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TALK ABOUT DIABETES
Lets talk about diabetes! I am sure you have heard about it just once in your life! Everyone is talking about the “BAD SUGAR” referring to over consumption of chocolates and soft drinks and moreover that it may lead to diabetes. Others believe that losing weight can cure diabetes mellitus or that someone suffering from that disease can’t travel etc. Some of these beliefs are totally wrong while others are half true.
DIABETES MELLITUS: Is a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas or by the ineffectiveness of the insulin produced. Such a deficiency results in increased concentrations of glucose in the bloodstream which in turn damage other body’s systems, mostly nerves and blood vessels! What are the types of DM? According to the mechanism that leads in the accumulation of glucose into the blood, there are 2 types; • TYPE 1 Diabetes Mellitus It is also called “Insulin dependent type”, and in this case, the pancreas fails to produce the insulin which is essential for survival! This form is being diagnosed in most times early in life (children/adolescents), but it can also be diagnosed later on! • TYPE 2 Diabetes Mellitus It is also called “non-insulin dependent” diabetes and it results from the body’s inability to respond properly to the action of insulin that is produced by the pancreas!
HERE IS A LIST OF WORDS REGARDING DIABETES MELLITUS, and their meaning: • INSULIN; Is a hormone produced by the pancreas (islets of Langerhans), which regulates the amount of glucose in the blood! Imagine that insulin is like a key that opens the doors of your cells, letting glucose (=sugar) enter in your cells! • GLUCAGON; Is a hormone produced by the pancreas well, together with insulin regulate the blood glucose levels! • PANCREAS; Is a large elongated gland/organ, located behind the stomach and produces digestive enzymes, together with glucagon and insulin! • GLUCOSE; Blood glucose (=blood sugar) is the principal sugar produced by the food we consume, from proteins, fats and mostly carbohydrates (bread, potatoes, rice, etc.). Is the body’s major source of energy and it is transported via blood circulation into cells. • MELLITUS; Means honeyed, from the blood sugar accumulation! • JUVENILE DIABETES; It is actually the D.M. type 1, and it’s called juvenile because it appears mostly during childhood/adolescence! • GESTATIONAL DIABETES; Means high blood sugar that develops during pregnancy and usually disappears after giving birth!
SYMPTOMS OF DM: The classic triad of symptoms in D.M. is, • POLYURIA; (from the Greek words poly=many, uria=urination). Means frequent urination, often in the middle of the night. This leads to dehydration, due to the body’s inability to absorb water thus forcing the diabetics to drink a lot of water! (=polydipsia)
• POLYDIPSIA; (from Greek words poly and dipsia=thirst) Means increase thirst sensation.
Although polydipsia refers to the abnormal and persistent thirst, even after drinking water! It may be accompanied by another symptom called xerostomia (from Greek words xero=dry, stoma=mouth).
• POLYPHAGIA; (from the Greek words poly and phagia=eating) Means excessive hunger and
consumption. It happens due to loss of glucose in the urine, together with the fact that the cells are starving due to the lack of glucose, which is essential for performing their functions. There are also other symptoms, such as excess tiredness, fatigue, weight loss, etc. All these symptoms may appear early in type1 D.M., while in type2 D.M. may be less marked and can even appear several years after its onset!
CAUSES OF D.M. The causes of D.M. differ among the two types, • In type1; the cause is autoimmune! It’s a condition in which your body “attacks” your own cells in the pancreas that normally produce insulin (beta cells). As a result, your body doesn’t produce insulin anymore and blood sugar accumulates in the bloodstream without reaching your cells in order to give them energy! • In type 2; the body produces insulin, but for some reason, either it can’t be used properly (Insulin resistance) or the amount is not enough for your cells (obesity)!
RISK FACTORS In type 1;
Another autoimmune disease
Having a parent or a sibling with D.M. , type1
In type 2;
Age > 40ys.
Having parent, or siblings diagnosed with D.M.
If you had gestational D.M.
If you DON’T exercise for 30’ daily
If you are overweight
If you have slight increase levels of blood glucose, or high cholesterol!
Low birth weight
WHAT IS PREDIABETIC STAGE? Prediabetes develops when your body can still move the glucose out of the bloodstream but not as quickly as it should! It’s the last warning signal of your body and if you don’t make some big changes in your lifestyle (diet, exercise, abnormal weight etc.) as soon as possible you may develop D.M. type2!
HOW TO DIAGNOSE D.M.? In order to be diagnosed with D.M. you have to undergo some tests,
Glycated Hemoglobin test (A1C)
It measures the percentage of blood sugar attached to hemoglobin. It doesn’t need fasting and the results indicate the average sugar level the past 2-3 months!
Random blood sugar test
Blood sample will be taken regardless the time, and your latest meal!
Fasting blood sugar test
A blood sample will be taken after an overnight fast!
Oral glucose tolerance test
It’s a specific test, in which you need to fast overnight and it measures the fasting blood glucose levels .After that you need to drink a sugary liquid and blood sugar levels are tested for the next 2 hours
Other tests include, urine test, autoantibodies etc.
DO I NEED A FOLLOW-UP AFTER DIAGNOSIS? According to American Diabetes Association (ADA), there are screening guidelines! • Every 3 years, for D.M. in case you have increase body mass index, or any other risk factor (heart disease, not a healthy lifestyle, history of polycystic ovarian syndrome, gestational diabetes, age>45, or close relatives suffering from D.M.) • Every year monitoring, for anyone who has been diagnosed with prediabetes!
TREATMENT For D.M. 1 treatment involves
Insulin injections
Frequent blood glucose check-ups
Diabetic diet
Transplantation
For D.M. 2
Primarily lifestyle changes
Monitoring blood glucose levels
Medication, (metformin etc.)
COMPLICATIONS OF D.M.
If diabetes is not managed correctly, there are many serious complications such as;
Heart diseases (coronary artery disease, angina, heart attack, stroke)
Nerve damage (diabetic neuropathy)
Kidney damage( diabetic nephropathy)
Eye damage (retinopathy)
Foot damage, serious infections may lead to leg amputations.
Other, like hearing impairment, skin conditions, Alzheimer disease, depression, etc.
DIET FRIENDLY TO PREDIABETICS AND DIABETICS PATIENTS: A healthy diet can help you keep your diabetes under control!
These are some foods that may help you;
Vegetables, like mushrooms, onions, eggplants,.
About Author: Dr. Chrysoula Valaroutsou is a Greek medical doctor graduated from UOC (english division Constanta,Romania). She is passionate about medicine and always eager to learn more. She has lots of love and loyalty towards serving mankind.
References:
Textbook of diabetes 4th edition, www.who.int , www.piktochart.com , www.diabetes.ie , www.NHS.uk, www.diabetes.org , www.nasilolyo.co , www.medium.com , www.mayoclinic.org , www.hmhospitales.com , www.istockphoto.com , www.yogurtinnutriotion.com www.discoverdiabetes.idf.org www.balboaunionchurch.org , www.liveeatlearn.com , www.cheesemaking.com www.adainthekitchen.com