Diabetes

WHAT IS IT?

Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is an important source of energy for the cells that make up your muscles and tissues. It’s also your brain’s main source of fuel.

If you have diabetes, it means you have too much glucose in your blood, which can lead to serious health problems.

Types
There are different types of diabetes. The most common are type 1 and type 2.

Type 1. With this type, which typically develops during childhood or adolescence, your pancreas is no longer able to produce the hormone insulin. This is critical because insulin is needed for glucose to enter your body’s cells. It’s like the key that unlocks the door.

Type 2. This type is more common in older adults, although it can occur in younger adults and children. With type 2 diabetes, your body either resists the effects of insulin or doesn’t produce enough insulin to maintain a normal glucose level.

Gestational diabetes. It develops during pregnancy and may resolve itself after the baby is born.

Prediabetes is a condition that often precedes diabetes, especially type 2. With prediabetes, your blood sugar levels are higher than normal, but not high enough to be classified as diabetes.

WHAT’S THE CAUSE?
The cause of diabetes varies and is dependent on the type.

Type 1 diabetes
With type 1 diabetes, your immune system — which normally fights harmful bacteria or viruses — attacks and destroys insulin-producing cells in the pancreas. Type 1 is thought to result from a combination of genetic susceptibility and environmental factors, although what many of those factors are is still unclear. Your risk of type 1 diabetes is increased if a parent or sibling has it.

Type 2 diabetes.
In type 2 diabetes, your cells become resistant to the action of insulin — making it more difficult for glucose to enter your cells and be used for energy. Exactly why this happens is uncertain. Genetics and environmental factors are thought to play a role. Being overweight is strongly linked to the development of type 2 diabetes. Medical conditions such as high blood pressure and high triglyceride levels may increase your risk as well.

Gestational diabetes. 
During pregnancy, the placenta produces hormones to sustain your pregnancy. These hormones make your cells more resistant to insulin. Normally, your pancreas responds by producing extra insulin. Sometimes it can’t keep up and diabetes results.

SYMPTOMS
Initially, some people don’t experience any signs or symptoms. The most common signs and symptoms of type 1 and type 2 diabetes are:

•  Increased thirst
• Frequent urination
• Extreme hunger
• Unexplained weight loss
• Ketones in the urine (Ketones are a byproduct of the breakdown of muscle and fat.)
• Fatigue
• Irritability
• Blurred vision
• Slow-healing sores
• Frequent infections, such as gum, skin and vaginal infections

WHAT TESTS TO EXPECT
The tests you may undergo will depend on the type of diabetes you may have. You may receive one or more of the following tests.

Hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It does this by measuring the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you’ll have with sugar attached.

Random blood sugar test. A blood sample is taken at a random time, regardless of when you last ate. A random blood sugar level of 200 milligrams per deciliter (mg/dL) or higher suggests diabetes.

Fasting blood sugar test. A blood sample is taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL is normal. A fasting blood sugar level from 100 to 125 mg/dL is considered prediabetes. If it’s 126 mg/dL or higher on two separate tests, you have diabetes.

Oral glucose tolerance test. You fast overnight, and your fasting blood sugar level is measured. Then you drink a sugary liquid, and your blood sugar level is tested periodically for the next two hours. A blood sugar level of less than 140 mg/dL is normal. A reading of more than 200 mg/dL after two hours indicates diabetes. A reading between 140 and 199 mg/dL indicates prediabetes.

Urine test. If type 1 diabetes is suspected, your urine may be tested for ketones.

TREATMENT

1. Insulin. If you have type 1 diabetes, you need daily insulin to survive. Some people with type 2 diabetes also take insulin. Insulin comes in many forms, include fast-acting and long-acting forms. Most often, the hormone is injected using a fine needle and syringe or an insulin pen — a device that looks like a large ink pen. An insulin pump also may be an option. Worn on the outside of your body, it dispenses the hormone as instructed.
2. Other medications. Other oral or injected medications may be prescribed for type 2 diabetes. Some stimulate your pancreas to produce and release more insulin. Others inhibit the production and release of glucose from your liver, which means you need less insulin to transport sugar into your cells. Still, others block the action of stomach or intestinal enzymes that break down carbohydrates or make your tissues more sensitive to insulin.
3. Bariatric surgery. Although not specifically a treatment for type 2 diabetes, people with a body mass index higher than 35 may benefit from this type of surgery. People who’ve undergone gastric bypass have seen significant improvements in their blood sugar levels.

LIFESTYLE 

• Lose weight. Fat cells interfere with insulin’s ability to work properly. Weight loss can help control blood sugar, especially among people with type 2 diabetes.
• Eat a healthy diet. Follow a diet that’s centered on fruits, vegetables, and whole grains — foods high in nutrition and fiber and low in fat and calories — and that limits animal products, refined carbohydrates, and sweets. A registered dietitian can help create a healthy meal plan. You’ll also learn about carbohydrate counting, especially if you have type 1 diabetes.
• Be physically active. Exercise increases your sensitivity to insulin, which means your body needs less insulin to transport sugar into your cells. Regular exercise can also prevent prediabetes from turning into diabetes.
• Monitor your blood sugar. You may need to check your blood sugar level daily, perhaps even several times a day.

SIGNS OF TROUBLE
If your blood sugar is very high or drops very low, serious conditions can result.

• High blood sugar (hyperglycemia). It can cause frequent urination, excessive thirst, blurred vision, fatigue, and nausea. Insulin is needed to relieve symptoms.
• Low blood sugar (hypoglycemia). People who take glucose-lowering medications or insulin are most at risk. Signs and symptoms include sweating, shakiness, dizziness, headache, blurred vision, heart palpitations, irritability, drowsiness, confusion, fainting, and seizures. Low blood sugar is treated with glucose tablets or a food or beverage high in carbohydrates that are quickly absorbed.

Manage your Diabetes effectively.

           Excerpt From: The Mayo Clinic. “Mayo Clinic A to Z Health Guide”.