What is Diabetes?

- Type 2 Diabetes:Type 2 Diabetes, also known as Adult Onset Diabetes Mellitus (AODM), is the most prevalent form of diabetes. This arises due to insulin resistance. Insulin resistance occurs when your body's cells do not respond properly to insulin. Consequently, the pancreas compensates by producing more insulin in an attempt to trigger an appropriate cellular response. However, over time, the pancreas becomes unable to sustain this heightened insulin production, leading to elevated blood sugar levels. This sets the stage for prediabetes and type 2 diabetes.

- Pre-diabetes:Prediabetes is a significant health concern characterized by blood sugar levels that are higher than normal but not yet at the threshold for a type 2 diabetes diagnosis.

- Type 1.5 Diabetes -Type 1.5 Diabetes has certain aspects of both Type 1 diabetes mellitus and type 2 diabetes mellitus. It is also commonly referred to as Latent Autoimmune Diabetes of Adults or LADA and as the name suggests it is an autoimmune condition which can set in during adulthood. LADA can easily be, and is often misdiagnosed as type 2 diabetes. Unfortunately, unlike type 2 diabetes, this can’t be brought under control through oral medications like metformin, dietary and lifestyle modifications. That’s the point at which many people discover that they were dealing with LADA or Type 1.5 Diabetes all along.

Gestational Diabetes:Women can develop diabetes during their pregnancy. Insulin blocking hormones produced by the placenta during pregnancy can hamper the ability of your body to use insulin effectively and lead to high blood sugar levels, causing gestational diabetes. Most women with gestational diabetes may not experience any obvious symptoms and it usually resolves for most women after childbirth. However, gestational diabetes can significantly increase the risk of developing Type 2 diabetes in the future.

Other types of diabetes include Brittle diabetes, neonatal diabetes, Maturity-onset diabetes of the young (MODY) or monogenic diabetes and Type 3c diabetes.

Consult your Doctor or get yourself tested for diabetes if you experience one or more of these following symptoms

Common symptoms of diabetes include:

1. Frequent urination (often at night)

2. Increased hunger

3. Cloudy urine with sweet or fruit smell

4. Increased thirst or polydipsia and dry mouth

5. Blurred vision

6. Unexplained weight loss

7. Fatigue

8. Tingling sensation or numbness in your limbs (hands and feets)

9. Frequent skin infections and vaginal yeast infections (in women)

Type 1 diabetes symptoms can develop and escalate quickly within a few weeks or months. One potentially fatal symptom is Diabetic Ketoacidosis (DKA).

Diabetic Ketoacidosis occurs when your body is unable to utilize insulin efficiently to produce energy. Your body resorts to breaking down fat for producing energy. Ketone is a byproduct of fat breaking down and when ketone levels in the bloodstream rise significantly it can cause dangerous imbalances or even lead to a coma. Common symptoms of DKA include

- Extreme thirst and urination.

- Fruity breath.

- abdominal pain

- Nausea

Confusion & drowsiness

Type 2 diabetes symptoms develop slowly and gradually, making them difficult to spot. A common type 2 diabetes symptom is Acanthosis nigricans or darkening of skin color in areas like armpits and neck

What Causes Diabetes?

The common cause of diabetes include (but aren’t limited to):

- Insulin resistance

- Autoimmune conditions

- Hormonal imbalances brought on by pregnancy or hormone related disorders or diseases such as acromegaly and Cushing syndrome

- Physical damage to your pancreas. This can lead to Type 3c diabetes

- Genetic mutations which can lead to MODY or neonatal diabetes

- Long term use of medications such as corticosteroids or medications for conditions such as HIV

What causes Type 2 Diabetes?

Type 2 diabetes mainly arises from insulin resistance which could be caused by several factors including obesity, physical inactivity, genetic factors, hormonal imbalances, certain medications and lifestyle choices such as diet, smoking & alcohol consumption.

The primary cause of type 1 diabetes and type 1.5 diabetes or LADA is your immune system attacking the insulin producing cells of the pancreas

What are the complications of diabetes?

If left untreated, diabetes can lead to serious or even fatal complications affecting various organs of the body. Some serious complications of diabetes include:

- Coronary artery disease & heart attack

- Kidney disease or nephropathy

- Stroke

- Hearing loss

- Dementia

- Vision loss and eye problems such as Cataracts, Glaucoma, Diabetic Retinopathy and Diabetic Macular Edema

- Nerve damage and peripheral neuropathy

- Amputation because of a combination or any one of the of factors including non-healing ulcers, reduced blood flow, injuries or infections

- Gastroparesis

- Gum disease or periodontal disease

- Loss of sex drive

- vaginal dryness (in women)

- Erectile dysfunction (in men)

- Depression

Gestational diabetes can lead to complications such as premature birth, jaundice, still birth, hypoglycemia (low blood sugar) and Increased birth weight of the baby

How is diabetes diagnosed?

The common tests used for diagnosing diabetes are:

1. Fasting blood glucose test - You are expected to give this test first thing in the morning after fasting for at least 8 hours before the test as food can alter your blood sugar levels significantly. You are allowed to drink water before this blood test.

The test is used in conjunction with a postprandial blood sugar (usually taken 2 hours after food) test to determine whether you are diabetic or even prediabetic.

2. Random blood glucose test - This test can be taken at any point in time regardless of whether you’ve fasted leading up to the test

3. HbA1C or A1c or glycated hemoglobin test -it reflects the average blood glucose level over the past two to three months

4. Urinalysis: Checking for glucose and ketones in urine can help diagnose and monitor diabetes-related complications.

5. C-peptideTest:This test measures the amount of C-peptide (a byproduct of insulin production) in the blood and helps estimate the amount of insulin produced by your body.

6. Insulin Level Test:This measures the amount of insulin in your blood and aids in the diagnosis of type 1 diabetes or assessment of insulin resistance in type 2 diabetes.

7. Microalbumin:For individuals with diabetes, especially those with type 1 or type 2 diabetes, monitoring microalbumin levels is crucial as it can help in the early detection and management of diabetic nephropathy (kidney disease). Kidney damage in diabetes often starts long before symptoms become apparent, so monitoring and detecting microalbuminuria early allows for interventions to slow or prevent further kidney damage.

8. Oral glucose tolerance test (OGTT):It is specifically used to diagnose gestational diabetes. It is used to check how well your body processes sugar (glucose). You fast for several hours before the test and then drink a sugary solution. Your blood sugar is measured at specific intervals (usually 1-3 hours). Higher blood sugar levels after 2 hours may suggest diabetes.

Diabetes risk factors

Diabetes risk may be increased by several factors. Some of them are listed below.

Risk of type 2 diabetesis higher if you:

- are obese

- are over 45 years of age

- Have a blood relative with this condition

- are physically inactive

- Had gestational diabetes

- are prediabetic

- Have high cholesterol, high blood pressure or high triglycerides

- Consume sugary, processed and unhealthy food

- Belong to certain ethnic groups like asian, african american, hispanic etc

Risk of type 1 diabetes:You are more likely to develop it if you are less than 19 years of age & if you’ve an immediate family member with this condition. Possessing certain genes may also increase the risk of diabetes significantly.

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Frequently Asked Questions

1. Is diabetes genetic?

Ans - Yes, genetics can play a role in increasing the potential risk of developing diabetes but it is not the only determining factor. Other factors such as obesity, diet and lifestyle choices also play a crucial role.

2. Can diabetes be prevented?

Ans - Certain types of diabetes such as Type 1 diabetes can’t be prevented but regular exercise, maintaining a healthy weight, regular health checkups, dietary and lifestyle modifications can certainly help reduce the risk of developing type 2 diabetes.

3. What role does diet play in managing diabetes?

Ans - A healthy diet is crucial for managing blood sugar levels. Consuming a lot of greens, fruits, vegetables, whole grains, and lean proteins while limiting processed foods, sugary drinks, and unhealthy fats can help keep diabetes at bay. what foods to avoid with diabetes

4. How often should I check my blood sugar levels?

Ans - Frequency of blood sugar tests depends on several factors including your medical history, current health condition, family history of diabetes and age. Please consult your doctor for personalized advice. It is recommended for healthy individuals to get a preventive health checkup including a diabetes profile once every 6 months.

5. Can diabetes affect pregnancy?

Ans - Yes, gestational diabetes can develop during pregnancy. Gestational diabetes increases the risk of developing type 2 diabetes later in life for both the mother and baby. Gestational diabetes can usually be kept in check with dietary & lifestyle modifications and regular exercise. In certain cases, your doctor may recommend medications to manage it. Talk to your doctor for personalized and expert advice.