Diabetes Symptoms, Risk Factors, Diagnosis and Treatment | Narayana Health

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Symptoms, Types, Causes and Treatment



What is Diabetes?

Diabetes has become a common condition over the last two decades and is increasingly being attributed to lifestyle and diet. While information about diabetes is more easily available today, it is important to consult a specialist considering the long term implications of the disease.

Diabetes is a chronic medical condition wherein not being able to utilize the hormone insulin to break down glucose to a form that is absorbable by the body's cells causes a high level of glucose in the body. Glucose is the main source of energy for the body and is broken down from the food we eat. Insulin helps the body break down the glucose into a form that allows the cells to carry this glucose in a form that can be used to provide energy to the body. Hyperglycemia is a characteristic symptom of this disease.

The pancreas is a gland located in the abdomen that has critical endocrine and exocrine functions; some of the hormones it produces are released directly into the bloodstream, whereas it also secretes into various ducts. Enzymes, or digestive juices are secreted by the pancreas into the small intestine. There, it continues breaking down food that has left the stomach. The pancreas also produces the hormone insulin and secretes it into the bloodstream, where it regulates the body's glucose or sugar level. Problems with insulin control can lead to diabetes. In cases where the pancreas is unable to produce insulin, the glucose levels in the body remain unutilized, with the blood carrying a high amount of glucose, causing a diabetic to experience various symptoms of diabetes.



Symptoms of Diabetes

Although the symptoms vary based on the type of diabetes, many of them are similar, especially in the beginning phases. One major difference is the speed of onset of the various symptoms in type 1 diabetes, which is higher than that of type 2.

Fatigue: Since insulin is necessary to help absorb the glucose in the blood, and in diabetics, insulin is either not produced or unutilized by the body, there is not enough glucose to provide energy to the cells. While the blood sugar levels are high in such patients, they tend 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 lack of processing of the sugar. Diabetics are very often hungry and tired despite regular meals, and this is an indication of a lack of insulin function in the body.

Frequent urination: Since blood sugar is high in cases of diabetes, the body's renal system is unable to reabsorb much of the water during the digestive process. This causes much of the water to be pushed out as urine, and thus raising the urge to urinate at frequent intervals. The number of times a diabetic has to urinate may often be double or more than the average person without diabetes. It is best not to ignore such a symptom as most often it’s a definitive sign of diabetes.

Thirst: Frequent urination causes the diabetic body to lose water more quickly, thus making the patient perpetually thirsty. Continuous thirst is a typical sign of either renal malfunction or of diabetes, and must not be ignored. It is more concerning if the condition does not subside after some time and is present in a relatively healthy individual.

Dry mouth: A lack of water absorption by the digestive system causes dry mouth and bad breath, and this is often accompanied by the feeling of thirst. Despite regular consumption of water, the body may simply feel dehydrated at all times in cases of diabetes.

Dry skin: Flaky or itchy skin that is not moisturized despite topical applications of ointments may indicate dehydration born of diabetes. Dehydrated skin is itchy and flaky, and an uncomfortable side effect for many diabetics.

Blurred vision: Long-term effects of diabetes include blurred vision and often glaucoma. Due to the body's inability to retain fluids and become dehydrated causes the shape of the lens to change, thus blurring a patient's vision.

Slow to heal cuts: The nervous system is adversely affected in the case of diabetes, and wounds will 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 may be 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.



Causes of Diabetes

The function of the hormone insulin is to transfer sugar from the blood into the body's cellular storage to be broken down by these cells to derive energy for the body's everyday tasks. In the case of diabetes, 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. Hyperglycaemia, if left untreated, causes severe damage to the renal system, eyes as well as other organs of the body, and may be fatal to the patient.

Different types of diabetes have different causes, but most of them relate to hormonal changes that affect the production or the functioning of insulin. For example, in type 1 diabetes, the insulin-producing cells of the pancreas are destroyed through autoimmune activity, leaving the body with a lack of insulin to metabolize sugar. In type 2 diabetes, the body may become resistant to the effects of insulin at a cellular level, with the cells unable to absorb sugar from the bloodstream. Pregnancy-related hormonal changes may also cause diabetes in some people, especially if weight-gain has become an issue during the time of pregnancy.

Type 1 diabetes is caused due to genetic factors and the onset of it is witnessed when patients are much younger. This condition is also referred to as juvenile diabetes and requires regular medical attention. In case a family member is known to suffer from type 1 diabetes, it is necessary to monitor symptoms that might indicate its onset. Type 2 diabetes is prompted by lifestyle and diet concerns, and the condition is more likely if it is genetically carried. Excess consumption of processed commodities, a lack of nutrition, high sugar in diet, a sedentary lifestyle, and obesity are often linked to type 2 diabetes.



Risk factors of Diabetes

Factors that put a person at higher risk of diabetes include:

  • Obesity
  • Sedentary lifestyle and a lack of exercise
  • Family history of type 2 diabetes
  • Previous onset of gestational diabetes
  • High blood pressure
  • High cholesterol or triglycerides
  • Polycystic ovary disorder (PCOD)
  • Lack of a balanced diet
  • Ageing; people over 40 years of age are more likely to be diagnosed with type 2 diabetes)

A large population today is at the risk of diabetes, and across the growing economies, the disease is becoming more and more common, affecting up to a quarter of the geriatric population. Diabetics are more prone to other health disorders as well, thus making them more vulnerable in terms of health. The above risk factors should be considered during regular check-ups to prevent the disease.



Steps to Prevent Diabetes

Research has shown that higher levels of insulin may likely cause insulin resistance and set off the development of type 2 diabetes in a patient with genetic propensity. Prevention of diabetes is suggested through the management of both diet and lifestyle, and a diet low in carbohydrates is the basic step suggested to avoid further complications of diabetes in order to reduce the levels of hyperglycaemia in the body. Exercise to specifically lower blood sugar levels and prevent obesity may also prevent type 2 diabetes. If a person is diagnosed with prediabetes, which is a condition where blood sugar levels in the body are higher than average but not as high as in diabetes, prevention of the diabetic condition is possible.

Some major steps to prevention of diabetes would be:

  • Restriction of alcohol consumption
  • Restriction of food items with high sugar content including, but not limited to, sweets and soft drinks
  • Restriction of food items high in carbohydrates such as potatoes, white bread and rice
  • Cutting out of processed foods
  • Quitting smoking
  • Exercise programs including regular cardiovascular activities
  • Regular walks in case of situations where sitting long hours is more required

A change in diet is the primary means of preventing diabetes. No amount of activity can undo the hormonal damage after the onset of the condition, although it may help control it. Diets high in refined sugar, and highly processed foods require the body to produce higher amounts of insulin to help absorb the increased blood sugar. In prediabetes, the body is resistant to the activity of blood sugar, causing a perpetual state of hyperglycaemia, leading to diabetes and further complications. Cutting out such foods goes a long way in preventing the onset of diabetes, especially in people already vulnerable to the condition.

Exercise has been shown to increase the insulin sensitivity of cells, helping the body utilize the hormone more efficiently to absorb sugar from the bloodstream. High-intensity workouts, rather than mild walks, have been shown to increase the sensitivity of the cells by a large percentage, and helps prevent diabetes. However, care must be taken to not counteract the effect of exercise through the consumption of processed foods. It also becomes necessary to maintain a regular exercise regimen in case diabetes is suspected, since the effect of workouts are not enough, and the body requires regular activity in order to maintain cellular sensitivity to insulin.



Diagnosis of Diabetes

Diagnosis of diabetes is performed by doctors through blood sugar tests in fasting conditions. Another means of determining diabetic conditions is through the A1C test, also known as the glycated haemoglobin test, which does not require fasting.

A1C: This test measures the amount of sugar attached to haemoglobin, and the results indicate the average amount of sugar for the past two or three months. A1C levels of 6.5% on two tests performed on two separate days indicate diabetes, and at this stage, the symptoms of the disease have already started to manifest and require definite medical intervention. A1C levels in the range of 5.7-6.4% indicate prediabetes. Below 5.7% in an A1C test is considered normal.

Fasting blood sugar test: This is performed in an empty stomach without eating or drinking anything for at least eight hours. Normal fasting blood sugar is less than 100 mg/dl. Diabetes is diagnosed if blood sugar levels are higher than 126 mg/dl, and prediabetes ranges fall between 100-125 mg/dl.

Random blood sugar test: Regardless of fasting, a blood sample suggesting levels of blood sugar higher than 200 mg/dl of blood on two separate test occasions is an indication of diabetes.

Oral glucose tolerance test: This test detects the rate of metabolization of glucose by the person. It requires overnight fasting after which fasting blood sugar levels are measured. After this, a sugary liquid is to be consumed, and blood sugar levels are tested periodically for the next two hours.

A blood sugar level less than 140 mg/dl is normal while levels higher than 200 mg/dl after two hours indicate diabetes. A reading between 140 and 199 mg/dl indicates prediabetes.



Treatment of Diabetes

Different types of diabetic conditions require different treatment methods. The methods are often customized depending on the family history of diabetes, 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.

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 the 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. If type 1 diabetes is suspected by a doctor, it means that the pancreas is unable to produce enough insulin to metabolize blood sugar, and insulin intake through injections or an insulin pump is required. Depending upon complete diagnosis, the patient may use one or a combination of rapid-acting, regular (short-acting), intermediate acting, long-acting or ultra-long-acting insulin doses. This treatment is also accompanied by exercise, overall lifestyle changes, and dietary modification. This type of diabetes requires monitoring of blood sugar levels several times a day to ensure steady levels and call for assistance in aggravated conditions, or determine the type of insulin intake in case a combination has been prescribed.

Medication for type 2 diabetes may become necessary at an advanced stage; however, in many diabetics, a combination of diet and active lifestyle choices are enough to treat the condition. The medicines work in different ways and include those that increase insulin production in the pancreas, decrease sugar absorption in the intestines, increase insulin efficiency, decrease sugar production by affecting liver function, those that prevent reabsorption of sugar by the renal system or synthetic insulin injections. Very often, a combination of these drugs is used to treat diabetic conditions in patients, and a number of drugs are available in each of the above categories.



Diabetes complications

If untreated, diabetes is a very severe condition that may cause multiple organ failures and eventual death. Some of the complications arising from diabetes include:

  • Heart disease: Cardiovascular function is immediately impacted by the rise of blood sugar levels in the body, and diabetics are more prone to heart disease than the average person.
  • Kidney disease: High levels of blood sugar as in the case of diabetes can severely damage the nephrons in the kidney, leading to irreversible damage. This may require dialysis or a kidney transplant if the diabetes has progressed to an advanced stage.
  • Nerve damage: Numbness towards the extremities or the feet are indicative of nerve damage due to untreated diabetes. Capillaries in the nerves are adversely affected by the condition and leads to tingling sensations, spasmodic pains or numbness. Men may be affected by erectile dysfunction in case of nervous damage.
  • Retinopathy or glaucoma: Eye conditions such as retinal damage or cataracts and glaucoma are exacerbated by diabetes since the optic nerve, retina or corneal shape may be affected by the high levels of blood sugar.
  • Skin conditions: Lower hydration levels in the body can leave skin dry and itchy, and vulnerable to bacterial and fungal infections, including eczema.
  • Hearing problems: Impairment in ears due to nervous damage is a complication arising from advanced diabetes, and affecting especially men.
  • Mental health conditions: Alzheimer's disease and depression are both more common in diabetics than in the average person.

Gestational diabetes, or diabetes occurring especially due to hormonal changes during pregnancy may result in a few complications:

  • Bigger babies: Extra glucose passing through the placenta to affect the baby is an indication of diabetes. This type of birth usually requires a C-section.
  • Hypoglycemia in babies: Some children of mothers with diabetes may be born with lower blood sugar since their insulin production may be affected. This can be treated through glucose solutions and regular feeding and may not require further treatment.

Rate of morbidity or development of type 2 diabetes later in adult life of children is high whose mothers are diabetic.



Road to Recovery and Aftercare

Lifestyle changes are a major part of recovery from diabetes. Most of these changes require regular check-ups with a doctor to ensure that they are having the necessary effect on the patient. In addition to increasing dietary intake of fresh fruits, raw vegetables and nuts, high-intensity exercise is recommended. In some cases, temporary break from work or a career change may be necessary. Regular activity as opposed to a sedentary lifestyle is a necessity. It is important to reduce weight around the belly, especially, for patients with diabetes, and overall weight loss is also recommended.



Diet for Diabetes

In addition to fruits and vegetables, a balanced diet including fatty fish such as salmon and anchovies is advised. Leafy greens, nuts and seeds, anti-inflammatory foods such as turmeric and certain varieties of cinnamon, fermented foods such as yogurt, kefir and kombucha as well as berries are a part of any healthy diet, and are especially recommended to diabetics. In addition to the consumption of specific foods, it becomes highly necessary to remove some foods from a diabetes diet, including:

  • Sugary drinks
  • Trans fats
  • White bread, pasta and other goods using refined flour
  • Rice
  • Flavoured yogurt and packaged juices; these usually contain very high levels of sugar
  • Flavoured cereals
  • French fries



Exercise regimen for Diabetes

Depending on the progression of diabetes, patients are recommended an exercise regimen which may include one or a combination of some of the below exercises:

  • Walking
  • Swimming
  • Cycling
  • Aerobics
  • Yoga
  • Resistance band exercises
  • Weight lifting

Cardiovascular activity especially forms a regular part of an exercise regimen for diabetics and helps prevent further complications.



Diabetes FAQs: All your concerns addressed

Q.  How do I help a family member with diabetes?

  1. In many cases, support in terms of diet and lifestyle are the best ways to help a loved one with diabetes. Following a diet and exercise regimen along with the patient may ensure ease of keeping up with the regimen for them. Ensuring that medication times are adhered to can also be very helpful.

Q.  How do I reduce the risk of getting diabetes, if a family member is already affected?

  1. Having a close family member affected by diabetes does put an individual at heightened risk of the condition. It is helpful to follow a healthy diet with minimal or no processed foods, Avoidance of sedentary lifestyle and regular monitoring of weight to ensure that obesity is kept at bay, go a long way with the prevention of the disease.

Q.  What is the main cause of Diabetes?

  1. The main cause of Diabetes in insufficient production of insulin in the body. Produced from the Pancreas, Insulin hormone helps the body to use Sugar (Glucose) from Carbohydrates in the food that you eat as an energy source. It also helps to keep the blood sugar level from getting too high (Hyperglycemia) or too low (Hypoglycemia).
    • You might develop Diabetes or Hyperglycemia -
    • When pancreas secrete less amount of insulin;
    • or produces defective insulin (a rare condition), or the body cells become unable to use the insulin properly.
    Few other conditions like overweight, obesity, and physical inactivity might trigger the sugar or glucose processing in your body and make you diabetic.

Q.  What foods can reverse Diabetes?

  1. A low glycemic load diet, that is a diet which is low in sugars along with being physically active helps a Diabetic condition. Try to include the following foods in your diet to control sugar level -
    • Beans like garbanzo, kidney, soy, pinto and black beans.
    • Fibre-rich fruits and vegetables, like apples, watermelon, grapefruit, carrots, and green peas
    • Good quality protein such as fish, and chicken (lean)
    • Lentils
    • Milk
    • Tomato Juice
    • Whole-wheat or Whole-grain foods
    • Cashews and peanuts

Q.  What are the first signs of Diabetes?

    • Frequent urination
    • Always feeling dehydrated and increased thirst
    • Always feeling hungry
    • Tiredness
    • Blurry Vision
    • Slow healing of cuts and wounds
    • Patches of dark skin
    • Itching and yeast infections
    In case of these early signs seek medication help immediately..

Q.  What are the 3 most common symptoms of undiagnosed Diabetes?

  1. Three most common symptoms of diabetes are -
    • The frequent urge of urination
    • Feeling very thirsty
    • Feeling very hungry - even though you are eating.
    Along with these also look out for other symptoms like fatigue, weight loss, and slow healing of cuts or bruises.

Q.  Can Diabetes be cured?

  1. As Diabetes is a condition where the blood sugar levels go out of control due to internal biochemical conditions, there is no cure for diabetes. But if left untreated or uncontrolled, it might lead to severe health issues like - Ensure to treat the diabetic condition and bring it into remission. When diabetes goes into remission, the body does not show any signs of diabetes, although the disease is technically still present. Remission can take different forms:
    • Partial remission - When the blood sugar level is maintained for at least 1 year without any medication.
    • Complete remission - In this condition, the blood sugar level returns to normal levels (i.e. outside the diabetic range) and stays there for at least for 1 year without any medications.
    • Prolonged remission - When complete remission lasts for at least 5 years.

Q.  Can bananas be part of a Diabetic’s diet?

  1. A diabetic person needs to carefully consider the contents of each meal. Eating bananas in moderation is safe for people with diabetes, as the mineral, vitamin and fibre content in banana adds nutritional benefit. However, ensure that you do not eat excessive portions as it has high levels of fructose which breaks down into sugar.

Q.  Does sugar consumption cause Diabetes?

  1. Sugar consumption will not directly cause either type of Diabetes - Type 1 or Type 2. However, too much sugar intake can make you overweight, which is a risk factor for Type 2 diabetes. On the other hand, Type 1 diabetes is an autoimmune condition, which causes a person’s immune system to attack the cells that produce insulin. In conclusion, if you are diabetic, eating too much sugar can cause complications once you have the disease. Cutting down sugar from your diet is essential for a healthy lifestyle whether you are diabetic or not.



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