Diabetes is a chronic medical condition in which the body cannot produce or properly use insulin, a hormone that regulates blood sugar levels.
Types of Diabetes
There are two main types of diabetes Type 1 and Type 2.
Type 1 diabetes
T1DM is an autoimmune disorder, a severe condition with high blood sugar levels, as your body can not make the hormone INSULIN. This happens because your Beta cells in the pancreas can not produce insulin as your body attacks these cells.
The body still breaks down carbohydrates to glucose which increases blood sugar levels. Still, the body can not create needed insulin to lower this blood sugar, where blood sugar adds up more and more as carbohydrate food and drinks are consumed. It is essential to have insulin injections for T1DM patients to lower high blood sugar levels.
The reason for T1Dm is still unknown, and scientists worldwide are still working hard to find the cause.
Type 2 diabetes
Type 2 diabetes is characterized by insulin resistance and relative insulin deficiency. In T2DM pancreas doesn’t work correctly to make insulin or can’t make enough insulin to lower the blood sugar due to insulin resistance. As blood sugar can’t be reduced, the pancreas works harder to create more insulin, which may tire out the pancreas that produces less insulin and eventually elevates the blood sugar.
Both types of diabetes can lead to elevated blood sugar levels, leading to various complications, including cardiovascular disease, nerve damage, and vision loss. Both are known as metabolic syndrome and get more information about metabolic syndrome here.
Gestastional Diabetes (GD)
This is a type of diabetes that occurs during pregnancy. It affects about 9% of all pregnancies and is caused by hormonal changes and increased insulin resistance during pregnancy. Women with gestational diabetes have high blood sugar levels, which can harm the mother and the baby.
Gestational Diabetes is the most common medical pregnancy complication, and the prevalence of undiagnosed hyperglycemia and even overt diabetes in young women is increasing. Maternal overweight and obesity, later age at childbearing, previous history of GD, family history of type 2 diabetes, and ethnicity are major GD risk factors. Diagnosis is usually performed using an oral glucose tolerance test (OGTT).
Gestational Diabetes can be controlled, usually through diet and exercise, and sometimes with insulin injections. If left untreated, gestational diabetes can lead to complications such as pre-eclampsia, premature delivery, and macrosomia (a large baby), increasing the risk of birth injuries and cesarean delivery. Women with gestational diabetes are at increased risk of developing type 2 diabetes later in life, so regular monitoring and lifestyle changes are essential after pregnancy.
Signs of Diabetes
Dry mouth, acanthosis nigricans, repeated infections, feeling thirsty, insulin resistance, fatigue, etc.
Diabetes is a widespread health condition, and its prevalence has increased globally in recent decades. According to the World Health Organization (WHO), an estimated 422 million people had diabetes worldwide in 2014, and this number is expected to rise to 629 million by 2045.
According to CDC 2022 National Diabetes Statistics Report, there are 37.3 million people with diabetes and 96 million people with prediabetes in the United States, a total %of 49.3 of the US population.
Fast Facts on Diabetes in the United States
- Total: 37.3 million people have diabetes (11.3% of the US population)
- Diagnosed: 28.7 million people, including 28.5 million adults
- Undiagnosed: 8.5 million people (23.0% of adults are undiagnosed)
Prediabetes
- Total: 96 million people aged 18 years or older have prediabetes (38.0% of the adult US population)
- 65 years or older: 26.4 million people aged 65 years or older (48.8%) have prediabetes
Diabetes is one of the fastest growing diseases Worldwide, projected to Affect 693 million adults by 2045
The global diabetes prevalence in 2019 is estimated to be 9.3% (463 million people), rising to 10.2% (578 million) by 2030 and 10.9% (700 million) by 2045. The prevalence is higher in urban (10.8%) than rural (7.2%) areas and in high-income (10.4%) than low-income countries (4.0%). One in two (50.1%) people living with diabetes do not know that they have diabetes. The global prevalence of impaired glucose tolerance is estimated to be 7.5% (374 million) in 2019 and is projected to reach 8.0% (454 million) by 2030 and 8.6% (548 million) by 2045.
Diabetes is a leading cause of;
- cardiovascular disease, heart disease, stroke
- vision loss, blindness,
- kidney failure,
- lower limb amputation,
- hearing loss
- depressidementiatia
It is a significant public health challenge that requires effective prevention and management strategies.
Other chronic diseases, including chronic obstructive pulmonary disease (COPD), are linked to Diabetes. These long-lasting diseases typically worsen over time, leading to disability and death.
Other complications ;
- Diabetic neuropathy
- Nephropathy
- Retinopathy
- Diabetic foot damage, such as infections and scars that don’t heal
How do doctors diagnose diabetes?
Type 2 diabetes is usually diagnosed using the glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. Results are interpreted as follows:
- Below 5.7% is normal.
- 5.7% to 6.4% are diagnosed with prediabetes.
- 6.5% or higher on two separate tests indicates Type 2 DM.
Even A1C test is below 5.7%, but above %5.4, the Health care provider may check Insulin and Insulin resistance levels to determine or predict the potential of becoming prediabetes or Type 2 DM.
Random blood sugar test. Blood sugar values are expressed in milligrams of sugar per deciliter (mg/dL) or millimoles of sugar per liter (mmol/L) of blood. Regardless of when you last ate, a level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially if you also have signs and symptoms of diabetes, such as frequent urination and extreme thirst.
Fasting blood sugar test. A blood sample is taken after an overnight fast. Results are interpreted as follows:
- Less than 100 mg/dL (5.6 mmol/L) is standard.
- 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is diagnosed as prediabetes.
- 126 mg/dL (7 mmol/L) or higher on two separate tests is diagnosed as diabetes.
Glucose tolerance test. This test is less commonly used than the others, except during pregnancy. You’ll need to fast overnight and drink a sugary liquid at the doctor’s office. Blood sugar levels are tested periodically for the next two hours. Results are interpreted as follows:
- Less than 140 mg/dL (7.8 mmol/L) is standard.
- 140 to 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) is diagnosed as prediabetes.
- 200 mg/dL (11.1 mmol/L) or higher after two hours suggests diabetes.
Becoming prediabetic or type 2 diabetic may take up to 15 years, depending on lifestyle and eating habits. Your healthcare provider can read early warning signs by checking the above tests + Insulin and Insulin resistance levels.
Treatment Options
- If you have type 1 diabetes, you’ll need to use insulin to treat your diabetes. You take the insulin by injection or by using a pump.
- If you have Type 2 diabetes, you may have to use insulin or tablets, though you might initially be able to treat your diabetes by eating well and moving more.
As mentioned above T1Dm is an impairment of the pancreas and cells that produce insulin to lower blood sugar, injection of insulting is necessary. But T2DM can be managed or treated by the below actions working with the guideline of the healthcare provider and dieticians.
- Healthy eating
- Regular exercise
- Weight loss
- Possibly, diabetes medication or insulin therapy
- Blood sugar monitoring
Healthy Eating
Please talk to your healthcare provider before making any changes in your diet.
In a clinical trial: Type 2 Diabetes Prevention Focused on Normalization of Glycemia: A Two-Year Pilot Study, Patients with prediabetes received a continuous remote care intervention focused on reducing hyperglycemia through carbohydrate-restricted nutrition therapy for two years which concluded cumulative incidence of normoglycemia at two years was 52.3%.
As mentioned above, carbohydrates taken via food or drink break down to make glucose, increasing blood sugar. That body needs insulin to lower this high level of sugar; this clinical trial may be an excellent example that being on the ketogenic diet and nutritional ketosis will not elevate blood sugar as much as carbohydrates, where insulin will not be needed which will lower Hemoglobin A1C to normal levels.
If you are taking in extra calories in one day, such as refined sugar, chocolate, or maybe fast food, please eat less. Healthy oils and healthy low glycemic index snacks are the most important thing you should know. Because when you eat healthy oil sources, low carb, and fewer portions are going to manage your appetite levels. And also the last suggestion would be to eat high fiber groups in every meal.
Regular Exercise
Talk to your primary healthcare provider before starting or changing your exercise program to ensure that your activities are safe.
Aerobic exercise;
A sedentary lifestyle is well-known as one of the primary reasons for the rising epidemic of type 2 diabetes mellitus. Clinical trials have shown that aerobic exercise at medium to vigorous intensity for 150 minutes a week is an efficient influencer that would switch back most known type 2 diabetes mellitus factors toward healthier positions.
Resistance exercise.
Resistance exercise increases your muscle, strength, balance, and ability to perform activities of daily living more easily. Resistance training includes weightlifting, yoga, and calisthenics. Clinical trials and surveys have shown that muscle mass is inversely associated with insulin resistance and prediabetes.
Weight Loss
According to American Diabetes Association being overweight raises your risk for type 2 diabetes, heart disease, and stroke. It can also increase the risk of high blood pressure, unhealthy cholesterol, and high blood glucose (sugar). Losing weight may help you prevent and manage these conditions if you are overweight. And you don’t have to lose a lot to improve your health—even losing 10–15 pounds can make a big difference.
Diabetes medication or insulin therapy
Your healthcare provider will prescribe medication or insulin injections according to your blood levels and lifestyle. Your lifestyle changes mentioned above may improve your T2DM, and you should be under the given medication until your healthcare provider says so.
Blood sugar monitoring
A continuous glucose monitor, or CGM, is designed to be worn and used over long periods. It can make checking your blood sugar levels as simple as checking your phone. Continuous glucose monitoring devices can be worn on the belly or the arm. They may help you make daily decisions based on your blood glucose readings, which can help manage diabetes. They are particularly well suited to patients who have to check multiple times a day or who want more frequent daily feedback.
