Diabetes, along with some non-communicable diseases like cardiovascular disease, has become a major health challenge of the 21st century. It is considered a global pandemic and a threat to human lives and global economies.
To put it in a proper perspective, there has been about a 50% increase in the number of diabetic patients worldwide in the last 20 years. According to a population health management research, the prevalence of Diabetes is projected to increase by 54% between 2015 and 2030 in the United States.
Diabetes Mellitus is a disease condition that is characterized by an elevated blood sugar level. The elevation occurs when the body is unable to properly utilize insulin or to produce insulin effectively.
Some Key points about Diabetes.
- In developed countries, diabetes prevalence is higher for immigrants from less developed regions than for the host.
- In developing countries, there is rapid growth in Diabetes in adults younger than 60years.
- Some findings have shown that low birth weight can increase the risk of developing type 2 diabetes in adult life.
- More than one-third of the world population is overweight or obese and are at risk
- of developing type 2 diabetes mellitus
- Cardiovascular complications are the leading cause of mortality and morbidity in diabetic patients.
Types of Diabetes mellitus!
Diabetes is majorly divided into the following general categories:
- Type 1 Diabetes mellitus
- Type 2 Diabetes mellitus
- Gestational Diabetes
- Diabetes due to other causes
Type 1 Diabtes mellitus
Type 1 diabetes mellitus accounts for about 5-10% of diabetes cases. It is more common in children and young adults, but it can occur at any age!
It is an autoimmune condition where your immune system, for an unknown reason, sees the cells of the pancreas as foreign cells.
The immune system attacks and destroys the cells of the pancreas, thereby reducing the ability of the cells to produce insulin effectively. When the amount of insulin produced is insufficient, glucose cannot effectively enter the cells, thereby resulting in elevated blood glucose level.
Type 1 diabetes mellitus is irreversible! Meaning once the damage is done, it cannot be undone.
People with this medical condition will have to keep taking insulin to prevent the blood glucose level from reaching dangerously high levels and to prevent complications.
The assumption that type 1 occurs in children and type 2 in adults is no longer valid as both diseases occur in both age groups.
Type 2 Diabetes mellitus
It is the most common form of diabetes mellitus. For your blood glucose level to be within the normal range, there must be a balance between insulin sensitivity and its production.
The journey to type 2 diabetes starts with your body initially getting less sensitive to insulin, meaning that your cells no longer respond to insulin-like they used to.
This insulin resistance stimulates the pancreas to secrete more insulin, and the cycle continues until the pancreas cannot keep up with the demand.
Once at this stage, there is a relative decrease in the amount of insulin produced and an elevated blood glucose level that results in diabetes mellitus.
Gestational Diabetes
When you are pregnant, the placenta produces several hormones to help sustain the pregnancy. These hormones reduce the sensitivity of your cells to insulin.
Your body tries to counteract this effect by increasing the amount of insulin that the pancreas produces.
However, when the pancreas is unable to keep up with the game of number, the glucose level in the blood is elevated due to the inability of glucose to enter the cells effectively. This results in gestational Diabetes. Most Gestational Diabetes are reversible after delivery.
Diabetes due to other causes
- Monogenic diabetes syndrome like maturity-onset Diabetes of the young and neonatal Diabetes.
- Diseases affecting the pancreas like pancreatitis
- Chemical induced diabetes-like use of glucocorticoids in the treatment of Hiv patients, or after organ transplant.
Signs and symptoms of Diabetes.
In both type 1 and type 2 diabetes mellitus, the progressive loss of β-cell function that results in hyperglycemia can be associated with various environmental and genetic factors. However, once hypoglycemia occurs, patients with all forms of Diabetes have the same risk factors for developing the same chronic complications even though the rate of progression can differ.
Fatigue and hunger
Your body mainly derives energy from sugar, and insulin is needed for sugar to enter the cells. If your body is unable to produce enough insulin or is resistant to it, your body will not generate energy, which makes it weak. The brain perceives the weakness as an inadequate amount of food in the body and therefore stimulates hunger. Diabetes associated hunger does not go away after food consumption, and the increased urge for eating worsens already elevated blood sugar.
polydipsia (excessive thirst)/polyuria (excessive urination)
Over 24hours, the average person urinates between 4 to 7 times, but diabetic patients urinate a lot more. When your blood glucose is elevated, the kidney tries to remove the body’s extra glucose by producing more urine. Because the body is losing fluids, the brain stimulates you to drink more water.
Symptoms of type 2 diabetes
Most of these symptoms are noticed after blood glucose has been high for a long time.
- Slow healing of wounds. When you have wounds, and your blood glucose is high, the high sugar concentration in your blood makes it suitable for micro-organisms to thrive. The thriving of micro-organisms makes wound healing difficult.
- Pain or numbness in the leg: High blood sugar can impair blood flow and cause nerve damage. It impairs the nerves’ ability to send signals and weakens the walls of small vessels that carry nutrients and oxygen to the nerves.
- Yeast infections: Anyone with Diabetes can get this infection irrespective of sex. Yeast feeds on glucose, and they thrive in moist areas like genital areas, areas below the breast, and the spaces between your fingers.
Symptoms of type 1 diabetes
- Weight loss: Due to lack of insulin, glucose from your food cannot effectively enter your cells. The body then starts breaking down muscle and fat for energy. This results in loss of body mass and subsequent loss of weight.
- Nausea and vomiting: Once your body starts breaking down fats, ketones are produced. A life-threatening condition called Diabetic Ketoacidosis can occur when the ketone levels reach a dangerously high level. Nausea and vomiting are among the symptoms of this condition.
Symptoms of Gestational Diabetes
This type of Diabetes usually has no symptoms, but polydipsia and polyuria can be noticed. Having your blood glucose checked during each trimester should be considered when you are pregnant.
Risk Factors
Risk Factors for Type 1 diabetes mellitus:
- Family history
- Pancreas diseases
- Infection or illness
Risk Factors for Type 1 diabetes mellitus:
- Obesity
- Impaired glucose tolerance
- Insulin resistance
- Ethnicity
- Family history
- Sedentary lifestyle
- Gestational Diabetes
- Polycystic ovary syndrome
- Age
Risk Factors for Gestational diabetes mellitus:
- Ethnicity
- Obesity/overweight
- Age
- Family history
- Glucose intolerance
- Smoking
- Overweight and obesity
- Physical inactivity
- A1C
- High blood pressure
- High cholesterol
Overweight and obesity
Having too much fat in the body can increase your likelihood of getting diabetes mellitus. Some findings have shown that excess fats is the single strongest risk factor for developing diabetes mellitus. It has been associated with metabolic disturbances, including insulin resistance.
Diet and lifestyle
People that embrace sedentary lifestyles are at a high risk of developing type 2 DM.
Active smokers have about a 45% higher risk of developing type 2 diabetes than non-smokers. Smoking induces insulin resistance and compensatory insulin-secretion responses. Also, smokers tend to have more central fat accumulations than non-smokers
