• Shruti GOCHHWAL

Diabetes

Diabetes or Diabetes Mellitus is a chronic disorder in which elevated levels of blood sugar are observed. According to the World Health Organization, 422 million people suffer from diabetes in the world. Diabetes also causes 1.6 million deaths per year.

It is one of the most common disorders in the world and requires constant care.

What are the risks associated with high blood sugar levels?

High blood sugar levels are a cause of concern as they can do significant damage. The normal blood sugar level for an adult after eating is less than 140mg/dl and on an empty stomach below 100mg/dl. When the blood sugar levels increase, the body is not able to cope with it. It can result in the following complications:

● Stroke

● Heart attack

● Loss of vision

● Kidney failure

● Increased urination

● Skin problems

● Gum disease

● Nerve disorders

Types of Diabetes

Diabetes can be classified into three types:

Type 1 Diabetes: In this disorder, insulin is not produced in the body. The immune system destroys the cells which produce insulin in the pancreas.

Type 2: Diabetes: In type 2 diabetes, the body produces insulin but the way in which that insulin is used gets affected. This ineffective use of insulin results in high blood sugar levels.

Gestational Diabetes: It is also referred to as overt diabetes. It is a condition which develops in pregnant women as the body becomes less sensitive to insulin. This disorder does not affect all pregnant women.

Type 1 Diabetes

Type 1 diabetes is caused due to the destruction of beta cells in the pancreas. 5% of the total diabetes cases are of type 1 diabetes.

Symptoms of Type 1 Diabetes

● Increased urination

● Thirst

● Blurred vision

● Tiredness and fatigue

● Mood Swings

● Sudden bedwetting in children

● Nausea

● Stomach problems

  1. Rapid breathing

● Confusion

● Loss of consciousness

Treatment of Type 1 Diabetes

Unfortunately, there is no freedom from type 1 diabetes as it does not have a cure. The treatment involves the administration of insulin in proper doses and ensuring constant extra care.

Apart from the usual syringe, the following ways are being currently used to administer insulin

● Insulin Pen: It is a device in which disposable insulin cartridges and needles are attached. The pen allows the user to select the dose. It is a more convenient option than the syringe.

● Insulin Pump: An insulin pump is a device which is designed to mimic the function of the pancreas and releases the exact amount of dose that is programmed into it. A catheter is inserted under the layer of the skin and the pump is attached to it from the outside. The pumps vary model to model but they usually have multiple dosage options programmed by doctors.

● Jet Injection: A jet injection is a relatively newer technique used by patients who are afraid of using needles It is held while it touches the skin and it uses a jet of air to push the insulin through the skin. It can cause bruising on the skin and is not widely used.

Type 2 Diabetes

It is the most common type of diabetes accounting for more than 90% of cases. The major function of insulin is to ensure the movement of blood glucose to the cells but in type 2 diabetes that does not happen. This results in an increase in the blood sugar levels.

Causes of Type 2 Diabetes

The exact manifestation of the disease is not known. However, it is widely accepted that the following risk factors contribute to the development of type 2 diabetes:

● Genetic Factors: A family history is a key component in diabetes. If you have a family history than you are at a much higher risk of diabetes.

● Obesity: Obese individuals are at a much higher risk of developing type 2 diabetes.

● Unhealthy Diet: An unhealthy diet has been linked to type 2 diabetes.

In most cases, a combination of the factors results in type 2 diabetes.

Symptoms of Type 2 diabetes

● Increased Hunger

● Low energy level

● Tiredness

● Unexplained weight loss

● Skin rashes

● Blurred vision

● Slow healing of wounds

● Pain in feet

● Numbness

● Yeast infections

Treatment of Type 2 Diabetes

The treatment involves two aspects. Medication and lifestyle changes.

Medication:

● Metformin: It is the most used drug in the treatment of type 2 diabetes. Metformin reduces blood sugar level by decreasing the amount of blood sugar produced by the liver. It is available in various doses.

● Sulfonylureas: These are drugs which increase the production of insulin. Examples include glimepiride and chlorpropamide.

● GLP -1 Receptor Agonists: They act by slowing the digestion process which helps in improving blood sugar levels. Exenatide and liraglutide are the most used drugs.

● Thiazolidinediones: These drugs increase the sensitivity towards insulin produced by the body. Commonly used drugs are pioglitazone and rosiglitazone.

● Meglitinides: Their mechanism of this action is to stimulate the pancreas so that it releases more insulin. Examples include Chlorpropamide and Glyburide.

● Sodium-Glucose Cotransporter-2 Inhibitors: The kidney reabsorbs glucose from the urine. These drugs ensure that the reabsorption does not take place and glucose is excreted through the urine. Canagliflozin and empagliflozin are commonly used.

● Insulin: In some extreme cases of type 2 diabetes, insulin has to be administered to the patient.

Gestational Diabetes and Overt Diabetes

If the onset of diabetes takes place within the first 24 weeks in a pregnancy, it is considered overt diabetes. After 24 weeks, it is known as gestational diabetes.

This type requires constant monitoring so that the mother and foetus are not bothered. The gynaecologist usually checks for this disorder in routine check-ups.

In most cases, this disorder resolves itself after the pregnancy. Medications are avoided unless necessary and the treatment focuses on making changes to the diet.

Gestational Diabetes Diet

The gestational diabetes diet or over diabetes diet focuses on eating healthy foods so that proper nutrition is maintained while managing diabetes.

Foods to Eat

● Variety of vegetables.

● Fruits

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Credits: Pexels Caption: Fruits and vegetables should be a part of gestational diabetes diet.

Protein-rich diet

● Eggs

● Healthy snacks such as popcorn

Food Items to Avoid

● Fried food

● Alcoholic Beverages

● Sweets such as candy

● Baked food items

● Fast food

● Sugary Beverages

The diet should focus on proper nutrition while avoiding sugary and fat-rich substances. Consulting the doctor about your diet is advised.

Lifestyle Changes for Diabetes

These lifestyle changes are common for all types of diabetes. Lifestyle changes are often considered the best medicine for diabetes.

These lifestyle changes act as preventive measures for people who are not suffering from diabetes.

● Healthy Diet: Watching your food intake is the first step towards your freedom from diabetes-induced risks. No food items are prohibited but their quantities have to be strictly monitored. The focus should be on limiting foods which have high sugar and fat content. Eating items such as fruits and vegetables are beneficial. Maintaining a regular diet is also an important aspect.

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Credits: Pixabay Caption: Fried Food should be avoided by diabetic patients.

● Workout: Regular Exercise is very important and your everyday workout duration should be at least 30 minutes. Physical activity helps your body in managing high blood sugar levels. The workouts can range from morning walks to the gym.

● Stress Management: High stress levels can make your diabetes worse as stress can increase blood sugar levels. Popular methods of stress relief include meditation and yoga.

● Monitoring Blood Sugar Levels: Monitoring blood sugar levels is important to eliminate the risk factors associated with fluctuating blood sugar levels. Home test kits are available for testing blood sugar levels.

● Alcohol and Smoking: Both alcohol and smoking have been linked with increased blood sugar levels and should be avoided.

Diagnosis of Diabetes

The following diagnostic methods are used in diabetes

● Glycated Haemoglobin Test or A1C Test: This test indicates the average blood sugar level for three months.

● Fasting Blood Sugar Test: This test is performed after an overnight fast. A blood test is performed to measure the blood sugar level.

● Random Blood Sugar: The test is similar to a fasting blood sugar test. The only difference is that it is performed after taking meals.

● Initial Glucose Challenge Test: In this test, the patient is made to drink a sugary liquid and then the blood sugar level is tested. This test is used in gestational diabetes.

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Credits: Pixabay Caption: Diagnostic Tests measure the blood glucose level at different times.

Prevalence of Diabetes in India

Diabetes has been increasing rapidly in India. According to the report published by the Ministry of Health and Family Welfare in 2019, the prevalence in India is at 11.8%.

The prevalence of diabetes in India is higher in urban areas as compared to rural areas. The prevalence of these diseases is so high that the government of India fixes retail prices of most drugs used for diabetes. The prices can be found in the National Pharmaceutical Pricing Authority Order.

Takeaway

Diabetes is a chronic condition which affects many people in the world. The most important factor is to ensure diabetes care so that it is not ignored. At the moment there is no cure but it can be managed.

Lifestyle changes especially diet and exercise are an essential part of managing the disease and should be given priority.

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