Diabetes !! Diabetes mellitus !! Type 1 Diabetes !! Type 2 Diabetes !! Diabetes Symptoms !! Treatment for diabetes

Diabetes | Type 2 Diabetes | Signs and Symptoms of Diabetes | Diabetes Causes | Diabetes Risk Factors | Diabetes Complications | Diabetes Treatment  

What is Diabetes

Diabetes is a chronic (long-lasting) disease, it occurs when the pancreas does not generate enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar (also called glucose) in the body. Hyperglycaemia is a common symptom of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the blood vessels and nerves.

Diabetes Symptoms

Symptoms of type 2 diabetes develop slowly and in fact, one can be living with type 2 diabetes for years without knowing it. Following are the symptoms of type 2 diabetes:

·         Increased thirst (polydipsia)

·         Frequent urination (polyuria)

·         Increased hunger (polyphagia)

·         Weight loss

·         Fatigue

·         Blurred vision

·         Slow-healing sores

·         Frequent infections

·         Numbness or tingling in the hands or feet.

Risk Factors of Diabetes

Risk factors of type 2 diabetes include:

·         Overweight or obese

·         Fat distribution mainly in the abdomen

·         Physical inactivity

·         Family history of type 2 diabetes

·         Race and ethnicity

·         High blood lipid levels

·         Increased Age

·         Prediabetes

·         Pregnancy-related risks

·         Polycystic ovary syndrome (PCOS).

Diabetes Statistics Worldwide

• Undiagnosed: 8.5 million people
• Diagnosed: 28.7 million people
• Total: 37.3 million people

Criteria for the Diagnosis of Diabetes

• A1C: ≥6.5% (48 mmol/mol)
• Fasting plasma glucose: ≥126 mg/dL (7.0 mmol/L)
• 2-hour plasma glucose during 75-g oral glucose tolerance test (OGTT): ≥200 mg/dL (11.1 mmol/L)
• Random plasma glucose: ≥200 mg/dL (11.1 mmol/L)

Classification of Diabetes

• Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is primarily a result of autoimmune pancreatic beta-cell destruction
• Type 2 diabetes (formerly called non-insulin-dependent, or adult-onset) results from secretory defect to insulin deficiency with insulin resistance
• Gestational diabetes mellitus refers to glucose intolerance with the inception or initial recognition during pregnancy
• Specific types of diabetes due to other causes, e.g., diseases of the exocrine pancreas and drug- or chemical induced diabetes (such as with glucocorticoid use, in the treatment of HIV/AIDS, or after organ transplantation)

Common Diabetes Problems Include or Complications of Diabetes

Diabetes affects many major organs of the body, including heart, eyes and kidneys, blood vessels and nerves. Some serious complications of diabetes are: 

·        Heart Disease & Stroke

·        Nerve Damage (Diabetic Neuropathy)

·        Foot Problems

·        Gum Disease & Other Dental Problems

·        Low Blood Glucose (Hypoglycemia)

·        Kidney Disease

·        Eye Disease

·        Sexual & Bladder Problems

·        Skin problems, such bacterial and fungal infections

·        Decline in memory and other thinking skills (Dementia)

·        Hearing problems (Hearing impairment)

·        Slow healing of serious infections

Prevention of Diabetes

Regular physical activity, a healthy diet, maintaining normal body weight, and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes. Below are some prevention ways:

• Lifestyle behavior change
• Having physically active lifestyle

• Weight reduction
• Quit smoking
• Cut back on sedentary behaviours
• Nutritious snacks
• Eat high fiber diet
• Get moving—and turn off the television

Read more: Notable Updates to the American Diabetes Association (ADA) Standards of Care in Diabetes ─ 2023 Guidelines

Diabetes Treatment

Diabetes can be managed and its consequences avoided or delayed with proper diet, lifestyle modification, physical activity, medication and regular screening and treatment for complications.

There are a number of drugs available for type 2 diabetes that work in different ways to bring blood sugar levels back to normal. These include:   

Antidiabetic Drugs



Biguanides

• Metformin

Thiazolidinediones

• Pioglitazone
• Rosiglitazone

Sulfonylureas

First generation

• Acetohexamide
• Chlorpropamide
• Tolazamide
• Tolbutamide

Second generation

• Glyburide
• Glipizide
• Glimepiride

Meglitinides

• Repaglinide
• Nateglinide

Glucagon-like peptide-1 receptor agonists

• Exenatide
• Liraglutide
• Albiglutide
• Dulaglutide
• Semaglutide
• Lixisenatide

Dipeptidyl peptidase-4 inhibitors

• Sitagliptin
• Saxagliptin
• Linagliptin
• Alogliptin

Sodium-glucose cotransporter 2 inhibitors

• Dapagliflozin
• Empagliflozin
• Canagliflozin
• Ertugliflozin

Alpha-glucosidase inhibitors

• Acarbose
• Miglitol

Summary

There isn’t a cure yet for diabetes but type 2 diabetes is largely preventable. Eating the right foods and adopting other lifestyle behaviours that promote healthy blood sugar and insulin levels will give the best chance of avoiding diabetes. Diabetes self-management education and support, taking medicine as per doctor’s recommendation and keeping health care appointments can also reduce the impact of diabetes.

References

1. American Diabetes Association. Standards of Medical Care in Diabetes—2022 Abridged for Primary Care Providers. 40(1); 10-38.

2. Centers for Disease Control and Prevention. National Diabetes Statistics Report website.

https://www.cdc.gov/diabetes/data/statistics-report/index.html.

3. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

https://www.niddk.nih.gov/health-information/diabetes/overview.

4. World Health Organisation (WHO). Diabetes Key facts. November 2021.