Diabetes, often referred to by doctors as diabetes mellitus, is a chronic condition associated with abnormally high levels of glucose (sugar) in your bloodstream. Normally a hormone called insulin that lowers the blood glucose levels by signaling cells to absorb sugar from the bloodstream tightly controls blood glucose levels.
- In Type 1 Diabetes, the body does not produce adequate insulin levels and patients have to inject themselves with insulin to maintain a normal blood sugar level
- In Type 2 Diabetes, the body has enough insulin but the cells cannot absorb the sugar because the cells have been sensitized to chronically elevated blood sugars
According to the Endocrine Society, diabetes affects approximately 34 million people in the United States with an estimated 88 million people having pre-diabetes. Unfortunately, 1 in 4 patients are unaware they have diabetes! Poorly managed diabetes increases a patient’s risk for:
- Kidney Disease
- Heart Disease
- Vascular Disease leading to amputation of toes, feet, and legs
There are two main types of diabetes referred to as Type 1 and Type 2 diabetes. Type 1 diabetes is often called insulin-dependent diabetes or juvenile diabetes. It occurs when the body does not properly produce insulin. According to theAmerican Diabetes Association, it is a less common type of diabetes, with only “5% of people with diabetes having this form of the disease.” Also, Type 1 diabetes tends to occur in young adulthood or teenage years before 30 years of age. Although there is currently no specific cure or treatment for this type of diabetes, heredity plays an important part in determining the development of this disease. However, other environmental factors such as foods, viruses and toxins may also play a role in the development of Type 1 diabetes. It can be managed with insulin, exercise and a healthy eating plan.
Type 2 diabetes, also referred to as non-insulin-dependent diabetes, occurs when the body does not respond to insulin. It is the most common type of diabetes, accounting for about 90+% of all cases of diabetes worldwide. While there is a strong genetic component to developing this type of diabetes, there are also a number of other risk factors that lead to the development of this disease. In particular, people who are overweight have a higher likelihood of developing Type 2 diabetes. In fact, according to MNT, people with a lot of centrally located fat, also known as abdominal obesity, are especially at higher risk of developing Type 2 diabetes. Other risk factors include increasing age, ethnic background, and sedentary lifestyle.
Also, unlike Type 1 diabetes which cannot be prevented, many of the risk factors for Type 2 diabetes can be mitigated by:
- Losing weight if overweight
- Following a healthy diet
- Tight blood glucose control levels
However, because Type 2 diabetes is a progressive disease, meaning that it can get worse over time, it is often required for patients to change their lifestyle while taking medications. Moreover, it is highly recommended for patients to follow a ‘Type 2 diabetic diet’ which focuses on low carbohydrate meal preparation. You can find more details and instructions on how to manage the diet here.
‘Gestational diabetes’ only occurs during pregnancy. This type of diabetes occurs due to a significant hormonal changes and blood sugar elevation during pregnancy. The majority of gestational diabetes patients can control their diabetes with exercising and following a diet plan. In addition, women who have undiagnosed gestational diabetes can have the risk of complications during their delivery, with the baby being bigger than he or she should be. Also, it is often highly likely for those women who took insulin during pregnancy and remained overweight after their delivery to eventually develop Type 2 diabetes. Genetic mutations affecting insulin actions, damage to the pancreas, autoimmune and endocrine diseases are also factors that can play into developing this type of diabetes.
What are the symptoms of diabetes? According to MNT, the most common symptoms of diabetes include:
- Frequent urination
- Excessive thirst
- Weight loss
- Blurred vision
There are three possible tests that doctors can use to determine whether patients have diabetes, pre-diabetes or neither.
- First, the fasting blood glucose test, also called fasting plasma glucose test, can be taken by a simple extraction of blood samples. According to MNT, those with glucose levels of 126mg/dl will be diagnosed with diabetes and those between levels of 100mg/dI and 126mg/dI as pre-diabetic.
- Another way to detect diabetes is the oral glucose tolerance test (OGTT), which is most commonly used to detect Type 2 and gestational diabetes. If a patient has at least 200mg/dI, it means that he or she has diabetes.
- The final test is the glycosylated hemoglobin (HbA1c) test, which measures a marker of the average blood glucose level over the past 3 months and diagnoses those with a level of at least 6.5% as diabetic. It is often the most preferred yet most expensive diagnosis method because it is the most convenient to administer.
In order to prevent further development and complication from diabetes, early detection, monitoring and treatment is necessary. Otherwise poorly controlled diabetes leading to chronically elevated blood sugars injure blood vessels.
- Microvascular complications include diseases in the eye, kidneys and nerves. In particular, foot complications, often referred to as “diabetic foot” results from damages in nerves and can be identified by tingling sensations and burning pain due to restricted blood supply.
- Macro-vascular complications, a disease of the large blood vessels, include heart-related diseases such as heart attacks or strokes.
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Reviewed by :
Gregory Weingart, MD, a practicing ER physician, and Assistant Professor at the Eastern Virginia Medical School