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Diabetes: Symptoms, causes, and treatments

Diabetes, often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body’s cells do not respond properly to insulin, or both. Patients with high blood sugar will typically experience polyuria (frequent urination), they will become increasingly thirsty (polydipsia) and hungry (polyphagia).

Fast facts on diabetes

Here are some key points about diabetes. More detail and supporting information is in the main article. Diabetes is a long-term condition that causes high blood sugar levels. In 2013 it was estimated that over 382 million people throughout the world had diabetes (Williams textbook of endocrinology).

  • Type 1 Diabetes – the body does not produce insulin. Approximately 10% of all diabetes cases are type 1.
  • Type 2 Diabetes – the body does not produce enough insulin for proper function. Approximately 90% of all cases of diabetes worldwide are of this type.

Gestational Diabetes – this type affects females during pregnancy. The most common diabetes symptoms include frequent urination, intense thirst and hunger, weight gain, unusual weight loss, fatigue, cuts and bruises that do not heal, male sexual dysfunction, numbness and tingling in hands and feet. If you have Type 1 and follow a healthy eating plan, do adequate exercise, and take insulin, you can lead a normal life. Type 2 patients need to eat healthily, be physically active, and test their blood glucose.  They may also need to take oral medication, and/or insulin to control blood glucose levels. As the risk of cardiovascular disease is much higher for a diabetic, it is crucial that blood pressure and cholesterol levels are monitored regularly. As smoking might have a serious effect on cardiovascular health, diabetics should stop smoking. Hypoglycemia – low blood glucose – can have a bad effect on the patient. Hyperglycemia – when blood glucose is too high – can also have a bad effect on the patient. This information hub offers detailed but easy-to-follow information about diabetes. Should you be interested in the latest scientific research on diabetes, please see our diabetes news section.

There are three types of diabetes:

1) Type 1 diabetes

The body does not produce insulin. Some people may refer to this type as insulin-dependent diabetes, juvenile diabetes, or early-onset diabetes. People usually develop type 1 diabetes before their 40th year, often in early adulthood or teenage years.

Type 1 diabetes is nowhere near as common as type 2 diabetes. Approximately 10% of all diabetes cases are type 1.

Patients with type 1 diabetes will need to take insulin injections for the rest of their life. They must also ensure proper blood-glucose levels by carrying out regular blood tests and following a special diet.

Between 2001 and 2009, the prevalence of type 1 diabetes among the under 20s in the USA rose 23%, according to SEARCH for Diabetes in Youth data issued by the CDC (Centers for Disease Control and Prevention).

2) Type 2 diabetes

The body does not produce enough insulin for proper function, or the cells in the body do not react to insulin (insulin resistance).

Approximately 90% of all cases of diabetes worldwide are type 2.

Diabetes patient measuring glucose level in blood. Measuring the glucose level in blood. Some people may be able to control their type 2 diabetes symptoms by losing weight, following a healthy diet, doing plenty of exercise, and monitoring their blood glucose levels. However, type 2 diabetes is typically a progressive disease – it gradually gets worse – and the patient will probably end up have to take insulin, usually in tablet form.

Overweight and obese people have a much higher risk of developing type 2 diabetes compared to those with a healthy body weight. People with a lot of visceral fat, also known as central obesity, belly fat, or abdominal obesity, are especially at risk. Being overweight/obese causes the body to release chemicals that can destabilize the body’s cardiovascular and metabolic systems.

Being overweight, physically inactive and eating the wrong foods all contribute to our risk of developing type 2 diabetes. Drinking just one can of (non-diet) soda per day can raise our risk of developing type 2 diabetes by 22%, researchers from Imperial College London reported in the journal Diabetologia. The scientists believe that the impact of sugary soft drinks on diabetes risk may be a direct one, rather than simply an influence on body weight.

The risk of developing type 2 diabetes is also greater as we get older. Experts are not completely sure why, but say that as we age we tend to put on weight and become less physically active. Those with a close relative who had/had type 2 diabetes, people of Middle Eastern, African, or South Asian descent also have a higher risk of developing the disease.

Men whose testosterone levels are low have been found to have a higher risk of developing type 2 diabetes. Researchers from the University of Edinburgh, Scotland, say that low testosterone levels are linked to insulin resistance. (Link to article)

For more information on how type 1 and type 2 diabetes compare, see our article: the difference between type 1 and type 2 diabetes.

More information on type 1 diabetes is available in our type 2 diabetes page.

3) Gestational diabetes

This type affects females during pregnancy. Some women have very high levels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, resulting in progressively rising levels of glucose. Diagnosis of gestational diabetes is made during pregnancy. The majority of gestational diabetes patients can control their diabetes with exercise and diet. Between 10% to 20% of them will need to take some kind of blood-glucose-controlling medications. Undiagnosed or uncontrolled gestational diabetes can raise the risk of complications during childbirth. The baby may be bigger than he/she should be. Scientists from the National Institutes of Health and Harvard University found that women whose diets before becoming pregnant were high in animal fat and cholesterol had a higher risk for gestational diabetes, compared to their counterparts whose diets were low in cholesterol and animal fats.

What is prediabetes?

The vast majority of patients with type 2 diabetes initially had prediabetes. Their blood glucose levels where higher than normal, but not high enough to merit a diabetes diagnosis. The cells in the body are becoming resistant to insulin. Studies have indicated that even at the prediabetes stage, some damage to the circulatory system and the heart may already have occurred.

Diabetes is a metabolism disorder

Diabetes (diabetes mellitus) is classed as a metabolism disorder. Metabolism refers to the way our bodies use digested food for energy and growth. Most of what we eat is broken down into glucose. Glucose is a form of sugar in the blood – it is the principal source of fuel for our bodies. When our food is digested, the glucose makes its way into our bloodstream. Our cells use the glucose for energy and growth. However, glucose cannot enter our cells without insulin being present – insulin makes it possible for our cells to take in the glucose. Insulin is a hormone that is produced by the pancreas. After eating, the pancreas automatically releases an adequate quantity of insulin to move the glucose present in our blood into the cells, as soon as glucose enters the cells blood-glucose levels drop. A person with diabetes has a condition in which the quantity of glucose in the blood is too elevated (hyperglycemia). This is because the body either does not produce enough insulin, produces no insulin, or has cells that do not respond properly to the insulin the pancreas produces. This results in too much glucose building up in the blood. This excess blood glucose eventually passes out of the body in urine. So, even though the blood has plenty of glucose, the cells are not getting it for their essential energy and growth requirements.

 

Source: https://www.medicalnewstoday.com/info/diabetes 

Treatments for Diabetes

Type 2 diabetes has a number of drug treatment options to be taken by mouth known as oral antihyperglycemic drugs or oral hypoglycemic drugs.

Oral diabetes drugs are usually reserved for use only after lifestyle measures have been unsuccessful in lowering glucose levels to the target of an HbA1c below 7.0%, achieved through an average glucose reading of around 8.3-8.9 mmol/L (around 150-160 mg/dL). The lifestyle measures that are critical to type 2 diabetes management are diet and exercise, and these remain an important part of treatment when pills are added. People with type 1 diabetes cannot use oral pills for treatment, and must instead take insulin.

How do oral drugs lower glucose levels?

Metformin is the most widely used oral antihyperglycemic drug and reduces the amount of glucose released by the liver into the bloodstream. Oral antihyperglycemic drugs have three modes of action to reduce blood glucose levels:

  • Secretagogues enhance insulin secretion by the pancreas
  • Sensitizers increase the sensitivity of the peripheral tissues to insulin
  • Inhibitors impair gastrointestinal absorption of glucose.

Each class of antihyperglycemic drug has a different adverse event or safety profile, and side effects are the main consideration when it comes to choosing a medication. Possible side effects range from weight gain, through gastrointestinal ones such as diarrhea, to pancreatitis and more serious problems. Hypoglycemia is also a possible adverse event.

What oral drugs are available for type 2 diabetes?

No one particular choice of oral hypoglycemic is considered the most effective form of treatment – the decision over which drug to use is instead based on:

  • Consideration of the adverse side effects
  • Convenience and overall tolerability
  • Personal preference.

In reality, weighing up each drug is something to do in partnership with a prescriber – guidelines partly drawn up by the American Diabetes Association list a great number of advantages and disadvantages for each of the available drug treatments, including the consideration of cost. The use of a single drug can be escalated to combination therapy with a second drug in an effort to improve glycemic control. Metformin is usually the first treatment offered, however, and it is the most widely used oral antihyperglycemic. Metformin is a sensitizer in the class known as biguanides; it works by reducing the amount of glucose released by the liver into the bloodstream and increasing cellular response to insulin. A metformin pill is usually taken twice a day. This drug is a low-cost antihyperglycemic with mild side effects that can include diarrhea and abdominal cramping. Metformin is not associated with weight gain or hypoglycemia.

 

Source: https://www.medicalnewstoday.com/info/diabetes/treatmentfordiabetes.php