What is diabetes?
Diabetes mellitus is a disorder in which the body fails to convert sugars, starches and other foods into energy due to inability of body to make enough insulin or use insulin correctly. This leads to high amounts of sugar in blood.
What is normal?
Normal blood sugar ranges between 60-100 mg/dl fasting and about 140 mg/dl after food.
What are the two types of Diabetes?
Diabetes is categorized into two types as Type 1 and type 2.
The second type
Diabetes Type 2 generally doesn't show any symptoms in the initial stage and goes unnoticed for a prolonged time until the glucose levels are consistently high for a long time. Diabetes can be a silent killer. One out of every three people with type 2 diabetes may not even know that they have a medical condition. Diabetes interferes with the body's ability to break down carbohydrates for energy, leading to high blood sugar levels. These persistent and prolonged high blood sugar levels put the person at risk of developing eye troubles, nerve problems, heart disease and other unhealthy conditions.
Warning signs of diabetes
Frequent visits to bathroom called as polyuria and increased thirst called as polydipsia, excessive tiredness, unexplained weight loss, genital itching, blurred vision, and slow healing of cuts and wounds could be the warning signs.
Some other symptoms due to persistent high sugars could be fatigue, blurred vision, headaches, and unusual hunger.
Recurrent infections like urinary tract infection, fungal skin infections, vaginal yeast infections and sores which take a long to heal could be a warning of diabetes.
Sexual dysfunction could be a warning
Do not ignore the vaginal dryness and erectile dysfunction. They could be indicative of impending diabetes. Type 2 diabetes can lead to sexual problems. Diabetes can harm the blood vessels and nerves of sex organs leading to diminished sensation potentially making orgasm difficult. Impotence as a complication of diabetes is common among men and about one-third of diabetic women show some type of sexual dysfunction.
Certain risk factors associated with diabetes are preventable like cigarette smoking, being overweight, especially around the waist, lack of exercise, high-calorie food, and high cholesterol and triglyceride levels.
Risk factors for diabetes which can’t be prevented include - Age and family history. People with family history (parent or sibling) of diabetes are more prone to develop diabetes. Chances of developing diabetes increase with age. People above 45 years of age should get regularly tested for diabetes. Get an advice from your doctor to know aptness of diabetes testing for you.
Two more risk factors for women
Insulin: Mechanism of action, insulin resistance and diabetes Type 2
Insulin is a hormone. It enables the body to utilize glucose effectively to produce energy. Carbohydrates are metabolized or broken down to sugars in the stomach. This glucose enters the bloodstream and stimulates the pancreas to produce insulin adequately. A function of insulin is to promote uptake of glucose by body cells and use as energy. When the body's cells are unable to take up glucose properly, glucose levels rise in the blood. A body can produce insulin, but the body's cells do not respond properly to the insulin produced. In the long run, pancreas reduces the amount of insulin that it produces. Thus Diabetes type 2.
How is it diagnosed?
Diagnosis is based on tests like: Hemoglobin A1c which measures the amount of glycosylated hemoglobin (hemoglobin bound to glucose) in blood and gives information of average blood glucose levels over the previous 2 to 3 months. Hemoglobin A1c level over 6.5% is suggestive of diabetes. Another test is fasting blood glucose. A level above 120 and random blood glucose above 200 suggests diabetes.
Testing blood glucose
Blood glucose needs to be monitored regularly in diabetic patients. How often you need to test your blood glucose will depend on blood sugar levels, severity of diabetes, response to medications, etc. Your doctor will decide and formulate a plan for you. Regular monitoring helps to get a fair idea of blood glucose status, helps to plan management accordingly and avoids any emergency situations. Commonest routines of blood sugar testing are: Fasting i.e. upon waking up in the morning, before and after meals. Sometimes glucose is also tested at night and before and after physical activity.
Managing diabetes: Diet
Management involves diet, exercise, stress attenuation, and medications. A healthy eating plan with a watch on carbohydrates intake and low calories along with management of total fat and protein consumption is recommended. Visit a dietician or a diabetes counselor.
Managing diabetes: Exercise
Exercise like walking helps lower blood glucose levels. Additionally, it reduces body fat, lowers blood pressure, and helps prevent cardiovascular disease. A simple 30 minutes of moderate exercise daily helps a lot to burn calories and maintain normal sugar levels in people with type 2 diabetes.
Managing diabetes: Manage stress
Stress elevates blood pressure and blood sugar. Stress is detrimental to people with diabetes. Yoga, meditation, or breathing and counseling are good ways of relaxation. Talking to a friend and listening to music are some other options.
Managing diabetes: Medicines
Oral medicines are given to people with type 2 diabetes who cannot adequately control blood sugar with diet and exercise. Many types of medicines are available and used singly or in combination. These act by increasing insulin production, or improving the body’s insulin utilization, or some others act by blocking starch digestion.
Managing diabetes: Insulin
Insulin is used in combination with oral medications in type-2 diabetes and in a condition where the pancreas is unable to produce sufficient insulin in response to increased blood sugar.
Long-term complication: Damage to arteries
Heart disease is closely related to diabetes. Diabetics are more prone to suffer heart attacks. Prolonged persistent high blood sugar levels damage the blood vessels, thus leading to an increased risk of clot formation and increased susceptibility to heart attack. Similarly, diabetes increases the risk for stroke.
Long-term complication: Damage to kidneys
Chronic diabetes puts kidneys at risk of developing a disease. Almost 45% of renal failures are due to uncontrolled high sugars and it is found to be the commonest cause for kidney failure. Keeping sugars under control can reduce the risk of kidney disease.
Long-term complication: Damage to eyes
High blood sugar over time damages tiny blood vessels within the retina of the eye. The condition is known as diabetic retinopathy. This can lead to progressive and permanent vision loss.
Long-term complication: Damage to nerves
Neuropathy or nerve damage presented as tingling, numbness, and a sensation of "pins and needles” in hands, feet, fingers, and toes are related to diabetes. Controlling glucose levels can help prevent this complication.
Long-term complication: Damage to feet
This is due to nerve damage. Damage to nerves impairs normal sensation of feet thus making it hard to sense or feel even injuries and wounds to the feet. Damage to the blood vessels causes reduction of blood supply to feet in people with diabetes. All this leads to poorly- healing wounds, non-healing wound, and gangrene. Severe cases might need amputation of the limb.
Prevention is better than cure
Prevention is better than cure even in case of diabetes. Proper diet, moderate exercise, healthy weight along with stress-free life helps to prevent diabetes type 2 in many and keep complications at bay in those who are already diabetic. Early screening helps timely management and reduces the risk of long-term complications.
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