Diabetes: A Comprehensive Guide

 

Introduction

Diabetes is a long-term metabolic condition in which the level of blood glucose becomes high because of the incapacity of the body to manufacture or utilize relatively well insulin. It is a worldwide health problem, and it also affects millions of people all over the world. The International Diabetes Federation (IDF) stated that in 2021 there were about 537 million adults living with diabetes and the number will increase to 643 million in 2030.

The paper is a detailed examination of diabetes, what it is, its types, causes, symptoms, complications, modes of diagnosis, and prevention and treatment.

 

Types of Diabetes

Diabetes comes in different categories, and each type has its causes and methods of management:

1. Type 1 Diabetes (T1D)

·        Cause: The immune system produces an autoimmune disease that destroys the insulin producing beta cells in the pancreas.

·        Onset: It is usually identified in children and young adults but it can be identified at any age.

·        Treatment: Needs a lifetime treatment of insulin by injection or insulin pump.

·        Risk Factors: Hereditary, environmental stimulus (e.g. viral infections).

2. Type 2 Diabetes (T2D)

·        Cause: Insulin resistance (no cells respond to insulin) and advancing deficiency of insulin.

·        Onset: It is most prevalent in adults over 45 years old, although there is an increasing prevalence in the younger population because of obesity and sedentary lifestyles.

·        Treatment: It is controlled by lifestyle modification, oral drugs and in some cases insulin.

·        Risk Factors: Obesity, lack of physical activities, family history, and poor nutrition.

3. Gestational Diabetes (GDM)

·        Cause: During pregnancy, the changes in hormones cause insulin resistance.

·        Development: It occurs during pregnancy, and often during the second or third trimester.

·        Treatment: Diet, exercise and occasionally insulin are used to control.

·        Risk Factors: Before pregnancy overweight, past history of GDM, family history of diabetes.

4. Other Types

·        Prediabetes: The level of the sugar in the blood is increased above normal but not to the extent that a person may be declared to have diabetes.

·        Monogenic Diabetes: This form of diabetes is wrought by one gene mutation (e.g. Maturity-Onset Diabetes of the Young (MODY)).

·        Secondary Diabetes: Outcome of other illnesses (e.g. pancreatitis, Cushing syndrome).

 

Causes and Risk Factors

Diabetes develops as a result of genetic, environmental and lifestyle:

Genetic Factors

·        History of family augmented risk (particularly that of T1D and T2D).

·        Some genes are associated with autoimmune beta cell annihilation (T1D).

Lifestyle and Environmental Factors

·        Obesity: The presence of excess fat, especially the abdominal fats, causes insulin resistance.

·        Physical Inactivity: Insensitivity to insulin is decreased in the presence of lack of exercise.

·        Poor Diet: Consumption of lots of sugary foods, refined carbohydrates and saturated fats.

·        Age: With age, the risk rises (this is particularly true of T2D).

Medical Conditions

·        Polycystic ovary syndrome (PCOS)

·        High Blood Pressure and High Cholesterol

·        Historical Gestational Diabetes

 

Symptoms of Diabetes

The symptoms differ according to the type and severity but usually contain:

Common Symptoms

·        Inordinate thirst (Polydipsia)

·        Urinary incontinence (Frequent urination) (Polyuria)

·        Crazed hunger (Polyphagia)

·        Weight loss (weight loss is characteristic of T1D)

·        Lassitude and impatience

·        Blurred vision

·        Slow-healing wounds

·        Recurrent infections (e.g. yeast infections)

Symptoms Specific to Type 1 Diabetes

·        Acute development of symptoms

·        Urinary ketones (which cause diabetic ketoacidosis when untreated)

Symptoms Specific to Type 2 Diabetes

·        Slow progression (can be unnoticed within years)

·        Vitiligo like dark spots on skin (Acanthosis nigricans)

 

Complications of Diabetes

Complications may result when diabetes is not well controlled:

Acute Complications

·        Diabetic Ketoacidosis (DKA) is a potentially fatal condition of T1D because of excessive ketones.

·        Hyperosmolar Hyperglycemic State (HHS) - high blood sugar with severe dehydration in T2D.

·        Hypoglycemia- Extreme low blood sugar, usually as a result of too much insulin.

Read Also: - Blood Poisoning: Causes, Symptoms, and Treatment

Chronic Complications

1. Cardiovascular Diseases

·        Heightened danger of heart attack, stroke and hypertension.

2. Neuropathy (Nerve Damage)

·        Peripheral neuropathy (tingling, pain or numbness of hands/feet).

·        Autonomic neuropathy (Gastrointestinal problems, erectile dysfunction).

3. Nephropathy (kidney disease)

·        Most common cause of kidney failure that needs dialysis.

4. Retinopathy (Eye Damage)

·        May cause blindness or blindness.

5. Foot Complications

·        Lack of circulation and nerve damage causes susceptibility to ulceration and amputations.

6. Skin Conditions

·        Heightened susceptibility of bacterial and fungal diseases.

 

Diagnosis of Diabetes

Diabetes is identified by means of blood tests:

Test	Normal	Prediabetes	Diabetes
Fasting Blood Sugar	<100 mg/dL	100–125 mg/dL	≥126 mg/dL
A1C Test	<5.7%	5.7–6.4%	≥6.5%
Oral Glucose Tolerance Test (OGTT)	<140 mg/dL	140–199 mg/dL	≥200 mg/dL
Random Blood Sugar	-	-	≥200 mg/dL with symptoms

 

Treatment and Management

1. Lifestyle Modifications

·        Healthy Diet: Emphasize on whole grains, protein, vegetables and healthy fats.

·        Regular exercise: 150 minutes of moderate exercise a week.

·        Weight Management: It is possible to enhance insulin sensitivity by losing 5-10 percent of body weight.

2. Medications

For Type 1 Diabetes

·        Insulin (rapid-acting, long-acting or a combination).

For Type 2 Diabetes

·        Metformin (first-line medication to decrease production of glucose by the liver).

·        SGLT 2 inhibitors (assist kidneys in eliminating extra glucose).

·        GLP-1 receptor agonists (insulin release stimulating).

3. Monitoring

·        Monitoring of the glucose in the blood (finger-prick tests or continuous glucose monitors).

·        Periodical tests A1C (3-6-monthly).

4. Advanced Treatments

·        Insulin pumps (to be accurate in insulin delivery).

·        Islet cell transplants or Pancreas transplants (experimental on T1D).

 

Prevention Strategies

For Type 2 Diabetes & Prediabetes

·        Be of healthy weight.

·        Exercise regularly.

·        Have a low-glycemic diet.

·        Do not smoke and drink a lot.

For Gestational Diabetes

·        Supervise sugar level in pregnancy.

·        Take a physician-prescribed diet.

 

Conclusion

Diabetes is an alarming yet controllable disease. Complications can be prevented with early diagnosis and proper treatment as well as lifestyle change that helps to improve quality of life. The awareness of people and their access to healthcare plays an important role in fighting this global epidemic.

Learning about the types, symptoms, risk factors and methods of management, people can make proactive efforts to prevent or manage diabetes in an effective way.

 

References:

·        American Diabetes Association (ADA)

·        World Health Organization (WHO)

·        International Diabetes Federation (IDF)

·        National Institute of Diabetes and Digestive and Kidney diseases (NIDDK)