Diabetes: Symptoms, Causes, Treatment, Prevention

Introduction

Diabetes mellitus, also known as just diabetes, is a metabolic condition that raises blood sugar levels. It describes a class of conditions that impact how the body utilizes blood sugar (glucose). The cells that make up the muscles and tissues rely heavily on glucose as a source of energy. It serves as the primary fuel for the brain. Each form of diabetes has a different primary etiology. However, diabetes can result in excess sugar in the blood regardless of your type. Serious health issues can result from an excess of sugar in the blood.

Types of Diabetes

Type 1 Diabetes: Every age, every race, and every shape and size are susceptible to type 1 diabetes. However, it frequently begins in childhood or adolescence.

In type 1 diabetes, the body does not manufacture insulin. Insulin is a hormone required by the body to transport glucose from the bloodstream to the body’s cells. Your body converts the carbs you consume into blood glucose (also known as blood sugar), which it uses as fuel and insulin facilitates the entry of glucose into body cells.

Type 2 Diabetes: The most prevalent type of diabetes is type 2 and it can manifest at any age. People over 40 are more likely to have this type of diabetes. In type 2 diabetes the body does not respond to the insulin it produces in a proper manner.  People with type 2 diabetes can maintain their blood glucose levels through a balanced diet and regular exercise, however others might require medication or insulin. 

Gestational Diabetes: Gestational diabetes is diabetes in pregnancy. This form of diabetes is brought on by substances the placenta secretes that block the action of insulin. This causes more sugar (glucose) to be available in the blood leading to the symptoms of diabetes.

Ketones are present in the urine. When insufficient insulin is available, muscle and fat are broken down, producing ketones.

Symptoms

Blood sugar levels determine the severity of diabetes symptoms. Some people may not exhibit symptoms, particularly if they have type 2 diabetes or prediabetes. 

Symptoms of type 1 diabetes frequently appear suddenly and are more severe.

Type 1 diabetes and type 2 diabetes can both cause the following symptoms:

• Excessive thirst.
• Frequent urination.
• Weight loss without putting in the effort.
• Becoming worn out and weak.
• Getting irritated or experiencing mood swings.
• Having visual problems
• Having wounds that take a long time to heal.
• Getting several infections, including vaginal, skin, and mouth infections.

Diagnosis

One of three tests is used to establish a diagnosis. 

Fasting blood glucose: A fasting glucose test measures the amounts of sugar in your blood before breakfast. If your level is 126 mg/dL or greater, you might have diabetes.

Oral glucose tolerance test: An oral glucose tolerance test (OGTT) comprises consuming a glucose-containing beverage, followed by blood glucose measurements every 30 to 60 minutes for three hours. You may have diabetes if your blood glucose level is 200 mg/dL or above after two hours.

Hemoglobin A1c test: The HbA1c test is a quick blood test that provides an average blood sugar reading for the past two to three months. If your HbA1c is 6.5% or above, you might have diabetes.

Your doctor will typically want a high test to be repeated in order to confirm the diagnosis:

Causes of Diabetes

Each form of diabetes has a different cause.

Type 1 diabetes: The precise cause of type 1 diabetes is unknown. The immune system wrongly targets and kills insulin-producing beta cells in the pancreas for unknown reasons. Some people may be predisposed to this auto-immune process by their genes. Additionally, a virus may trigger an immune system attack that destroys the beta cells.

Type 2 diabetes: The cause of type 2 diabetes is a result of both hereditary and environmental factors. Your risk is further increased if you are overweight or obese. The effects of insulin on your blood sugar are resisted by your cells more when you are overweight, especially in the abdomen. This form of diabetes runs in Families. Family members have genes that increase their risk of type 2 diabetes and obesity.

Gestational diabetes: Hormonal changes during pregnancy are the cause of gestational diabetes. The placenta secretes hormones that reduce the sensitivity of a pregnant person’s cells to insulin’s effects. Pregnancy-related elevated blood sugar can result from this. Gestational diabetes is more likely to develop in overweight people before becoming pregnant or women who put on too much weight during pregnancy.

Complications of Diabetes

Your body’s organs and tissues are damaged by high blood sugar. Your risk of complications increases as your blood sugar level rises and as you live with it for longer.

Diabetes-related complications include:

• Stroke, heart attack, and heart disease
• Nerve damage
• Kidney damage
• Poor eyesight
• Loss of hearing
• Damage to the feet, such as infections and wounds that don’t heal easily.
• Skin problems including fungal and bacterial infections
• Depression
• Dementia

Gestational diabetes:

Gestational diabetes that is not treated might result in issues for both the mother and the unborn child. Baby-related complications can take the following forms:

• preterm delivery
• higher-than-average birth weight
• a later-life increase in the risk of type 2 diabetes
• low blood glucose
• jaundice
• stillbirth

A woman with gestational diabetes during pregnancy risks getting high blood pressure during the pregnancy (preeclampsia) or type 2 diabetes following delivery. 

You may also need a cesarean section delivery (C-section).

Treatment

Your doctor will work with you to create a personalized diabetes treatment plan that you can understand. On your diabetes treatment team, you could also require the services of a foot doctor, dietitian, eye doctor, and diabetes expert (called an endocrinologist). 

A combination of medications, exercise, and dietary changes must be used to closely monitor your blood sugar levels and keep them at a target level determined by your doctor.

Type 1 Diabetes

The main treatment for type 1 diabetes is insulin. It takes the place of the hormone your body cannot produce. People with type 1 diabetes frequently utilize a variety of insulin kinds. They differ in their rates of action and the duration of their effects:

• Rapid-acting insulin lasts 2 to 4 hours after it begins to work within 15 minutes of administration.
• Short-acting begins to work in 30 minutes and lasts for 3 to 6 hours.
• Intermediate-acting insulin starts to act in two to four hours and lasts 12 to 18 hours.
• Long-acting insulin begins to function two hours after injection and lasts up to twenty-four hours.
• Ultra-long acting insulin: begins to work six hours after injection and lasts for at least 36 hours.
• Pre-mixed insulin begins to function within 5 to 60 minutes and lasts 10 to 16 hours.

Type 2 diabetes

Some persons with type 2 diabetes can manage it with diet and exercise. You’ll need to take oral medication or insulin if changing your lifestyle isn’t enough to lower your blood sugar levels.

These medications work in several ways to reduce blood sugar:

They consist of: 

• Drugs that stimulate the pancreas to produce more insulin-like, Chlorpropamide (Diabinese), glipizide (Glucotrol), glimepiride (Amaryl), glyburide (DiaBeta, Glynase), repaglinide (Prandin), nateglinide (Starlix).
• Drugs that reduce the intestines’ ability to absorb sugar, like miglitol (Glyset) and acarbose (Precose). 
• Medications that enhance the body’s utilization of insulin, such as rosiglitazone (Avandia) and pioglitazone (Actos). 
• Drugs that reduce the liver’s synthesis of sugar and improve insulin resistance like metformin (Glucophage). Weight loss is one of the ways metformin helps restore normal blood sugar levels.
• Medications that enhance the pancreas’ synthesis of insulin or its blood levels such as exenatide (Byetta, Bydureon), alogliptin (Nesina), saxagliptin (Onglyza), dulaglutide (Trulicity), liraglutide (Victoza), semaglutide (Ozempic), lixisenatide (Adlyxin), and sitagliptin (Januvia).
• Drugs known as sodium-glucose co-transporter 2 (SGLT2) inhibitors prevent the kidneys from reabsorbing glucose and boosting urine glucose excretions. 

Additionally, they cause weight loss, which aids in restoring normal blood sugar levels. The medications include dapaglifozin (Farxiga), ertuglifozin (Steglatro), empaglifozin (Jardiance), and canaglifozin (Invokana). Additionally, these medications can assist individuals with heart failure in lowering their risk of cardiovascular death and hospitalization for heart failure.

• An injectable synthetic hormone, pramlintide (Symlin), aids in lowering blood sugar levels in people with diabetes who use insulin after meals.

More than one type of diabetes medication is present in certain pills.

Gestational Diabetes

If you are told you have gestational diabetes, you must check your blood sugar levels multiple times a day while pregnant. Dietary adjustments and exercise may be sufficient to lower it if it’s high. According to research, 15% to 30% of women who acquire gestational diabetes will require insulin to reduce their blood sugar. The developing baby is safe when using insulin.

Prevention

You cannot prevent type 1 diabetes. However, adopting a healthy lifestyle can help avoid gestational diabetes, type 2 diabetes, and prediabetes as well as treat them.

• Eat nutritious foods. Pick foods with more fiber and fewer calories and fat. Emphasize whole grains, vegetables, and fruits. Eat a variety of foods to avoid getting bored.
• Get regular exercise. On most days of the week, try to get around 30 minutes of moderate aerobic exercise. Or try to complete 150 minutes or more of moderate aerobic exercise each week. Take a brisk daily stroll as an example. Break up a long workout into shorter periods throughout the day if you cannot fit it in.
• Lose any extra weight. Even a 7% weight loss can reduce your risk of developing diabetes if you are overweight. If you weigh 200 pounds (90.7 kilograms), decreasing 14 pounds (6.4 kilograms) can reduce your risk of developing diabetes.
• However, avoid attempting to lose weight when pregnant. Find out from your doctor how much weight you can safely gain while expecting.
• Work on long-term improvements to your food and exercise routines to maintain a healthy weight. Keep in mind the advantages of decreasing weight, like a healthier heart, increased energy, and improved self-esteem.

Featured Image Credit: Photo by David Moruzzi on Unsplash 

References

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