Diabetes (Diabetes mellitus)
What is Diabetes?
Diabetes is a disease in which the person has high level of blood sugar (glucose).
Diabetes is on the rise and now becoming an important health problem to the whole world.
What is the cause of diabetes?
Diabetes is caused mainly due to the slowly changing life style from manual work to highly automated industries, migration of people from villages to cities, environmental changes, and increased inactivity leading to obesity. Consumption of high caloric-high fat diet and Jung food are major factors that produces diabetes. Heredity also plays a role.
Type 1 Diabetes: Juvenile diabetes, also known as insulin dependent or child hood onset diabetes .Here the beta cells of the pancreas does not produce insulin.
Our digestive system change the carbohydrates and sugar we eat to simple sugar called glucose, which can be used as energy by the cells. Insulin is necessary to push glucose from blood into the cells of our body.
Type 1 diabetes may be congenital (heredity) or our immune system may destroy the beta cells of pancreas which produce insulin. It is usually diagnosed in children and young adults.
Type 2 Diabetes: Here the insulin production is slowly reduced and the secreted insulin may not be enough to reduce glucose level or the cells are unable to recognize the insulin and use it (insulin resistance).
Gestational diabetes: It affects some female when they are pregnant. Their children are at risk of becoming diabetic. Their children may be overweight at birth.
Pre-diabetics: When Persons blood glucose level is little higher than normal but not up to diabetic level (fasting blood glucose 100-120 mg\d}.
What are the symptoms?
Frequent urination (polyuria), Frequent thirst and hunger, tiredness and fatigue, non-healing wounds, Numbness or burning sensation of hands and feet, Giddiness, Loss of memory .loss of vision, Weight gain or weight loss.
What test to do?
Hb A1C: Hb A1C is called glycosylated haemoglobin, a form of haemoglobin that is attached to glucose. It is a blood test which shows the average blood glucose level in the past 3 months.
Normal: Below 5.7 %.
Pre-diabetic: 5.7 % – 6.4 %.
Diabetic: above 6.5 %.
Fasting blood glucose: Blood glucose values measured in Empty stomach. Normal value: Below 110 mg\dl or below 6.1 m mol \ l.
Post- prandial blood glucose: Blood glucose level measured 2 hours after food. Normal value: Below 140 mg\ dl or below 7.8 m mol \ l.
Oral glucose tolerance test: Here 75 grams of glucose is given orally and blood glucose levels measured at the end of one hour and at the end of two hours. Fasting blood glucose: 110 mg\ dl or 6.1 m mol \ l 1 hour: 10 m mol \ l or 180 mg \ dl 2 hours: 7.8 m mol \ l or 140 mg \ dl.
Diabetes can affect any part of the body.
• Peripheral neuropathy
• Loss of vision, diabetic retinopathy
• Hearing loss
• Loss of blood supply to legs
• Gangrene of foot may lead to amputation.
• Reduced sexual libido and impotency.
• Arterial diseases and stroke.
• Diabetic keto-Acidosis; (DKA). If the body cannot get enough insulin, it breaks down fat cells. This produces chemical called ketones, leading to DKA, a life threatening condition.
The main treatment of diabetes is Diet Control, Daily Exercise and Drugs.
Eat more vegetables and fruits. It is better if they are more colourful.
Eat high fibre cereals legumes and whole grains.
Have lot of fish, skin less chicken, milk and eggs.
Reduce the intake of carbohydrates, deep fried foods, sugary drinks and packaged foods.
Daily exercise like yoga, brisk walking. Taichi, Cycling or swimming has to be followed.
Type 1 Diabetes: Injection Insulin is the main line of treatment for type 1 diabetes.
Type 2 Diabetes: Oral anti diabetics can be given.
Drugs that stimulate insulin secretion like Glibenclamide, Glipizide, Gliclazide and Glimepiride may be given.
Drugs that delays absorption of carbohydrates from intestine like acarbose and voglibose can be given.
Biguanides like Metformin to reduce hepatic glucose production can be given. Thiaolidinediones like pioglitazone which increase the insulin sensitivity may be given.
These drugs can be given alone or in combinations.
In some type 2 diabetics injection insulin is necessary.
Healthy foods, healthy body weight, active life with moderate physical activity and proper sleep can prevent diabetes. Avoiding smoking, avoiding mental stress and reduced alcohol intake can also helps in preventing Diabetes.