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Diabetes – What you need to know ?
Introduction
When you eat foods such as carbohydrates, it gets broken down by your gut into sugars. The main sugar called glucose passes through the gut wall in to the bloodstream. When your blood glucose levels rise after eating food, the insulin level should also rise. Insulin is a hormone made by the pancreas, that acts like a key to let glucose from the food we eat pass from the blood stream into the cells in the body to produce energy. If there is not enough insulin or does not do its job, glucose builds up in your blood causing Diabetes.
Diabetes Mellitus is a condition in which the body does not produce or does not properly use the hormone insulin. The risk for diabetes is largely influence by ethnicity, age, obesity and physical inactivity, unhealthy diet, and behavioral habits in addition to genetics and family history. In 2019, 77 million individuals had diabetes in India, which is expected to rise to over 134 million by 2045 and approximately 57% of these individuals remain undiagnosed.
Types of Diabetes
There are two types of diabetes: Type 1, Type 2 and Gestational.
Type 1 is an autoimmune disease, meaning the body’s defence system attacks and destroys insulin-producing beta cells in the pancreas. As a result, the body produces very little or no insulin. It can develop at any age, but occurs most frequently in children and adolescents.
In Type 2 diabetes your body does not make good use of the insulin that it produces and accounts for around 90% of all diabetes cases. It is generally characterized by insulin resistance, where the body does not fully respond to insulin. Because insulin cannot work properly, blood glucose levels keep rising, releasing more insulin. It is caused by lifestyle factors such as obesity, lack of exercise and poor diet choice.
Gestational Diabetes – Pregnant women who have never had diabetes before but who have high blood glucose levels during pregnancy, particularly during the third trimester between 24 and 28 weeks of pregnancy, are said to have gestational diabetes. Gestational diabetes is the result of the insulin receptors not functioning properly and generally resolves once the baby is born, but can cause complications during pregnancy and birth.Maternal overweight and obesity, later age at childbearing, previous history of GDM, family history of type 2 diabetes mellitus and ethnicity are major GDM risk factors.
Symptoms of Diabetes
- Increased thirst
- Increased hunger
- Frequent Urination
- Darker-than-usual urine (more concentrated)
- Lack of energy and extreme tiredness
- Tingling or numbness in hands and feet.
- Sudden Weight loss, especially around the middle and lower body mass index (BMI). This is a common sign of diabetes. If you are concerned about your weight, talk to your doctor about whether it's time for you to see a nutritionist or dietitian for help with managing this symptom
- Blurred vision, slow-healing wounds,fatigue and frequent infections
Diagnosis of Diabetes
Your doctor will perform a number of tests, including:
Random Blood glucose test. This is the most common test used to diagnose diabetes. It involves drawing blood from your vein and testing its glucose level.
Fasting blood glucose test or Glucose Postprandial (2 Hours Post Meals) Test This type of test measures how much sugar is in your bloodstream right after waking up in the morning and before eating any food or drink at all (fasting for 8-10 hours).
The HbA1c blood test measures your average blood glucose control over the last 3 months (the life of the red blood cell) HbA1c refers to glycated haemoglobin. When the glucose (sugar) in your blood rises, it binds to the haemoglobin in your red blood cells and this test indicates your risk of pre-diabetes and diabetes.
Oral Glucose Tolerance Test (OGTT) requires you to fast for the first blood sample and then drink a liquid containing a specified amount (75 grams) of glucose; a further blood sample is then taken after 2 hours. This test is commonly offered to pregnant patients for diagnosis of diabetes in pregnancy (gestational diabetes).
Capillary blood glucose (home monitoring) test are done with blood from finger prick is tested on a test strip in the glucose kit. This home testing is useful for patients with diabetes to check glucose levels who require insulin.
You are considered Prediabetic if your fasting plasma glucose levels between 100-125mg/dL Having prediabetes is serious because it raises the chance of developing type 2 diabetes. But developing type 2 diabetes can be prevented. Adults and children diagnosed with prediabetes should be tested for type 2 diabetes every year.
If your fasting plasma glucose is ≥ 126 mg/dL, plasma glucose after 2-h is ≥ 200 mg/dL, HbA1c is ≥ 6.5% or a random plasma glucose ≥ 200 mg/dL, it is diagnostic of diabetes. A blood sugar result of 70 mg/dL or lower is usually considered low.
Management of Diabetes
The treatment of diabetes depends on the type and severity of the disease. Your doctor will discuss a treatment plan with you, which may include medications, self-monitoring tools, lifestyle changes.
Medicines
Your doctors will prescribes medications to help manage your blood glucose levels. In addition to taking pills you might also need to use insulin injections or an insulin pump that supplies continuous glucose monitoring through an electronic monitor or a glucose meter. New treatments are called “insulin sensitizers” increase sensitivity to insulin so that less is needed for control over blood sugar levels in areas where it’s needed most such as muscles where activity causes rapid spikes in blood sugar leveland lower fluctuations in blood sugar caused by eating too much at once or not enough food overall during meals.
Manage diabetes with healthy eating and being physically active
Good diet and exercise are the main ways to manage diabetes. Your doctor may recommend that you follow a healthy diet, which means eating foods that are low in sugar, glycemic index and salt but high in fiber content. You should also limit how much saturated fat you eat each day (about 10 grams) as a diet high in fatty foods cause fat to build up inside our cells which interferes with insulin’s ability to move sugar out from our blood stream and into our cells. This glucose fails to enter the cells to provide energy and remains in our blood stream leading to diabetes. Studies have shown a plant-based diet is low in fat and helps insulin to function properly thereby reversing your diabetes.
A healthy weight is important for people with diabetes because it can help control blood glucose levels and reduce any risk of complications from the disease. Nutritionists and diabetes educators can also help educate you on appropriate lifestyle modifications and at-home glucose management. Set a weight goal with being more physically active at least for 30 – 60 minutes a day 5 days of the week and tailor a physical activity plan to reach and maintain your goal weight. Being active helps lower blood glucose levels, lowers blood pressure, improves blood flow, burns extra calories and helps you sleep better.
Check your blood glucose levels regularly
Checking your blood glucose levels regularly is important if you are taking insulin and it can help you make decisions on your meals and physical activity. Ideally, the aim is to maintain your fasting glucose levels between 80 to 130 mg/dL, post prandial glucose levels to less than 180 mg/dL and HbA1c levels to less than 6.5%. Low blood sugar (hypoglycaemia) episodes are common in people with Type 1 diabetes and people with Type 2 diabetes who take certain medications. It can be life threatening and needs to be treated right away.If your blood glucose level is high or if it’s difficult to keep it under control on your own, talk with your doctor about taking medication or other treatment options. And review your self care plans with your doctor.
Coping with Diabetes
You would need regular screening to assess diabetic retinopathy causing blindness, heart diseases and stroke, nephropathy causing kidney failure, diabetic neuropathy causing nerve damage, gum diseases and daily foot inspections to identify foot lesions that may go unnoticed. The goal here isn’t necessarily to cure diabetes; but balance your blood glucose with diet, physical activity , medications and prevent or delay any complications.
Conclusion
In conclusion, diabetes affects millions of people worldwide but the good news is that there are many ways to manage your diabetes and prevent it from worsening into the more serious condition of type 2 diabetes. Remember to eat healthy foods with little added sugar, exercise regularly, and take your medicine as prescribed by your doctor
