What comes to your mind when you hear the word ‘diabetes’? Well, I guess you said an abnormal increase in blood sugar level. However, there’s more to the disorder than that.

Diabetes is an endocrine disorder that affects and cuts across all races, nationalities, and gender. Depending on the type, the condition may be due to the pancreas’ inability to produce a sufficient amount of insulin. While in other cases, it may be due to the reduction in insulin sensitivity to the blood sugar level.

Regardless of the cause, diabetes results in an increase in blood sugar level, which is very detrimental to human health. Some of the symptoms that come with the disorder include frequent urination, dry mouth, tiredness, and persistent thirst.

A 2018 study reports that about 34.2 million Americans were diagnosed with diabetes, out of which 34.1 million are adults (18 years and above). Unfortunately, a high amount (7 million) of US citizens is yet to know their status.

Medically, diagnosing diabetes on time is right for several reasons. One, it gives the medical practitioner ample time to manage the condition appropriately. Secondly, a late discovery can lead to multiple organ damage or failure, resulting in death.

Will you like to know more about diabetes, the appropriate diagnosis, and how to manage the condition successfully? Please read on to discover the hidden treasure.

The use of glucometer in diabetes and all you need to know about diabetes!

How to Know if Your Blood Glucose is Normal?

It is important that you understand the function and the usefulness of blood glucose. With this, you will do all that is necessary to keep it in a normal range.

Usually, when you eat foods like carbohydrates, the body converts them into glucose. The glucose remains in the blood for some time, after which it moves to other body cells for storage and energy purposes. Mind you, insulin is the hormone that facilitates the entrance of glucose into the body.

In the absence or insensitivity of the hormone to the blood glucose, the glucose stays beyond the appropriate time in the blood, starving the cells and other parts of the body. With this, the blood glucose level goes above the normal value.

Also, you must know that your blood glucose level depends on if you’ve eaten or not. For instance, NHS Scotland recommends that before a meal, a non-diabetic patient’s blood glucose level should be between 3.5mmol/l-5.5mmol/l. Anything more than that is unhealthy.

In comparison, a blood glucose level of 8mmol/L, 120minutes after a meal, is okay for a non -diabetic patient.

However, for diabetic patients, the figures might be different. The blood sugar level termed normal by NHS Scotland for a diabetic patient varies depending on the type of diabetes. For example, a type-1 diabetes patient with a blood sugar level between 5-9mmol/l, 120 minutes after a meal is healthy.

In type-2 diabetes patients, a healthy blood sugar level is when your blood sugar level is less than 8.5mmol/l 120 minutes after a meal.

Meanwhile, it is also possible to have a low blood glucose level. According to NHS Scotland, hypoglycemia results when your blood glucose level goes below 4mmol/L.

You can quickly know this by pricking your finger to measure your blood glucose on the appropriate blood sugar machine. However, there are better and more accurate methods to diagnose diabetes:

Random plasma glucose test:

A random plasma glucose test involves taking a sample of blood at any random time; this procedure gives information about the amount of glucose in circulation.

If the test shows a blood sugar level of at least 200mg/dl, that implies that the person might have diabetes. However, this is not a confirmatory test. You will need a definitive diagnosis by undergoing further tests.

A study reported that an RPG test is an excellent indicator for detecting diabetes early. The implication of this is that the test can tell the GP about the disease’s progression in the next five years. For instance, someone who has a blood glucose of at least 115mg/dl might test positive for diabetes in the future.

Unlike the oral glucose tolerance test, where you need to eat before checking your blood sugar level, you can conduct an RPG test whether you’ve eaten or not.

Fasting plasma glucose test:

Apparently, you are not to eat or drink anything for at least eight hours before the test. Therefore, morning is the best time to do the test, so you won’t have to fast throughout the day. One great thing about this test is that it is simple and easy to interpret. Your GP can also use the test to assess the effect of dietary changes on diabetic patients.

To avoid error, you can conduct the test twice to eliminate any possible error in reading.

The Center for Disease Control and Prevention believes that a fasting blood glucose of 99mg/dl and lower is normal. In comparison, a blood sugar between 100-125mg/dl shows that the patient is pre-diabetic. Also, a fasting plasma glucose reading of 126mg/dl and above implies that the patient is diabetic.

Oral glucose tolerance test:

Before now, an oral glucose test was the standard for diagnosing type-2 diabetes. However, there are now accurate and better methods of diagnosing the disease.

Like the Fasting plasma glucose test, you are not to eat or drink any fluid before the test, so we advise that you conduct the test in the morning.

After conducting the fast glucose level test, the professional will ask you to take you a glucose solution. At different time intervals, the professional will prick your finger to collect your blood.

For the test to be accurate, the patient needs to be in good health (even the smallest body cold will impact the result). Also, the patient must not take any drug that could interfere with the blood glucose level.

What is the test result interpretation for non-diabetic patients?

A blood glucose level of 6mmol/l or less before taking the glucose solution.
A blood sugar level between 7.9-11.0mmol/l two hours after taking the sweet solution

When does the test result indicate a diabetic blood sugar level?

When the fast blood glucose level is higher than 7mmol/l
If the blood glucose level is greater than 11.0mmol/l, 2 hours after taking the glucose solution.

The oral glucose tolerance test can tell if a person’s sugar level is between the standard and diabetic glucose levels. In this case, the medical practitioner can quickly devise a way to curb the menace.

Blood sugar level between 6-7mmol/l or a value of 7.9-11.0mmol/l, 120 minutes after taking the glucose solution signifies that the patient is pre-diabetic.

Although the test comes with its limitations, a recent study shows that the 2-hour blood glucose level gives a better diagnosis than the fasting plasma glucose level.

Hemoglobin A1c (HbA1c) test:

The HbA1c test measures the amount of sugar attached to your red blood. For diabetic patients, their cells and other body parts can’t access the blood glucose. Therefore, the amount of glucose in their blood is usually on the high side.

Laboratory Professionals perform HbA1C tests quarterly due to the lifespan of an average red blood cell. In this test, you don’t have to fast; but keep in mind that genetics or illness can affect the test result.

The HbA1c method of diagnosing diabetes came into existence in 1980; still, only a few countries use the method. Also, the issue of standardization/harmonization of results is another limitation of the method.

For instance, in some countries, the test result is in percentage, while in other countries, the result is available in mmol/l.

An HbA1c result of at least 6.5% (48mmol/l) might signify that the patient has diabetes, while a patient with an average blood glucose value between 6-6.5 (42-47mmol/l) may be on the verge of coming down with the endocrine disorder.

Your doctor can use the test to monitor your blood sugar level for a length of time. With this, you and the doctor can agree on a targeted blood sugar level.

Type-1 and Type-2 Diabetes Complications

It is no news that diabetes is a significant cause of morbidity and death in the world.

Traditionally, type-1 and type-2 are the two kinds of diabetes; however, they both have something in common- hyperglycemia. It is this abnormal rise in blood level that leads to several health issues and complications.

The abnormal increase in blood glucose damages the eyes (retinopathy), nervous system (neuropathy), and kidney (nephropathy).

In fact, in the US, diabetic retinopathy is responsible for about 10,000 new blindness cases every year.

Aside from the microvascular complication that comes with type-1 diabetes, the diseases also cause macrovascular issues of which cardiovascular disease (CVD) is number one. The International Journal of Endocrinology, in its 2018 study, found out that 69% of the patients diagnosed with type-1 diabetes within the age range of 0-26 years are very much pre-disposable to cardiovascular diseases, CVD.

Meanwhile, type-1 diabetes causes diabetic ketoacidosis, weight loss, excessive urination, and constant thirst in children.

Like type-1, type-2 diabetes also causes the same micro and macrovascular complications in different proportions. For example, diabetic neuropathy only affects about 5-20% of type-2 diabetes patients against 15-40% of people with type-1 diabetes.

In addition, pregnant people are not immune to the harmful effect of gestational diabetes as this disorder could damage the fetus’ organs.

How Are The Different Types of Diabetes Treated?

Doctors treat diabetes either by counseling the patient on lifestyle modification or by prescribing drugs. Here are some approaches to treating and managing the condition:

Pharmacological approach

Type-1 diabetes

Low or no insulin production is the cause of the disease. Therefore, type-1 diabetes treatment aims to provide the body with sufficient insulin.

In reality, doctors use up to four varieties of insulin in treating the disorder. Mind you, they all differ in their onset and duration of action. They include:

Rapid-acting insulin (Insulin Lispro):

When you take the drug, it starts functioning within 15 minutes, with effects lasting up to 4 hours. It is crucial that you take the insulin shot before a meal.

Short/regular acting insulin:

Like the rapid-acting insulin, the patient must take the shot before meals, preferably 30-60 minutes before serving the dishes. Although it takes about 30-60 minutes before it starts working, it lasts longer than the rapid-acting insulin. Some of the drugs in this category include Novolin and Velosulin.

Intermediate-acting insulin:

Scientists added zinc (or other compounds) to delay the drug’s onset of action during the making of the drug. With this, the insulin effect can last for up to 14 hours, but it might take about 2 hours after injection before it starts working optimally. Meanwhile, you need to take the insulin shot twice a day for a lasting response. Neutral Protamine Hagedorn is an example of intermediate-acting insulin.

long-acting insulin:

Long-acting insulin might take hours to work. However, its impact can last for a whole day or more. Insulin glargine is a popular example of this insulin variety. Actually, a single shot is okay, but some people may need to take two to manage the sugar level better.

Despite all these, the insulin approach is not always 100% effective. A study shows that the combination of metformin, sodium-glucose inhibitors, glucagon-like peptide-1 (GLP-1) antagonists, and dipeptidyl peptidase-4 inhibitors often work well in the management of type-1 diabetes. This approach is called non-insulin adjunct therapy.

Type-2 diabetes

Type-2 diabetes arises as a result of insulin’s resistance to blood sugar. Also, a decrease in insulin production can lead to the disorder. In response to this, doctors customize each treatment therapy to suit the patient’s unique needs.

To manage type-2 diabetes, doctors prescribe dieting and life modifications, but the practitioner may switch to drugs if those approaches fail.

Metformin is the primary (first line) drug in treating this disorder. Depending on the patient’s glucose level, your GP may have to combine metformin with other classes of diabetic medications. Some of which include sulphonylureas, DPP-4 inhibitors, and others. This combination is to help them treat other side complications.

Mind you, insulin therapy is still beneficial in type-2 diabetes. In fact, the combination of insulin with sulphonylureas controls the blood sugar better. However, insulin is not necessary for all type-2-diabetes patients. See how these classes of drug manage type-2 diabetes:

Sulphonylurea:

This class of anti-diabetic drugs manages blood glucose levels by increasing insulin production. It does this by shutting the ATP-sensitive potassium channel, thereby stimulating the release of insulin. Examples of drugs in this class include Glibenclamide, Glipizide, and others.

Biguanides:

Like we earlier said, metformin (a biguanide) is the primary drug in combating type-2 diabetes. It achieves healthy changes in the blood sugar level by activating the AMPK enzyme. This action improves the sensitivity and efficiency of insulin.

Depending on the doctor’s discretion, s/he might prescribe fast or slow release metformin. While in some cases, the professional may combine metformin with other classes of drugs.

Dipeptidyl peptidase-4 inhibitors (Dpp-4):

Usually, glucagon increases the blood glucose level. What Dpp-4 does is activate the production of incretin. This production obstructs glucagon release while increasing insulin production, leading to the mopping up of more blood glucose. Some examples of Dpp-4 include sitagliptin, vildagliptin, and linagliptin.

Gestational diabetes:

It is no news that 6-9% of pregnant women experience glucose intolerance during pregnancy. The probability of this happening increases with age.

An Australian scientific group found out that family history and obesity, among other factors, play a significant role in developing the disease. If gestational diabetes is not managed correctly, the resulting complication will most likely damage the fetus organs.

Meanwhile, insulin remains a potent solution to gestational hypertension; however, it is a better treatment approach in older pregnant women.

Non-Pharmacological approach

Dieting

Dieting is the first approach to managing gestational diabetes. Most GPs consider the pregnant woman’s unique needs while watching out for her BMI and nutritional deficiencies.

The American Diabetes Association recommends medical nutrition therapy (MNT); this therapy manages type-1 and 2 diabetes well.

MNT can be a primary, secondary, or tertiary approach; it all depends on the patient’s risk level. You need to know that MNT aims to control the blood sugar level. Besides, the therapy also manages other comorbidities like hypertension and dyslipidemia.

In other news, the Mediterranean diet (MD) is another option. The plant-based therapy contains legumes, olive oil, vegetables, fruit, and other beneficial ingredients. Regardless of the type of dieting, you must consume fruits and vegetables frequently. At the same time, you are to limit your legume and dairy product consumption.

Ensure you speak with your medical practitioner/dietician; he/she will help you select the appropriate dieting therapy.

Exercise/physical activity

Several studies report that exercise is one potent way of increasing insulin sensitivity. It also reduces the hormone’s resistance to glucose. In fact, exercise improves the movement of glucose into cells.

You must know that exercise is not meant for everyone. So, your doctor needs to conduct some tests before considering the option.

In type-2 diabetes patients, moderate and aerobic exercise for at least 3 hours a week is okay. A recent analysis confirmed this by proving that exercise can help achieve a healthy blood glucose level in type-1 diabetes patients.

Getting the best from exercise in type-1 patients depends on the exercise’s frequency, age, the intensity of the activity, and the patient adherence to the program.

Metabolic surgery

Metabolic or bariatric surgery is a procedure suitable for type-2 diabetes patients. The process can help manage and prevent type-2 diabetes. It achieves this by improving insulin release, increasing beta-cell mass, and correcting mal-absorption of nutrients.

One great thing about this procedure is that the probability of you coming down with complications is very low. However, the infection of the abdominal wall skin might occur.

That being said, bariatric surgery is not always effective in controlling blood glucose. Therefore, it may not be so useful in type-1 diabetes patients, but it can help obese type-1 diabetes patients.

Multi- combination lifestyle

It requires a combination of two or more non-pharmacological approaches. You can combine exercise with medical, nutritional therapy.

Good sleeping habit

Good sleeping habit is a 2 in 1 therapy; it regulates hormone activities while correcting metabolic errors. Scientists discovered that people who don’t have up to 6 hours’ night rest might test positive for diabetes in the future.

When you deprive yourself of adequate sleep, it causes several damages. One, the deprivation will deplete your brain glucose level. Secondly, it will reduce your hormone efficiency. Therefore, we advise that you sleep for at least 7 hours every night.

Diabetes doesn’t just happen all of a sudden; something(s) is(are) definitely responsible. Here are some risk factors that can trigger type-1 diabetes:

Genetics:

If you have a family history of type-1 diabetes, your risk of developing the disease is relatively high. A 2011 study supported this claim. The research shows that most of the children with type-1 diabetes probably had someone in their family with diabetes or autoimmune diseases like thyroid disease.

Environmental issues:

Environmental factors can precipitate type-1 diabetes. For instance, those who live in cold regions are more likely to have the condition. The American Diabetes Association observes that more diabetic cases are recorded in winter than in summer. Also, staying in a polluted environment may make you susceptible to diabetes.

Location:

Type-1 diabetes seems to be common in people living up the north; this might be due to their climatic condition. Meanwhile, those in Southern American countries are less likely to develop the disease. Researchers found that the winter season seems to breed more viral infections, making them test positive for the medical condition in the future.

Diet
Ethnicity

Some of the risk factors associated with type-1 diabetes are also responsible for type-2 diabetes. However, type-2 has some unique trigger factors, some of which are:

Weight:

Obesity reduces your insulin sensitivity to blood glucose. It is common knowledge that the body mass index is linked directly to the risk of having diabetes. For instance, an obese person possesses a high amount of hormones, cytokine, and other indicators that contribute to insulin resistance.

Sedentary lifestyle:

The more you sit in a day, the higher your chances of testing positive for the disease in the future. Medically, exercise keeps your weight in a healthy range. Also, exercise helps burn and use up glucose, but you leave the glucose hanging with a sedentary lifestyle. In fact, you seem to add more to it when you eat junk.

Age:

As you age, your body’s efficiency declines; therefore, your organs and hormones might not work optimally as before. Little wonder why NHS UK recommends that adults between the age of 40-74 should go for a medical check-up regularly. With this, you can spot the disease on time.

Since 2011, the number of type-2 diabetes cases in the age group 65 and above is at least eight times higher than those within age 18-44 in the US.

As you age, your blood glucose level keeps increasing while your beta cells decline in their function, thereby affecting insulin production.

Race
High blood pressure

Gestational diabetes

It will be unfair to leave out gestational diabetes. This disorder affects one in every six pregnant women in the UK. You must know that those with gestational diabetes never had the disease before pregnancy. Therefore, it goes away once they put to bed. Here are the categories of people who are the risk of developing the disorder:

obese or overweighed patients
Former gestational diabetes patients and many others

However, you can reduce the odds by;

Watching what you eat
Exercising regularly
Watching your weight

How to Prevent Diabetes

Here comes the question- can you prevent type-1 diabetes? Sincerely, it is almost impossible to avoid this disease- and this is due to so many reasons.

One, the etiology/ cause of the disease is poorly understood. Most scientists suspect that genes play a significant role in the building and progression of the disease.

Secondly, some children or adults had a viral disease while growing. However, with proper lifestyle changes and dieting, you can somehow prevent type-2 diabetes:

Weight loss:

Weight loss is a simple way to prevent or delay the onset of diabetes. However, it requires some level of discipline. A study discovered that shedding up to 4kg fat prevents type-2 diabetes in pre-diabetic patients. To achieve this, you need to exercise daily and also make some necessary dietary changes. Meanwhile, weight management also shields you from cardiovascular diseases and other health-related issues.

Diet:

Healthy eating is a natural and cheaper alternative to preventing type-2 diabetes. Being careful about what you eat is essential. Dieting reduces and prevents the onset of diabetes by bringing about weight loss.

The National Institute of Diabetes and Digestive and Kidney Diseases recommends that you eat more vegetables and fruits. Also, do not forget to reduce your calorie intake by limiting your salt and sugar consumption. Though this information is not exhaustive, you can always meet your dietician to put you through. Lastly, do not forget to limit your food portion.

Do not smoke:

Smoking poses a severe threat to our health. Before now, there has been a long-term argument on if smoking is a risk factor for diabetes. Coincidentally, a recent study explained that nicotine (the active constituent in cigarettes) makes insulin resistant to blood glucose.

Smoking at least 20 sticks of cigarettes in a day increases your risk of getting diabetes by 61%. Besides, cigarettes can make your metabolic process awful. Mind you; passive smokers are not left out.

In summary, if you are a light or heavy smoker, we advise that you stop smoking.

Avoid sedentary kind of lifestyle.

Boost your vitamin D level with supplements.

Timely diagnosis of diabetes is critical; it helps the medical practitioner decide the suitable therapy approach. Mind you; diabetes is not a death sentence; with adequate monitoring and treatment, you can manage the disease well.

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All you need to know about Diabetes