“This world diabetes day, pledge to follow a lifestyle that can make your life diabetes free.” Laughter is the best medicine. But if you have Diabetes, you should try insulin. Wish you a happy and safe World Diabetes Day.
The purpose of this one day is to raise awareness of a condition that millions of people all around the world live with every day.
This year’s theme, ‘access to diabetes education’, underpins the larger multi-year theme of ‘access to care’. In the lead-up to and on 14 November, WHO will highlight not only the challenges, but more importantly the solutions, to scaling-up access to diabetes medicines and care.
This World Diabetes Day, IDF is calling on policymakers to increase access to diabetes education to help improve the lives of the more than half a billion people living with diabetes worldwide.
DIABETES
Diabetes mellitus is a group of metabolic diseases in which the person has high blood glucose (blood sugar) level either due to inadequate insulin production or because the body’s cells do not respond properly to insulin or both. The term “Diabetes Mellitus” describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat (dyslipidaemia) and protein metabolism resulting from defects in insulin secretion, insulin action, or both.
The main types of diabetes are:
Type 1 diabetes: It is due to the body’s malfunction to produce insulin in the body, and requires the person to inject insulin. This form was previously referred to as “Insulin-Dependent Diabetes Mellitus” (IDDM) or “Juvenile Diabetes”.
Type 2 diabetes: It is due to insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. This form was previously referred to as non insulin-dependent diabetes mellitus (NIDDM) or “adult-onset diabetes”.
Type 1 diabetes can develop quickly, over weeks or even days. Many people have type 2 diabetes for years without realizing because early symptoms tend to be common.
The main symptoms of diabetes are:
- Polyuria: urinating frequently (particularly at night)
- Polydipsia: feeling very thirsty
- Polyphagia: feeling hungry frequently
- Weakness
- Weight loss and loss of muscle bulk
- Frequent episodes of thrush
- Cuts or wounds that heal slowly
- Blurred vision
CAUSES –
Type 1 Diabetes: The immune system of body attacks and destroys the cells that produce insulin. As no insulin is produced, glucose levels further increase, which can seriously damage the body’s organs. Type 1 diabetes is often known as insulin-dependent diabetes. It is also sometimes known as juvenile diabetes or early-onset diabetes because it usually develops before the age of 40, often during the teenage years. Type 1 diabetes is less common than type 2 diabetes.
Type 2 Diabetes: Type 2 diabetes is where the body does not produce enough insulin or the body’s cells do not respond to insulin. This is known as insulin resistance. Type 2 diabetes, and is far more common than type 1 diabetes.
Risk factors for type 2 diabetes:
- Obesity or being overweight
- Impaired glucose tolerance
- High blood pressure
- Dyslipidaemia – Low levels of high-density lipoproteins (HDL) (“good”) cholesterol and high levels of triglycerides, high low-density lipoproteins (LDL)
- Gestational diabetes
- Sedentary lifestyle
- Family history
- Age
Gestational Diabetes: Some women tend to experience high levels of blood glucose as during pregnancy due to reduced sensitivity of insulin receptors.
DIAGNOSIS –
The clinical diagnosis of diabetics is often prompted by symptoms such as increased thirst and urination and recurrent infections.
Blood Tests – Fasting plasma glucose, two-hour postprandial test and oral glucose tolerance test are done to know blood glucose levels.
Glycated Haemoglobin (HbA1c) may be used to diagnose diabetes(if facilities are easily available).
Diabetes can be diagnosed by blood glucose and HBA1c levels.
Other tests –
- Fasting lipid profile, including total, LDL, and HDL cholesterol and triglycerides
- Liver function tests
- Kidney function tests
- Thyroid stimulating hormone (TSH) in type 1 diabetes, dyslipidaemia, or women over 50 years of age.
MANAGEMENT –
Currently, six classes of oral antidiabetic drugs (OADs) are available: biguanides (e.g., metformin), sulfonylureas (e.g., glimepiride), meglitinides (e.g., repaglinide), thiazolidinediones (e.g., pioglitazone), dipeptidyl peptidase IV inhibitors (e.g., sitagliptin), and α-glucosidase inhibitors (e.g., acarbose).
Medications:
- Insulin: Type 1 diabetes is generally treated with combinations of regular and NPH (neutral protamine Hagedorn) insulin or synthetic insulin analogues. When insulin is used in type 2 diabetes, a long-acting formulation is usually added initially while continuing oral medications.
- Treatment of coexisting medical conditions (high blood pressure, dyslipidaemia etc.)
Lifestyle measures:
- Regular exercise
- Proper diet
- No smoking
- No alcohol
These goals help in keeping both short-term and long-term blood glucose levels within acceptable limits.
COMPLICATIONS –
The complications of diabetes mellitus are less common and less severe in people who have well-controlled blood sugar levels. Its complications are:
- Acute:
- Diabetic ketoacidosis (DKA)
- Hyperglycaemia
- Hypoglycaemia
- Diabetic Coma
- Chronic:
- Micro vascular diseases (due to damage to small blood vessels):
- Eye Diseases:
- Retinopathy (nonproliferative/ proliferative)
- Macular oedema
These conditions can lead to serious vision loss or blindness.
- Neuropathy:
- Sensory and motor (mono-and polyneuropathy) neuropathy:
- Autonomic neuropathy
- Nephropathy: Damage to kidney can lead to chronic renal failure.
- Macro vascular diseases:
- Coronary artery disease
- Peripheral arterial disease
- Cerebrovascular disease
- Other diseases:
- High blood sugar level in blood can lead to cataract, glaucoma.
- Dermatological complications- bacterial infections, fungal infections and some other skin conditions are more common in diabetic persons.
- Infectious diseases are more frequent and/or serious in patients with diabetes mellitus.
- Periodontal Disease-When diabetes is not controlled properly high glucose levels in mouth fluids may help germs to develop and cause periodontal diseases.
- Cheiroarthropathy is a condition of limited joint mobility in patients with diabetes and is characterized by thickening of the skin resulting in contracture of the fingers.
- Diabetic dyslipidaemia:The characteristic features are a high plasma triglyceride concentration, low high-density lipoprotein (HDL) concentration and increased concentration of low-density lipoproteins (LDL).