to insulin in the usual way.

Hence, this causes the blood glucose levels to exceed beyond normal limits.

Types of Diabetes Mellitus

Multiple types of diabetes exist with various etiologies, risk factors, symptoms, and treatment plans.

Let's discuss the most common ones that you will find people living with:

1. Type 1 Diabetes: This type of diabetes is the result of an auto-immune reaction. Our immune system detects beta cells in the pancreas as foreign bodies and makes antibodies against these insulin-producing cells to destroy them. This leads to low levels of insulin production. The onset of type 1 diabetes is usually during childhood which is why it is also sometimes referred to as 'Juvenile Diabetes.' The prevalence of this type of diabetes is around 5%. Research suggests that there might be viral infections that trigger our immune system to destroy the insulin-producing cells. Stress and physical illness may also trigger type 1 diabetes. Additionally, there might be certain genetic tendencies that might make some children more prone to this disorder.

2. Type 2 Diabetes: Individuals diagnosed with type 2 diabetes produce enough insulin, however the body cells don't respond to insulin the usual way. Muscle, liver, and fat cells develop insulin resistance which means they lose the ability to uptake glucose and use it. The onset of type 2 diabetes is usually after 30 years of age. Older people often develop this condition. Statistically, 95% of diabetics are type 2, making it the most common version of the condition.

Risk Factors for Diabetes Mellitus

The risk factors for type 2 diabetes are quite different than those for type 1.

Because it is more common, let's focus on the risk factors for type 2 diabetes.

• Obesity increases the risk of developing type 2 diabetes significantly. Around 80-90% of people with type 2 diabetes are overweight.
• Lower levels of HDL or 'good' cholesterol also increases the chances of developing type 2 diabetes.
• People with a history of cardiovascular conditions such as hypertension, stroke are also more prone to have this condition.
• Women with polycystic ovarian syndrome are also at higher risk.
• Smoking
• Sedentary lifestyle
• Family history

Symptoms

Type 1 and Type 2 Diabetes

1. More hunger than usual

2. Frequent urination

3. Higher thirst

4. Feeling of tiredness

5. Slow healing of injuries

6. Mood changes

Gestational Diabetes

This type of diabetes is perhaps symptomless. During pregnancy, females develop a placenta structure that secretes various hormones to maintain the gestation period. Hormones released by the placenta make some of the body's cells more resistant to insulin. Hence, glucose levels in the blood start rising.

Risk factors that increase the chances of developing Gestational Diabetes include family history, early pregnancies, and obesity. Also, women from some ethnic groups are more prone to develop this type.

Complications

Type 1 and Type 2 Diabetes:

Diabetes causes the constriction of the blood vessels. This restriction in blood flow makes the patient susceptible to many side complications related to different organs.

Some of the more prevalent ones are:

1. Kidney damage (nephropathy)

2. Nerve damage (neuropathy)

3. Eye damage (retinopathy)

4. Cardiovascular conditions such as atherosclerosis, coronary artery disease, and heart attack, etc.

5. Erectile dysfunction

6. Brain disorders like dementia and depression, etc.

7. Foot damage/gangrene

Gestational Diabetes:

Mild gestational diabetes might not result in any complication, but uncontrolled blood glucose levels may prove life-threatening for both the baby and mother.

Some of the complications to the baby include:

1. The higher than usual weight of the baby

2. Low blood sugar (hypoglycemia)

3. More prone to develop type 2 diabetes later in life

4. Untreated, gestational diabetes may lead to the death of the baby

Some of the complications to the mother include:

1. Preeclampsia

2. Future pregnancies might also suffer from gestational diabetes

3. C- section delivery of the baby

What to Expect from the Doctor?

If you experience any of the above symptoms, you will have to visit your primary care physician. They are likely to prescribe blood tests to identify blood glucose.

Either you will have to undergo a fasting plasma glucose (FPG) test after 8 hours of fasting, or an HbA1C test, which tests your record of the previous three months. HbA1C is quite a common test used to diagnose prediabetes and diabetes.

If you are pregnant, you will have to undergo tests at regular intervals, especially between 24 and 28 weeks of pregnancy.

An early diagnosis can help you manage diabetes at the early stages before you develop severe complications.

Treatment of Diabetes:

1. Type 1: Since you lose the ability to produce insulin naturally, you need to inject insulin to cope up. Depending on your blood tests, your diabetologist will prescribe you the type of Insulin that will meet your requirements, such as either Rapid/intermediate-acting insulin or long/short-acting insulin.

2. Type 2: To manage your type 2 diabetes, start with simple lifestyle changes such as exercise and dietary manipulations. Sometimes, a few combinations of medications may also help.

3. Gestational Diabetes: Continuous monitoring is must during pregnancy. Again, you might have to do some exercise keeping in mind the health concerns of the baby and make dietary changes to bring down glucose levels. A few shots of insulin might have to be injected as well.

Simple Lifestyle Changes:

While diabetes isn't entirely preventable, simple lifestyle changes can make more significant impacts.

Doing mild-level exercise, making dietary changes such as following a Mediterranean diet, cutting down saturated fats, or eating fruits and vegetables can minimise the risk.

Try losing weight if you fall into the obese category. It will do wonders!

Way Ahead if You have been Diagnosed with Diabetes

If your blood tests indicate diabetes of any type, the first thing is not to panic.

Make sure to have a detailed appointment with a doctor. Your diabetologist will help you set a roadmap that will include your routine, diet, medication, and pretty much everything.

All we would suggest is you strictly follow the plan. Occasional cheat meals are acceptable, but that too within precise limits. Just be disciplined and persistent!

Eat sugar but avoid getting sugary (on a lighter note). Interpret this hack to stay miles away from diabetes.