Diabetes is a syndrome in which there is hyperglycemia i.e. sugar levels in blood is increased and it is a result of deficiency of insulin. Insulin is a hormone secreted by the pancreas which regulates the blood sugar levels.
Types of diabetes
Type 1
Type 2
Type 1 diabetes is observed in younger patients because it is due to genetic susceptibility. These patients have vulnerable genes which can get activated by infections or other biological processes.
Type 2 diabetes is more related to resistance of body tissues to insulin. It occurs in older age groups
HOW WOULD YOU KNOW THAT YOU HAVE DIABETIES! WHEN TO CONSULT A DOCTOR!
2. Polydipsia: Thirst has increased
3. Polyuria : Frequency of urination has increased
4. There is weight loss despite of a good appetite
5. A wound that doesn’t heal early
6. Visual disturbances
Well, these symptoms might not always relate to diabetes but it is alarming. You need to consult your doctors immediately. Delay in this can lead to delay in initiating a treatment. People with diabetes can most of the times live a normal life with appropriate treatment
If you are still reading then you got to know this too!!
Type 1 diabetes is of two types : 1A and 1B.
1A is immune mediated type and 1B is idiopathic i.e. no specific cause
Type 2 diabetes is mostly an acquired disease though genetic reasons may play a role. In this type our liver produces more glucose, and/or the body becomes resistant to insulin.
Insulin is a hormone secreted by the pancreas. Β cells in the pancreas. In type 2 initially there might be increased activity of these cells to produce more insulin so onset of diabetes is delayed but later these cells get exhausted and diabetes is established.
What’s important for you is why is diabetes so dangerous
1. Diabetic retinopathy: Diabetes causes vascular (blood vessel) changes in the eyes. It can lead from blurring of vision to complete loss of vision. Fundoscopy (examining the interior (retina) of eye) can detect that. An ophthalmologist can be consulted.
2. Diabetic Nephropathy: This causes enlargement of kidneys and loss of protein in urine. Protein in urine in early stages is reversible but once its quantity increases to a significant extent in urine it Is difficult to treat. This is important reason for morbidity and mortality in diabetes
3. Diabetic neuropathy: These are effects of diabetes involving the nervous system. Tingling sensations usually in legs and numbness might be present. In some cases there night be excruciating pain
4. Acute manifestations of diabetes
Type 1 diabetes that usually occurs in children may sometimes result into a condition called diabetic ketoacidosis. It occurs because insulin levels in blood fall to such an extent that brain and other tissues cannot utilize glucose though levels of glucose are very high. In such cases body derives energy from “ketone” which results into accumulation of acid results in acidosis.
In this case there might be nausea, vomiting, pain in abdomen and patient may go into come. It is a medical emergency and patient needs prompt treatment.
In type 2 diabetes there occurs a condition know as hyperglycemic hyperosmolar state i.e. blood sugar levels might be higher than 600mg/dl but there is absence of acidosis. It is seen in adults and does not develop as rapidly as ketoacidosis but the reason is increase in sugar levels in blood. It is also treated as an emergency
Some terms you would like to know
Glycosuria : loss of glucose in urine is called glycosuria. It may occur due to increased blood sugar levels (hyperglycemia) or changes in the kidney which excretes more glucose in urine (in the absence of diabetes)
Polyphagia : is a medical condition in which there is excessive hunger and abnormally large intake of solids by mouth. Reasons other than diabetes might be Grave’s disease or hyperthyroidism or emotional disturbances
Polydipsia : It is excessive intake of water more than a normal person drinks in a day. There is increased feeling of thirst. Other reasons may be blood loss, If it is not severe and is acute or metabolic conditions like hypokalemia or deficiency of zinc. Also may be due to poising with atropine (anti cholinergic) (drugs for motion sickness not used now). Or just mild dehydration.
Polyuria : It is increased production of urine and passage of urine along with increased frequency of urination. Might be also due to increased intake of fluids, hypercalcaemia
Hyperthyroidism, congestive heart failure, hypopituitarism, migraine, cold temperature
Gestational diabetes: is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy. Gestational diabetes is caused when the body of a pregnant woman does not secrete excess insulin required during pregnancy leading to increased blood sugar levels.
gestational diabetes
Blood glucose laboratory tests
1.fasting blood sugar test (FBS)
2.postprandial blood sugar test
3.glycosylated hemoglobin (HbA1C) more specific and reliable test!!
4.self-monitoring of glucose level via patient testingurine glucose test
5.oral glucose tolerance test (OGTT)
6.intravenous glucose tolerance test (IVGTT)
7.glycosylated hemoglobin (HbA1C)
8.urine glucose test
blood sugar after eating : these are postprandial levels and should be not more than 180 mg/dl
blood sugar low : this condition is called hypoglycemia
Fasting blood glucose
It is level of blood sugar prior to taking meals and is an important criteria for assessing diabetes. Normal fasting blood sugars should be : level of sugar in blood should be in the range of 90–130 mg/dL. Persons with levels between 100 and 125 mg/dL have impaired fasting glucose. It has been a dependable method for detection of diabetes. However oral glucose tolerance tests are more specific and blood sugar level tests are good screening procedures.
how is it tested?
gestational diabetes
Blood glucose laboratory tests
1.fasting blood sugar test (FBS)
2.postprandial blood sugar test
3.glycosylated hemoglobin (HbA1C) more specific and reliable test!!
4.self-monitoring of glucose level via patient testingurine glucose test
5.oral glucose tolerance test (OGTT)
6.intravenous glucose tolerance test (IVGTT)
7.glycosylated hemoglobin (HbA1C)
8.urine glucose test
blood sugar after eating : these are postprandial levels and should be not more than 180 mg/dl
blood sugar low : this condition is called hypoglycemia
Fasting blood glucose
reference :en.Wikipedia.org
how is it tested?
patient is made to fast overnight (for at least 8 hours) and blood sugar samples are taken No food or drinks is allowed prior to the test. postprandial test is done after 2 hours of meals and can detect postprandial blood sugar levels.
Obesity picture in India/ Statistics of Obesity in India and its relationship to diabetes mellitus
India has got a high prevalence of diabetes and one reason for this is obesity. With increase in standard of living in India ranging from consumption of junk food to consumption of traditional fat rich food, Diabetes is becoming commoner in India. Consumption of rice in South India to consumption of Fatty foods in North India are some of the risk factors. States like Punjab where people generally consume fat rich food and states like Tamil Nadu, Kerala ad Andhra Pradesh where carbohydrate rich food (rice) is consumed more have higher incidences of diabetes while those like Maharashtra where a more balanced diet is practiced have lower incidences. Hence diet and obesity has a significant influence on the outcome of diabetes. Insulin Resistance is reported to be higher in Diabetes caused due to dietary factors.
Maharashtrian diet : A typical Maharashtrian lunch or dinner usually starts with Poli (chapati), accompanied by one or more bhaaji(s) (cooked vegetables) and a koshimbir(vegetable salad) along with some sides(usually pickles, Chutneys, or papad (Poppadom)). This is usually followed by a second course of varan(lightly or unspiced Daal preparation), aamti (spicy Daal preparation) or rassa with rice.
Obesity picture in India/ Statistics of Obesity in India and its relationship to diabetes mellitus
India has got a high prevalence of diabetes and one reason for this is obesity. With increase in standard of living in India ranging from consumption of junk food to consumption of traditional fat rich food, Diabetes is becoming commoner in India. Consumption of rice in South India to consumption of Fatty foods in North India are some of the risk factors. States like Punjab where people generally consume fat rich food and states like Tamil Nadu, Kerala ad Andhra Pradesh where carbohydrate rich food (rice) is consumed more have higher incidences of diabetes while those like Maharashtra where a more balanced diet is practiced have lower incidences. Hence diet and obesity has a significant influence on the outcome of diabetes. Insulin Resistance is reported to be higher in Diabetes caused due to dietary factors.
Maharashtrian diet : A typical Maharashtrian lunch or dinner usually starts with Poli (chapati), accompanied by one or more bhaaji(s) (cooked vegetables) and a koshimbir(vegetable salad) along with some sides(usually pickles, Chutneys, or papad (Poppadom)). This is usually followed by a second course of varan(lightly or unspiced Daal preparation), aamti (spicy Daal preparation) or rassa with rice.
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