Diabetes is a chronic metabolic disorder that affects millions globally. As the cases continue to surge sharply, so does the need for knowledge about diabetes. This blog discusses diabetes in detail. It covers its background, causes, types, symptoms, and treatments. This provides insights into managing the condition.
History of Diabetes
Evidence of diabetes can be found in the history dating back as far as ancient Egypt, around 1550 BC. Ancient Egyptian manuscripts describe a disease. It caused excessive urination and severe weight loss. Later, these were found to be symptoms of diabetes. The word “diabetes” comes from the Greek for “siphon.” Aretaeus of Cappadocia coined it in the 1st century AD to describe the excessive urination, a typical symptom of the disease.
In the 5th century, Sushruta, an Indian physician, discovered that diabetic patients’ urine tasted sweet. He suggested the term “Madhumeha,” which means “honey urine.” This would be reinforced in the seventeenth century by Thomas Willis of what would later become the expression “diabetes mellitus,” with “mellitus” in Latin indicating “honey-sweet.”.
Undoubtedly, the most important milestone in the history of diabetes came in the 20th century with the discovery of insulin. In 1921, Frederick Banting and Charles Best were the first to isolate insulin. This was the start of the first effective treatment for the disease. This discovery fundamentally changed the course of diabetes from a death sentence to a chronic disease, marking a major turning point in medical history.
What is Diabetes?
Diabetes is a group of metabolic diseases. They cause high blood sugar. It includes disorders where the body can’t produce enough insulin or use the insulin it makes. Insulin is a hormone made in the pancreas. It maintains blood sugar levels by helping cells use glucose for energy.
There are many types of diabetes, but the most common are Type 1, Type 2, and gestational diabetes. They each have different causes and mechanisms. But, all raise blood sugar levels. If unmanaged, this can cause serious complications.
Recent News and Updates
Diabetes is now a growing concern for public health, although appreciable developments are being seen in health agencies worldwide.
World Health Organization (WHO)
The WHO reports that, in 2014, the global diabetes rate had almost quadrupled since 1980, rising from 108 million to 422 million. The WHO identifies diabetes as a major cause of blindness, kidney failure, heart attack, stroke, and lower limb amputation. The organization’s Global Report on Diabetes calls for better ways to prevent diabetes, improved care, and a stronger health system to tackle it.
Recently, WHO has also stressed the impact of diabetes in Low and middle-income nations, where most cases of deaths are recorded. It has launched initiatives to eliminate risk factors for Type 2 diabetes. These include an unhealthy lifestyle, obesity, and inactivity. It aims to promote healthy behaviors through public health campaigns.
Diabetic Association of India
More than 77 million people in India, live with diabetes, earning it the often-quoted title “diabetes capital of the world.” The Diabetic Association of India supports this cause. It seeks to raise awareness, educate, and improve care across the country. It organizes educational programs, screening camps, and workshops to raise diabetes awareness.
DAI’s recent work includes collaborations with governments to improve diabetes care, especially in rural areas. It also networks with resource-based organizations. It lobbies for policies to manage the growing burden of diabetes. It seeks a comprehensive national strategy to tackle the disease.
Types of Diabetes
Diabetes can be divided into different types, and it is not the same for all. Three common diabetes types are Type 1 diabetes, Type 2 diabetes, and gestational diabetes.
Type 1 Diabetes
Type 1 diabetes is an auto-immune disease. It occurs when the body’s immune system attacks and destroys its insulin-making pancreatic cells. Consequently, the body produces very minimal, if any, insulin at all. This category of diabetes typically occurs in children, although it could have its onset at any age.
Type 1 diabetics require insulin therapy lifelong. The cause of type 1 diabetes is unknown. It is thought to be due to a mix of genetic and environmental factors.
Type-2 Diabetes
Type 2 diabetes is the most common type, accounting for 90%. It is marked by insulin resistance. The body either resists insulin or the pancreas can’t make enough insulin. Unlike Type 1 diabetes, which is an autoimmune disease, Type 2 diabetes is different. Lifestyle plays a major role in it. Obesity, inactivity, and a bad diet cause it.
Type 2 diabetes develops gradually; it can remain undetected until complications occur. Early detection and intervention are important in managing Type 2 diabetes effectively. The first treatment is lifestyle changes. It includes weight loss, more exercise, and a healthy diet. If needed, medications can be taken orally or sometimes via insulin injections.
Gestational Diabetes
Gestational diabetes is a type of diabetes that develops during pregnancy. It occurs when the body has insufficient capacity to make and use all the insulin needed for pregnancy, and blood glucose remains at high levels. Gestational diabetes usually goes away after birth. But, it raises the mother’s and child’s risk of developing Type 2 diabetes later in life.
We must treat gestational diabetes aggressively during pregnancy. It reduces health risks for the mother and baby. Blood glucose is controlled with lifestyle changes and sometimes insulin therapy while pregnant.
Blood Glucose Values
Blood glucose levels are an indicator for the presence and management of diabetes. Below are levels which are used to screen and to monitor for diabetes:
Normal Blood Glucose:
Fasting Blood Glucose: Less than 100 mg/dL (5.6 mmol/L)
Postprandial (2 hours after a meal): Less than 140 mg/dL (7.8 mmol/L)
A1C (average over 2-3 months): Less than 5.7%
Prediabetes:
Fasting Blood Glucose: 100 to 125 mg/dL (5.
Postprandial: 140 to 199 mg/dL (7.8 to 11.0 mmol/L)
A1C: 5.7% to 6.4%
Diabetes:
Fasting Blood Glucose: ≥126 mg/dL (7.0 mmol/L)
Postprandial: ≥200 mg/dL (11.1 mmol/L)
A1C: 6.5%
It is crucial to keep blood glucose within the recommended range. Diabetes can cause serious complications. Hence, a proper management plan will include regular monitoring of blood sugar, adhering to any medication prescribed, and necessary.
Pathophysiology
The pathophysiology of diabetes depends on the type. But, all types share one factor: chronic hyperglycemia. It causes severe tissue and organ damage.
Type 1 Diabetes Pathophysiology
In Type 1 diabetes, the immune system attacks the insulin-producing beta cells in the pancreas. It misidentifies them as harmful. This autoimmune attack cuts insulin production to very low or zero levels. It causes a build-up of glucose in the blood. In the absence of insulin, cells can no longer absorb glucose. Then, blood sugar significantly increases. This can cause ketoacidosis, a fatal excess of acids in the blood.
Type 2 Diabetes Pathophysiology
The simplest form of the problem in Type 2 diabetes is insulin resistance. It is when the body’s cells become less responsive to insulin. As a result of this former deficit, the pancreas makes more insulin, but over time, it cannot keep up with demand, and thus, blood glucose remains high. Obesity, more specifically visceral fat, is known to be one of the major inducers of insulin resistance. Chronic inflammation and fatty liver also play a causative role in the development of Type 2 diabetes.
Symptoms and Complications
Diabetes presents in many ways, most of the time with various symptoms that at times may be mild or unnoticed until complications develop. Early recognition of the symptoms is, therefore, important for early diagnosis and treatment.
Symptoms of Diabetes
Increased Thirst (Polydipsia): Excess glucose draws water from tissues. This causes dehydration and a persistent thirst.
Frequent Urination (Polyuria): It means increased urine production. The body tries to wash out excess blood sugar by urinating more.
Increased Hunger (Polyphagia): People with diabetes may feel very hungry despite eating. As their cells lack glucose.
Unexplained Weight Loss: This is more common in Type 1 diabetes, where in the absence of glucose, the body breaks down fat and muscles for energy.
Fatigue: It is always experienced because the organs lack glucose in the cells.
Blurred Vision: High blood sugar levels can also cause the lens of the eye to swell, leading to problems with vision temporarily.
Slow-Healing Wounds: High blood glucose can harm circulation and slow healing. This may increase the risk of infection.
Tingling or Numbness in Hands and Feet: Diabetes can cause peripheral neuropathy, which leads to these sensations.
Complications of Diabetes
If not kept under control, diabetes can produce a really long list of major complications, those of which include the following:
Cardiovascular Disease: It raises the risk of heart disease, stroke, and high blood pressure. The high blood sugar levels cause damage to blood vessels and nerves that regulate the heart.
Neuropathy: Nerve damage, especially in the legs, causes pain, tingling, or numbness. It can lead to foot ulcers or amputation.
Nephropathy: High blood sugar can damage the kidneys’ filters. This can cause kidney failure, requiring dialysis or a transplant.
Retinopathy: High blood sugar can harm the small blood vessels in your retina. This may damage your vision or cause blindness.
Problems with the Feet: Poor circulation and nerve damage greatly increase the risk of foot ulcers, infections, and, in severe cases, amputation.
Higher Infection Risk: A high blood sugar level is capable of weakening one’s immunity; hence, it puts the human body at the mercy of many infections.
Diagnosis of Diabetes
The early diagnosis of diabetes is very essential for the prevention of complications. The following are some diagnostic tests used in identifying diabetes:
- Fasting Plasma Glucose (FPG) Test: Measures blood glucose after an overnight fast. A result of 126 mg/dL or higher on two separate tests indicates diabetes.
- A1C Test: Provides an average of blood glucose levels over the past 2-3 months. An A1C level of 6.5% or higher on two separate tests indicates diabetes.
- Oral Glucose Tolerance Test (OGTT): Measures blood glucose before and two hours after consuming a sugary drink. A level of 200 mg/dL or higher indicates diabetes.
Also, patients with diabetes or at high risk must regularly test their blood sugar. A continuous glucose monitor and a glucometer should be used. They provide very valuable data in keeping blood glucose levels under control.
Intervention
A multifactorial intervention is necessary for the management of diabetes. Control of blood glucose within the stipulated range is the priority to prevent complications of the disease.
Medications
Type 1 Diabetes: Insulin therapy is essential for survival. Patients may take either rapid-acting, long-acting, or intermediate-acting insulin. It is injected either by injections or from an insulin pump.
Type 2 Diabetes: It would be managed with oral meds like metformin, sulfonylureas, or DPP-4 inhibitors. Insulin therapy may be needed in a few cases more when the effect from oral medications is not up to mark.
Lifestyle Modifications
Physical Activity: It improves insulin sensitivity, lowers blood sugar, and aids in weight control. Regular exercise is key. A combination of aerobic exercises like brisk walking or cycling and resistance training is advised.
Weight Reduction: Losing excess weight, especially from the belly, improves insulin sensitivity. This reduces complications.
Quit Smoking: Smoking puts a person at risk for cardiovascular disease. This is already an elevated risk factor for diabetes. Quitting smoking is essential to overall health.
Quit alcohol. It can disrupt your blood sugar levels. This makes it harder to monitor diabetes. Second, it will lead to weight gain and raise the risk of developing heart diseases, liver damage, and other health complications. So, it’s best to avoid alcohol. It helps keep blood sugar levels stable and promotes good health.
Dietary Changes
Balanced Diet: Eat a range of nutrient-dense foods. Include various vegetables, whole grains, lean proteins, and healthy fats.
Carbohydrate Control: It’s vital to manage carb intake to avoid blood sugar spikes. Go for complex carbohydrates that have a low glycemic index.
Low GI foods: Try to be more focused on low GI foods, these increase the level of blood sugar gradually. Examples include sweet potatoes, broccoli, spinach, and whole-grain bread. These help in maintaining stable energy levels and preventing insulin spikes.
Fiber-Rich Foods: A high-fiber diet regulates blood sugar and aids digestion.
Healthy Fats: Unsaturated fats, as found in nuts, seeds, and olive oil, are better than saturated and trans fats.
Hydrate: Drink a lot of water throughout the day. This helps the kidneys filter glucose out of the blood if there is too much.
Sample Diet Plan
Success Story: Aruna’s Journey
A 61-year-old lady, Aruna, had diabetes for ten years. She also had serious health problems. She stood 5’2″ tall, weighed 82 kgs, and suffered from heart diseases and kidney stones, which made her case more complex. After diagnosis, Aruna was overwhelmed. She couldn’t handle her blood sugar. It kept fluctuating, causing many complications.
She then took steps to get back in shape. First, Aruna started walking daily for half an hour. She gradually did more and more physical activity with improved stamina. Other changes included a heart-healthy diet. It consisted of whole grains, lean protein, and vegetables. It minimized refined carbs and unhealthy fats. She followed her doctor’s advice on medication very strictly and took metformin and insulin as prescribed.
Soon enough, the efforts that Aruna put in started paying off. From an initial weight of 82 kgs, she lost 12 kgs to reach 70 kgs, and her blood sugar levels also stabilized. Her heart-related episodes decreased. With medical supervision, she could lower her insulin dose. Aruna has become an example by managing diabetes. She proved, with dedication and support, that it’s possible to control diabetes, despite health challenges.
Conclusion
Diabetes happens to be one of those complex conditions that call for a multi-faceted approach to management. To understand diabetes, one must know its history and treatments. Also, one must identify its causes, types, symptoms, and complications. Early diagnosis and intervention could help prevent long-term damage. But, lifestyle changes and medication are key to managing it.
Most people who have diabetes can enjoy a very healthy, productive life if they remain informed and proactive. This journey, as depicted by the success story of Aruna, may be demanding. It is, however, not insurmountable. Continued research into better ways of treating this killer disease and higher awareness among the public offer hope for the future for millions afflicted with diabetes. We can all work toward a world where diabetes is manageable and preventable.