What You Need To Know About Diabetes: Causes, Symptoms and Treatment.

Diabetes is a prevalent condition impacting individuals of all age groups, with various forms. Type 2 diabetes is the most widespread. Employing a blend of treatment approaches is essential for effectively managing the condition, enabling individuals to lead healthy lives and ward off potential complications.

What is diabetes?

Diabetes occurs when your blood sugar (glucose) levels become elevated. This can happen if your pancreas doesn’t produce sufficient insulin or any at all, or if your body doesn’t respond appropriately to insulin’s effects. It is a condition that can affect individuals of all ages. Most types of diabetes are chronic, requiring lifelong management through medications and/or lifestyle adjustments.

Glucose, the primary source of energy for your body, is primarily derived from carbohydrates in your food and beverages. Your blood transports glucose to all cells throughout your body, serving as their energy source.

Glucose in your bloodstream requires insulin—a hormone acting as a “key”—to facilitate its journey to its destination. If your pancreas produces insufficient insulin or your body doesn’t utilize it effectively, glucose accumulates in your bloodstream, leading to high blood sugar (hyperglycemia).

Consistently elevated blood glucose levels over time can lead to health issues like heart disease, nerve damage, and eye problems. The technical term for diabetes is diabetes mellitus. It’s important to note that there is another condition, diabetes insipidus, which shares the term “diabetes,” but they are distinct. Both conditions cause increased thirst and frequent urination, but diabetes insipidus is considerably rarer than diabetes mellitus.

Types of Diabetes

Various types of diabetes exist, with the most prevalent forms being:

• Type 2 diabetes: In this type, your body either doesn’t produce enough insulin or your body’s cells don’t respond adequately to insulin (insulin resistance). It is the most common type of diabetes, predominantly affecting adults, but children can also be affected.
• Prediabetes: This stage precedes Type 2 diabetes. Blood glucose levels are higher than normal but not elevated enough to warrant an official Type 2 diabetes diagnosis.
• Type 1 diabetes: An autoimmune disease where the immune system inexplicably targets and eliminates insulin-producing cells in the pancreas. Approximately 10% of individuals with diabetes have Type 1. It typically manifests in children and young adults but can emerge at any age.
• Gestational diabetes: Developing during pregnancy, this type affects certain individuals. While gestational diabetes often resolves post-pregnancy, those who experience it are at an increased risk of developing Type 2 diabetes later in life.
• Other variations of diabetes include:

• Type 3c diabetes: This type occurs when damage to the pancreas, excluding autoimmune damage, impairs its insulin production. Conditions such as pancreatitis, pancreatic cancer, cystic fibrosis, and hemochromatosis can lead to pancreas damage resulting in diabetes. Type 3c can also arise from the removal of the pancreas (pancreatectomy).
• Latent autoimmune diabetes in adults (LADA): Similar to Type 1 diabetes, LADA is triggered by an autoimmune reaction, but it progresses more gradually. Typically diagnosed in individuals over the age of 30, LADA showcases a slower onset compared to Type 1 diabetes.

Maturity-onset diabetes of the young (MODY): Also known as monogenic diabetes, MODY stems from an inherited genetic mutation impacting insulin production and utilization. With over 10 distinct types, MODY accounts for up to 5% of diabetes cases and frequently exhibits a familial pattern.

• Neonatal diabetes: A rare type of diabetes emerging within the first six months of life, neonatal diabetes is also categorized as monogenic diabetes. Approximately 50% of infants with neonatal diabetes experience the lifelong variant known as permanent neonatal diabetes mellitus. For the remaining half, the condition resolves within a few months of onset but may reappear later in life, termed transient neonatal diabetes mellitus.
• Brittle diabetes: Characterized by frequent and severe fluctuations in blood sugar levels, brittle diabetes is a subtype of Type 1 diabetes. This instability often necessitates hospitalization, and in rare instances, a pancreas transplant may be required for a permanent remedy.

How Common is Diabetes?

Diabetes is widespread, affecting roughly 37.3 million individuals in the United States, constituting approximately 11% of the population. Type 2 diabetes is the predominant form, comprising 90% to 95% of all diabetes cases.

Globally, around 537 million adults grapple with diabetes, and projections indicate an increase to 643 million by 2030 and 783 million by 2045.

Causes and Symptoms

Diabetes manifests with various symptoms, including:

• Increased thirst (polydipsia) and dry mouth.
• Frequent urination.
• Fatigue.
• Blurred vision.
• Unexplained weight loss.
• Numbness or tingling in hands or feet.
• Slow-healing sores or cuts.
• Recurrent skin and/or vaginal yeast infections.

Consulting with your healthcare provider is crucial if you or your child experiences these symptoms.

Further symptoms specific to each type of diabetes include:

• Type 1 diabetes: Symptoms of T1D may emerge rapidly, evolving over weeks or months. Additionally, signs of a severe complication known as diabetes-related ketoacidosis (DKA) may appear, requiring immediate medical attention. DKA symptoms encompass vomiting, stomach pains, fruity-smelling breath, and labored breathing.
• Type 2 diabetes and prediabetes: Symptoms may be absent, or they may develop gradually, potentially going unnoticed. Regular blood tests might reveal elevated blood sugar levels before symptoms become apparent. A potential indicator of prediabetes is the presence of darkened skin on specific body parts (acanthosis nigricans).
• Gestational diabetes: Symptoms of gestational diabetes are usually not evident. Testing for gestational diabetes typically occurs between 24 and 28 weeks of pregnancy, facilitated by your healthcare provider.

Causes of Diabetes

Diabetes, irrespective of its type, is characterized by an excess of glucose in the bloodstream. However, the underlying causes for elevated blood glucose levels differ across the types of diabetes.

The causes of diabetes encompass:

• Insulin resistance: Predominantly associated with Type 2 diabetes, insulin resistance occurs when cells in muscles, fat, and the liver exhibit diminished responsiveness to insulin. Contributing factors to varying degrees of insulin resistance include obesity, insufficient physical activity, dietary choices, hormonal imbalances, genetic predisposition, and specific medications.

• Autoimmune disease: Type 1 diabetes and LADA arise from the immune system’s attack on the insulin-producing cells in the pancreas.
• Hormonal imbalances: Pregnancy-related hormonal shifts, leading to insulin resistance, can result in gestational diabetes if the pancreas cannot produce sufficient insulin. Conditions such as acromegaly and Cushing syndrome, linked to hormonal imbalances, may also contribute to Type 2 diabetes.
• Pancreatic damage: Physical harm to the pancreas, stemming from conditions, surgeries, or injuries, can impair insulin production, leading to Type 3c diabetes.
• Genetic mutations: Specific genetic mutations underlie MODY and neonatal diabetes.

Extended use of specific medications, such as those for HIV/AIDS and corticosteroids, can contribute to the development of Type 2 diabetes.

Diabetes can result in both acute (sudden and severe) and long-term complications, primarily stemming from prolonged elevated blood sugar levels.

Acute diabetes complications:

• Hyperosmolar hyperglycemic state (HHS): Primarily impacting individuals with Type 2 diabetes, this complication arises when blood sugar levels are significantly elevated (exceeding 600 milligrams per deciliter or mg/dL) for an extended period. It leads to severe dehydration and confusion, necessitating urgent medical intervention.
• Diabetes-related ketoacidosis (DKA): Primarily impacting individuals with Type 1 diabetes or undiagnosed T1D, DKA occurs when the body lacks sufficient insulin. Without insulin, the body cannot utilize glucose for energy, prompting the breakdown of fat. This process releases ketones, elevating blood acidity and resulting in symptoms such as labored breathing, vomiting, and loss of consciousness. Urgent medical treatment is essential for DKA.
• Severe low blood sugar (hypoglycemia): Hypoglycemia occurs when your blood sugar level falls below a healthy range, with severe hypoglycemia representing very low blood sugar. Primarily affecting individuals with diabetes using insulin, symptoms include blurred or double vision, clumsiness, disorientation, and seizures. Emergency glucagon administration and/or medical intervention are necessary for treatment.

Long-term diabetes complications:
Prolonged elevated blood glucose levels can lead to damage in your body’s tissues and organs, primarily affecting blood vessels and nerves supporting the body’s tissues.

Cardiovascular (heart and blood vessel) issues:

• Coronary artery disease.
• Heart attack.
• Stroke.
• Atherosclerosis.

Additionally, other diabetes complications include:

Additional diabetes complications:

• Nerve damage (neuropathy), causing numbness, tingling, or pain.
• Nephropathy, potentially leading to kidney failure, dialysis, or transplant.
• Retinopathy, increasing the risk of blindness.
• Diabetes-related foot conditions.
• Skin infections.
• Amputations.
• S*xual dysfunction, including erectile dysfunction or vaginal dryness.
• Gastroparesis.
• Hearing loss.
• Oral health problems, such as gum (periodontal) disease.

Living with diabetes can impact mental health, with individuals facing a two to three times higher likelihood of experiencing depression compared to those without diabetes.

How Diabetes is Diagnosed

Healthcare providers diagnose diabetes by assessing blood glucose levels through three tests: the fasting blood glucose test, random blood glucose test, and the A1c test, which indicates the average blood glucose level over the past two to three months.

• The fasting blood glucose test requires an eight-hour fast, during which you abstain from eating or drinking anything except water. This approach helps your healthcare provider assess your baseline blood sugar, as food can significantly influence blood sugar levels.
• The random blood glucose test can be conducted at any time, regardless of whether you’ve fasted. This flexibility allows for an assessment of blood glucose levels without the need for a specific fasting period.
• The A1c test, also known as HbA1C or glycated hemoglobin test, offers insights into your average blood glucose level over the preceding two to three months.

How Can Diabetes be Managed ?

Managing diabetes involves addressing various aspects of the condition, tailored to individual needs. The key components include:

1. Blood Sugar Monitoring: Regular monitoring with a glucose meter or continuous glucose monitor provides crucial insights into managing diabetes. Establishing an optimal blood sugar range, determined with your healthcare provider, is vital.
2. Oral Diabetes Medications: These medications, taken orally, are designed to regulate blood sugar levels. They are commonly prescribed for individuals with Type 2 diabetes and prediabetes, with Metformin being a prevalent choice.
3. Insulin Therapy: For those with Type 1 diabetes or certain cases of Type 2 diabetes, insulin is essential. It can be administered through injections with syringes, insulin pens, pumps, or rapid-acting inhaled insulin.
4. Lifestyle Modifications: Adopting a healthy lifestyle, including a balanced diet, regular physical activity, and managing stress, is fundamental to diabetes management. Individualized plans are crucial due to the varied impact of diabetes on each person.
5. Dietary Management: Crafting a personalized meal plan is crucial for managing diabetes, as food choices significantly influence blood sugar levels. Carb counting becomes especially relevant for insulin users, as it determines the required insulin dosage. Maintaining healthy eating habits aids in weight management and reduces the risk of heart disease.
6. Physical Activity: Regular exercise enhances insulin sensitivity and reduces resistance, making it a vital component of diabetes management for all individuals. Engaging in physical activity contributes to overall well-being and helps control blood sugar levels.

Remember, effective diabetes management often involves a combination of these strategies, adapted to suit individual circumstances and preferences. Regular communication with healthcare providers ensures ongoing adjustments for optimal care.

How Can Diabetes Be Prevented?

While autoimmune and genetic forms of diabetes may not be preventable, there are proactive steps you can take to reduce the risk of developing prediabetes, Type 2 diabetes, and gestational diabetes:

1. Adopt a Healthy Diet: Consider following dietary patterns like the Mediterranean diet, known for its positive impact on health.
2. Regular Physical Activity: Strive for at least 30 minutes of physical activity on at least five days per week to promote overall well-being.
3. Maintain a Healthy Weight: Achieve and sustain a weight that aligns with your health goals.
4. Stress Management: Incorporate strategies to effectively manage stress in your daily life.
5. Moderate Alcohol Consumption: Limit alcohol intake to promote better health outcomes.
6. Adequate Sleep: Aim for 7 to 9 hours of quality sleep, addressing any sleep disorders with appropriate treatment.
7. Quit Smoking: If you smoke, quitting can positively impact your overall health.
8. Medication Adherence: Take prescribed medications as directed by your healthcare provider to manage existing risk factors for heart disease.

These lifestyle choices contribute to a holistic approach to well-being and can significantly reduce the risk of diabetes-related conditions.