Closer view of Diabetes
Disease Bhagyashree  

Closer view of Diabetes

Diabetes mellitus (or simply Diabetes) is a metabolic disease when blood sugar levels are always higher than the average level. Diabetes occurs when the body cannot metabolize blood sugar from the food. The body breaks down the food into sugar (glucose). Every cell of the body requires glucose for the survival; for reaching glucose to the every cell insulin (a hormone produced by the pancreas) is required. If there is no insulin glucose cannot enter the cell, it remains into the blood, resulting in high blood glucose levels. Higher blood glucose levels can lead to various complications related to multiple organs in the body like heart, brain, kidney, eye, Etc. These complications may result in permanent damage to the organ or death. Diabetes complications can be delayed and prevented with the proper understanding and following doctors’ advice for lifestyle modification and taking regular medicines.

Generally, There Are Three Major Types of Diabetes

Type 1 Diabetes occurs due to absolute insulin deficiency in the body. The insulin-producing cells (beta cells) present in the pancreas get destroyed due to autoimmune disorder (A disease in which the body’s immune system attacks healthy cells). The patients with Type 1 diabetes need to take insulin shots to control their blood glucose. Type 1 diabetes generally occurs in children, and the total population of type 1 diabetes is about 5% of the total diabetes types. 

Type 2 diabetes, in which there is insulin resistance (the body cannot utilize insulin properly) or less insulin produced in the body. Type 2 diabetes patient needs to do lifestyle modification and oral antidiabetic drugs (as per the doctor’s recommendation). The significant risk factors for developing type 2 diabetes are family history, sedentary lifestyle, obesity, stress smoking and tobacco Etc. Type 2 diabetes generally occurs in persons older than 35-40 years, and the total population of type 2 diabetes is more than 85%. 

Gestational Diabetes develops during the pregnancy (in the third trimester). The women with gestational diabetes have a higher risk of development of type 2 diabetes. It affects up to 10% of pregnant women. Some pregnant women’s can manage gestational diabetes with diet and exercise only, but in other cases, to control the high glucose level insulin and other medications used.

Blood Glucose Measurement In Diabetes 

Doctors generally ask to perform various blood glucose test to confirm diabetes. Like, Fasting Plasma Glucose (FPG) can be done when fasting for more than 8 hours. FPG value less than 110 mg/dL is considered normal; a fasting blood sugar value between 100 to 125 mg/dL is considered prediabetes or borderline to develop diabetes and FPG range 126 mg/dL then the person considered as diabetic.

Postprandial plasma glucose (PPG) test is done 2 hours after taking the meal. Blood glucose less than 140 mg/dL is considered normal. If the blood glucose level is between 140- 180 mg/dL is considered prediabetes or borderline diabetes and FPG more than 200 mg/dL considered diabetic.

The confirmation of diabetes is done with Glycosylated haemoglobin (HbA1c ) test. This test gives average blood glucose over the past three months. If HbA1c value is more than 7%, then the person is considered as diabetic. The person is regarded as a normal when HbA1c level is less than 5.7%. If the HbA1c level is between 5.7 to 7% the person is considered a prediabetic or borderline diabetic.

Doctors may ask for gestational diabetes patients to perform Oral Glucose Tolerance Test (OGTT), which is generally done after the FPG test. For this test, the person needs to drink 75gm of a glucose drink, and after 2 hours blood glucose is measured. 

Symptoms of Diabetes

Most diabetes patients do not experience any obvious symptom. However, some patients may feel symptoms like weight loss, increased thirst, increased appetite, increased urination, blurry vision, elevated cholesterol levels, high blood pressure, sexual problems, numbness and tingling, fatigue, slow healing of wounds, and itchy skin.

Diabetes complications

High blood glucose for a prolonged period may damage micro-blood vessels of the eye (retinopathy), kidney (nephropathy), and nerves (neuropathy) and macro-blood vessels of the heart (coronary heart disease), brain (stroke) and lower extremities (peripheral vascular disease). 

Prevention and management

First and the foremost thing to control blood glucose is lifestyle modification, i.e. diet and exercise.

Diet

Diet and exercise planning should be done as per the recommendation of the doctor or dietitian, but the basic principles for the diet plan are 

  • How much to eat (Calories in the diet- If you are less active fewer calories are required)
  • When to eat (Diet schedule-4-6 small meals per day)
  • What to eat (Diet composition- 50% of your plate consist of vegetables, 25% protein and 25% of starch)

General diet advice

  • Eat a regular meal
  • Eat a variety of foods
  • Eat less salt
  • Eat less fat
  • Eat less sugar
  • Avoid or consume less alcohol
  • Eat fruits having a low glycemic index

Exercise

One should exercise 30 minutes every day for good health, and you can increase it up to 40-60 minutes if you need to lose weight.

Regular exercise will lower your

  • Blood glucose
  • Blood pressure and cholesterol
  • Weight
  • Stress

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