Diabetes has become a common condition over the last few decades and India has the dubious distinction of being the diabetes capital of the world! What’s even more alarming is the lack of awareness due to several myths on diabetes. A study conducted in May 2019 reveals that 47% of diabetics in India are completely unaware of their condition and only 24% of diabetic patients manage their diabetes and keep it under control. All these show our apathy – individual as well as collective – towards a disease that can wreak havoc if not controlled!
What Is Diabetes Mellitus?
Diabetes is the condition in which the blood glucose level, or what is commonly known as blood sugar, is too high. Blood sugar provides the energy for the body to function. In this condition, the body does not produce enough of the hormone insulin, resulting in high levels of sugar in the bloodstream.
What is the reason for diabetes?
Well, insulin is an anabolic hormone that promotes glucose uptake, and protein synthesis of skeletal muscle and fat tissue. This hormone plays an important role in the regulation of plasma glucose homeostasis.
When there’s a hormonal imbalance in the body and the amount of insulin is secreted in less quantity, diabetes mellitus occurs. Thus, it is safe to say that lack of insulin is why diabetes occurs.
What Are the Symptoms of Diabetes Mellitus?
Although the symptoms vary based on the type of diabetes, many of them are similar, especially in the beginning phase. Some of the common diabetes symptoms include –
- Fatigue: Since insulin is necessary to help absorb the glucose in the blood, and in diabetics, there is not enough glucose to provide energy to the cells. The patient tends to suffer fatigue since there is little uptake of the glucose available by the cells.
- Hunger: Despite eating larger quantities, it is likely that patients with diabetes will suffer hunger pangs since the body does not register the nutrition due to a lack of processing of the sugar.
- Frequent urination: It is one of the most common diabetes symptoms. The body’s renal system is unable to reabsorb much of the water during the digestive process, causing water to be pushed out as urine.
- Thirst: Frequent urination causes the diabetic body to lose water more quickly, thus making the patient perpetually thirsty.
- Dry mouth: A lack of water absorption by the digestive system causes dry mouth and bad breath.
- Dry skin: Flaky or itchy skin that is not moisturized despite topical applications of ointments may indicate dehydration born of diabetes.
- Blurred vision: Long-term effects of diabetes include blurred vision and often glaucoma.
- Slow to heal cuts: Wounds tend to heal slower than average in diabetics due to the inability of the body to aid the healing process efficiently.
- Weight loss: Despite regular meals, the body is unable to utilize nutrition and may start to burn fat in the absence of sugar. This can lead to unhealthy weight loss problems and is often seen in juvenile diabetics.
What Causes Diabetes Mellitus?
Insulin transfers sugar from the blood to the body’s cellular storage. These cells further break down this sugar to derive energy for everyday tasks. In the case of diabetes mellitus, the body is either deficient in insulin or is unable to effectively use the insulin made in the pancreas, leaving a high residual amount of sugar in the blood, causing hyperglycemia and symptoms of diabetes.
Hyperglycemia, if left untreated, causes severe damage to the renal system, eyes as well as other organs of the body, and can be fatal to the patient. There can be different causes of diabetes, but most of them relate to hormonal changes that affect the production or the functioning of insulin.
Type 1 Diabetes vs Type 2 Diabetes
These are the two prime diabetes mellitus types. Type 1 is an autoimmune disease that destroys the cells in the pancreas that produce insulin. The exact reason why the immune system attacks the body’s own cells is unknown but it may have something to do with genetic and environmental factors. The primary treatment for type 1 diabetes is insulin. Usually, four types of insulin are used.
- Rapid-acting insulin that gets to work within fifteen minutes and lasts for about three to four hours.
- Short-acting insulin can last three to four hours higher than rapid-acting insulin and starts to work within thirty minutes.
- Intermediate-acting insulin starts working within one to two hours and its effects can stay up to twelve to eighteen hours.
- Long-acting insulin takes the longest to function and can last for twenty-four hours or more.
Whereas in type 2 diabetes, the body becomes resistant to insulin resulting in sugar build-up in the blood. It can be managed by diet and exercise, but if that doesn’t work to lower the blood sugar, then medication is a must. Drugs such as Alpha-glucosidase inhibitors like acarbose and miglitol or DPP-4 inhibitors like linagliptin, saxagliptin and sitagliptin are prescribed for type 2 diabetes. There is a lot of information about diabetes and its medication, but it is strictly advisable to visit a diabetologist to treat such conditions. A diabetologist is a specialist who diagnoses and treats diabetes.
How Many Types of Diabetes Are There?
Apart from type 1 and type 2 diabetes, there’s another type known as Gestational Diabetes (GDM). GDM occurs due to insulin-blocking hormones produced during pregnancy. It is associated with complications to both mother and child. GDM usually disappears after pregnancy but women affected and the children are at increased risk of developing type 2 diabetes later in life.
Prediabetes is another medical condition that occurs when you have abnormally higher levels of blood sugar, but not high enough for type 2 diabetes.
How to Treat Diabetes
As there are different causes of diabetes, you might wonder what is the treatment for diabetes? Well, the treatment methods are often customized depending on the family history of diabetics, the patient’s overall health, and financial considerations. Diet and lifestyle changes are a major part of the regimen required for the treatment of diabetes, in addition to medication. There are certain foods that are considered the best foods to help control diabetes. Include them in your diet plan.
Treatment of diabetes also requires continued monitoring of blood sugar levels and keeping them to levels recommended by a medical specialist along with lifestyle changes. The diet regimen prevents rapid fluctuations in the blood sugar levels and allows the body to maintain steady levels of glucose in the body, making it easier for the medication to take effect.
While we have gathered a lot of information about what causes diabetes and how to treat it, it is important to consult a doctor specialized in diabetology to get the right treatment.
Dr. Kiran V H, Consultant – Internal Medicine, Sahyadri Narayana Multispecialty Hospital, Shimoga