DIABETES: WHAT IS IT?
- Diabetes is a chronic disease characterized by high sugar/glucose in blood.
- Glucose enters the blood from the food we eat which is later used for fuel in the body.
- Pancreas which is an important gland is located near the stomach and it makes Insulin which plays a role in moving glucose inside our muscles, Liver and Fat cells.
- In Diabetes Pancreas either fail to make enough insulin or our Liver, muscles, fat cells fail to respond to insulin properly.
- As a result various body tissues do not get enough glucose inspite of high blood sugars therefore our body cells starve for energy.
- Over a period of time this can cause damage to various organs of the body like Heart, Kidney, Eyes and nerves.
TYPES OF DIABETES
There are 4 major types of Diabetes:
Type 1 Diabetes:-
- Autoimmune disease –Body’s own Antibodies destroys Pancreas.
- Also called as Insulin Dependent Diabetes.
- Pancreas fail to make adequate levels of Insulin.
- Therefore patients with type 1 diabetes require Insulin daily to survive.
Type 2 Diabetes:-
- Most common type.
- Usually diagnosed in adults but now days increasingly seen in younger generation.
- Rates are rising due to increased obesity and failure to exercise and eat healthy.
- Pancreas are able to make Insulin but obesity cause insulin receptors to decrease and dysfunctional.
- Blood sugars are high during pregnancy in women.
- Placental hormones are responsible for causing insulin resistance leading to diabetes.
- High risk of progression to type 2 diabetes and Heart diseases.
- Above average blood glucose levels but not high enough to be classified as type 1 or type 2 diabetes.
- Starts with unhealthy eating habits and lack of exercise.
- At least 80 million people are diagnosed with diabetes each year.
SYMPTOMS OF DIABETES:
- Excessive thirst
- Excessive urination
- Excessive hunger
- Poor wound healing
- Blurry vision
- Recurrent infections
- Numbness and tingling sensation in hands and feet.
- Poor diet and obesity.
- Lack of exercise.
- Family history of diabetes.
- High blood pressure.
TESTING FOR DIABETES
Fasting plasma glucose test:-
- Patient must fast for 8 hours.
- Doctor will then draw blood.
- For Pre Diabetics blood glucose will be in 100-125mg/dl range.
- For Diabetics blood glucose will be above 126mg/dl.
Random glucose test:-
- More than 200mg/dl.
- According to latest guidelines oral glucose tolerance test (OGTT) is not used routinely.
- Urine test for proteins may show elevated urine Albumin levels.
- Urine test for ketones may show elevated levels especially in type 1 diabetics.
- HbA1c of more than 6.5% may be seen in diabetic patients.
- Exercise increases uptake of glucose by muscles therefore improving blood sugars.
- 150 minutes of exercise per week has shown to decrease bad cholesterol (LDL) and increase good cholesterol (HDL).
CAUTION- Check blood sugars before, during and after exercise if exercise is prolonged.
- Patients on insulin should check blood sugars 2 -4 times a day by help of glucometer.
- Patients not on insulin should check blood sugars 2-3 times per week.
- Parameters from physician are very important.
- Continuous Glucose monitoring
- Subcutaneous sensor in the abdomen.Download data quarterly every 72 hours.
- Helps in evaluating the trends and efficacy of treatment over 24hours.
- Rapid acting insulin-Lispro and Aspart
- Short acting insulin-Regular
- Intermediate acting insulin
- Long acting insulin
CAUTION-Always CONSULT your physician before taking any form of insulin.
Methods of insulin delivery:-
- Insulin pens
- Jet Injectors
- Insulin pumps
- Implanatable devices
- Latest-islet cell transplantation.
CAUTION-Always CONSULT your physician before using any form of insulin injecting device.
CAUTION-Always CONSULT your physician before starting oral drugs.
- Cardiovascular diseases such as Myocardial infarction (HEART ATTACK) is the MOST COMMON cause of DEATH in DIABETICS.
CALL the AMBULANCE IMMEDIATELY if the patient develops any of the following symptoms.
- PERIPHERAL VASCULAR DISEASE in DIABETICS is the LEADING CAUSE of non traumatic AMPUTATIONS.
- Inspect feet daily.
- Wear closed toe shoes.
- Visit Podiatrist at least annually.
- Maintain good foot hygiene.
- Maintaining proper blood sugar is the key to preventing complications.
- CHRONIC KIDNEY DISEASE can be seen due to involvement of small blood vessels of kidney.
- Controlling blood pressure halts the progression of kidney disease .
- DIABETES is one of the LEADING CAUSES of BLINDNESS.