Diabetes mellitus

Diabetes mellitus, or simply diabetes, is a chronic health condition that affects how your body turns food into energy. The food you eat is broken down into a sugar called glucose, which enters your bloodstream. Insulin, a hormone made by your pancreas, acts like a key to let glucose into your body's cells for use as energy. 

In people with diabetes, either the body doesn't produce enough insulin or can't use its own insulin effectively. This causes blood sugar levels to become too high, which can lead to serious health complications over time if left unmanaged. 

Type 1 vs. Type 2 Diabetes

There are two main types of diabetes, which have different causes. 

  • Type 1 Diabetes

    • What it is: An autoimmune disease where the body's immune system attacks and destroys the insulin-producing cells in the pancreas.

    • Who it affects: While it is often diagnosed in children and young adults, it can develop at any age.

    • Cause: The exact cause is unknown, but it is not related to diet or lifestyle choices.

    • What it means: The body produces little to no insulin and needs to be replaced daily.

  • Type 2 Diabetes

    • What it is: The body develops "insulin resistance," meaning its cells don't respond to insulin as they should. The pancreas works overtime to make more insulin to compensate but can't keep up over time.

    • Who it affects: Most common in middle-aged and older adults but is increasingly diagnosed in younger people, including children.

    • Cause: Often linked to genetics, being overweight or obese, and a sedentary lifestyle, though other risk factors play a role.

    • What it means: Many people can manage it through lifestyle changes, though medication and/or insulin may be needed over time. 

Signs and symptoms

The signs and symptoms of diabetes can develop slowly or appear suddenly, depending on the type. Some people with Type 2 diabetes may not experience any symptoms for years. 

Common symptoms of diabetes include: 

  • Increased thirst and frequent urination: As excess sugar builds up in your blood, your kidneys work to flush it out, causing you to urinate more often and leading to thirst.

  • Unexplained weight loss: When your body can't use sugar for energy, it starts breaking down muscle and fat.

  • Increased hunger: Your body's cells are not getting the energy they need, triggering hunger.

  • Fatigue: A feeling of extreme tiredness or a lack of energy.

  • Blurry vision: High blood sugar can cause the lens of your eye to swell, affecting your sight.

  • Slow-healing sores or frequent infections: A high blood sugar level weakens the immune system.

  • Numbness or tingling: High blood sugar can damage nerves over time, causing a loss of feeling in the hands or feet. 

Diagnosis

A doctor diagnoses diabetes based on blood tests that measure your blood sugar levels. 

  • A1C test: This blood test provides your average blood sugar level over the past two to three months. It does not require fasting beforehand.

  • Fasting plasma glucose (FPG) test: This measures your blood sugar after you have not had anything to eat or drink for at least eight hours.

  • Oral glucose tolerance test (OGTT): This test checks your blood sugar before and two hours after you drink a sugary liquid.

  • Random plasma glucose test: A blood sample is taken at a random time of day. A reading of 200 mg/dL or higher suggests diabetes, especially with other symptoms. 

Treatment

Managing diabetes requires controlling blood sugar levels to prevent complications. 

For Type 1 Diabetes 

  • Insulin therapy: This is the main treatment, as the body cannot produce its own insulin. It can be administered through injections, an insulin pump, or an insulin inhaler.

  • Regular monitoring: Checking blood sugar levels regularly with a glucometer or a continuous glucose monitor (CGM).

  • Lifestyle management: A healthy diet and regular physical activity are essential for managing blood sugar. 

For Type 2 Diabetes 

  • Lifestyle changes: Many can manage the disease through healthy eating, weight loss, and regular physical activity.

  • Medications: Oral medications, such as metformin, are often prescribed to help your body produce more insulin or use it more effectively.

  • Insulin therapy: As the disease progresses, some people with Type 2 diabetes may eventually need to take insulin. 

Other important considerations

  • Regular check-ups: Frequent visits with your healthcare team are important to monitor your blood sugar and adjust your treatment plan.

  • Preventing complications: Managing your blood pressure and cholesterol, taking care of your feet, and quitting smoking are crucial to preventing complications.

  • Diabetes education: Working with a diabetes educator can help you learn how to manage your condition effectively.


 

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