Diabetes is a condition in which blood sugar (glucose) levels rise above a certain threshold. The body uses glucose (carbohydrates) as a source of energy and insulin is a hormone (released by β-cells of the pancreas) that helps to move glucose from the blood to cells. Insulin acts like a key that helps to open up the gates of a cell in which glucose can enter and can be used for energy. In the case of diabetes, the body either doesn’t produce enough insulin (or no insulin at all) or doesn’t use the insulin efficiently (insulin resistance ) as it should. This hampers the lock and key mechanism and thus glucose cannot enter the cells and blood glucose levels rise.
What is Insulin Resistance
β-cells of the pancreas produce insulin that acts as a carrier for glucose in the blood and helps to transport glucose into the cells. In certain cases, like obesity, this usual response of insulin gets affected and the cells don’t respond to the insulin-mediated glucose transport. This led to more and more production of insulin by β-cells and thus causing hyperinsulinemia. This resistance by cells to the usual insulin response is called insulin resistance. If not managed well, this condition will lead to diabetes.
Type of Diabetes and Causes
Type 1 Diabetes occurs when the immune system starts destroying (autoimmune disorder) the healthy β-cells of the pancreas and thus insulin is not produced. The exact reason for the same is unknown. The prevalence of type 1 diabetes is low and usually detected at a very young age. It is also called Insulin Dependent Diabetes Mellitus or Juvenile Diabetes.
Type 2 diabetes is a more common one and is marked by insulin resistance. It is generally caused by lifestyle factors such as being overweight or not getting enough physical activity. Other causes can be a positive family history of diabetes, the presence of hypertension (high BP), gestational diabetes (diabetes during pregnancy).
Anyone at any age can get type 1 or type 2 diabetes but type 2 is more common among the masses and is usually detected at an older age. Also, as is mentioned above obesity is one of the major risk factors for type 2 diabetes, still do not consider every obese individual as diabetic and every lean person as diabetic free.
Signs and Symptoms and Complications
The three most common symptoms of diabetes are increased hunger (polyphagia), increased thirst (polydipsia) and increased urination (polyuria). Other signs and symptoms include lethargy, fatigue, weakness, blurred vision, frequent infections, unexplained weight loss, tingling sensation in hands or feet, dark colour patches on the neck and armpits (acanthosis nigricans).
It is important to note that a diabetic individual can show multiple signs or symptoms or there is a possibility that an individual doesn’t show even a single sign or symptom of diabetes and it is only detected through the routine examination.
The reason management of diabetes is important is because of major complications it can lead to
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Macrovascular
- Atherosclerosis – build-up of cholesterol plaques in and around artery walls
- Heart Diseases
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Microvascular
- Retinopathy – damage to the retina
- Neuropathy – damage to nerves
- Nephropathy – damage to kidneys
Diagnosis of Diabetes
Fasting Plasma Glucose – Test that measures the amount of glucose in the blood after fasting (not eating or drinking, except water) for at least 8 hours
2-hour postprandial glucose – Test that measures the glucose level after 2 hours of consuming a meal
A1C test (HbA1C Test) – It measures average blood glucose levels over the past three months.
What is Hypoglycemia
A condition where blood glucose levels fall below 70 mg/dl and can be caused by an overdose of medication or medication taken but missed meals. In the long-fasted state, glucagon is a hormone secreted by α-cells of the pancreas that acts opposite to insulin and helps to restore normal levels of sugar in the blood. In case of an overdose of medication, even glucagon fails to restore the balance and thus individuals experience hypoglycemia. Symptoms include sweating, trembling of hands, hunger pangs, craving for sugar, dizziness, sleepiness.
To avoid episodes of hypoglycaemia, it is advisable to monitor sugar medications under a physician and shouldn’t be taken or changed voluntarily.
Diabetes Management
As of now, there is no cure for diabetes but it can be managed well to make sure there are no further complications and dependency upon medication can be reduced. One of the easiest ways of managing diabetes is by taking medications like insulin or diabetes pills (metformin, sulfonylureas etc) or non-insulin injectables. It is always advisable to monitor the intake of medications under the expert guidance of a physician to avoid hypoglycemia.
Another long term measure that can be adopted is lifestyle modification by reducing 5-10% of the weight and an active lifestyle, helps to reduce the body fat percentage. Weight training helps to transport glucose within the muscle cells by bringing glut-receptors on the surface without the insulin and thus mediate glucose transport in insulin-resistant muscle cells also.
Certain studies talk about bariatric surgery also as an option to manage diabetes but its long-term efficacy needs to be studied in detail.
Type 2 Diabetes in today’s time is one of the most common lifestyle disorders and becomes a root cause for multiple health issues, if not managed well. Understanding his/her condition and managing it well should always be a priority for any individual.
