In order to have better control of your blood glucose (blood sugar) you need to know about diabetes mellitus. Diabetes mellitus is a disorder of endocrine ( hormone) system, occurs when blood glucose levels stays consistently above normal in the body. In this condition body is unable to properly store or use glucose.
You get glucose in blood from the food you eat and it is also made in your muscles and liver. Insulin is a hormone made by the pancreas which helps glucose to enter cells of the body. If pancreas is not making enough insulin or insulin is not functioning properly then glucose starts building up in the blood ,unable to enter the cells, rising blood glucose levels resulting in pre-diabetes or diabetes.
When glucose builds up in the blood instead of going into cells, it can cause two problems.
-Your cells may get starved for energy
-Overtime, high blood glucose levels may affect your eyes, kidneys, heart and nerves. It can even lead to lower limb amputation.
But keeping blood glucose on target can help prevent or delay problems
According to National Diabetes Statistics Report 2014
Diagnosed and undiagnosed diabetes in the United States
TOTAL: 29.1 million people or 9.3% of the population have diabetes. That's about 1 out of every 11 people have diabetes.
DIAGNOSED: 21.0 million people
UN DIAGNOSED: 8.1 million people with diabetes are undiagnosed. 1 out of 4 do not know they have diabetes.
TYPES OF DIABETES:
They are of three types
*Type 1 Diabetes
*Type 2 Diabetes
* Gestational Diabetes
TYPE 1 DIABETES:
It is also called Juvenile diabetes or insulin dependent diabetes. It occurs mostly in children and young adults. In this type of diabetes body's immune system attack and destroy pancreas (insulin producing cells), resulting in decreased or no production of insulin. About 5-10% of people with diabetes have type 1 diabetes.
TYPE 2 DIABETES :
It is also called adult onset diabetes or non insulin dependent diabetes.In this type of diabetes there is insulin resistance, a condition in which cells fail to respond to insulin properly. As the disease progresses a lack of insulin may also develop. It is the most common type of diabetes.
GESTATIONAL DIABETES:
It occurs when a pregnant women without previous history of diabetes develop a high blood glucose level. It usually subsides at the end of pregnancy, but such women are at higher risk to develop diabetes later in life.
Who are at risk of developing type 2 diabetes? Since it is the most common type , one should know about the risk factors. There is a combination of factors which can lead to insulin resistance , the leading factors are genetic susceptibility, being overweight and physical inactivity.Other risk factors are high risk race/ethnicity, women who delivered baby >9 Ibs or were diagnosed with gestational diabetes, hypertension (blood pressure greater than or equal to 140/90 mmHg or patient is on therapy), high blood cholesterol levels (triglycerides greater than or equal to 250 mg/dL or HDL less than 35), pre-diabetes.
What is Pre-diabetes? It is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. People with pre-diabetes are at risk for developing type 2 diabetes, but moderate physical activity and weight loss can help them to delay or prevent type 2 diabetes.
SIGNS & SYMPTOMS OF TYPE 2 DIABETES:
Increased thirst (polydipsia)
Increased hunger (polyphagia)
Increased urination (polyuria)
Dry mouth
Unexplained weight loss
Feeling tired and weak
Blurring of vision
Recurrent infections
Delayed healing of wounds
Numbness of hands and feet
Itching of the skin
Male sexual dysfunction
CRITERIA FOR DIABETES DIAGNOSIS:
According to American Diabetes Association following four options are the criteria for diagnosis of diabetes.
A1C : greater than or equal to 6.5%
Fasting Blood Glucose : greater than or equal to 126 mg/dL ( 7.0 mmol/L)
Two readings of fasting blood glucose greater than or equal to 126 mg/dL is considered diagnostic for diabetes
2-hr blood glucose greater than or equal to 200 mg/dL ( 11.1 mmol/L) during OGTT
OGTT (oral glucose tolerance test) is performed as described by WHO, using glucose load containing the 75g of anhydrous glucose dissolved in water
Random Blood Glucose : greater than or equal to 200 mg/dL (11.1 mmol/L)
Categories of Pre-diabetes:
A person having fasting blood glucose between 100- 125 mg/dL
OR
A person having 2-hr blood glucose in 75g OGTT , 140-199 mg/dL
OR
A1C 5.7%-6.4%
Who should be tested ?
Type 2 diabetes testing should be done in all adults who are overweight or obese (BMI greater than or equal to 25 or greater than or equal to 23 in Asian American) or who have one or more than one diabetes risk factor.
TARGET RANGE OF BLOOD GLUCOSE FOR DIABETICS:
American Diabetes Association suggests the following targets for most non pregnant adults with diabetes
A1C 7%
Blood glucose before meal should be between 80-130 mg/dL
Blood glucose 1-2 hrs after beginning of meal should be less than 180 mg/dL
What is hypoglycemia? Hypoglycemia is a condition characterized by abnormally low blood glucose levels, usually below 70 mg/dL. Common signs and symptoms of hypoglycemia includes nervousness, anxiety, chills,sweating, confusion ,dizziness, nausea, sleepiness, fast heart beat, weakness, headache, fits, unconsciousness. If you are having any of the above mentioned signs and symptoms , get your blood glucose checked immediately.If hypoglycemia present take 15-20 gms of glucose or simple carbohydrates ( 1 tablespoon of sugar, honey or corn syrup or half cup of juice), recheck your blood glucose after 15 minutes. If hypoglycemia continues , take another 15-20 gms of glucose. If left untreated hypoglycemia can lead to fits and unconsciousness (coma)
MANAGEMENT OF DIABETES :
It can be managed through diet, exercise and medicines according to American Diabetes Association
EATING HEALTHY:
Many people think that having diabetes means you can't eat your favourite foods. You can still eat the food you like ,its the amount that counts. Ask for a referral to a dietitian, so together you can design a meal plan that can help you reach your goals. These steps can help you manage your diabetes.
Count Carbohydrates : carbohydrates ( bread, rice, crackers, juice, milk, yogurt, potatoes, corn, peas, sweets) raise your blood glucose levels the most. Keep the amount of carbohydrate in your meal about the same from day to day to help you reach your blood glucose targets.
Choose food low in saturated fats : food high in saturated fats include meat, butter, whole milk, cream, cheese, many baked goods, palm and coconut oil.
Lower portion sizes: cutting back on food portions at meals and snacks can help with weight loss.
Eat more fibre: eat more high fibre food such as fruits ,vegetables, dried beans, oatmeal ,whole grain bread and cereals.
PHYSICAL ACTIVITY:
Being active throughout the day
Examples: Gardening, taking the stairs instead of elevators. Work up to about 30 minutes each day.
Aerobic exercise
Examples: Brisk walking, dancing, rowing, swimming or riding a bicycle. Get up and move every 90 minutes if you sit for long periods of time.
Strength training:
example: Lifting light weights a few times a week.
MEDICINES:
Some people can manage their diabetes with diet and exercise while others may need to take pills or insulin. Commonly prescribed drugs for diabetes type 2 include metformin ,generally it is the first medicine prescribed for type 2 diabetes, sulphonylureas, meglitinides, thiazolidinediones, DPP-4 inhibitors, GLP-1 receptor agonist, SGLT2 inhibitors, insulin therapy.
The purpose of this article is to provide awareness and to improve lives of people affected by this disease. By having knowledge about your condition you can manage it more effectively and prevent or delay serious complications.
