Diabetes is the most prevalent disease around the globe. The condition is multifactorial, and many factors such as gender, lifestyle, socioeconomic and genetics come into play. This article provides a complete guideline about diabetes, its stages, types, and management via anti-diabetic drugs and lifestyle modification.
Let us dive in so you can access all vital information about this disease.
What is Diabetes?
Diabetes is a prevalent disease that typically emerges from pancreas dysfunction or insulin sensitivity induced in the body. In these cases, the body’s insulin level drops while glucose level increases, then borderline, and ultimately, the patient becomes hyperglycemic.
It is not wrong to say that diabetes is a hormonal disorder, as insulin imbalance is a real game changer in type 1 diabetes. Still, on the other side, type 2 is not considered an insulin causative diabetes.
To figure out this mystery, it is essential to know the types of diabetes mellitus and the role insulin plays in each type.
Diabetes Types: (Type 1 & 2)
An Egyptian manuscript around 3000 years ago for the first time In 1936, the distinction between type1 and type 2.
Based on the role of insulin, there are two major types of diabetes mellitus:
Diabetes Type 1 (insulin-dependent)
Diabetes Type 2 (non-insulin-dependent)
Diabetes Type 1: Insulin-dependent
Type 1 diabetes is insulin-dependent diabetes. As we all know, our pancreas has a specialized group of cells called Langerhans. These specialized cells are further subdivided into 4 types holding their specialized function. B-cell is one of the subtypes that are responsible for insulin production.
Whenever blood glucose level increases, b-cells in the pancreas produce insulin that plays a vital role in normalizing the blood glucose level. But wait, are you curious about what happens to your b-cells in cases of type 1 diabetes?
The simple answer is that your body’s b-cells get destroyed due to an autoimmune response. This destruction of B-cells usually leads to absolute insulin deficiency as no insulin production is occurring by pancreatic cells, ultimately leading to higher blood glucose, and the condition is called hyperglycemia.
Diabetes Type 2: Non-insulin dependent
As the name indicates, type 2 is considered non-insulin-dependent. Here it is not wrong to say that it’s partially or indirectly dependent if you develop type 2 diabetes due to a progressive loss of b-cell insulin secretion and insulin resistance.
Simply, due to insulin insensitivity, the body cells cannot uptake glucose from the blood.
In type 2, insulin is produced in an inadequate amount, or due to insensitivity, the cells won’t detect insulin presence.
Signs and Symptoms of diabetes
- Feeling very thirsty (Polydipsia).
- Feeling very hungry (Polyphagia)
- Extreme fatigue.
- Blurry vision
- The slow healing process.
- Unexplained Weight loss—even though you are eating more (in type 1)
- Tingling or numbness in the hands/feet (in type 2)
Causes of Diabetes
When it comes to finding out the underlying cause of diabetes, in type 1, an impaired pancreas is the identified culprit. Due to an autoimmune attack, the pancreas is destroyed and unable to produce insulin.
Moreover, genetic predisposition is closely related to type 1 cause.
The triggering factors may include :
- Viral infection
- Low levels of vitamin D
- Increased demand for insulin( excess intake of food with high GI )
On the other hand, type 2 diabetes majorly can be caused by poor lifestyle and genetics.
One of the most prevalent causes of type 2 is being obese. Due to excess body fat in the abdominal region, the insulin efficiency towards sugar disease, i.e., insulin resistance, increases.
Diabetes risk factors
The following are the risk factors that may be responsible for the onset of diabetes:
- Unhealthy eating habits
- Sedentary lifestyle
If you are at risk of developing diabetes, you should have an appointment with the doctor today.
Similar to hypertension, diabetes, too, is a silent killer. As the disease progresses, it can affect other organs and organ systems. Following are some complications that occur when diabetes is not managed or poorly managed:
- Cardiovascular disease.
- Nerve damage (neuropathy).
- Kidney damage (nephropathy).
- Eye damage (retinopathy).
- Foot damage.
- Skin conditions.
- Hearing impairment.
- DKA (DMT1)
Diagnosis of type 1 diabetes
Childhood or puberty is the most common onset period for T1D.
Patients with T1D can usually be identified by their
Three significant symptoms, including
polyuria (frequent urination)
polydipsia (excessive thirst),
polyphagia (extreme hunger)
- FBS/BSF 3 Consecutive days
- BSR/BSL 3 Consecutive days
- Urine Sugar
HBA1C is the most common test recommended as A glycosylated hemoglobin concentration confirms the diagnosis. Here are the blood sugar standard values that indicate different stages of the disease
Normal value =
- Blood sugar fasting (BSF) = 80-110 mg/dl
- Blood sugar Random( BSR)= 11O-140mg/dl
Pre-diabetes = 140 mg to 180mg/dl
Diabetes ≥ 180 mg/dl
After taking the test as recommended, you must see your doctor get a proper diagnosis and a follow-up report.
Prevention is the most critical aspect that protects against particular diseases and helps to avoid related complications.
Diabetes prevention can be done through essential lifestyle modifications.
- Regular exercise
- Avoid alcohol
- Avoid excessive use of antibiotics
- Eat healthy carbs
- Eat adequate protein
- Avoid junk food
- Avoid sugary drinks
- Proper 8-hour sleep
- Watch symptoms for the prediabetic stage
- Maintain normal body weight
Diabetes in Men
Endogenous sex hormones predict impairments in glucose control. Lower testosterone production in males may raise their metabolic syndrome and diabetes incidence. However, an increased risk of metabolic syndrome and diabetes is associated with lower binding globulin concentrations for sex hormones in both men and women.
Numerous hazardous consequences can result from diabetes. Therefore, a blood test should be given to all overweight men above 45.
Diabetes Symptoms in Men
- Erectile dysfunction (ED)
When men cannot obtain or sustain an erection, it is called erectile dysfunction (ED). Although the prevalence of erectile dysfunction in males with diabetes is still debatable, it may be prevalent. Consider diabetes as a potential reason if you have ED.
- Damage to the autonomic nervous system (ANS)
Sexual issues can result from diabetes, affecting the autonomic nervous system (ANS).
The ANS controls your blood vessels’ ability to dilate or constrict. Diabetes can cause harm to the penis’ blood vessels and nerves, leading to ED. Diabetes can harm blood arteries, reducing the amount of blood that reaches the penis. It is a further typical factor in ED in diabetic males.
Retrograde ejaculation could also affect men having diabetes. In turn, the bladder experiences a small amount of semen discharge. Less semen being discharged during ejaculation is one of the symptoms.
Genital Mycotic Infections
Diabetes patients, particularly those with moderate to severe glycemia, are more likely to acquire Candida balanitis—a genital mycotic infection primarily affecting uncircumcised men.
The warm, wet area behind the foreskin of uncircumcised men is thought to encourage yeast growth, mainly when personal hygiene is inadequate.
Diabetes in Women
Diabetes patients are more susceptible to sepsis and other catastrophic bacterial invasion consequences because glucose metabolism impacts many infectious disorders. In addition, higher testosterone production in women may raise their metabolic syndrome and diabetes incidence.
- Vulvovaginal Candidiasis
Recurrent bladder colonization frequently leads to upper urinary tract infections (UTIs). If glycemia is not well controlled, vaginal candidiasis is a prevalent issue. Vaginal bacteria infections include:
● Bacterial vaginosis
● Vaginal atrophy with bacterial colonization
● Aerobic vaginitis
- Abortions and Major Malformations
Significant congenital abnormalities and spontaneous miscarriages during the first trimester are much more likely to occur in women suffering from insulin-dependent diabetes mellitus. The severity of these risks depends on how well their diabetes was metabolically controlled during the first trimester.
- Preterm Deliveries
Women already have pre-existing type 1 or 2 diabetes mellitus are more likely to experience pregnancy issues like congenital abnormalities, preeclampsia, and preterm birth. In addition, fetal overgrowth complicates almost half of deliveries in women with pre-existing diabetes mellitus, putting the unborn child at risk for birth trauma and causing them to be overweight.
- Sexual Dysfunction
The occurrence of sexual dysfunction in women with DM is usually connected less to biological factors but more to psychological factors, particularly coexisting depression. Women with DM are at greater risk of sexual dysfunction than those without DM. There is wide variation in results across different research studies.
Diabetes In Children
Children are particularly susceptible to both types of diabetes (type1 and type2).
Type 1 Diabetes
It makes up the majority of new cases in children and is the most prevalent variety—one of the most common chronic childhood diseases. With the highest probability of occurrence in the ages of 14 and 18, affecting 1 in 350 kids by the time they become 18, the incidence has recently been rising, especially in kids under the age of 5. Due to the autoimmune death of pancreatic beta-cells, which may be brought on by any virus, bacteria, or environmental contact in genetically sensitive individuals, the pancreas releases very little or no insulin.
Type 2 Diabetes
Although it is uncommon in children, it has become more common in accordance with the rise in childhood obesity. With the highest rate occurring between the ages of 15 and 19, it often appears after puberty. In children, type 1 diabetes differs from type 2 diabetes but also type 2 diabetes in adults. Beta-cell function reduction and the emergence of problems from diabetes happen more quickly in children. It seems that genetics and family history are significant factors.
Symptoms of Diabetes In Children
- Intensified thirst
- Frequent urine and possible bedwetting in a child who has completed toilet training
- Severe hunger
- An unexpected loss of weight
- Intolerability or altered behavior
- A fruity mouth odor
The kind of diabetes medication you take is determined by the type of diabetes you have.
The selection is determined by:
- Type of the diabetes
- The situation of the individual
The classification is based on the type of diabetes.
Medication for Type 1 Diabetes
For individuals with type 1 diabetes to stay healthy. They will need insulin therapy for the rest of their life.
● Short-Acting Insulin
This type of insulin, often known as regular insulin, starts working roughly half an hour after injection. It has a maximum impact time of 90 to 120 minutes and 4 to 6 hours. Humulin R, Afrezza, and Novolin R are some examples.
● Rapid-Acting Insulin
This form of insulin starts acting within 15 minutes. It has a maximum effect after 60 minutes and lasts roughly 4 hours. This type is frequently used 15 to 20 minutes before meals. Examples include glulisine (Apidra) and aspart (Novolog and FiAsp).
● Intermediate-Acting Insulin
This form of insulin, also known as NPH insulin, begins to work in 1 to 3 hours. It has a maximum impact after 6 to 8 hours and 12 to 24 hours. Examples include insulin NPH (Novolin N, Humulin N).
● Long- and Ultra-Long-Acting Insulin
This form of insulin may protect for up to 14 to 40 hours. Glargine (Lantus, Basaglar), detemir (Levemir), and degludec are among examples (Tresiba).
It is an injectable anti-diabetic that is given before meals. Pramlintide (SymlinPen 60, SymlinPen 120 ) is an amylinomimetic medicine. It acts by slowing the time your stomach takes to empty itself. As a result, it lowers glucagon secretion following meals and reduces blood sugar levels.
Medication for Type 2 Diabetes
In people with type 2 diabetes, medication will be administered orally in the form of tablets or intravenously.
These drugs assist your body in breaking down starchy foods and table sugar. This effect reduces your blood sugar levels. It includes: Miglitol (Glyset)
Biguanides lower the quantity of sugar synthesized by your liver. They limit the amount of sugar absorbed by your intestines.
Metformin is the most frequently used biguanide ( ER, Riomet).
Dipeptidyl Peptidase-4 (DPP-4) Inhibitors
They function by lowering blood sugar levels without inducing hypoglycemia. This includes: Alogliptin (Nesina)
Glucagon-Like Peptide-1 Receptor Agonists
They boost B-cell growth and the quantity of insulin your body utilizes. They reduce your hunger and the amount of glucagon your body produces. These include: Exenatide (Byetta)
These drugs assist your body in secreting insulin. This includes Nateglinide (Starlix)
Sodium-Glucose Transporter (SGLT) 2 Inhibitors
They restrict the kidneys from storing glucose and remove it from your body through urine.Alogliptin, exenatide, and nateglinide inlcudes Dapagliflozin(fraxiga).
Role of Diet in Diabetes Management
When it comes to the management of diabetes, diet plays a vital role in it. A diabetes-friendly diet can help a patient to live a healthy life for years. Still, a poor diet can bring up adverse effects that may nullify the effect of medication therapy and let the diabetes progress devastatingly.
Therefore, to manage a proper diet, a doctor will refer you to a dietitian who will work on your diet and help you stay healthy without putting on kgs or losing your muscle mass.
Some significant recommendations for diabetic patients include the following:
- Frequent small meals
- Consistent carbs intake
- Adequate protein intake
- Avoid fruits with the high glycemic index
- Avoid starchy vegetables
- Intake of green leafy vegetables
- Intake high fiber foods
- Avoid alcohol consumption
- Avoid added salt and sugar
When to Consult a Doctor for Diabetes
The right time to see your doctor is when you feel any symptoms of diabetes. People with diabetes in their family history should often visit their doctor, which can help them get a diagnosis at the prediabetic stage. Remember that the prediabetic stage can be reversed and treated easily until its progression into diabetes. After you get diabetes, proper management is the only way to live a healthy life.
FAQs About Diabetes
According to the existing knowledge, diabetes cannot be cured but managed, but some new studies show there are chances to reverse type 2 diabetes.
A diabetic patient can live a healthy life if he manages diabetes with a balanced diet, regular exercise, and medication.
Yes, people with diabetes can drink alcohol but in moderation. However, to avoid complications, it is recommended to quit alcohol altogether.
Fasting is not recommended for diabetes, as the patient may experience a sudden drop in glucose. Many dieticians and doctors also warn about fluctuations in blood sugar and metabolic health outcomes.
Some Early research shows that fasting protocols can help reduce the symptoms of diabetes and address some of its underlying causes when exercised with purpose.