What is Diabetes? Definition
Diabetes is a chronic, metabolic disease typically characterized by elevated levels of blood sugar and which can lead over time to serious complications such as heart disease, and diseases of the eyes, kidneys, and nerves.
Diabetes has been known to man since the ancient past and the layman often refers to it as the sugar disease.
It is a chronic disease accompanying the diabetic throughout life, but it is not contagious. Most of the time, a diabetic patient remains without any symptoms, which are polyurea (excessive urine), polydipsia (excessive thirst), and polyphagia (excessive hunger).
In these asymptomatic patients, the disease is detected accidentally when they undergo a health check-up or if they develop complications, which often produce symptoms.
Diabetes mellitus is a chronic metabolic disorder or disease wherein the body’s mechanism of maintaining normal blood glucose levels does not function properly.
The body cannot convert blood glucose into energy, as it normally does. As a result, the glucose levels in the blood rise above the normal limits, giving rise to its symptoms.
Carbohydrates provide most of the body’s energy. The carbs obtained from the food that we eat are ultimately converted into glucose, which travels in the blood. The blood glucose is picked up by the body cells for cellular respiration and cellular metabolism.
When people refer to “blood sugar”, it means blood glucose, and “sugar disease” simply means diabetes mellitus.
The glucose in the blood is used for energy, which the body requires for bodily functions such as breathing, metabolism, and physical activity.
This process of transferring blood glucose into the tissue cells is brought about by the hormone called insulin, which is produced and secreted by the pancreas.
There’s no permanent cure for diabetes and there is no way to completely get rid of it. However, it can be reversed in some people.
Different types of sugars
Sugar is the main component of our food that is linked to diabetes mellitus. It is a simple, crystalline, edible carbohydrate that comes in different forms and which we derive from our diet
- Fructose is derived from fruits. It is a simple carbohydrate.
- Lactose from milk is also a simple carbohydrate
- Starches, which are complex carbohydrates, are derived from corn, potatoes, beans, peas, grains, pasta, and rice.
All these sugars are converted into glucose in the body and circulated in the blood.
Simple carbohydrates are made up of shorter molecular chains and are quicker to digest than complex carbohydrates. Quicker digestion means quicker absorption in the blood resulting in a spike in blood glucose. This provides the body with a short-lasting source of energy.
Complex carbohydrates, on the other hand, take longer to break down and therefore are absorbed more slowly. They, therefore, do not cause spikes in blood sugar levels. Since they are gradually absorbed over a longer time, they provide the body with longer-lasting energy than simple carbohydrates.
The measurement unit for blood glucose is milligrams of glucose per deciliter of blood (mg/dl). This is the unit of measurement in most countries.
How do you get diabetes mellitus? Etiology
In a healthy human being, many hormones are in play, which keeps the blood sugar levels normal. We have the thyroid hormone, adrenal hormone, growth hormone, and glucagon which tend to increase glucose levels when needed and on the other hand, we have insulin secreted by the pancreas, which lowers glucose levels and prevents them from rising above normal levels.
Any imbalance in these hormonal actions, causes the blood sugar to rise and cause diabetes. This most commonly happens due to reduced secretion of insulin.
Diabetes is a metabolic disorder in which insulin function is impaired and the pathway of blood glucose does not take place normally. This can happen due to two reasons:
- The pancreas does not produce enough insulin due to some pathology. This happens in type 1 or juvenile diabetes.
- The insulin produced does not facilitate the body cells to take up glucose from the blood, either due to insufficient quantity or due to some defect in the insulin. This is called insulin insensitivity and forms the etiology of Type 2 diabetes.
Both these lead to low insulin efficiency leading to an increase in levels of glucose in the blood.
Genetics and Diabetes
The genetic factor does increase your predisposition, especially to type 1 diabetes. If your first-degree relative (sister, brother, son, daughter) has type 1, you have a 6 out of 100 chance of developing it. While, in the general population, the chance rate is 6 out of 300.
According to the American Diabetes Association (ADA), the risk of your child developing type 2 diabetes is:
- One in seven, if one of its parents is diagnosed before the age of 50 years.
- One in thirteen, if the diagnosis was made after the age of 50 years.
- One in two, if both the parents of the child have this disorder.
But, there are other causes and risk factors, such as your lifestyle habits, that can trigger the onset of this metabolic disease even if you do not have a history in your family.
Normal blood sugar levels
It is important that a diabetic controls his blood sugar levels and keeps them within the recommended range always. Uncontrolled diabetes has its serious downside, which can lead to serious complications that have a poor prognosis and an increased mortality rate.
Fasting blood glucose levels
- For a normal healthy person: 70–99 mg/dl
- For a person with diabetes as per ADA recommendation: 80–130 mg/dl
Levels 2 hours after meals
- For a normal healthy person: Less than 140 mg/dl (7.8 mmol/L)
- For a person with diabetes as per the ADA recommendation: Less than 180 mg/dl
HbA1c blood test
HbA1C is a measure of your average blood glucose levels over the past 3 months
- For a normal healthy person: Less than 5.7%
- For a person with diabetes as per ADA recommendation: 7.0% or less
These numbers serve as guidelines both for diabetics and non-diabetics and you should strive to stay within these limits.
Regular checkups help to identify this condition, and if present can help to prevent its complications with prompt treatment.
Proper exercise and the right diet also help to control blood sugar levels and improve the effects of medications.
Effective natural remedies also play a synergistic role in the control of this metabolic disorder.
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Types of Diabetes
There are two types of chronic forms of diabetes:
- diabetes mellitus is caused by your body not producing enough insulin,
- diabetes insipidus is a disease where kidneys are unable to save or preserve water. It does not affect your blood sugar levels.
Then, there are two other types that are potentially reversible: Gestational diabetes and prediabetes.
(A) Diabetes mellitus
This is the more common type, which we often hear about, and is classified into three types.
- Type 1 diabetes. The type 1 variety is commonly found in children and young adults. It is also referred to as juvenile or insulin-dependent diabetes and is an autoimmune disorder. This form typically occurs due to inadequate secretion of insulin by the pancreas. Insulin is the hormone, which is responsible for keeping the glucose levels in the blood within normal limits. It is secreted by the beta cells of the pancreas. Type 1 diabetes is caused by the autoimmune destruction of pancreatic β-cells. This leads to insulin deficiency, which leads to hyperglycemia. The beta cells may also be damaged by a viral disorder, which elicits this autoimmune disease. Only 5% of all people with diabetes mellitus have type 1 variety. That is over 10 million people worldwide suffer from this juvenile disorder.
- Type 2 diabetes. The Type 2 form of this disorder is a chronic metabolic disorder, which is very common. In this condition, the secretion of insulin is normal, but the utilization of glucose in the blood by the body cells is not proper. Insulin fails to bring about this utilization. This is, therefore, called insulin resistance or insulin insensitivity. Since the glucose in the blood is not properly utilized, it builds up in the blood causing hyperglycemia (high blood sugar levels). It is commonly found in the middle-aged and older people. Hence, it is also referred to as adult-onset diabetes. It is a life-long disease and requires life-long treatment.
- Gestational diabetes. This type is detected in a pregnant woman who did not have it earlier. It sets in during the second trimester of pregnancy. Unlike the other types, this type disappears after the baby is born. The woman is likely to develop gestational diabetes again in her next pregnancy, which puts her at an increased risk of developing the Type 2 form of this disorder.
(B) Diabetes insipidus
This is a rare form, which results from deficient secretion of a pituitary gland hormone called vasopressin. The condition is caused by hormonal abnormality and isn’t related to diabetes mellitus.
However, the symptoms of excessive thirst and excessive urination are common in both, but the treatment for diabetes insipidus and diabetes mellitus is different.
(C) What is Prediabetes?
Prediabetes is a condition, which acts as a warning signal that you may acquire diabetes mellitus sooner or later. It is a sort of a forecast warning that you are going to acquire this condition. It is also called borderline diabetes.
If adequate precautions are taken at this stage, then you may still be able to prevent diabetes. Many times, prediabetes may be present for a long time and may be missed in people, who do not have regular medical check-ups.
Precautionary measures include a proper diet, regular exercise, and healthy lifestyle habits.
(D) Secondary diabetes
In some cases, secondary diabetes is brought on by another health condition. Secondary diabetes, unlike diabetes mellitus, doesn’t develop because of any insulin problem but rather because of other disorders that affect the endocrine system. It can result from problems with medication use, hormonal disorders, and genetic syndromes. The symptoms of both, however, are the same
It is mostly permanent, and there is no cure. Drug-induced secondary diabetes is often reversible if the medication has been taken only in the short term. The cure for secondary diabetes depends on the cause and damage to your body.