What is the root cause of Diabetes/ Diabetes Mellitus?
Diabetes mellitus also referred to as diabetes is a group of metabolic disorders or a disease that results in high glucose levels in the blood over an extended period of time. Glucose levels in the blood are regulated by a hormone named insulin, which is made by the pancreas and is responsible for breaking down sugar in the blood. The disease occurs when the patient’s body is unable to produce insulin or response to insulin is impaired, usually due to a resistance that can develop in some people.
How many types of diabetes are there?
People with high blood glucose levels develop different types of diabetes but the most common are Type 1 and Type 2 diabetes:
Type 1 diabetes (Insulin-dependent)
Type 1 diabetes is a lifelong disease characterized by high glucose levels in blood and it caused when the immune system destroys beta cells in the pancreas that make the hormone insulin (It isproduced in the pancreas which controls glucose in the blood). Damage to beta cells causes glucose to build up in the blood and prevents the ability for glucose to be absorbed into the cells from the blood, thereby leading to high blood sugar levels, dehydration, weight loss and damage to the body. It usually develops at under 30 years of age but also can occur at any age. Type 1 diabetes is not curable but can be controlled with exercise, healthy diet and insulin injections. It is rare and only 5% of the patients have Type 1. The symptoms include tremors, headache, dizziness and change in mood.
Type 2 diabetes (non-insulin dependent)
Type 2 diabetes is the most common form of diabetes, and commonly known as mature onset diabetes and occurring in people who are overweight and obese. It is a common condition that causes high levels of glucose in the blood due to a lack of responsiveness to insulin or because the pancreas does not make enough insulin. Sugar starts forming in the bloodstream instead of moving into the cells. As the level of blood sugar increases, the beta cells which produces insulin in the pancreas release more insulin to compensate and eventually the cells become impaired and are not able to make enough insulin as required. 85% to 90% of cases fall in this category. It is not curable but can be delayed or prevented by lifestyle modifications.
Gestational diabetes Mellitus (GDM) is defined as any degree of glucose intolerance with first recognition during pregnancy with a heightened risk of pre-ecalmpsia (a rise in blood pressure and signs of organ damage), depression and requiring a cesarean section to give birth. It can cause a number of problems in the child including excessive weight at birth,an enlarged body, jaundice and low blood glucose levels, particularly if the blood glucose levels in the mother were elevated prior to childbirth. If monitored and treated, these risks can be reduced substantially.
Pre-diabetes is characterized by slightly elevated blood glucose levels regarded as indicative that a person is at a risk of progressing to Type 2 diabetes. It doesn’t manifest in symptoms but risk factors includehigh blood pressure, obesity and heart diseases. Without treatment, people with pre-diabetes may develop type 2 diabetes
It is a rare condition in which the kidneys are not able to conserve water and is characterized by extreme thirst and frequent urination. This is caused by the inadequate production of a hormone known as ADH which helps the kidneys and other parts of the body to retain the appropriate amount of water.
Without treatment it can cause dehydration and eventually lead to coma which is caused by concentration of salt (sodium) in the blood. It can be treated with medications and a low-salt diet.
What are the early symptoms of diabetes?
Understanding the onset
Symptoms may occur when blood sugar levels are abnormally elevated. People with Type 1 diabetes may notice quick and sudden weight loss. Risk factors of Type 2 diabetes include being overweight, sedentary or a family history of Type 2. In some cases people with Type 2 don’t experience any symptoms. Some of the common signs and early symptoms include:
- Persistent thirst
- Frequent urination
- Extreme hunger
- Unexplained weight loss
- Excessive Fatigue
- Blurry vision
- Slow healing or recovery from infections and wounds
What are the complications of diabetes?
Uncontrolled or elevated blood glucose levels over a prolonged period can lead to a number of complications which can be short or long-term and can be characterized as:
Microvascular complications: These are caused due to damage to small blood vessels which includedamage to eyes, kidneys, nerves and feet.
Macrovascular complications: These are caused due to damage to larger blood vessels which include cardiovascular diseases and insufficiency in blood flow to the legs.
Other parts of the body can also be affected by diabetes, including the digestive system, skin, sexual organs, immune system, teeth and gums.
Diabetic retinopathy (eye disease)
It is a diabetic condition in which retina is damaged by blood vessels and is mostly found in patients suffering from Type 1 or Type 2 diabetes. Blurred vision may be experienced, caused by progressive damage to the retina. This can eventually lead to loss of sight. Metabolic control and treatment can delay diabetic retinopathy.
Nephropathy (kidney disease)
In Diabetic Nephropathy part of the kidney is damaged, compromising the kidney’s ability to filter the blood and causing protein to enter the urine. This eventually leads to renal failure and loss of life. If diagnosed at an early stage, control of blood sugar levels and blood pressure can delay the progression of nephropathy.
Neuropathy (Nerve disease)
Neuropathy is the complication where nerves are damaged throughout the body due to high blood glucose levels leading to impotence, damage to limbs and sensory loss. It can be prevented if there is control over blood glucose levels.
Diabetic foot disorder
This is caused due to changes in the blood vessels and nerves, leading to foot ulcers. Patients feel tingling and pain and numbness in the feet because there is reduced blood flow in the legs. It can be prevented through good care of the feet and regular medical examinations.
Atherosclerosis or clogging of arteries is a disease when there is less blood flow to the heart which causes strokes and heart attacks. Dizziness, chest and leg pain, nausea are classic symptoms of this condition. It can be prevented or delayed through control over blood pressure, glucose levels and cholesterol levels as well as through regular cardiovascular exercise.
Skin problems and diabetes
Skin disorders may be experienced in people suffering from diabetes. Some common skin conditions in diabetes include: Acanthosis, Allergic reactions, Bacterial infections, Bullosisdiabeticorum (diabetic blisters), diabetic dermopathy, digital sclerosis, disseminated granuloma annulare, eruptive xanthomatosis, fungal infections, itching, necrobiosislipoidicadiabeticorum, scleroderma diabeticoruandvitiligo. Regular skin care and maintaining control of blood glucose levels can help reduce the risk of skin-related problems.
Tooth and gum problems indiabetes
When the disease is not controlled, it thickens the blood vessels which slows the flow of nutrients and removal of harmful waste. High glucose levels in saliva help harmful bacteria to grow which combines with food and forms a soft sticky film called plaque causing gingivitis, other problems include periodontitis, dry mouth (calledxerostomia), thrush (called candidiasis), oral burning. Avoiding acidic drinks, brushing teeth and gum lines, using mouth gels and chewing sugar-free candy to stimulate saliva production can help you steer clear of gum disease.
Mental health and diabetes
People with type 1 or type 2 can experience stress, anxiety and depression which affect blood glucose levels. Diabetes, particularly type 2, is linked with Alzheimer’s disease and vascular dementia. When there is reduced blood supply to the brain over time, the brain changes, which increases the risk for development of these conditions. Lifestyle modifications can help reduce mental stress and manage blood glucose levels.
Diabetes and infections
High glucose levels in blood slow down the white blood cells, which makes it difficult for the immune system to fight infections. Maintaining blood glucose levels, getting enough sleep, having a yearly influenza (flu) immunization can support the immune system and reduce the risk of infections.
Thyroid problems and diabetes
People with type 1 or type 2 are at increased risk of thyroid disease which includes both overactive and underactive thyroid. It can affect blood glucose levels and general health. Medicines can help slowdown metabolism by controlling the release of the thyroid hormone.
Sexual dysfunction and diabetes
Sexual functions can be affected by reduced blood supply or damage to nerves. It is a common problem for men of all ages and is more common in men with diabetes who often experience impotence or erectile dysfunction. It is important to seek medical help to manage diabetes.
Hypoglycemia refers to a low blood glucose level. At times blood glucose can drop, especially if patient is on insulin or a sulfonylurea drug (it makes the body produce insulin throughout the day) or if the patient is an alcoholic. Mild cases of hypoglycemia can be treated by drinking orange juice or eating a glucose tablet which quickly restores the blood glucose level to what is considered normal.
Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
It is very rare but occurs when blood glucose level goes too high and the body tries to get rid of all the excess glucose through frequent urination. This can lead to dehydration and the patient becomes very thirsty. When not rehydrated, the blood glucose level continues to climb, and it can eventually go too high, leading to coma. Elderly people are most likely to develop it and if not treated, it can be a risk to life. To avoid HHNS syndrome, blood glucose levels should be closely monitored.
What happens if diabetes goes undetected?
Some of the patients with diabetes have mild or no symptoms that seem relatively harmless. If untreated, the disease can be very dangerous. Over the time, complications can develop due to chronically high blood sugar levels. People who are experiencing any symptoms should see doctor and should undergo labs tests or perform a fasting blood sugar test to screen.
Can we reduce the risk of diabetes complications?
High blood glucose levels should be treated in time before they result in serious complications. The risk of most diabetes-related complications can be reduced by controlling blood pressure, blood glucose and cholesterol levels within the recommended range. Also, maintaining a healthy weight, eating a healthy and balance diet, reducing alcohol intake, and quitting smoking can help delay, prevent or manage diabetes. Regular check-ups and screening can help detect the disease early and take appropriate measures.
Is diabetes curable? Is there a treatment for diabetes?
There is no cure for the disease but treatment aims to prevent complications by controlling and managing diabetes. Several precautions should be taken for staying as healthy as possible and these include:
- Increasing the amount of refined carbohydrates in the diet
- Daily dose of Insulin injections
- Self-monitoring of blood sugar levels
- Eating healthy foods can help control blood glucose, cholesterol levels and blood pressure
- Regular physical activity
- Limiting alcohol intake
- Maintaining healthy weight
- Monitoring blood pressure and blood glucose levels
- Cholesterol and triglyceride tests.