What is Diabetes?
Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose). If you have diabetes you have too much glucose in your blood which can lead to serious health problems.
What are some types of Diabetes?
Chronic diabetes conditions include type 1 diabetes and type 2 diabetes.
Potentially reversible diabetes conditions include prediabetes, when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes.
Gestational diabetes, which occurs during pregnancy but may resolve after the baby is delivered.
What are the symptoms of Diabetes?
Diabetes symptoms vary depending on how much your blood sugar is elevated. Some people, especially those with prediabetes or type 2 diabetes, may not experience symptoms initially. In type 1 diabetes, symptoms tend to come on quickly and be more severe.
Some of the signs and symptoms of type 1 and type 2 diabetes are:
At what age does diabetes develop ?
Although type 1 diabetes can develop at any age, it typically appears during childhood or adolescence. Type 2 diabetes, the more common type, can develop at any age, though it’s more common in people older than 40.
What are the causes of Diabetes ?
To understand diabetes, first you must understand how glucose is normally processed in the body.
Causes of type 1 diabetes :
The exact cause of type 1 diabetes is unknown. Your immune system attacks and destroys your insulin-producing cells in the pancreas. This leaves you with little or no insulin. Instead of being transported into your cells, sugar builds up in your bloodstream.
Type 1 is thought to be caused by a combination of genetic susceptibility and environmental factors, though exactly what many of those factors are is still unclear.
Causes of prediabetes and type 2 diabetes :
In prediabetes and type 2 diabetes, your cells become resistant to the action of insulin, and your pancreas is unable to make enough insulin to overcome this resistance. Instead of moving into your cells where it’s needed for energy, sugar builds up in your bloodstream. Genetic and environmental factors play a role in the development of type 2 diabetes. Being overweight is strongly linked to the development of type 2 diabetes, but not everyone with type 2 is overweight.
Causes of gestational diabetes :
During pregnancy, the placenta produces hormones to sustain your pregnancy. These hormones make your cells more resistant to insulin.
What are some risk factors for Diabetes ?
Risk factors for diabetes depend on the type of diabetes.
Risk factors for type 1 diabetes:
Factor that may contribute to type 1 diabetes include:
1- Family history.
2- Environmental factors.
3- The presence of damaging immune system cells (autoantibodies) : If you have these autoantibodies, you have an increased risk of developing type 1 diabetes.
4- Dietary factors.
Risk factors for prediabetes and type 2 diabetes:
Certain factors increase the risk of prediabetes and type 2 diabetes, including:
1- The more fatty tissue you have, the more resistant your cells become to insulin.
2- Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin. The less active you are, the greater your risk.
3- Family history
Your risk increases as you get older. This may be because you tend to exercise less, lose muscle mass and gain weight as you age.
4- Gestational diabetes : If you developed gestational diabetes when you were pregnant, your risk of developing prediabetes and type 2 diabetes later increases.
5- Polycystic ovary syndrome : For women, having polycystic ovary syndrome (characterized by irregular menstrual periods, excess hair growth and obesity) increases the risk of diabetes.
6- High blood pressure : Having blood pressure over 140/90 millimeters of mercury (mm Hg) is linked to an increased risk of type 2 diabetes.
7- Abnormal cholesterol and triglyceride levels : If you have low levels of high-density lipoprotein (HDL), or “good,” cholesterol, your risk of type 2 diabetes is higher. People with high levels of triglycerides have an increased risk of type 2 diabetes.
What are the Complications of Diabetes?
Possible complications include:
1- Cardiovascular disease : Diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis). If you have diabetes, you are more likely to have heart disease or stroke.
2- Nerve damage (neuropathy) : This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Left untreated, you could lose all sense of feeling in the affected limbs. Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, it may lead to erectile dysfunction.
3- Kidney damage (nephropathy) : Diabetes can lead to kidney failure or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.
4- Eye damage (retinopathy) : Diabetes can damage the blood vessels of the retina or diabetic retinopathy leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.
5- Foot damage : Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can develop serious infections, which often heal poorly. These infections may ultimately require toe, foot or leg amputation.
6- Skin conditions : Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.
7- Hearing impairment : Hearing problems are more common in people with diabetes.
When should I see a doctor?
1- If you suspect you may have diabetes : If you notice any possible diabetes symptoms, contact your doctor. The earlier the condition is diagnosed, the sooner treatment can begin.
2- If you’ve already been diagnosed with diabetes : After you receive your diagnosis, you’ll need close medical follow-up until your blood sugar levels stabilize.
How is Diabetes treated ?
Treatment for type 1 diabetes involves insulin injections or the use of an insulin pump, frequent blood sugar checks, and carbohydrate counting.
Treatment of type 2 diabetes primarily involves monitoring of your blood sugar, along with diabetes medications, insulin or both.
Monitoring your blood sugar : Depending on your treatment plan, you may check and record your blood sugar as often as several times a week to as many as four to eight times a day. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range.
Even with careful management, blood sugar levels can sometimes change unpredictably. With help from your diabetes treatment team, you’ll learn how your blood sugar level changes in response to food, physical activity, medications, illness, alcohol, stress.
In addition to daily blood sugar monitoring, your doctor will likely recommend regular A1C testing to measure your average blood sugar level for the past two to three months. A1C testing better indicates how well your diabetes treatment plan is working overall. An elevated A1C level may signal the need for a change in your insulin regimen or meal plan. American Diabetes Association recommends an A1C of below 7 percent.
Insulin : People with type 1 diabetes need insulin therapy to survive. Many people with type 2 diabetes or gestational diabetes also need insulin therapy.
Many types of insulin are available, including rapid-acting insulin, long-acting insulin and intermediate options. Insulin can’t be taken orally. Often insulin is injected using a fine needle and syringe or an insulin pen.
An insulin pump may also be an option. The pump is a device worn on the outside of your body. You program an insulin pump to dispense specific amounts of insulin. It can be adjusted to deliver more or less insulin depending on meals, activity level and blood sugar level.
Oral or other medications : Sometimes other oral or injected medications are prescribed as well. Some diabetes medications stimulate your pancreas to produce and release more insulin. Others inhibit the production and release of glucose from your liver, which means you need less insulin to transport sugar into your cells. Still others block the action of stomach or intestinal enzymes that break down carbohydrates or make your tissues more sensitive to insulin.
Transplantation : In some people who have type 1 diabetes, a pancreas transplant may be an option. With a successful pancreas transplant, you would no longer need insulin therapy. Transplants are usually reserved for people whose diabetes can’t be controlled or those who also need a kidney transplant.
Bariatric surgery : Although it is not specifically considered a treatment for type 2 diabetes, people with type 2 diabetes who also have a body mass index higher than 35 may benefit from this type of surgery.
How is Prediabetes treated ?
If you have prediabetes, healthy lifestyle choices can help you bring your blood sugar level back to normal or at least keep it from rising toward the levels seen in type 2 diabetes.
Exercising at least 150 minutes a week and losing 5 to 10 percent of your body weight may prevent or delay type 2 diabetes.
Some medications are an option if you’re at high risk of diabetes. In some cases, medications to control cholesterol and high blood pressure medications are needed. Your doctor might prescribe low-dose aspirin therapy to help prevent cardiovascular disease if you’re at high risk.
What can I do to prevent complications ?
Identify yourself : Wear a tag or bracelet that says you have diabetes.
Keep a glucagon kit : nearby in case of a low blood sugar emergency and make sure your friends and loved ones know how to use it.
Schedule a yearly physical and regular eye exams : Your regular diabetes checkups aren’t meant to replace yearly physicals or routine eye exams. During the physical, your doctor will look for any diabetes-related complications and screen for other medical problems. Your eye care specialist will check for signs of retinal damage, cataracts and glaucoma.
Keep your vaccinations up to date : High blood sugar can weaken your immune system. Get a flu shot every year, and your doctor may recommend the pneumonia vaccine, as well. The Centers for Disease Control and Prevention (CDC) also currently recommends hepatitis B vaccination if you haven’t previously been vaccinated against hepatitis B and you’re an adult ages 19 to 59 with type 1 or type 2 diabetes. The most recent CDC guidelines advise vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you are age 60 or older, have diabetes, and haven’t previously received the vaccine, talk to your doctor about whether it’s right for you.
Pay attention to your feet : Wash your feet daily in lukewarm water. Dry them gently, especially between the toes. Moisturize with lotion, but not between the toes. Check your feet every day for blisters, cuts, sores, redness or swelling. Consult your doctor if you have a sore or other foot problem that doesn’t heal promptly on its own.
Keep your blood pressure and cholesterol under control : Eating healthy foods and exercising regularly can go a long way toward controlling high blood pressure and cholesterol. Medication may be needed, too.
Take care of your teeth : Diabetes may leave you prone to more-serious gum infections. Brush and floss your teeth at least twice a day. And if you have type 1 or type 2 diabetes, schedule regular dental exams. Consult your dentist right away if your gums bleed or look red or swollen.
If you smoke or use other types of tobacco, ask your doctor to help you quit : Smoking increases your risk of various diabetes complications. Smokers who have diabetes are more likely to die of cardiovascular disease than are nonsmokers who have diabetes, according to the American Diabetes Association. Talk to your doctor about ways to stop smoking or to stop using other types of tobacco.
If you drink alcohol, do so responsibly : Alcohol can cause either high or low blood sugar, depending on how much you drink and if you eat at the same time. If you choose to drink, do so only in moderation one drink a day for women of all ages and men older than 65, and up to two drinks a day for men age 65 and younger and always with food.
Take stress seriously : The hormones your body may produce in response to prolonged stress may prevent insulin from working properly, which will raise your blood sugar and stress you even more. Set limits for yourself and prioritize your tasks. Learn relaxation techniques. And get plenty of sleep.
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