Diabetes Mellitus
Types, causes, symptoms, treatments and diet
What would you like to know?
What is Diabetes Mellitus?
Human body requires glucose as a source of energy for all the cells in muscles, tissues and brain. At any given time, the levels of glucose in the blood are controlled by a hormone called ‘insulin’, which is released by the pancreas. In people with diabetes, the insulin secreted by the pancreas is in inadequate quantity, or the body cells become resistant to insulin. This results in an increase in the blood glucose levels, commonly known as high blood sugar.
What are the types of diabetes?
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- Type 1 diabetes (total lack of insulin): Type 1 diabetes, also known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin.
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- Type 2 diabetes (inadequate insulin and insulin resistance): In type 2 diabetes, the body does not use insulin properly which is called insulin resistance. At first, the pancreas makes extra insulin to make up for it, but over time it is not able to keep up and can’t make enough insulin to maintain normal blood glucose.
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- Gestational diabetes (diabetes acquired during pregnancy): Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy, and usually reversible after giving birth. It can occur at any stage of pregnancy, but is more common in the second half of the gestation period.
Diabetes Diagnosis and treatment
What are the risk factors for diabetes?
The risk of developing diabetes is higher if one:
- Has a family history of diabetes (especially parents)
- Is overweight/obesity
- Is of age >45 years
- Has a sedentary lifestyle
- Has other diseases, such as diseases of pancreas, polycystic ovary syndrome
- Has previous or family history of gestational diabetes
What are the symptoms of diabetes?
Sometimes, diabetes causes no symptoms and remains undetected for a long period of time. The most commonly reported symptoms of diabetes for men and women are:
Diabetes symptoms common in men and women
- Unintentional weight loss
- Tiredness that does not go away
- Blurred eye vision
- Feeling of excessive thirst
- Frequent urination
Diabetic symptoms, specifically in women:
- Vaginal and oral yeast infections or vaginal thrush
- Polycystic ovary syndrome
- Urinary infections
What are the complications of diabetes?
Diabetes, if left untreated for a long time, can result in serious complications. These complications can even be disabling or life-threatening. Some of the common complications are:
- Cardiovascular disease like heart attack or stroke.
- Damage to the nerves (neuropathy) leading to loss of sensation.
- Damage to foot due to neuropathy, leading to ulcers or infections. Progressive damage may need amputation of affected areas such as toe, foot or leg.
- Damage to kidneys leading to end-stage renal disease, needing dialysis or a kidney transplant.
- Damage to the retina of eye or retinopathy that may lead to blindness or other eye conditions like cataract and glaucoma.
- Skin infections like bacterial and fungal infections due to poor wound healing.
- Hearing impairment.
Uncontrolled gestational diabetes can result in:
Defects in newborn:
- Birth weight of 4 or 4.5 kg or more. Commonly expressed as “large for gestational age”.
- Low blood sugar or hypoglycemia.
- Risk of type 2 diabetes.
- Fetal death.
Complications in pregnant women like:
- Preeclampsia: A potentially life-threatening condition associated with high blood pressure, increased protein secretion in the urine and generalized swelling in the body.
- Increased risk of gestational diabetes in future pregnancies.
- Increased risk of developing type 2 diabetes.
When should one consult a doctor?
If you or someone in family is at increased risk for diabetes, discuss with your doctor or an endocrinologist immediately. Also, if you observe any symptoms of diabetes, like frequent urination, excessive thirst or sudden weight loss, bring it to the notice of your doctor/endocrinologist. A regular check-up with the endocrinologist can help keep a check on blood glucose levels and prevent the complications of diabetes.
How is diabetes diagnosed?
The diabetologist or endocrinologist diagnoses diabetes by evaluating:
- Signs and symptoms
- Medical history
- Physical examination
- Tests
- HbA1c levels
- Fasting plasma glucose
- Random plasma glucose
Gestational diabetes is detected with:
- Glucose challenge test
- Oral glucose tolerance test
What are the normal blood sugar levels for diabetes?
Fasting blood sugar levels-
- For a person without diabetes: 70–99 mg/dl (3.9–5.5 mmol/L)
- Official ADA recommendation for someone with diabetes: 80–130 mg/dL (4.4–7.2 mmol/L)
Blood sugar levels 2 hours after meals:
- Normal for person without diabetes: Less than 140 mg/dl (7.8 mmol/L)
- Official ADA recommendation for someone with diabetes: Less than 180 mg/dL (10.0 mmol/L)
Normal blood sugar levels during pregnancy:
- Fasting sugar less than 95 mg/dL
- Blood sugar level less than 120 mg/dL – 2 hours after eating.
What is the normal HbA1c level?
For people without diabetes, the normal range for the hemoglobin A1c level remains between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% mean you have a higher chances of getting of diabetes. Levels of 6.5% or higher mean you have diabetes.
What is the treatment for diabetes?
Your physician/endocrinologist will suggest the best treatment options, which may or may not include oral medication and/or insulin. Lifestyle changes, such as regular physical activity and a strict dietary modification, are also recommended. Sometimes, associated treatment options like weight loss surgery, may also be advised. Due to the risk of complications, controlling associated health factors, such as blood pressure and cholesterol levels, is also suggested.
How can diabetes be prevented?
While there is no permanent cure for diabetes, it can be prevented or delayed by controlling the risk factors in people who are prone to develop diabetes. Some such measures include:
- If overweight/obese, weight reduction
- Regular physical exercise
- Low calorie diet plan
- Quit smoking
- Reduce alcohol intake
To know more about diabetes, its complications and their treatment, you can request a callback and our experts will call you and answer all your queries. Our team of diabetes doctors in Hyderabad are well-versed in the management and treatment of diabetes and its associated conditions.
Is there a Diabetic Diet which I can follow?
If you are looking for a “diabetic diet”, there is hardly any plan that fits for all. An individual may choose to eat wholesome diet that is healthy, nutritive and safe in maintaining blood sugars in healthy range.
The choice should be such that it is easy, practical, guilt-free and binge-free. Control intake of fried foods, sweetened beverages to less than twice a week. Avoid alcohol drinks or enjoy them in moderation. Customize your diet plan for good control on blood sugars, vital cholesterol and lipid profile after talking to your doctor and dietician.
What are common triggers of high blood sugars?
Monitor your blood sugars regularly. Also, look for common triggers of high blood sugar levels. They include food, exercise, medication, stress and hormonal changes.
Food:
- Have you had a high fat meal? If so, sugar levels tend to be high for long hours.
- Are you tracking sugar load? If so, ensure you enjoy the optimal calorie count and total carbohydrates per serving. They directly increase the blood sugars.
- Did you binge eat? That is something you must avoid. A diabetic should eat small amounts more frequently for a steady sugar level.
- Do you say yes to alcohol? Moderate to excessive alcohol intake disrupts body’s response to insulin. Thereby, hyperglycemia becomes difficult to manage.
Exercise:
Exercise affects our body in different ways. Exercises improve body’s response to insulin (insulin sensitivity) thus burning more sugar from the blood. If your body lacks insulin during workouts, blood sugars may stay dangerously high.
However, if you notice high blood sugar levels during exercise, it means that you are over-exerting. The body is pushing more sugar into blood to compensate this physical stress. Recap and rework on all physical activities. Also, do not miss any medicine or insulin.
A perfect balance between medicine, food, destress and exercise is essential in managing blood sugars.
How to self-manage high blood sugar levels?
Every diabetic experiences high blood sugar (hyperglycemia) at least once in their lifetime. Challenges in managing blood sugars vary based on the type of diabetes you are suffering from. So, it is important to have a personalized action plan approved by the doctor.
Call your doctor:
Type 1 Diabetes Mellitus: You must already be using insulin on regular basis. With a high blood sugar episode, you may need a higher dose than usual. Discuss with your doctor to understand the extent of blood sugar spike and suitable insulin doses.
Type 2 Diabetes Mellitus: Based on the extent and duration of high blood sugars, your doctor may or may not prescribe medicine, insulin or change their dose. Talk to your doctor as soon as possible.
Avoid exercises until sugar levels normalise:
As advised by ADA (American Diabetes Association), avoid exercising when –
- Blood sugars increase beyond 250 mg/dl and urine tests detect ketones.
- Blood sugars increase beyond 300 mg/dl without ketones in urine.
Manage sick day:
It is common to have above normal sugar levels when you are ill, injured or infected. Talk to your doctor for a better sick day management to control hyperglycemia.
Manage stress:
Emotional stress can be hard to manage immediately. On a long run, mindfulness and relaxation therapy improves not only blood sugars but also overall well being and health. So, invest some time on activities such as yoga, meditation and deep breathing every day.
Our informative blogs on Diabetes:
References:
- National Institute of Diabetes and Digestive and Kidney Disease. Diabetes. Available at: https://www.niddk.nih.gov/health-
information/diabetes. Accessed on Dec 15, 2017. - US Department of Health and Human Services. Diabetes: Overview Available at:
https://www.nichd.nih.gov/health/topics/diabetes/Pages/default.aspx. Accessed on Dec 15, 2017 - National Institute of Diabetes and Digestive and Kidney Disease. National Diabetes Education Program. Available at:
https://www.niddk.nih.gov/health-information/communication- programs/ndep. Accessed on Dec 15, 2017 - Mayo Clinic. Diabetes. Available at: https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms- causes/syc-20371444.
Accessed on Dec 15, 2017
