World Diabetes Day

Diabetes is a type of metabolic disorder in which the patient’s blood glucose level remains above the normal.

The common symptoms of diabetes include polyphagia (increased hunger), polydipsia (increased thirst) and polyuria (increased urination).

Incidence of diabetes in America

Around 26 million Americans suffer from diabetes, out of which 18.8 million people have been diagnosed with the condition; while in another 7 million, the disease is yet to be diagnosed. Apart from this, 79 million Americans suffer from a condition called as pre-diabetes, i.e., they run a high risk of developing diabetes. If nothing drastic is done in the coming years to control the disease, experts believe that by 2050, one in every three Americans would develop diabetes.

Diabetes can be divided into three common types:

• Type I diabetes
• Type II diabetes
• Gestational diabetes

As type II diabetes alone accounts for around 90% to 95% of all diabetes cases worldwide, we will focus on it first.

Type II diabetes

Type II diabetes is the condition in which either the patient does not produce sufficient quantities of insulin, or the cells of the body develop insulin resistance, i.e., they are unable to utilize the insulin to facilitate the entry of the glucose into the cells.

Insulin resistance by the cells produces two effects:

• The amount of glucose present in the blood increases.
• The cells do not get adequate amount of glucose needed to meet their energy requirements and for their growth.

Experts tell us that it is more of a lifestyle disease caused due to obesity. The central obesity, i.e., the amount of fat concentrated around the waist in relation to the organs present in the abdomen, is the main reason behind the increased risk of developing diabetes. 

The abdominal fat releases a group of hormones known as adipokines which impair the glucose tolerance.

Patients suffering from type II diabetes can bring their disease under control by taking care of their diet and exercising regularly to bring down their body weight. But it is important to remember that once the body cells develop resistance to insulin, this tendency tends to continue. Therefore, even when a patient of type Ii diabetes has lost excess weight, he has to continue with his healthy lifestyle pattern to keep the blood sugar under control.

The main risk factors for type II diabetes include:

• Age and ethnicity: people above the age of 40 are more likely to develop the condition. It has also been seen that people of South Asian origin and blacks are five times more prone to develop type II diabetes.

• Positive family history: You are more likely to develop diabetes if your close family members suffer from the condition

• Body-weight: Four-fifths of all type II diabetes patients were overweight when they developed the disease.

• Cardiovascular diseases and stroke: Hypertension, heart attack and stroke increase the chances of developing type II diabetes.

• Gestational diabetes: Women who develop diabetes during pregnancy or give birth to a large baby are more likely to develop type Ii diabetes later on.

• Impaired glucose tolerance: People who have been diagnosed with impaired glucose tolerance are more prone to develop the condition.

Later on in the course of the disease, when the pancreas is no longer able to produce enough insulin, the patient may need insulin therapy to control the blood glucose levels.

Type I Diabetes

Type I diabetes is generally regarded as a type of autoimmune disorder in which the beta cells of the pancreas, which are responsible for the production of insulin, get destroyed.

The condition is usually seen below 40 years of age and as it often begins in childhood, it is also called as juvenile or childhood diabetes. Around 10% of all diabetes cases are of type I diabetes.

Unlike type II diabetes, it is not a lifestyle disease. Type I diabetes cannot be prevented and most of the patients are of a normal weight when the disease onsets.

A C-peptide assay can differentiate between type I and type II diabetes. As insulin from exogenous source does not contain C-peptide, its absence indicated type I diabetes.

Gestational diabetes

This type of diabetes is encountered during pregnancy when, due to some hormonal and metabolic changes, the amount of glucose present in the blood becomes abnormally high. The body is unable to produce sufficient insulin to transport all this glucose into the cells. Therefore, the blood glucose levels remain high.

Most of the cases of gestational diabetes respond well to diet control and exercise. However, in 1 to 20% of cases, medication is required. Uncontrolled gestational diabetes can give rise to the delivery of a large baby and other complications.

Complications arising out of poorly controlled diabetes

Persistently high blood glucose can affect almost all the organs of the body adversely. Some of the complications include:

• Eye complications: These include development of glaucoma, diabetic retinopathy, cataract

• Skin complications: Increased susceptibility to skin infections

• Foot complications: Development of foot ulcers, neuropathy and gangrene

• Hypertension: It is common in patients suffering from diabetes and may increase the risk of stroke and other complications

• Psychiatric problems: Uncontrolled diabetes can give rise to depression and anxiety

• Ketoacidosis: When the blood sugar is too high, ketone bodies accumulate in the body along with severe acidosis

• Neuropathy: diabetes affects the nerves all over the body leading to neuropathy

• Nephropathy: diabetes can give rise to many kidney diseases

• Erectile dysfunction: Uncontrolled diabetes is the reason behind erectile dysfunction in many men

• Infections: Besides the above mentioned complications, blood rich in glucose as seen in diabetes is a fertile breeding ground for many pathogens. This is turn can give rise to all sorts of infections.

Taking into consideration, the innumerable problems related to diabetes, it is necessary to improve our lifestyle, exercise regularly and eat healthy in order to prevent diabetes. It is equally important for patients suffering from diabetes to take their medicines regularly so as to keep their blood sugar in check.