Diabetes

Dr.Dipen Rajendrakumar Patel-

Qualification: MD General Medicine

Experience: 6 yrs experience as a General Physician

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Diabetes types

Diabetes mellitus, commonly known as diabetes, is a metabolic disease that causes high blood sugar. The hormone insulin moves sugar from the blood into your cells to be stored or used for energy. With diabetes, your body either doesn’t make enough insulin or can’t effectively use the insulin it does make.

Untreated high blood sugar from diabetes can damage your nerves, eyes, kidneys, and other organs.

There are a few different types of diabetes:

  • Type 1 Diabetes is an autoimmune disease. The immune system attacks and destroys cells in the pancreas, where insulin is made. It’s unclear what causes this attack. About 10 percent of people with diabetes have this type.
  • Type 2 diabetes occurs when your body becomes resistant to insulin, and sugar builds up in your blood.
  • Prediabetes occurs when your blood sugar is higher than normal, but it’s not high enough for a diagnosis of type 2 diabetes.
  • Gestational diabetes is high blood sugar during pregnancy. Insulin-blocking hormones produced by the placenta cause this type of diabetes.

A rare condition called diabetes insipidus is not related to diabetes mellitus, although it has a similar name. It’s a different condition in which your kidneys remove too much fluid from your body.

Diabetes symptoms are caused by rising blood sugar.

General symptoms

The general symptoms of diabetes include:

  • increased hunger
  • increased thirst
  • weight loss
  • frequent urination
  • blurry vision
  • extreme fatigue
  • sores that don’t heal

Symptoms in men

In addition to the general symptoms of diabetes, men with diabetes may have a decreased sex drive, erectile dysfunction (ED), and poor muscle strength.

Symptoms in women

Women with diabetes can also have symptoms such as urinary tract infections, yeast infections, and dry, itchy skin.

Type 1 diabetes

Symptoms of type 1 diabetes can include:

  • extreme hunger
  • increased thirst
  • unintentional weight loss
  • frequent urination
  • blurry vision
  • tiredness

It may also result in mood changes.

Type 2 diabetes

Symptoms of type 2 diabetes can include:

  • increased hunger
  • increased thirst
  • increased urination
  • blurry vision
  • tiredness
  • sores that are slow to heal

It may also cause recurring infections. This is because elevated glucose levels make it harder for the body to heal.

Gestational diabetes

Most women with gestational diabetes don’t have any symptoms. The condition is often detected during a routine blood sugar test or oral glucose tolerance test that is usually performed between the 24th and 28th weeks of gestation.

In rare cases, a woman with gestational diabetes will also experience increased thirst or urination.

The bottom line

Diabetes symptoms can be so mild that they’re hard to spot at first. 

Causes of diabetes

Different causes are associated with each type of diabetes.

Type 1 diabetes

Doctors don’t know exactly what causes type 1 diabetes. For some reason, the immune system mistakenly attacks and destroys insulin-producing beta cells in the pancreas.

Genes may play a role in some people. It’s also possible that a virus sets off the immune system attack.

Type 2 diabetes

Type 2 diabetes stems from a combination of genetics and lifestyle factors. Being overweight or obese increases your risk too. Carrying extra weight, especially in your belly, makes your cells more resistant to the effects of insulin on your blood sugar.

This condition runs in families. Family members share genes that make them more likely to get type 2 diabetes and to be overweight.

Gestational diabetes

Gestational diabetes is the result of hormonal changes during pregnancy. The placenta produces hormones that make a pregnant woman’s cells less sensitive to the effects of insulin. This can cause high blood sugar during pregnancy.

Women who are overweight when they get pregnant or who gain too much weight during their pregnancy are more likely to get gestational diabetes.

Diabetes risk factors

Certain factors increase your risk for diabetes.

Type 1 diabetes

You’re more likely to get type 1 diabetes if you’re a child or teenager, you have a parent or sibling with the condition, or you carry certain genes that are linked to the disease.

Type 2 diabetes

Your risk for type 2 diabetes increases if you:

  • are overweight
  • are age 45 or older
  • have a parent or sibling with the condition
  • aren’t physically active
  • have had gestational diabetes
  • have prediabetes
  • have high blood pressure, high cholesterol, or high triglycerides
  • have African American, Hispanic or Latino American, Alaska Native, Pacific Islander, American Indian, or Asian American ancestry

Gestational diabetes

Your risk for gestational diabetes increases if you:

  • are overweight
  • are over age 25
  • had gestational diabetes during a past pregnancy
  • have given birth to a baby weighing more than 9 pounds
  • have a family history of type 2 diabetes
  • have polycystic ovary syndrome (PCOS)

 Diabetes complications

High blood sugar damages organs and tissues throughout your body. The higher your blood sugar is and the longer you live with it, the greater your risk for complications.

Complications associated with diabetes include:

  • heart disease, heart attack, and stroke
  • neuropathy
  • nephropathy
  • retinopathy and vision loss
  • hearing loss
  • foot damage such as infections and sores that don’t heal
  • skin conditions such as bacterial and fungal infections
  • depression
  • dementia

Gestational diabetes

Uncontrolled gestational diabetes can lead to problems that affect both the mother and baby. Complications affecting the baby can include:

  • premature birth
  • higher-than-normal weight at birth
  • increased risk for type 2 diabetes later in life
  • low blood sugar
  • jaundice
  • stillbirth

The mother can develop complications such as high blood pressure (preeclampsia) or type 2 diabetes. She may also require cesarean delivery, commonly referred to as a C-section.

The mother’s risk of gestational diabetes in future pregnancies also increases.

 Treatment of diabetes

Type 1 diabetes

Insulin is the main treatment for type 1 diabetes. It replaces the hormone your body isn’t able to produce.

There are four types of insulin that are most commonly used. They’re differentiated by how quickly they start to work, and how long their effects last:

  • Rapid-acting insulin starts to work within 15 minutes and its effects last for 3 to 4 hours.
  • Short-acting insulin starts to work within 30 minutes and lasts 6 to 8 hours.
  • Intermediate-acting insulin starts to work within 1 to 2 hours and lasts 12 to 18 hours.
  • Long-acting insulin starts to work a few hours after injection and lasts 24 hours or longer.

Type 2 diabetes

Diet and exercise can help some people manage type 2 diabetes. If lifestyle changes aren’t enough to lower your blood sugar, you’ll need to take medication.

These drugs lower your blood sugar in a variety of ways:

Types of drug How they work Example(s)
Alpha-glucosidase inhibitors Slow your body’s breakdown of sugars and starchy foods Acarbose (Precose) and miglitol (Glyset)
Biguanides Reduce the amount of glucose your liver makes Metformin (Glucophage)
DPP-4 inhibitors Improve your blood sugar without making it drop too low Linagliptin (Tradjenta), saxagliptin (Onglyza), and sitagliptin (Januvia)
Glucagon-like peptides Change the way your body produces insulin Dulaglutide (Trulicity), exenatide (Byetta), and liraglutide (Victoza)
Meglitinides Stimulate your pancreas to release more insulin Nateglinide (Starlix) and repaglinide (Prandin)
SGLT2 inhibitors Release more glucose into the urine Canagliflozin (Invokana) and dapagliflozin (Farxiga)
Sulfonylureas Stimulate your pancreas to release more insulin Glyburide (DiaBeta, Glynase), glipizide (Glucotrol), and glimepiride (Amaryl)
Thiazolidinediones Help insulin work better Pioglitazone (Actos) and rosiglitazone (Avandia)

You may need to take more than one of these drugs. Some people with type 2 diabetes also take insulin.

Gestational diabetes

You’ll need to monitor your blood sugar level several times a day during pregnancy. If it’s high, dietary changes and exercise may or may not be enough to bring it down.

According to the Mayo Clinic, about 10 to 20 percent of women with gestational diabetes will need insulin to lower their blood sugar. Insulin is safe for the growing baby.

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