Diabetes mellitus is derived from the Greek word diabetes meaning siphon – to pass through the Latin word mellitus meaning honeyed or sweet. This is because in diabetes excess sugar is found in the blood as well as the urine. It was known in the 17th century as the “pissing evil”.
Diabetes | Type 1 Diabetes | Type 2 Diabetes
There are three major types of diabetes: type 1 diabetes, type 2 diabetes, and gestational diabetes.
SYMPTOMS OF DIABETES
The main symptoms of diabetes are three – polydipsia, polyphagia, and polyuria. These mean increased thirst, increased hunger and increased frequency of urination. In addition, patients complain of feeling very tired and weight loss and loss of muscle bulk.
The common signs and symptoms of diabetes include:
- Increased frequency of urination, especially at night
- Frequently feeling thirsty
- Weakness and fatigue
- Unexplained loss of weight
- Genital itching or thrush
- Blurred vision
- Increase in healing time of cuts and wounds
All types of diabetes mellitus have something in common. Normally, your body breaks down the sugars and carbohydrates you eat into a special sugar called glucose. Glucose fuels the cells in your body. But the cells need insulin, a hormone, in your bloodstream in order to take in the glucose and use it for energy. With diabetes mellitus, either your body doesn’t make enough insulin, it can’t use the insulin it does produce or a combination of both.
Since the cells can’t take in the glucose, it builds up in your blood. High levels of blood glucose can damage the tiny blood vessels in your kidneys, heart, eyes, or nervous system. That’s why diabetes — especially if left untreated — can eventually cause heart disease, stroke, kidney disease, blindness, and nerve damage to nerves in the feet.
TYPES OF DIABETES
Type 1 Diabetes
Type 1 diabetes is also called insulin-dependent diabetes. It used to be called juvenile-onset diabetes because it often begins in childhood. Type 1 diabetes is an autoimmune condition. It’s caused by the body attacking its own pancreas with antibodies. In people with type 1 diabetes, the damaged pancreas doesn’t make insulin. This type of diabetes may be caused by a genetic predisposition. It could also be the result of faulty beta cells in the pancreas that normally produce insulin. A number of medical risks are associated with type 1 diabetes. Many of them stem from damage to the tiny blood vessels in your eyes (called diabetic retinopathy), nerves (diabetic neuropathy), and kidneys (diabetic nephropathy). Even more serious is the increased risk of heart disease and stroke.
Type 2 Diabetes
The most common form of diabetes is type 2 diabetes, accounting for 95% of diabetes cases in adults. Type 2 diabetes used to be called adult-onset diabetes, but with the epidemic of obese and overweight kids, more teenagers are now developing type 2 diabetes. Type 2 diabetes was also called non-insulin-dependent diabetes.
Type 2 diabetes is often a milder form of diabetes than type 1. Nevertheless, type 2 diabetes can still cause major health complications, particularly in the smallest blood vessels in the body that nourish the kidneys, nerves, and eyes. Type 2 diabetes also increases your risk of heart disease and stroke.
With Type 2 diabetes, the pancreas usually produces some insulin. But either the amount produced is not enough for the body’s needs, or the body’s cells are resistant to it. Insulin resistance, or lack of sensitivity to insulin, happens primarily in fat, liver, and muscle cells.
People who are obese — more than 20% over their ideal body weight for their height — are at particularly high risk of developing type 2 diabetes and its related medical problems. Obese people have insulin resistance. With insulin resistance, the pancreas has to work overly hard to produce more insulin. But even then, there is not enough insulin to keep sugars normal.
There is no cure for diabetes. Type 2 diabetes can, however, be controlled with weight management, nutrition, and exercise. Unfortunately, type 2 diabetes tends to progress, and diabetes medications are often needed.
HbA1C test is a blood test that estimates average glucose levels in your blood over the previous three months. Periodic HbA1C testing may be advised to see how well diet, exercise, and medications are working to control blood sugar and prevent organ damage. The HbA1C test is typically done a few times a year.
Diabetes that’s triggered by pregnancy is called gestational diabetes (pregnancy, to some degree, leads to insulin resistance). It is often diagnosed in middle or late pregnancy. Because high blood sugar levels in a mother are circulated through the placenta to the baby, gestational diabetes must be controlled to protect the baby’s growth and development.
As per the research, the rate of gestational diabetes is between 2% to 10% of pregnancies. Gestational diabetes usually resolves itself after pregnancy. Having gestational diabetes does, however, put mothers at risk for developing type 2 diabetes later in life. Up to 10% of women with gestational diabetes develop type 2 diabetes. It can occur anywhere from a few weeks after delivery to months or years later.
With gestational diabetes, risks to the unborn baby are even greater than risks to the mother. Risks to the baby include abnormal weight gain before birth, breathing problems at birth, and higher obesity and diabetes risk later in life. Risks to the mother include needing a cesarean section due to an overly large baby, as well as damage to the heart, kidney, nerves, and eye.
Other Forms of Diabetes
A few rare kinds of diabetes can result from specific conditions. For example, diseases of the pancreas, certain surgeries, and medications, or infections can cause diabetes. These types of diabetes account for only 1% to 5% of all cases of diabetes.
How to control diabetes?
- Treatment during pregnancy includes working closely with your nursing home.
- Careful meal planning to ensure adequate pregnancy nutrients without excess fat and calories
- Daily exercise
- Controlling pregnancy weight gain
- Taking diabetes insulin to control blood sugar levels if needed
Type 1 Diabetes
- Having type 1 diabetes does require significant lifestyle changes.
- Frequent testing of your blood sugar levels
- Careful meal planning
- Daily exercise
- Taking insulin and other medications as needed
People with type 1 diabetes can lead long, active lives if they carefully monitor their glucose, make the needed lifestyle changes, and adhere to the treatment plan.
Treatment for type 1 diabetes involves taking insulin, which needs to be injected through the skin into the fatty tissue below. The methods of injecting insulin include:
- Insulin pens that use pre-filled cartridges and a fine needle
- Jet injectors that use high-pressure air to send a spray of insulin through the skin
- Insulin pumps that dispense insulin through flexible tubing to a catheter under the skin of the abdomen
A simple blood test, the A1c (your doctor may call it “glycosylated hemoglobin”) is done on a sample of blood taken from a finger-stick or from a small vial of it drawn from your arm. Not to be confused with the daily at-home monitoring that allows some people with diabetes to measure their blood sugars in the moment, the A1c test paints a picture of your average blood sugar level for the past 3 months.
Random blood sugar test (BSL Random)
A blood sample will be taken at a random time. Regardless of when you last ate, a random blood sugar level of 200 milligrams per deciliter (mg/dL) — 11.1 millimoles per litre (mmol/L) — or higher suggests diabetes.
A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it’s 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes.
Oral glucose tolerance test (OGCT)
For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours. A blood sugar level of less than 140 mg/dL (7.8 mmol/L) is normal. A reading of more than 200 mg/dL (11.1 mmol/L) after two hours indicates diabetes. A reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes.
Urine Routine Test
Urine tests aren’t always used to diagnose diabetes. Doctors often use them if they think you may have type 1 diabetes. The body produces ketone bodies when fat tissue is used for energy instead of blood sugar. If ketone bodies are present in moderate to large amounts in the urine, this could indicate your body is not making enough insulin.
Other Diabetes Tests
Along with the above test, it’s important for people with diabetes to have;
High blood sugar and high blood pressure can do a number on the tiny blood vessels in your eyes, but the damage can be prevented if your doctor spots it early. The best way to do that? A yearly eye exam. With the help of eye drops that enlarge your pupils for a short time, your eye doctor will examine the inside of your eyes for signs of leaky blood vessels. It’s a painless test, but you won’t be able to see clearly for a few hours afterward.
Diabetes can also slow circulation in your feet and legs and cause you to lose feeling there. That’s why the American Diabetes Association says you should get an annual foot exam. Your doctor will check them for redness, cracks, sores, or open wounds. He’ll look for weird problems (like overlapping toes), and he’ll do a monofilament test. You’ll close your eyes and he’ll simply press a piece of nylon to various parts of your foot. If you can’t feel it, you might have nerve damage. He may also tap on your Achilles tendon to see if the nerves on the back of your ankle are in good condition.