What is Diabetes?
Source : letstalkhealth.in
Medically known as ‘diabetes mellitus’, this disease is characterised by excessive thirst and urination with the urine being concentrated with high levels of glucose. In normal healthy persons, insulin, a hormone produced by pancreas mobilises glucose into body cells. However, in persons suffering from diabetes, either the insulin is not produced or even when it is being so, the body cells develop a resistance towards its action.
As such, the glucose keeps on building up in the body leading to a condition called hyperglycemia. The causes are multiple varying from genetic, infections and unhealthy diet to sedentary lifestyle. However, by religiously adhering to the medication, controlling weight and diet and modifying the lifestyle, diabetes can be managed.
Insulin dependent diabetes mellitus or Type 1 diabetes
Type 1 diabetes occurs when the pancreas are unable to produce the much required insulin for controlling the blood sugar levels. This type of diabetes affects about 5-10 per cent of the people diagnosed with diabetes and there is no age bar for the same. Symptoms develop rather quickly.
- Increased thirst and dry mouth
- Fruity odour in the breath
- Increased frequency of urination
- High blood sugar levels
- Unexplained weight loss despite an increased appetite
- Weakness and lethargy
- Skin ailments including bacterial and fungal infections and dry, itchy skin
- Fungal infections in genital areas of women
Amongst the complications and other severe symptoms are:
- Blurring of vision
- Tingling sensation in hands and feet
- Dangerously low blood sugar levels or hypoglycemia
- Loss of consciousness and ultimately diabetic coma
Even though a family history of diabetes increases the risk factor for Type 1 diabetes, it has the features of an auto-immune disease wherein the body’s own immune system kills the beta cells in the pancreas which produce insulin. Type 1 diabetes often follows viral infections. The other risk factors include obesity or over weight, sedentary lifestyle, gestational diabetes during pregnancy, delivery of an overweight baby and certain medications including diuretics. It usually becomes visible in older persons.
Non-insulin-dependent diabetes mellitus (NIDDM) or Type 2 diabetes
More than 90 per cent of persons suffering from diabetes have Type 2 diabetes. What happens in this type is that even though the insulin is being produced in the body, the cells become ‘insulin resistant’, i.e., they don’t respond to its action and thus do not take up the glucose from the blood for metabolism to get energy. As such, the glucose keeps on piling up in the blood. Weight loss, physical activity and oral medication for glucose control, can help in an integrated diabetes management. Pre-diabetes is often a precursor to Type 2 diabetes.
Symptoms which develop gradually include:
- Cuts or sores which take a long time to heal
- Skin infections
- Excessive thirst and dry mouth
- Fatigue and pain in legs
- Frequent urination
- Blurring of vision
Other risk factors
ther risk factors for Type 2 diabetes include increasing age, family history, a sedentary lifestyle without indulging in enough physical exercise, stress, over-weight, unhealthy eating like a diet rich in fats and carbohydrates and devoid of fibre, high blood pressure and high cholesterol and incidence of gestational diabetes.
The most common cause for secondary diabetes is intake of certain diabetogenic drugs like steroids, some antipsychotics and drugs which are used after transplantation. People who have diseases which affect the pancreas, certain infections like mumps or rubella and hormone imbalance diseases like acromegaly, cushing’s syndrome, hyperthyroidism, pheochromocytoma and hyperaldosteronism have increased risk of developing diabetes irrespective of the risk factors mentioned above. There are some genetic syndromes with which if you are diagnosed, you may be at an increased risk for diabetes.
Even though gestational diabetes recedes away on its own after the delivery of the baby, studies show that a significant percentage of women with gestational diabetes develop Type 2 diabetes subsequently. Tests for gestational diabetes should be conducted between the 24th and 28th week of pregnancy. Hormones produced during pregnancy interfere with the action of insulin.
Treatment of diabetes
Even though no cure has been found as of yet for diabetes and the person has to be on medication forever after the initial diagnosis, but here is a different approach. Consider your daily medicine or insulin dose like a vitamin that helps you stay fit and be religiously regular about your medication for diabetes.
Symptoms of diabetes appearing at 30 or beyond or even the more serious kind of diabetes can be reversed by making lifestyle changes and regular glucose monitoring in addition to regular insulin dose.
Treatment for Type 1 diabetes: Type 1 diabetes is treated by the recommended daily dose of insulin by injection as well as a diet meant to control diabetes. Exercise and walking in addition to yoga and a stress free living are extremely beneficial in controlling blood sugar levels. Do not skip meals and be regular with tests for checking the extent of diabetes control.
Treatment for Type 2 diabetes: In fact, just a change in the diet can control this form of diabetes like restricting the carbohydrate and sugar intake and losing weight. You have to monitor your calorie intake with respect to your weight. You should not starve yourself and should eat fibre rich diet at regular short intervals. Cutting down on sugar rich food will show improvement in the condition.
Other types of diabetes
Other than Type 1 and Type 2 diabetes, there are other varieties of diabetes emanating from certain genetic syndromes, surgery, drugs, unhealthy food, infections, and other disease.
Maturity onset diabetes of the young (MODY)
MODY has a strong genetic factor attached to it and shares symptoms with Type 2 and usually affects the young, quite often below 25 years of age. MODY’s incidence amounts upto one or two per cent of the total number of diabetes patients. Early stages are often not accompanied with any symptoms and do not invariably require insulin administration.
MODY is caused by change in just one gene. The probability of children born to a MODY parent, getting or inheriting this kind of diabetes is 50 per cent. So far, six types of MODY have been identified.
Different types of MODY
HNF1 alpha is the most common MODY type accounting for approximately 70 percent of MODY cases. In this kind, the amount of insulin produced by pancreas starts decreasing over a period of time as the person grows older. In yet another kind of MODY, the gene that helps the body in recognising blood glucose levels stops functioning properly. Amongst the other forms of MODY, HNF4 – alpha is a rare form while HNF1 – beta is associated with renal cysts. PDX1 and IPF1 are even rarer.
Latent Autoimmune Diabetes of Adulthood (LADA)
Persons suffering from LADA though have some of the Type 2 kind of symptoms (also share features with Type 1 diabetes) but do not fulfill all of those including age, obesity or the overweight and the difficulty in obtaining glycaemic control using oral medications for diabetes or controlling glucose levels. In its early stages, insulin is not required but the progression to a stage requiring insulin is quite fast. Incidence of LADA is more amongst the young persons and the same is diagnosed with the presence of increased level of pancreatic autoantibodies. Such persons despite having been diagnosed with diabetes do not require insulin administration.
LADA is also characterized by the absence of metabolic syndrome symptoms, elevated blood glucose levels or hyperglycaemia despite the medications to treat the same. At times LADA is accompanied with another autoimmune disease. Persons who are diagnosed with LADA and also possess metabolic syndrome features are also called as Type 1.5 diabetics.
It is a rare form of diabetes which though not related to diabetes mellitus, shares its signs and symptoms like frequent urination, abnormal thirst, and dehydration. Children when affected show the symptoms of irritability, lethargy and fever.
Diabetes Insipidus (DI) occurs when the body’s mechanism to maintain the fluid balance goes out of gear. Result is the abnormal thirst and abnormally low levels of ADH or the Antidiuretic Hormone.
Diagnosis and differentiation from diabetes mellitus can be made by urinalysis, fluid deprivation, and MRI scans. At times the symptoms in children and adolescents develop rather rapidly over a period of just one week or so.
Types of Diabetes Insipidus
- Central DI in which the pituitary gland is damaged resulting in ADH deficiency.
- Dipsogenic DI in which the thirst mechanism goes haywire.
- Gestational DI which occurs during pregnancy when an enzyme produced by the placenta destroys the ADH in the mother.
- Nephrogenic DI in which either a chronic ailment like polycystic kidney disease or kidney failure or a drug induction causes impairment of ADH.