Diabetes: Causes, Symptoms, Treatments, Remedies, and Prevention
Diabetes (a.k.a: Diabetes mellitus) is a most common metabolic syndrome and a major health concern. According to World Health Organisation (WHO), it is the 8th leading cause of death globally.
What is Diabetes?
Diabetes is a condition in which blood glucose levels persistently rise to more than normal levels. It occurs when cells don’t respond to insulin (insulin resistance) or the pancreas fail to produce enough insulin required by the body.
What Causes Diabetes?
Glucose is considered as fuel or energy for the cells. Glucose level in the body is regulated by insulin hormone as insulin helps in uptake of glucose by the cells. Beta cells present in the pancreas release insulin when blood glucose levels are high. Insulin helps to store glucose in muscle, fat, and liver for future use. When there is insulin production or action, glucose levels in the blood increases leading to hyperglycemia. If this condition is persistent, it may eventually lead to diabetes mellitus.
Types of diabetes: Diabetes can be classified into type 1 and type 2 based on the underlying causes:
- Type 1 diabetes: It is a condition in which immune cells destroy the beta cells of pancreas that produce insulin.
- Type 2 diabetes: It is a condition in which there are sufficient levels of glucose in the body but the cells cannot utilize this insulin due to insulin resistance.
Other types of diabetes:
Prediabetes is a condition in which blood glucose levels are high, but not too high to be diagnosed as type 2 diabetes. It is considered as a warning sign for type 2 diabetes.
Gestational diabetes is a condition in which diabetes develops during pregnancy. However, the blood glucose levels become normal after giving birth.
Symptoms of Diabetes:
Symptoms also vary based on the type of diabetes. Generally, the patients with prediabetes are asymptomatic where as type 1, type 2, and gestational diabetes have similar symptoms. However, symptoms in type 1 appear suddenly and type 2 appears gradually. The symptoms include:
- Weight loss
- Increased thirst (polydypsia)
- Excessive hunger (polyphagia)
- Increased urination, especially at night (polyuria)
- Visual disturbances
- Extreme fatigue
- Numbness in hands and feet
- Slow and improper healing of cuts or bruises
- Dry mouth
Risk Factors of Diabetes:
Type-1 diabetes is an autoimmune disorder and mostly runs in a family. Therefore, children and adolescents are at higher risk for this condition. Risk factors are:
- Age < 30 years
- Genetic factors or family history
- Diseases of the pancreas
- Viral or bacterial infection
- Intake of chemical toxins present within food
Obesity is the leading risk factor of type 2 diabetes both in adults and also children. Sedentary life style and unhealthy eating habits are the major predisposing factors for obesity. Other risk factors of type 2 diabetes are:
- Age > 45 years
- Family history
- Hormone fluctuations
- High blood pressure
- High cholesterol levels
- Low high density lipoprotein levels (HDL)
- History of gestational diabetes
- Heavy alcohol consumption
As in case of type 2, obesity and sedentary life style are risk factors for gestational diabetes. Other risk factors include:
- Maternal age > 25 years
- Previous pregnancy with gestational diabetes
- History of polycystic ovarian syndrome
- Previous child birth of > 4 kg
- Family history of diabetes
Complications of Diabetes:
Diabetes has slower progression and can lead to severe complications gradually. They are:
- Diabetic neuropathy – High blood glucose leads to damage of the nerves, especially peripheral nervous system leading to neuropathy.
- Diabetic nephropathy – High blood glucose levels damage blood vessels that supply kidney leading to kidney damage. This leads to accumulation of wastes in the blood.
- Diabetic retinopathy – High blood sugars can damage blood vessels of eye leading to cataracts and glaucoma.
- Heart diseases – Diabetes can cause blockage of blood vessels leading to chest pain, stroke, and heart attack.
- Foot damage – Due to damage in the nerves of peripheral nervous system, foot ulcers or gangrene can occur. These wounds heal slowly and sometimes may lead to amputation or loss of limb.
- Brain damage – Diabetes may gradually lead to cognitive impairment or memory loss in the patients. Stroke may also occur in some patients.
- Diabetic ketoacidosis – It is a life-threatening complication and considered diabetic emergency. If the glucose is not taken by the cells, fats breakdown to produce ketones. If there is high amount of production of ketones due to absence of glucose, ketones appear in blood and urine. Presence of ketones causes acidosis leading to toxic complications.
- Gestational diabetes can cause complications in both mother and fetus. Nephropathy, retinopathy, heart diseases, prolonged labor, risk of cesarean delivery, and pre-eclampsia are commonly seen in mother. In fetus, congenital abnormalities such as cardiac and neural tube defect, hypoglycemia, macrosomia (birth weight > 4kg), hypocalcemia, birth injuries, and childhood obesity can occur.
Diagnosis of Diabetes:
People with at least one predisposing factor should undergo screening annually. This helps in early diagnosis. Tests recommended for diagnosis of diabetes are:
- Fasting plasma glucose (FPG): In this test, glucose levels are measured after fasting for some hours (at least 6 to 8 hours). If the glucose levels are more than 126 mg/dl after performing two consecutive tests, then the condition is said to be type 2 diabetes.
- Random blood sugar test (RBS): In this test, glucose levels are measured at any time during the day. There is no need of fasting for this test. If blood glucose levels are > 160 mg /dL, then other tests are recommended for the diagnosis to confirm.
- Oral glucose tolerance test (OGTT): The patient is kept on fast for at least 8 hours and the blood sample is drawn. Then, 75 grams of syrupy glucose solution is given. After two hours, blood sample is obtained again for measuring blood levels.
- In case of gestational diabetes, blood sample is obtained two times (after the first and second hour).
- Glycated hemoglobin (HbA1c): The glycated hemoglobin indicates the average levels of blood glucose levels in past two to three months.
Criteria for the diagnosis of diabetes:
|FPG (mg/dL)||100 to 125||>126|
|OGTT (mg/dL)||140 to 199||>200|
|HbA1c (%)||5.7 to 6.4||>6.5|
In patients with chronic diabetes, regular screening tests should be done to monitor blood glucose levels. Kidney function tests, eye examination, foot examination, and reflexes can be examined during follow-up visits to check for complications.
Prediabetes condition doesn’t require treatment. However, lifestyle modifications help to decrease the risk of developing diabetes. Treatment options for other diabetic conditions are:
- Insulin therapy: Insulin therapy is the major treatment option for patients with type 1diabetes. Patients with type 2 diabetes may also require insulin therapy depending on their glucose levels. Insulin cannot be administered orally and injections are available.
- Oral antihypoglycemic agents: Biguanides, sulfonyl ureas, and glitazones are some examples of antihypoglycemic medications. These medications act either by stimulating the production of insulin from pancreas or inhibit the breakdown of fats to produce glucose.
- Transplantation: Patients with type 1 diabetes may be considered for pancreas or islet cell transplantation. But the research is still going on to find out potential risks of the therapy.
Home remedies and foods for diabetes may help ton control blood glucose levels and prevent complications. These remedies include:
- Bitter gourd, cinnamon, aloe vera, okra, and fenugreek seeds are known to decrease glucose levels naturally.
- Proper foot care helps to prevent complications.
- Don’t skip meals if you are on antidiabetic medications, as this may cause hypoglycemia (decrease in glucose levels more than normal).
Prevention and Cure for Diabetes:
Lifestyle modifications play a significant role in the prevention and management of diabetes. Measures to follow are:
- Consume healthy diet that is low in sugars, carbohydrates, and fats. Opt more for fiber-rich and whole grain foods.
- Be physically active. Exercise regularly at least one hour per day. Physical activity can include a brisk walking, jogging, swimming, or even gardening.
- Undergo screening tests regularly, at least once in a year.
- Reduce stress.
- Quit smoking.
- Limit alcohol consumption.