What is Diabetes ?

Diabetes is a chronic disease characterised by high levels of glucose in the blood. Blood sugar levels are controlled by insulin, a hormone produced by the pancreas. Diabetes occurs when the pancreas is unable to produce enough insulin, or the body becomes resistant to insulin, or both. or in other word Diabetes is a disease in which the body does not produce or properly use insulin, a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes is a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles. There are three types of diabetes

• Type 1
• Type 2
• Gestational Diabetes

Type 1

The body does not produce insulin. Some people may refer to this type as insulin-dependent diabetes, juvenile diabetes, or early-onset diabetes. People usually develop type 1 diabetes before their 40th year, often in early adulthood or teenage years. Type 1 diabetes is nowhere near as common as type 2 diabetes. Approximately 10% of all diabetes cases are type 1. Patients with type 1 diabetes will need to take insulin injections for 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 2

The body does not produce enough insulin for proper function, or the cells in the body do not react to insulin (insulin resistance). Approximately 90% of all cases of diabetes worldwide are of this type.
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 patient will probably end up have to take insulin, usually in tablet form.
Overweight and obese people have a much higher risk of developing type 2 diabetes compared to those with a healthy body weight. People with a lot of visceral fat, also known as central obesity, belly fat, or abdominal obesity, are especially at risk. Being overweight/obese causes the body to release chemicals that can destabilize the body's cardiovascular and metabolic systems.
Being overweight, physically inactive and eating the wrong foods all contribute to our risk of developing type 2 diabetes. Drinking just one can of (non-diet) soda per day can raise our risk of developing type 2 diabetes by 22%, researchers from Imperial College London reported in the journal Diabetologia. The scientists believe that the impact of sugary soft drinks on diabetes risk may be a direct one, rather than simply an influence on body weight.
The risk of developing type 2 diabetes is also greater as we get older. Experts are not completely sure why, but say that as we age we tend to put on weight and become less physically active. Those with a close relative who had/had type 2 diabetes, people of Middle Eastern, African, or South Asian descent also have a higher risk of developing the disease.
Men whose testosterone levels are low have been found to have a higher risk of developing type 2 diabetes. Researchers from the University of Edinburgh, Scotland, say that low testosterone levels are linked to insulin resistance.

3) Gestational Diabetes

This type affects females 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.
Diagnosis of gestational diabetes is made during pregnancy.
The majority of gestational diabetes patients can control their diabetes with exercise and diet. Between 10% to 20% of them will need to take some kind of blood-glucose-controlling medications. Undiagnosed or uncontrolled gestational diabetes can raise the risk of complications during childbirth. The baby may be bigger than he/she should be.
Scientists from the National Institutes of Health and Harvard University found that women whose diets before becoming pregnant were high in animal fat and cholesterol had a higher risk for gestational diabetes, compared to their counterparts whose diets were low in cholesterol and animal fats.

What are the symptoms of diabetes?

People can often have diabetes and be completely unaware. The main reason for this is that the symptoms, when seen on their own, seem harmless. However, the earlier diabetes is diagnosed the greater the chances are that serious complications, which can result from having diabetes, can be avoided.

Here is a list of the most common diabetes symptoms:

• Frequent urination
  Have you been going to the bathroom to urinate more often recently? Do you notice that you spend most of the day going to the toilet? When there is too much glucose (sugar) in your blood you will urinate more often. If your insulin is ineffective, or not there at all, your kidneys cannot filter the glucose back into the blood. The kidneys will take water from your blood in order to dilute the glucose - which in turn fills up your bladder.
• Disproportionate thirst
  If you are urinating more than usual, you will need to replace that lost liquid. You will be drinking more than usual. Have you been drinking more than usual lately?
• Intense hunger
  As the insulin in your blood is not working properly, or is not there at all, and your cells are not getting their energy, your body may react by trying to find more energy - food. You will become hungry.
• Weight gain
  This might be the result of the above symptom (intense hunger).
• Unusual weight loss
  This is more common among people with Diabetes Type 1. As your body is not making insulin it will seek out another energy source (the cells aren't getting glucose). Muscle tissue and fat will be broken down for energy. As Type 1 is of a more sudden onset and Type 2 is much more gradual, weight loss is more noticeable with Type 1.
• Increased fatigue
  If your insulin is not working properly, or is not there at all, glucose will not be entering your cells and providing them with energy. This will make you feel tired and listless.
• Irritability
  Irritability can be due to your lack of energy.
• Blurred vision
  This can be caused by tissue being pulled from your eye lenses. This affects your eyes' ability to focus. With proper treatment this can be treated. There are severe cases where blindness or prolonged vision problems can occur.
• Cuts and bruises don't heal properly or quickly
  Do you find cuts and bruises take a much longer time than usual to heal? When there is more sugar (glucose) in your body, its ability to heal can be undermined.
• More skin and/or yeast infections
  When there is more sugar in your body, its ability to recover from infections is affected. Women with diabetes find it especially difficult to recover from bladder and vaginal infections.
• Itchy skin
  A feeling of itchiness on your skin is sometimes a symptom of diabetes.
• Gums are red and/or swollen - Gums pull away from teeth
  If your gums are tender, red and/or swollen this could be a sign of diabetes. Your teeth could become loose as the gums pull away from them.
• Frequent gum disease/infection
  As well as the previous gum symptoms, you may experience more frequent gum disease and/or gum infections.
• Sexual dysfunction among men
  If you are over 50 and experience frequent or constant sexual dysfunction (erectile dysfunction), it could be a symptom of diabetes.
• Numbness or tingling, especially in your feet and hands
  If there is too much sugar in your body your nerves could become damaged, as could the tiny blood vessels that feed those nerves. You may experience tingling and/or numbness in your hands and feet.

Treatment for diabetes - how is diabetes managed?

A long time ago

Before insulin was discovered in 1921 Diabetes Type 1 was a fatal disease - most patients would die within a few years of onset. Things have changed a great deal since then.

You can lead a normal life

If you have Type 1 and follow a healthy eating plan, do adequate exercise, and take insulin, you can lead a normal life.

Balance insulin intake with food and lifestyle

The quantity of insulin intake must be closely linked to how much food you consume, as well as when you eat. Your daily activities will also have a bearing on when and how much insulin you take.

Checking your blood glucose levels
A person with diabetes has to have his/her blood glucose levels checked periodically. There is a blood test called the A1C which tells you what your average blood glucose levels were over a two-to-three month period.
Type 2 patients need to eat healthily, be physically active, and test their blood glucose. They may also need to take oral medication, and/or insulin to control blood glucose levels.

Prevent developing cardiovascular disease
As the risk of cardiovascular disease is much higher for a diabetic, it is crucial that blood pressure and cholesterol levels are monitored regularly.
Healthy eating, doing exercise, keeping your weight down will all contribute towards good cardiovascular health - some patients will need oral medication for this.

Stop smoking!

As smoking might have a serious effect on the cardiovascular health the patient should stop smoking.

A health care provider

A health care professional (HCP) will help the patient learn how to manage his/her diabetes. The HCP will also monitor the diabetes control. It is important that you know what to do and that a professional is helping and monitoring the management of your diabetes.
In most countries the GP (general practitioner, primary care physician, family doctor) provides this regular care. There are also diabetitians, endocrinologists, cardiologists, nurses, internists, pediatricians, dietitians, podiatrists, ophthalmologists, optometrists, sports specialists and many others.
If a diabetes patient is pregnant she should see an obstetrician who specializes in diabetes (gestational diabetes). There are pediatricians who specialize in caring for the infants of diabetic mothers.

The aim of diabetes management

The main aim of diabetes management is to keep the following under control:

• Blood glucose levels
• Blood pressure
• Cholesterol levels

High and low blood glucose

The patient will need to make sure his/her blood glucose levels do not fluctuate too much.

Hypoglycemia - low blood glucose - can have a bad effect on the patient. Hypoglycemia can cause:

• Shakiness
• Anxiety
• Palpitations, Tachycardia
• Feeling hot, sweating
• Clamminess
• Feeling cold
• Hunger
• Nausea
• Abdominal discomfort
• Headache
• Numbness, pins and needles
• Depression, moodiness
• Apathy, Tiredness, Fatigue, Daydreaming
• Confusion
• Dizziness
• Bad coordination, slurred speech
• Seizures
• Coma

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