DIABETES

 DIABETES:

Introduction:

·         It is preferably known as Diabetes Mellitus. It is a group of metabolic disorders in which the person has high blood glucose or blood sugar either because insulin production is inadequate or because the body’s cells do not respond properly to insulin or both.

·         Diabetes is a disease in which blood glucose or blood suagr level is too high. Glucose comes from the food that we eat. Insulin is a hormone that helps the glucose get into our cells to supplement energy to our body.

·         Diabetes is a long term condition that cause high blood glucose level.

·         Patients with high blood sugar will typically experience polyuria (frequent urination), they will become increasingly thirsty (polydipsia) and hungry (polyphagea).

·         In 2013, it was estimated that over 382 million people throughout the world had diabetes.

·         The body does not produce enough insulin. Some people may refer to this type as insulin dependent diabetes, juveline diabetes or early onset diabetes. People usually develop type-1 diabetes before their 40 years, often in early adulthood or teenage years.

Risk factor for Diabetes:

Family history is a known risk factor for type-1 diabetes. Other risk factors can include having certain infections or disease of the pancreas.

Risk factors for type-2 diabetes or pre-diabetics are as follows:

         i.            Being Obese or overweight.

       ii.            High BP

      iii.            Elevated level of triglycerides and low level of good cholesterol (HDL)

     iv.            Sedentary lifestyle

       v.            Family history

     vi.            Increasing age

    vii.            Polycystic ovary syndrome

  viii.            Impaired glucose tolerance

     ix.            Insulin resistance

       x.            Gestational diabetes during pregnancy

     xi.            Ethnic background

Signs and Symptoms:

·         Elevated blood sugar levels and loss of glucose in urine, it leads to frequent urination which leads to dehydration.

·         Dehydration also caused increased thirst and water consumption.

·         A relative or absolute insulin deficiency which leads to weight loss. It occurs despite an increase in appetite.

·         Untreated diabetics patients also complain of fatigue.

·         Nausea and vomiting can also occur in patients with untreated diabetes.

·         Frequent infections are more likely to occur in people with untreated or poorly controlled diabetes.

·         Fluctuations in blood glucose levels can lead to lethargy and coma.

          

Diagnosis:

Fasting blood glucose test is preferred way to diagnose diabetes. This can also be done accurately in doctor’s observation by using Glucometer.

·         Normal fasting plasma glucose levels are less 100 mg/dl.

·         Fasting plasma glucose levels of more than 126 mg/dl on two or more tests on different days indicate diabetes.

·         Random blood glucose tests can also be used to diagnose diabetes. Seven blood glucose levels of 200 mg/dl or higher indicates diabetes.

Oral Glucose Tolerance Test: (OGTT)

OGTT is a good standard for making diagnosis of type-2 diabetes. It is still commonly used for diagnosing gestational diabetes and in condition of pre-diabetes, such as polycystic ovary syndrome.

Complications:

·         Having high blood sugar can cause diabetes related complications like chronic kidney disease, foot problems non- traumatic lowest limb amputation, eye disease (retinopathy) can lead to blindness, heart attack, stroke anxiety, nerve damage and erectile dysfunction.

·         Diabetes related can be very serious and even life threatening proportion managing blood sugar levels reduces the risk of developing these complications.

Types of Diabetes:

There are three types of diabetes:

        I.            Type- I Diabetes or Insulin dependent diabetes:

·         It is also known as juvenile diabetes or early onset diabetes.

·         This is an auto-immune condition it occurs when the immune system mistakenly attacks and kills the beta cells of the pancreas. Very little insulin is released into the body. As a result sugar built up in the blood instead of being used as energy.

·         It can occur generally in childhood or adolescence but can develop in adulthood.

·         Body does not produce enough insulin in type-I. Immune system attacks and destroys the cells of pancreas that make insulin. The body does not produce insulin in the body.

·         People usually develop type-1 diabetes before 40 year of their age, often in early adulthood or teenage years.

·         Approximately 10% of diabetic cases are type-1. In 2001-2009, the prevalence of type-1 diabetes among the under 20s in the USA rose 23%. (According to diabetes in youth date issued by CDC, Centre for Disease Control and Prevention).

·         Type-1 diabetes also includes latent autoimmune diabetes in adults (LADA), the term used to describe the small number of people with apparent type-2 diabetes who appear to have immune mediated loss of pancreatic beta cells. Number of medical risk associated with tye-1 diabetes.

·         Many of them stem from damage to the tiny blood vessels in eyes (diabetic retinopathy), nerves (diabetic neuropathy) and kidneys (diabetic nephropathy).

Treatment:

·         Patients with type-1 diabetes will need to take insulin injections in the rest of their life.

·         They must also ensure proper blood glucose levels by carrying out regular blood tests and following a special diet.

·         Type-1 diabetic patients must follow a healthy diet plan and do adequate exercise.

           

      II.            Type- 2 Diabetes:

·         It occurs when the body can’t properly use the insulin that released (called insulin insensitivity). As a result sugar builds up in the blood instead of being used as energy.

·         Body does not produce enough insulin for proper function or cells in the body do not reach to insulin (insulin resistance).

·         Approximately 90% of all the cases are type-2 diabetes.

·         Some people may be able to control their type-2 diabetes symptoms by losing weight following a healthy diet, doing plenty of exercise and monitoring their blood glucose levels.

·         However, type-2 diabetes is typically a progressive disease, it gradually gets worse and the patients will probably end up have to take insulin usually in tablet form.

·         Obese people have a much risk of developing type-2 diabetes compared to those with a healthy body weight.

·         People with lot of visceral fat also known as central obesity, belly fat or abdominal obesity are especially at risk.

·         Being overweight, physically inactive and eating the wrong foods contribute all contribute to our risk of developing type-2 diabetes.

·         Drinking just one can of non diet soda can raise our risk of developing type-2 diabetes by 22%.

·         Risk of developing type-2 diabetes increase with increasing age. As we age we tend to put on weight and become less physically active.

            

Treatment:

·         Patients with type-2 diabetes are usually treated with tablets, exercise and a special diet but sometimes insulin injections are also required.

·         Type-2 diabetes lasts a lifetime; however some people have managed to get rid of their symptoms without medications, through a combination of exercise, diet and body weight control.

·         Researchers showed that gastric bypass surgery can reverse type-2 diabetes in high proportion of patients. They added that within 3-5 years. The disease reoccurs in approximately 21% of them.

 

    III.            Gestational Diabetes:

·         Gestational diabetes affects female during pregnancy.

·         Some women have very high levels of glucose in their blood and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, resulting in progressively rising levels of glucose.

·         Scientists from National Institute of Health and Harvard university found that some whose diet before becoming pregnant were high in animal fat and cholesterol had a higher risk for gestational diabetes, compared to their counter parts when diet were low in cholesterol and animal fats.

          

Treatment:

·         Majority of Gestational diabetes patients can control their diabetes with exercise and diet. Between 10-20% of them will need to take some kind of blood glucose medications.

·         Undiagnosed or uncontrolled gestational diabetes can raise the risk of complication during childhood.

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