Understand Diabetes
Diabetes is a condition that happens when your blood sugar (glucose) is too high. It develops when your pancreas doesn’t make enough insulin or any at all, or when your body isn’t responding to the effects of insulin properly. Diabetes affects people of all ages. Most forms of diabetes are chronic (lifelong), and all forms are manageable with medications and/or lifestyle changes.
Glucose (sugar) mainly comes from carbohydrates in your food and drinks. It’s your body’s go-to source of energy. Your blood carries glucose to all your body’s cells to use for energy. When glucose is in your bloodstream, it needs help — a “key” — to reach its final destination. This key is insulin (a hormone). If your pancreas isn’t making enough insulin or your body isn’t using it properly, glucose builds up in your bloodstream, causing high blood sugar (hyperglycaemia).
Over time, having consistently high blood glucose can cause health problems, such as heart disease, nerve damage and eye issues. The technical name for diabetes is diabetes mellitus. Another condition shares the term “diabetes” — diabetes insipidus — but they’re distinct. They share the name “diabetes” because they both cause increased thirst and frequent urination. Diabetes insipidus is much rarer than diabetes mellitus.
Types of diabetes
There are several types of diabetes. The most common include:
Type 2 diabetes: With this type, your body doesn’t make enough insulin and/or your body’s cells don’t respond normally to the insulin (insulin resistance). This is the most common type of diabetes. It mainly affects adults, but children can have it as well.
Prediabetes: This type is the stage before Type 2 diabetes. Your blood glucose levels are higher than normal but not high enough to be officially diagnosed with Type 2 diabetes.
Type 1 diabetes: This type is an autoimmune disease in which your immune system attacks and destroys insulin-producing cells in your pancreas for unknown reasons. Up to 10% of people who have diabetes have Type 1. It’s usually diagnosed in children and young adults, but it can develop at any age.
Gestational diabetes: This type develops in some people during pregnancy. Gestational diabetes usually goes away after pregnancy. However, if you have gestational diabetes, you’re at a higher risk of developing Type 2 diabetes later in life.
Other types of diabetes include:
Type 3c diabetes: This form of diabetes happens when your pancreas experiences damage (other than autoimmune damage), which affects its ability to produce insulin. Pancreatitis, pancreatic cancer, cystic fibrosis and hemochromatosis can all lead to pancreas damage that causes diabetes. Having your pancreas removed (pancreatectomy) also results in Type 3c.
Latent autoimmune diabetes in adults (LADA): Like Type 1 diabetes, LADA also results from an autoimmune reaction, but it develops much more slowly than Type 1 People diagnosed with LADA are usually over the age of 30.
Maturity-onset diabetes of the young (MODY): MODY, also called monogenic diabetes, happens due to an inherited genetic mutation that affects how your body makes and uses insulin. There are currently over 10 different types of MODY. It affects up to 5% of people with diabetes and commonly runs in families.
Neonatal diabetes: This is a rare form of diabetes that occurs within the first six months of life. It’s also a form of monogenic diabetes. About 50% of babies with neonatal diabetes have the lifelong form called permanent neonatal diabetes mellitus. For the other half, the condition disappears within a few months from onset, but it can come back later in life. This is called transient neonatal diabetes mellitus.
Brittle diabetes: Brittle diabetes is a form of Type 1 diabetes that’s marked by frequent and severe episodes of high and low blood sugar levels. This instability often leads to hospitalization. In rare cases, a pancreas transplant may be necessary to permanently treat brittle diabetes.
Symptoms of diabetes
General symptoms
Type 1 diabetes: Symptoms of T1D can develop quickly — over a few weeks or months. You may develop additional symptoms that are signs of a severe complication called diabetes-related ketoacidosis (DKA). DKA is life-threatening and requires immediate medical treatment. DKA symptoms include vomiting, stomach pains, fruity-smelling breath and laboured breathing.
Type 2 diabetes and prediabetes: You may not have any symptoms at all, or you may not notice them since they develop slowly. Routine bloodwork may show a high blood sugar level before you recognize symptoms. Another possible sign of prediabetes is darkened skin on certain parts of your body (acanthosis nigricans).
Gestational diabetes: You typically won’t notice symptoms of gestational diabetes. Your healthcare provider will test you for gestational diabetes between 24 and 28 weeks of pregnancy.
The general symptoms of diabetes include:
increased hunger
increased thirst
weightloss
frequent urination
blurry vision
extreme fatigue
sores that don’t heal
Symptoms in men
In addition to the general symptoms of diabetes, men with diabetes may have:
a decreased sex drive
erectile dysfunction
poor muscle strength
Symptoms in women
Women with diabetes can have symptoms such as:
vaginal dryness
urinary tract infections (increased frequency)
yeast infections
dry, itchy skin
Causes of diabetes
Too much glucose circulating in your bloodstream causes diabetes, regardless of the type. However, the reason why your blood glucose levels are high differs depending on the type of diabetes.
Causes of diabetes include:
Insulin Resistance: Type 2 diabetes mainly results from insulin resistance. Insulin resistance happens when cells in your muscles, fat and liver don’t respond as they should to insulin. Several factors and conditions contribute to varying degrees of insulin resistance, including obesity, lack of physical activity, diet, hormonal imbalances, genetics and certain medications.
Autoimmune disease: Type 1 diabetes and LADA happen when your immune system attacks the insulin-producing cells in your pancreas.
Hormonal imbalances: During pregnancy, the placenta releases hormones that cause insulin resistance. You may develop gestational diabetes if your pancreas can’t produce enough insulin to overcome the insulin resistance. Other hormone-related conditions like acromegaly and Cushing syndrome can also cause Type 2 diabetes.
Pancreatic damage: Physical damage to your pancreas — from a condition, surgery or injury can impact its ability to make insulin, resulting in Type 3c diabetes.
Genetic mutations: Certain genetic mutations can cause MODY and neonatal diabetes.
Long-term use of certain medications can also lead to Type 2 diabetes, including HIV/AIDS medications and corticosteroids.
Diabetes Complications
Blood glucose levels that remain high for too long can damage your body’s tissues and organs. This is mainly due to damage to your blood vessels and nerves, which support your body’s tissues. Cardiovascular (heart and blood vessel) issues are the most common type of long-term diabetes complication. They include:
Coronary artery disease.
Heart attack.
Stroke.
Atherosclerosis.
Other diabetes complications include:
Nerve damage (neuropathy), which can cause numbness, tingling and/or pain.
Nephropathy, which can lead to kidney failure or the need for dialysis or transplant.
Retinopathy, which can lead to blindness.
Diabetes-related foot conditions.
Skin infections.
Amputations.
Sexual dysfunction due to nerve and blood vessel damage, such as erectile dysfunction or vaginal dryness.
Gastroparesis.
Hearing loss.
Oral health issues, such as gum (periodontal) disease.
Living with diabetes can also affect your mental health. People with diabetes are two to three times more likely to have depression than people without diabetes.
Diabetes diagnosis
Anyone who has symptoms of diabetes or is at risk for the condition should be tested. People are routinely tested for gestational diabetes during their second trimester or third trimester of pregnancy.
Doctors use these blood tests to diagnose prediabetes and diabetes:
The fasting plasma glucose (FPG) test measures your blood sugar after you’ve fasted for 8 hours.
The A1C test provides a snapshot of your blood sugar levels over the previous 3 months.
A 75-gram oral glucose tolerance test is also used. This checks the BG 2 hours after ingesting a sugary drink containing 75 grams of carbs.
Diabetes and Diet
Healthy eating is a central part of managing diabetes. In some cases, changing your diet may be enough to manage the disease.
Types 1 and 3c diabetes
Your blood sugar level rises or falls based on the types of foods you eat. Starchy or sugary foods make blood sugar levels rise rapidly. Protein and fat cause more gradual increases. Your medical team may recommend that you limit the amount of carbohydrates you eat each day. You’ll also need to balance your carb intake with your insulin doses. Counting carbs helps to balance the carb intake with the insulin doses.
Type 2 Diabetes
Eating the right types of foods can both manage your blood sugar and help you lose any excess weight. Carb counting is an important part of eating for type 2 diabetes. soulFIT Clinic can help you figure out how many grams of carbohydrates to eat at each meal.
In order to keep your blood sugar levels steady, try to eat small meals throughout the day. Emphasize healthy foods such as:
fruits
vegetables
whole grains
lean protein
healthy fats
Certain other foods can hurt efforts to manage your blood sugar.
Gestational diabetes
Eating a well-balanced diet is important for both you and your baby during these 9 months. Making the right food choices can also help you avoid diabetes medications.
Watch your portion sizes, and limit sugary or salty foods. Although you need some sugar to feed your growing baby, you should avoid eating too much.
Diabetes and exercise
Along with diet and treatment, exercise plays an essential role in diabetes management. This is true for all types of diabetes. Staying active helps your cells react to insulin more effectively and lower your blood sugar levels. Exercising regularly can also help you:
reach and maintain a healthy weight
reduce your risk of diabetes-related health complications
boost mood
get better sleep
improve memory
If you have type 1 or type 2 diabetes, general guidance is to aim for at least 150 minutes of moderate-intensity exercise each week. There are currently no separate exercise guidelines for people who have gestational diabetes. But if you’re pregnant, start out slowly and gradually increase your activity level over time to avoid overdoing it.
Diabetes-friendly exercises include:
walking
swimming
dancing
cycling
Diabetes prevention
Type 1 and type 3c diabetes are not preventable because they are caused by an issue with the immune system. Some causes of type 2 diabetes, such as your genes or age, aren’t under your control either.
Yet many other diabetes risk factors are manageable. Most diabetes prevention strategies involve making simple adjustments to your diet and fitness routine.
If you’ve received a diagnosis of prediabetes, here are a few things you can do to delay or prevent type 2 diabetes:
Get atleast 150 minutes per week of aerobic exercises like walking or cycling.
Cut saturated and trans fats, along with refined carbohydrates, out of your diet.
Eat more fruits (not all), vegetables, and whole grains.
Eat smaller portions.
Try to lose 10% of your body weight if you have overweight or obesity.
Prognosis for Diabetes
The prognosis (outlook) for diabetes varies greatly depending on several factors, including:
The type of diabetes.
How well you manage the condition over time and your access to diabetes care.
Your age at diagnosis/how long you’ve had diabetes.
If you have other health conditions.
If you develop diabetes complications.
Chronic high blood sugar can cause severe complications, which are usually irreversible. Several studies have shown that untreated chronic high blood sugar shortens your lifespan and worsens your quality of life. However, it’s important to know that you can live a healthy life with diabetes. The following are key to a better prognosis:
Lifestyle changes.
Regular exercise.
Dietary changes.
Regular blood sugar monitoring.
Studies show that people with diabetes may be able to reduce their risk of complications by consistently keeping their A1c levels below 7%.
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