What is Diabetes?

Diabetes Mellitus (DM) is a chronic or long-lasting disease. It occurs when the pancreas is unable to make enough insulin, or when our body can’t properly use the insulin it produces.

Insulin is a hormone. It regulates blood sugar (glucose) and is produced by the pancreas. It allows glucose (extracted from the food we eat) to pass from the blood into the body cells to produce energy. 

If the pancreas fails to produce enough insulin or our body fails to make effective use of insulin, then glucose level increases in the blood. This condition is called hyperglycemia. 

High glucose levels in the blood, can be harmful to the body and various organs and tissues.

Disease Overview:

Diabetes has a high prevalence throughout the world. According to the International Diabetes Federation data report, instances of diabetes are on the continuous rise:

• An estimated 537 million adults (age: 20-79 years) have diabetes.
• The number of people with diabetes is projected to rise to 643 million by 2030.
• Around 240 million adults having diabetes go undiagnosed
• About 541 million adults have a high risk of developing type 2 diabetes

Type 2 diabetes constitutes more than 90% of diabetes cases. It creates severe physical and psychological complications for diabetic patients. It is a major cause of heart attacks, stroke, kidney failure, blindness, and lower limb amputation.

In spite of growing public awareness about this disease and the successful implementation of various prevention programs, the disease goes on rising globally.

Types of Diabetes:

There are 3 main types of diabetes:

1. Type 1 diabetes (T1DM):

This type of diabetes may develop at any age. But it mostly occurs in children and teen adults. In this type, our body produces very little or no insulin. Hence we need daily insulin injections to keep blood glucose levels under control.

2. Type 2 diabetes (T2DM):

This type of diabetes occurs when our body can’t effectively use the insulin it produces. It is more common in adults and about 90% of diabetes cases fall under this category. This is mainly the result of obesity and lack of physical activity.

Previously, this type of diabetes was found only in adults but now children are also suffering from this disease.

Type 2 diabetes can be controlled by following a healthy lifestyle, along with increased physical activity and a healthy diet. However, over time many people with this diabetes type will also require oral drugs and insulin to keep their blood glucose under control.

3. Gestational diabetes (GDM):

This type of diabetes is seen in pregnant women. During pregnancy, some women tend to have high blood glucose which causes complications for both mother and child. Normally, this diabetes type disappears after pregnancy. However, the affected women and their kids have a high risk of developing type 2 diabetes in the future.

Diabetes: Do you have a type?

Informational video by World Health Organization

Causes & Warning Signs of Type 2 Diabetes:

• Obesity/Overweight. Responsible for about 55% of cases of type T2DM.
• Aged 45 and above
• Unhealthy diet
• Lack of physical activity
• Have diabetes in the family (genetics)
• Smoking 
• Having high blood pressure
• Having high cholesterol
• Excessive drinking of alcohol

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Complications / Health impact:

Diabetic people run a high risk of having many other serious health issues. Consistently high blood sugar levels may cause critical diseases affecting the heart, blood vessels, eyes, kidneys, nerves, teeth, and feet. Diabetic patients also have a high risk of developing serious infections. 

• Diabetic adults have a 2-3 times higher risk of heart attacks and strokes
• Reduced blood flow and nerve damage in the feet may lead to foot ulcers, infection, and limb amputation.
• Diabetes may cause blindness due to damage to the small blood vessels in the retina. 
• Diabetes may also lead to kidney failure

Symptoms & Risk Factors:

• Always Feeling very Hungry & Tired:

Our body converts the eaten food into glucose. This glucose is then used by the body cells for energy. Body cells use insulin to get glucose. If our body makes very little or no insulin, or if cells resist the insulin our body makes, the glucose cannot pass to the cells and we have no energy. This makes us feel hungry and fatigued.

• Urinating Frequently and Feeling very Thirsty: 

An average person normally passes urine from 4 to 7 times during 24 hours. However, diabetic people urinate more frequently and then feel more thirsty. 

• Having Dry Mouth and Itchy Skin: 

Because of excessive discharge of urine and usage of fluids by the body, there is little moisture left.  Thus our body gets dehydrated, and our mouth and skin become dry and itchy.

• Having Blurred Vision: 

Due to the change in fluid levels in the body, our eyes’ lenses swell up. Their shape changes and they can’t focus, thus leading to blurred vision.

• Yeast Infections: 

Yeast feeds on glucose, and diabetic patients have excess glucose in the blood. Hence, they are more prone to developing yeast infections. Infections may grow in any warm, and moist part of the skin particularly between fingers and toes, under the breast, and around genitals.

• Slow Healing of Wounds and Cuts: 

Diabetic patients have high sugar (glucose) in the blood. This affects the blood flow and damages the nerves. Due to this, our body takes a longer time to heal wounds.

• Numbness, Pain in Legs & Feet:

This happens when blood glucose remains high over a period of time and causes nerve damage.

• Unexpected weight loss: 

When our body fails to get energy from the food we eat, it starts burning muscle and fat to obtain energy. This results in unplanned loss of weight.

• Nausea & Vomiting 
• Heart attack, heart stroke
• Men may experience reduced sex desire and erectile dysfunction
• Depression
• Dementia (gradual loss of mental abilities such as the ability to think, reason, and remember things)
• Hypoglycemia / low blood sugar:

In this condition, the sugar or glucose level in the blood drops too low to fuel the body. 

• Hyperglycemia / high blood sugar:

This condition refers to having a very high level of sugar or glucose in the blood. This condition ultimately leads to many complications, as cited above.

• Diabetic Coma:

This is a highly critical complication that leads to diabetic coma and even death. It occurs when the blood sugar is too high and the body is extremely dehydrated.

Diagnosis, and Treatment:

• Early diagnosis through testing of blood sugar
• Treatment involves a healthy diet, physical activity, controlling levels of blood sugar
• Control over blood pressure
• Avoid smoking
• Foot care, through foot hygiene and regular examination by physicians
• Type 1 diabetes patients require insulin. Type 2 diabetic patients are usually treated with oral medication and injections. But they may also need insulin.

Diabetes Management:

Type 1 diabetes: This is not preventable because it occurs due to the malfunction of the immune system. 

Type 2 diabetes: Certain causes such as your age or genes, are not under your control. However, there are many controllable risk factors, such as:

• Consuming the right foods will control your blood sugar and help lose excess weight. You should take small meals at regular intervals to keep your blood sugar level steady. Following healthy foods are best:
  • Fruits
  • Vegetables
  • Whole grains, fiber
  • Low protein meat such as poultry and fish
  • Olive oil and nuts containing healthy fat
• Avoid intake of saturated fats (butter, cheese, cream) and trans fats and refined carbohydrates
• Minimize sugar consumption  
• Exercise regularly. Aerobic exercise of 150 minutes a week, such as walking or cycling is the best.
• Reduce weight, if you’re overweight or obese.
• Abstaining from smoking
• Minimizing alcohol intake

Final Thoughts

There is no definite cure for diabetes yet. However, its onset can be delayed or prevented by choosing a healthy diet, becoming physically active, keeping body weight under control, shunning smoking, and through proper medication and regular screening.

“People with high blood pressure, diabetes – those are conditions brought about by lifestyle. If you change the lifestyle, those conditions will leave”. – Dick Gregory