Understanding Diabetes: A Silent Killer

A type of lifestyle disease, affects millions of people worldwide. As per current statistics, 347 million people worldwide have diabetes.  An estimated 3.4 million people died due to high blood sugar in the year 2004.  More than 80% of diabetes deaths occur in low- and middle-income countries. According to WHO, between 2008 and 2030 diabetes death is likely to increase two thirds.

diabetes

Blood glucose measurement (Image source: sxc.hu)

Although there is no cure for diabetes, there are several ways to manage and cope with this condition. A few lifestyle changes like sticking on to a healthy diet plan, regular physical activity, maintaining normal body weight and abstaining from use of tobacco and alcohol can prevent or delay the onset of type 2 diabetes.  Nonetheless, the success of living with diabetes depends largely on the patient.  In this article, let us discuss the different types of diabetes along with a few simple useful tips for effective management of this disease.

 

Diabetes

A chronic lifelong disease, Diabetes often termed the “Silent Killer,”occurs due to inadequate production of insulin by the pancreas, or due to the body’s ineffective use of the insulin produced.

 

Insulin

A hormone, which regulates the blood sugar, is known as insulin. This hormone has intense effects on metabolism playing a major role in the absorption of blood glucose by the body’s cells in the liver, muscle and fat tissues.  This glucose, however, stores up in the liver and muscle preventing the body from using up fat as a source of energy.

 

However, with inadequate amounts of insulin in the blood, the body cells do not take up Glucose.  Under these circumstances, the body utilizes fat as a source of energy.  Insulin is responsible for the control of other body systems, such as making use of amino acid by the body cells.

 

Different types of diabetes

Diabetes is of three main types.  The most common types are as follows:

Type 1 Diabetes

An autoimmune disease, Type 1 diabetes, mostly referred to as “insulin-dependent”, “immune-mediated” or “juvenile-onset diabetes”, is caused when the immune system destroys the cells in the insulin producing pancreas.  Although this type of Diabetes may affect people of any age, it usually develops in children or young adults.  People with type 1 diabetes cannot make insulin, therefore in order to control the levels of glucose in their blood, insulin injections are administered on a daily basis for survival.

 

Type 2 Diabetes 

The most common form of diabetes, Type 2 diabetes accounts for at least 90% of all cases of diabetes.  Referred to as “non-insulin-dependent diabetes mellitus” or “adult-onset diabetes” this type is most often associated with certain ethnic origins such as people of Asian, Hispanic, African or Native American ancestry, advancing age, family history of diabetes, previous history of gestational diabetes, physical inactivity and obesity.  It is a condition known as insulin resistance, when the body fails to make effective use of the insulin produced by the pancreas.  Unlike type 1 diabetes, the symptoms of type 2 diabetes develop gradually, remaining subtle, undetected for many years.

 

Gestational Diabetes (GD)

During pregnancy about 3 to 5 percent of women, suffer from Gestational Diabetes.  Normally, after the birth of the baby, these types of diabetes cease to exist.  Nevertheless, in 40 to 60 % cases, within a span of five to ten years time, women with gestational diabetes are most likely to develop type 2 diabetes. Therefore, retaining ideal body weight and being physically active is highly imperative to prevent the occurrence of type 2 diabetes.  A shortage of insulin or certain pregnancy hormones are some of the factors responsible for the development of Gestational Diabetes.  As in cases of Type 2 Diabetes, the risk of Gestational Diabetes occurs among women, with a family history of diabetes.

 

Prediabetes

Prediabetes is a condition without symptoms.  Depending upon the tests, prediabetes is also termed impaired fasting glucose (IFG) or impaired glucose tolerance (IGT).  Both these conditions indicate high blood glucose levels after overnight fast, with the blood sugar ranging to higher than normal levels yet not high enough to be called diabetes.  A precursor of Type 2 Diabetes, often referred to as “borderline Diabetes,” this condition, if left unchecked, may lead to Type 2 Diabetes with a risk of developing cardiovascular disease and stroke.  However, the greatest advantage for people with this condition is that they may prevent or delay the onset of Type 2 Diabetes with regular exercise and by maintaining ideal body weight.

 

Signs and Symptoms of Diabetes

A silent killer, Diabetes, most often arrives as an uninvited guest, without prior sign or symptom.  However, there are a few common symptoms typical of the diseases, which are listed below:

 

Frequent Urination

Elevated glucose levels in the blood result in frequent urination, especially at nights.  This is mainly because the body flushes out excess sugar through urine. However, due to the excretion of excess fluid and sugar there may be possibilities of dehydration.

 

Excessive Thirst

thirst

Image source: sxc.hu

When the body tries to replenish the lost fluids excretes via urine, it results in excessive thirst.

 

Excessive Hunger

The insufficient insulin levels exhaust the muscles and the organs due to the body’s inability to move sugar into the cells and the tissues making a person ravenous.

 

Weight Loss

The excess glucose released through urine, resulting in a significant loss of calories.  Due to an inability to metabolize glucose levels, the body utilises alternative fuels stored in muscle and fat.  Therefore, despite an increased food intake there is tremendous weight loss.

 

Blurred Vision

Uncontrolled diabetes or unusual changes in blood sugar levels affect the lens inside the eye resulting in blurring of vision.


Skin Problems

Due to suppression of immune system, whenever there is fluctuation in blood sugar levels, the body gives few signals through symptoms of frequent skin infections like fungal, bacterial, or urinary tract infection.  Another sign may be itching of skin, caused, perhaps, due to poor circulation or dry skin.  Some of them with type 2 diabetes have a condition, called acanthosis nigricans, which is darkening of the skin around neck or armpit regions.  This may be a sign of insulin resistance, despite the blood sugar levels remaining normal.

 

Delayed Wound Healing

wound

Image source: morgueFile.com

Another characteristic symptom of diabetes is that there is a delay in the healing of infections, cuts and bruises.  This happens due to the thickening of blood vessels, affecting blood circulation in different body parts.

 

Irritability

Diabetics experience irritability and mood swings on numerous occasions, which depends on blood glucose levels in the body.  These fluctuations arising in the blood sugar levels, lead to inept glucose supply to the brain which is responsible for irritability and grumpiness.

 

Numbness or Tingling

Prolonged diabetes causes nerve damageknown as diabetic neuropathy.  This often results in numbness or tingling sensation, especially in the hands and legs, combined with swelling or burning pain.

 

Fatigue

Shortage of sugar in the cells is the cause for unexplained fatigue or tiredness.

 

Diabetes Complications

Untreated or uncontrolled Type 2 Diabetes may lead to serious life threatening complications.  Few of them are:

 

Retinopathy

One of the major complications is diabetic retinopathy with symptoms of pain in the eye gradually resulting in loss of vision.  Diabetes also increases the risk of other serious conditions pertaining to vision such as cataracts and glaucoma.

 

Cardiovascular Disease

Cardiovascular disease is one of the foremost factors for mortality in about 50% of the population. Prolonged, uncontrolled diabetes may affect the heart and blood vessels leading to coronary heart disease, resulting in heart attacks and stroke.

 

Nephropathy

Diabetic renal disease, also known as diabetic nephropathy, is one of the most common and devastating complications of diabetes. The kidneys contain millions of tiny blood vessels filtering waste from blood.  However, prolonged Diabetes may damage the delicate filtering system causing organ deterioration and function, which, ultimately results in kidney failure, termed end-stage renal disease, (ESRD).

 

Neuropathy/ Autonomic Neuropathy

Elevated blood sugar levels may damage the walls of the tiny blood vessels, supporting the nerves, especially on the legs known as diabetic neuropathy.  This often demonstrates as tingling, burning, numbness, tightness, shooting or stabbing pain in the hands or feet, especially at nights, with a loss of feeling ultimately leading to ulceration and amputation of the affected limbs.

 

Another type is the autonomic neuropathy, a condition damaging the nerves controlling internal organs because of high blood sugar levels.  This results in digestive problems, diarrhoea, erectile dysfunction, rapid heartbeat, and low blood pressure.

 

Osteoporosis

Diabetes may lead to lower than normal bone mineral density, increasing risk of osteoporosis.

 

Depression

Diabetics are prone to depression, which in turn, may increase blood sugar levels and allied complications.

 

Dementia/Alzheimer’s Disease

Dementia caused by Alzheimer’s disease, may be due to problems related to blood vessels in the brain. Excessive or insufficient insulin may lead to either brain damaging inflammation or deprivation of glucose in the brain cells.

 

Hearing Loss 

Diabetes leads to hearing impairment.

 

Gum infections

Gum infections may also be a concern, especially with a history of poor dental hygiene.

 

Infections

High blood glucose levels in the blood slow down the action of white blood cells causing inability to fight infection.

 

Tests and Diagnosis
  • Measuring the fasting blood glucose levels after an 8-hour fast.
  • Oral glucose tolerance test (OGTT) conducted by measuring blood glucose levels, after 2 hours of drinking 75 grams of glucose, dissolved in water.
  • HbA1c, a blood test measuring the percentage of blood sugar attached to haemoglobin, the oxygen-carrying protein in red blood cells signifying the average blood sugar level for the past two to three months.

 

Effective Management of Diabetes

Although there is no cure for Diabetes, it is imperative to tackle this condition prudently yet patiently.

 

Monitoring levels

The A1C test with frequent monitoring of blood glucose levels, depending upon the severity of the condition, is a way to make sure that blood sugar level remains within target range.

 

Healthy Food Choices

Low calorie nutritious food sans fat, taken in small portions, with high fiber content,  fresh leafy green vegetables, fruits and cutting down on salt are the prerequisites of a healthy diabetic meal plan.

 

Ideal Body Weight

Developing healthy eating habits help control body weight, preventing risk of High blood pressure, cholesterol and cardiovascular diseases.

 

Regular Exercise

Exercise

Jogging (Image source: morgueFile.com)

Half an hour Regular exercise a day,activate insulin thereby controlling blood sugar levels.  However, to avoid exercises known to cause further complications like cardiovascular diseases, hypoglycaemia etc.,it will be wise to consult a physician.

 

Combat Stress

Undue stress raise blood sugar levels, as stress hormones interfere with effective functioning of insulin.

 

Quit smoking

Smoking increases risk of various diabetes complications.  Therefore seeking professional help will be a good option to quit smoking. (Read harmful effects of smoking)

 

Limit Alcohol

Alcohol consumption cause either high or low blood glucose levels. Therefore, drinking in moderation is recommended.

 

Feet care

Checking the feet each day for blisters, cuts, sores, redness or swelling, and seeking professional help in case of soreness may help prevent complications.

 

Sparkling Teeth

Brushing teeth twice a day combined with gentle flossing prevent infection and bleeding of the gums.

 

Eye Care

Any changes in vision ought to be discussed with a doctor.

 

Living with diabetes is not as difficult as it sounds, provided the person adopts a positive outlook of life with a cheery attitude!

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