Know About Diabetes

• What is diabetes?

Diabetes is a condition where the amount of glucose (sugar) in your blood is too high. This can be because your pancreas does not produce any insulin, or not enough, to help glucose enter your body’s cells or the insulin that is produced cannot be utilized properly (known as insulin resistance).

• What is Insulin?

Insulin is the hormone produced by the pancreas that allows glucose to enter the body’s cells; it’s like a key to the cell.

• Where does glucose come from?

Glucose mainly comes from digesting carbohydrate and is also produced by the liver. Carbohydrate comes from many different kinds of foods and drink, common foods are like bread, potatoes, corn, chapattis, fruit, some dairy products, sugar and other sweet foods. Protein can also be converted to glucose.

• What are the types of diabetes?

There are mainly four types of diabetes:

1. Type 1 Diabetes-

When no insulin is produced at all because the insulin-producing cells in the pancreas have destroyed is known to be Type 1 Diabetes. Most common cause is auto immune destruction. Type 1 is usually common in children. There is nothing you can do to prevent Type 1 Diabetes. This type of diabetes is always treated with insulin injections.

2. Type 2 Diabetes-

Diabetes occurs when the body either does not produce enough insulin, or the insulin it produces does not work properly (insulin resistance). It is the most common type of diabetes. 90% of diabetes is Type 2. This type of diabetes in adjunction to medications and/or insulin is treated with lifestyle changes, following a healthy balanced diet increasing physical activity, and losing weight to achieve normal blood glucose levels.

3. Gestational Diabetes-

This type of diabetes occurs when pregnant women who never had diabetes before and are diagnosed with high blood sugar levels during pregnancy. Gestational diabetes usually develops later in pregnancy and is usually treated with insulin and goes away after pregnancy. However, women who have had gestational diabetes have a 35% to 60% chance of developing Type 2 diabetes in the future.

4. Secondary Diabetes-

Diabetes develops as a result of other conditions which can be either hormonal, genetic, caused by chemicals or drugs. Severe illnesses that stress the body including pancreatic disease, alcoholism, and malnutrition can cause secondary diabetes. Several medications can also impair the body’s use of insulin. If we cure the main illness successfully the diabetes usually regresses.

• What are risk factors of diabetes?

The major risk factors of diabetes are:

1. A close member or first degree relatives of your family has Type 2 diabetes.
2. You’re overweight or have a waist circumference over 35.5 inches for men, or over 31.5 inches for women.
3. You have high blood pressure or you’ve had a heart attack or a stroke.
4. You’re a woman with polycystic ovary syndrome and you are overweight.
5. You’ve had high blood glucose levels during pregnancy (gestational diabetes).
6. You have severe mental health problems.

• What are the main symptoms of diabetes?

The main symptoms of diabetes are:

1. Increased thirst
2. Increased urination-especially at night
3. Extreme tiredness
4. Unexplained weight loss
5. Genital itching or regular episodes of infection
6. Slow healing of wound
7. Blurred vision

• What are the complications of diabetes?

People with diabetes have a higher risk of developing long term complications such as:

1. Heart disease
2. Stroke
3. Nerve damage
4. Damage to the kidneys
5. Damage to the eyes especially retina

• How to diagnose diabetes?

The tests carried out to diagnose diabetes are:

1. Blood Tests-

These blood tests include blood glucose level. Both fasting and 2 hours after food unless pregnant then we do a 1 hour post meal. HbA1C should be performed every 3-4 months. Lipid profile, kidney function test, liver function test and thyroid function should be done at least once a year.

2. Urine Test-

Urine micro albumin and simple routine test is particularly useful to diagnose infection or diabetic kidney disease at an early stage.

3. Other Tests-

ECG and echocardiograms to see heart function should be done once in a year along with retina exam for the eye, which is a must for all diabetic patients.

-Dr. Dina Shrestha

 Consultant Endocrinologist