Diabetes Mellitus or commonly called as Diabetes is a condition in which your body cannot produce the insulin or it can’t properly uses the insulin that it produces. Insulin is the hormone that is responsible to control the amount of glucose (sugar) in blood. If you are experiencing the symptoms of Diabetes then you have high levels of glucose in your blood and this too much glucose can lead to some serious health problems such as the condition that can damage blood vessels, organs and nerves. There are various types of Diabetes, each type having its own causes. If you carefully follow the treatment of Diabetes which is recommended by the doctor then it becomes feasible to live a healthy lifestyle while managing the condition and keeping the blood sugar level in control.

Here’s what you need to know about Diabetes, its symptoms, types, causes, risk factors, complications, diagnosis and treatment. But in order to understand about Diabetes, it is important for you to understand the role of pancreas, insulin and glucose.

What is the role of pancreas, insulin and glucose?

Pancreas is an organ located back of the abdomen, behind the stomach. The head of the pancreas which is on right side of abdomen is connected to duodenum, the first section of small intestine, through small tube called as pancreatic duct.

Pancreas plays an important role in converting the food we eat into the energy for the cells of the body. It helps in digestion and regulates glucose or blood sugar level. In a healthy body, when the blood sugar level gets high then the special cells in pancreas (which called as beta cells) secrete a hormone, called as insulin into the bloodstream. The insulin circulates and enables the cells to take in glucose to use as energy and this lowers the sugar level in your bloodstream. When your body doesn’t produce enough insulin or it can’t use the insulin properly which it produced then this makes the high level of glucose in the blood which leads to Diabetes.

Glucose is the source of energy for the cells that helps in making up muscles and tissues. Glucose comes from the food we eat and the liver. Sugar is absorbed into the blood where it enters the cells with the help of insulin.

What are the types of Diabetes?

The four main types of Diabetes include:

1. Type 1 Diabetes
2. Type 2 Diabetes
3. Prediabetes
4. Gestational Diabetes

Type 1 Diabetes:

This type occurs when your immune system mistakenly attacks and then kills beta cells of pancreas. Very little or no insulin is released into body resulting in building up sugar in the blood instead of entering into the cells of the body. This type typically develops in childhood and adolescence but adults can also be affected with it.

Type 2 Diabetes:

This type occurs when the body doesn’t make enough insulin or the body can’t properly use the insulin that is released, which results in high level of sugar in the blood instead used for energy. This type is more common and develops at any age, though it is more common in people over 40.

Prediabetes:

This type occurs when your blood sugar levels are higher than normal but not high enough to be diagnosed as Diabetes. If this condition is left untreated then it can lead to type 2 Diabetes. Prediabetes is reversible which means that it can be treated and cured.

Gestational Diabetes:

This type is a temporary condition that occurs during the pregnancy. It is also reversible which means that it is treated and cured after the delivery. But at the same time, if it left untreated then it may increases the risk of developing Diabetes for mother and child.     

What are the symptoms of Diabetes?

The symptoms of Diabetes vary depending on the level of sugar in your blood. The symptoms of Type 2 Diabetes or Prediabetes not occur initially but the symptoms of Type 1 Diabetes come quickly with more severity.  Some common signs and symptoms of type 1 and type 2 Diabetes include:

• Extreme hunger
• Increased thirst
• Frequent urination
• Unexplained weight loss
• Blurred vision
• Irritability
• Fatigue
• Slow-healing sores
• Frequent infections, including gums, skin infections or vaginal infections
• Presence of ketones in urine (ketones are by-product of breakdown of muscle and fat while there is not enough insulin available)

If you notice any of these symptoms then immediately consult the doctor. Early diagnosis is better for starting a proper treatment plan. If you have already diagnosed with the disease then you need to carefully follow the treatment plan and have close follow-up with the doctor.

What causes Diabetes?

The causes of Diabetes depend on the type of Diabetes. Let’s see the causes in detail:

Causes of Type 1 Diabetes:

The exact cause of this type is unknown. What is known is that it is autoimmune condition in which your immune system – which fights against harmful viruses and bacteria – attacks and kills the beta cells (insulin-producing cells in pancreas). It leaves you with no or little insulin leading to building up sugar in blood instead of transported to the cells. The cause of the attack made by the immune system is a combination of genetic vulnerability and environmental factors, though many of these factors are still unknown.

Causes of Type 2 Diabetes and Prediabetes:

In both these types, your body cells become resistant to the function of insulin and your pancreas can’t produce enough insulin to overcome this resistance. As a result, the sugar builds up in the blood instead moving into cells for giving energy. The exact cause that why this condition happen is still uncertain but it is believed that genetics and environmental factors play vital role in developing the condition. If you are overweight, then you can develop this type but not every one of you with type 2 is overweight.

Causes of Gestational Diabetes:

During pregnancy, the placenta (an organ that connects developing fetus to uterine wall for allowing nutrient uptake) produces hormones to sustain the pregnancy. These hormones make your cells resistant to insulin. Usually, your pancreas produces extra insulin to overcome this resistance but sometimes it can’t keep up, which results in glucose building up in blood instead getting in the cells.

What are the risk factors of Diabetes?

The factors that increase the risk of developing Diabetes depend on the type of the condition. These risk factors include:

Risk factors for type 1 Diabetes:

1. Family history: In case if your parent or sibling having it.
2. Environmental factors: Exposure to viral illnesses can increase the risk.
3. Dietary factors: It includes low vitamin D usage, early exposure to cow’s milk and exposure to cereals before 4 months of age.
4. Geography: Some countries such as Sweden and Finland have high rates of type 1 diabetes.
5. Presence of damaging immune system cells (auto-antibodies): Having these auto-antibodies increase the risk of developing the disease. Family members of affected people are tested for diabetes auto-antibodies.

Risk factors for prediabetes and type 2 Diabetes:

1. Age: People over the age of 40 have high risk.
2. Family history: You have high risk if your parent or sibling has the condition.
3. Race: People of some races, such as American Indians, Asian Americans, blacks and Hispanics have greater risk of developing the condition.
4. Overweight: Your cells become insulin resistant if you have more fatty tissues.
5. Less physical activity: The more inactive you are the greater is the risk. Physical exercise helps in maintaining the weight.
6. High blood pressure: A blood pressure over 140/90 is associated with developing the condition.
7. Abnormal cholesterol & triglyceride levels: A low level of good cholesterol and high levels of triglycerides (a type of fat carried in blood) are linked to increased risk of developing the disorder.
8. Gestational Diabetes: If you had Gestational Diabetes during your pregnancy then later you can have increased risk of developing type 2 and prediabetes. If the weight of the baby is more than 9 pounds (4 kg), you are also at risk of developing type 2 Diabetes.
9. Polycystic ovary syndrome: Those women who have polycystic ovary syndrome – a condition that affects hormones level, ovulation and menstrual periods – have high risk of developing the disease.

Risk factors for Gestational Diabetes:

Although, any pregnant woman can have this type of Diabetes, but some women are at higher risk of developing it. These risk factors include:

1. Age: Women older than 25 years are at high risk.
2. Family or personal history: Your risk is higher if you have Prediabetes or if your parent or sibling has type 2 Diabetes. You are also at higher risk if you had Gestational Diabetes during previous pregnancy, if you delivered large baby or if you had unexplained stillbirth (birth of infant that has died in the womb).  
3. Overweight: Being overweight before pregnancy increases your risk.
4. Race: Women who are Hispanic, black, American Indian or Asian are more likely to develop the condition.

What are the complications of Diabetes?

The long-term complications develop gradually. If you have the disease for long time period and you didn’t control your blood sugar then the risk of complications becomes high, which may be life-threatening. Possible complications include:

• Cardiovascular problems, which include angina, stroke, heart attack and narrowing of arteries
• Nerve damage or neuropathy
• Kidney damage or nephropathy
• Eye diseases or problems, also called Diabetic Retinopathy
• Various foot problems such as cuts and blisters if left untreated may develop serious infections
• Skin problems such as bacterial and fungal infections
• Hearing problems
• Type 2 Diabetes increases the risk of Alzheimer’s disease when blood sugar level poorly controlled

Complications of Gestational Diabetes include:

Uncontrolled or untreated blood sugar level can cause serious complications to the mother and to the child. Complications in the baby are:

• Excess growth of the baby due to excess glucose level
• Low blood sugar level
• Baby can have high risk of developing obesity and Type 2 Diabetes later in life
• Baby’s death before or shortly after the birth

Complications in the mother are:

• Preeclampsia, a condition with the symptoms of high blood pressure, swelling in legs and feet and excess protein in urine
• Risk of having a subsequent Gestational Diabetes in the next pregnancy

The complication of Prediabetes includes the risk of developing into Type 2 Diabetes.

How Diabetes is diagnosed?

The symptoms of Type 1 Diabetes occur suddenly but the symptoms of other types of the disease develop gradually and may not be evident so due to this, the American Diabetes Association (ADA) has recommended the screening guidelines for Diabetes. According to ADA, following people should be screened for the condition:

• Anyone having body mass index higher than 25, regardless of the age and who has additional risk factors of sedentary lifestyle, high blood pressure and cholesterol level, history of having heart disease, having close relative with Diabetes, history of having polycystic ovary syndrome, delivered a baby more than 9 pounds and history of having Diabetes in pregnancy.
• Anyone older than 45 years of age is recommended to have initial blood sugar screening and if results are normal then he/she should be screened every 3 years.

The doctor performs various blood tests for diagnosing Type 1, Type 2 and Prediabetes, which include glycated hemoglobin (A1C) test, random blood sugar test, fasting blood sugar test and oral glucose tolerance test.

The doctor evaluates the risk factors for Gestational Diabetes early during the pregnancy. If you have an average risk of developing the disease then you will have screening test anytime during your second trimester (usually between 24-48 weeks of pregnancy). The doctor may also perform some screening tests which include initial glucose challenge test and follow-up glucose tolerance test.

How Diabetes is treated?

The treatment depends on the specific type of Diabetes that you have but monitoring blood sugar level, insulin and oral medications also play an important role in your treatment. Eating healthy and balanced diet, maintaining healthy weight and regular physical activity are vital factors in the management of Diabetes.

Treatment that manages the blood sugar in all types of Diabetes:

1. Healthy Eating:

Although there is no specific diet for the disease but you need to add those foods in your diet that are high in fiber and nutrition and low in fat and calories. Add fruits, vegetables and whole grains and avoid sweets, refined carbohydrates and animal products. Sugary foods are fine to eat once in a while but it is recommended to discuss with your doctor and a registered dietician about the amount of sugary foods to add in our diet plan.

2. Physical activity:

Exercise lowers blood sugar level by moving the sugar into blood cells for energy and increases sensitivity to insulin, meaning that less insulin is needed by your body to transport sugar into the cells. Discuss with your doctor about choosing the physical activity which may include walking or swimming and then make it a part of your regular routine while giving at least 30 mints to the physical activity. If you have not been active earlier then start exercising slowly (give 10-15 mints) and then build it up gradually.   

Treatment for Type 1 Diabetes:

 As pancreas damages permanently in this type so the patients need to take insulin, which is injected under the skin. The doctor instructs you how to properly inject the insulin and how to rotate the injection sites. Insulin pump can also be used to take insulin, which is a device that you wear outside your body and it is programmed in a way to release the specific dose. Moreover, the patients should also monitor the blood sugar levels throughout the day. If necessary, the doctor also recommends medications for controlling high blood pressure, cholesterol and other complications.

Treatment for Type 2 Diabetes:

This type can be managed with proper diet and regular exercise and also treated with various medications to control blood sugar levels. The most common medication prescribe to treat type 2 is Metformin (Glucophage, Glumetza, others). This drug helps your body to use the insulin more effectively. If this medication didn’t work, then the doctor can prescribe any other medication. Monitoring blood sugar levels is essential for the treatment. The doctor may also prescribe medications to control blood pressure and cholesterol, if needed.

Treatment for Gestational Diabetes:

In order to keep your baby healthy and to avoid complications during delivery, it is essential for you to control your blood sugar levels. Along with diet and exercise, your treatment plan also include monitoring blood sugar levels and in some cases, using oral medications or insulin. The doctor also monitors blood sugar level during labor.  

Treatment for Prediabetes:

The treatment of Prediabetes is thought to be the prevention of Type 2 Diabetes. The first and foremost treatment option is healthy lifestyle changes that can help to bring down the blood sugar level to normal or keep it away from rising to that level seen in Type 2 Diabetes. If you eat healthy diet and maintain healthy weight then these also can really help you. Sometimes, the doctor recommends medications such as (Glucophage, Glumetza, others) if you are at high risk of developing Diabetes or your Prediabetes is worsening or you have fatty liver disease, cardiovascular disease or polycystic ovary syndrome. In some cases, the doctor also prescribes medications for controlling blood pressure and cholesterol. Most importantly, healthy lifestyle choice is the key in treating Prediabetes.

Book an appointment with specialists at Island Medical Consultants in NYC:

If you’re experiencing any symptoms of Diabetes then you can consult Island Medical Consultants in NYC, who have expertise in treating patients and providing best Diabetes care and management services. Regular screening tests, customized treatment and management plan and best dietary advice, by our qualified, experienced and trained doctors, help you to live a healthy and normal life while perfectly managing the disease.