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.
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.
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.
Factors that put a person at higher risk of diabetes include:
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.
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:
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 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.
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.
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:
Gestational diabetes, or diabetes occurring especially due to hormonal changes during pregnancy may result in a few complications:
Rate of morbidity or development of type 2 diabetes later in adult life of children is high whose mothers are diabetic.
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.
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:
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:
Cardiovascular activity especially forms a regular part of an exercise regimen for diabetics and helps prevent further complications.
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