Causes: To understand diabetes, one must first understand how glucose is processed in the body.
- The role of insulin
Insulin is one of the essential hormones in the body, which comes from the pancreas. The pancreas releases insulin into the blood, which is then circulated into the body. As a result of this, the sugar enters the cells. The role of the insulin is to manage the amount of sugar that goes into the blood. With a fall in the blood sugar levels, the amount of insulin secreted by the pancreas also lowers.
- Working of glucose
Glucose is a type of sugar that is an important energy source for the cells responsible for the build-up of the tissues and the muscles. There are two primary sources of glucose, i.e., the liver and the food that one eats. So, when the sugar enters the cells via insulin, the blood absorbs it. The liver stores the requisite amount of sugar and converts it into glucose. In case one is fasting or does not eat enough on a particular day, the liver will use the stored glycogen, and break it down into glucose as a measure to ensure that there’s adequate glucose.
- Type 1 diabetes – causes
There’s no certainty on the real cause of Type-1 diabetes. However, what happens in this type of diabetes is that the immune system, which is supposed to combat harmful viruses and bacteria, sometimes destroys the cells that produce insulin. Consequently, one’s body has only little to no insulin. So, there’s no transport of sugar, which causes a build-up in the blood. In general, this type of diabetes is mainly caused by a combination of factors, which are genetic and environmental.
- Type 2 and prediabetes – causes
Prediabetes could be a major cause of type 2 diabetes. In this type of diabetes, the cells are resistant to insulin. Furthermore, the pancreas fails to produce surplus insulin to make up for this resistance. So, again, instead of heading to the cells which require energy, the sugar stays back in the bloodstream. Yet, the reason why all of this happens is uncertain. However, the genes and environment do play a quintessential role in contributing to type-2 diabetes. People on the heavier side are more prone to this type of diabetes, but not everyone with this diabetes is obese.
- Gestational diabetes – causes
The placenta produces hormones to sustain a pregnancy
The hormones make the cell resistant to insulin. In general, the pancreas tries to make up for this resistance. But sometimes, the resistance is so high that the pancreas fails to keep up with it; as a result, not enough glucose reaches the cell, causing the surplus to stay in the blood, and that leads to gestational diabetes.
The symptoms of diabetes depend on the degree of elevation in the blood sugar levels. People with type 2 diabetes or those in the prediabetes stage might not experience any symptoms in the initial phase. However, in type 1 diabetes, the symptoms occur quickly and are often severe. Common symptoms of type 1 and type 2 include:
- Excessive hunger
- Weight loss
- Excessive thirst
- Frequent infections – vaginal, skin, or gum infection
- Constant urination
- Constant irritation
- Ketones in urine
- Slow-healing of sores
- Blurry vision
One can get type 1 diabetes at any age. However, it most likely occurs during adolescence or childhood. On the other hand, type 2 diabetes can happen anytime, but it is more common in people over 40.
For the diagnosis, several tests need to be performed. The doctor will suggest the test, depending on the symptoms.
- Glycated hemoglobin test
It is a blood test, also known as the A1C test, wherein one does not need to fast. It gives one an average of the past two to three months of the blood sugar level. A1C calculates the percentage of blood sugar against that of hemoglobin. So, if the blood sugar level increases, the hemoglobin levels will be more as attached to sugar. One will have to undergo two separate tests to be sure of this. If the A1C level is 6.5% or higher than that in both of these tests, then one has diabetes. People who fall in the category of 5.7 to 6.4 % are in their prediabetes stage. The value below 5.7 is reasonable.
In case there’s any inconsistency between the two tests, the doctor will recommend further tests, including the following:
- Random sugar test
In this, a sample of one’s blood is taken at any random time. So, irrespective of what one ate last, if in the random blood sugar level, the value is between the range of 200 mg/dL to 11.1 mmol/L, then one has diabetes.
- Fasting sugar test
So, in this, a blood sample is taken after overnight fasting. In this case, if the values are below 100, one does not have sugar, if it is in the range of 100 to 125 mg/dL, then one is in the prediabetes stage. If it is anywhere over 126, then one has diabetes.
- Oral glucose test
In this test, too, after overnight fasting, the blood sugar level is tested. After this, one will drink a liquid that has sugar in it, and the sugar levels are tested again. If the blood sugar level is lower than 140 mg/dL, then it is normal. On the other hand, a figure between 140 to 199 mg/dL would mean prediabetes and anything over 200 means diabetes.
In case, after these tests, type 1 is suspected, then they’ll have to undergo a urine test. Autoantibodies will also be performed for further clarity.
- Gestational diabetes test
These tests examine the risk of gestational diabetes and are mostly done in the early days of pregnancy. It would include the following:
- Initial glucose test
Under this, one will have to drink a syrupy glucose solution. After that, possibly after an hour, their blood test will be taken. In this, if the value is below 140 mg/dL, it is reasonable, else it is a diabetic situation.
- Follow-up test
In this, one will be asked to fast overnight, and then following it, their blood sugar levels will be measured. After this, they’ll consume a sweet solution, which will have a higher glucose concentration, and a sugar test will be conducted every hour for the following 3 hours. If two readings are higher than usual, then they have gestational diabetes.
The type of treatment performed will depend on the type of diabetes, degree of insulin resistance, and blood sugar levels.
- Type 1 and type 2
In the treatment of this diabetes, an insulin pump or injection is used. It will be followed by carbohydrate counting and frequent sugar tests. On the other hand, type 2 treatment involves frequent sugar tests, consumption of medications, insulin injections, and lifestyle changes.
- Blood sugar levels monitoring
Depending on the type of treatment plan, one will have to record and check the blood sugar levels at least four times a day. The count will be higher if one is on insulin injections. In addition to this, one should get an A1C test to be updated on average sugar levels. Despite regular testing, the A1C is still a better indicator of well-balanced and maintained diabetes. If it is not well-maintained, they’ll need a few changes in diet and other lifestyle changes.
Those with type 1 diabetes would need insulin therapy. Some with gestational or type 2 diabetes might require insulin therapy too. There are different varieties of insulin available and would depend on one’s body’s needs. Insulin isn’t taken orally and is instead injected into the body.
People with diabetes might also be given medicines orally or through injection. Certain drugs are for pancreatic stimulation, which in turn would lead to higher insulin production. On the other hand, some medications work toward reducing the glucose levels in the liver. It solely depends on whether the insulin requirement of the body is more or less. For type 2 diabetes, the most common medication is metformin.
For people with type 1 diabetes, the pancreas transplant is also an alternative. But transplants come with a high degree of risks, which is why it is only reserved for people whose diabetes cannot be controlled or those whose kidneys have failed.
- Bariatric surgery
It is a type 2 treatment option for people who have a BMI higher than 35.
- Gestational diabetes
A bundle of lifestyle changes is necessary to ensure that one’s blood sugar level is brought back to a reasonable level and is not aggravated to type 2 diabetes. Healthy eating and exercises certainly help. Metformin and other medications, such as Glumetza and Glucophage, can also be taken. Furthermore, medication to keep a check on cholesterol, statins, and blood pressure will also be needed.
Diabetes and diet
Often people think that diabetes means eliminating foods that one loves. However, that’s not true. One only needs to be a bit careful and eat them either less often or in smaller portions.
- Food to eat
Some foods to add to the diet include the following:
- Fruits, such as apples, berries, oranges, grapes, melon, and bananas
- Vegetables, such as tomatoes, broccoli, peppers, carrots, greens, green peas, corn, potatoes.
- Whole grains, such as wheat, quinoa, cornmeal, rice, pasta, bread, tortillas, cereal, and barley.
- Protein, such as peanuts, nuts, certain peas, dried beans, split peas, and chickpea.
- Dairy, such as milk (low-fat versions), yogurt, and cheese.
- Healthy fats, such as olive oil, canola, seeds, nuts, avocado, etc.
- Foods to limit or avoid
Some foods to remove or reduce from the diet include the following:
- Fried foods or food rich in trans-fat or saturated fat
- Foods with high sodium content
- Processed food
- Sweets, such as ice cream, candy, and baked food
- Beverages with sweeteners, such as soda, energy drinks, juice, and sports drinks
Some vital lifestyle changes that one should undertake are as follows:
- Always use oil for cooking, over butter or cream
- Pick oils which are in the liquid state at room temperature
- Prefer water over a sweetened beverage
- Opt for a sugar substitute in tea or coffee
- Consume alcohol in moderation
- Exercise everyday
Prevention of type 1 diabetes is possible. However, for it to happen, one needs to make specific lifestyle changes that work likewise for gestational, type 2, and prediabetes.
Do a physical activity for at least 30 minutes every day. One can either ride a bike, go for a brisk walk, do swimming, or engage in any activity that one likes.
- Consume healthy foods
Always opt for foods that are high in fiber and low in calories or fat. One can add a lot of vegetables, whole grains, or fruits in one’s diet. To prevent boredom, one must include a variety of foods in their diet.
- Shed off the extra weight
If a person is on the heavier side, losing the extra pounds will help. However, one must not try any fad diet during pregnancy. To ensure health, one should try to make permanent changes in one’s exercising and eating habits, and stay motivated to reap the best benefits.
At times, medication can be sought too. One can take oral medicines, such as metformin, to reduce the risk of type 2 diabetes; regardless of medication, healthy lifestyle choices are still relevant. One must get a check-up done once a year to ensure that they haven’t developed type 2 diabetes.