Diabetes Overview

Diabetes is a set of related diseases in which the body cannot regulate the amount of sugar (glucose) in the blood.

Glucose in the blood gives you energy—the kind you need when you walk briskly, run for a bus, ride your bike, take an aerobics class, and perform your day-to-day chores.

• Glucose in the blood is produced by the liver from the foods you eat.
• In a healthy person, the blood glucose level is regulated by several hormones, one of which is insulin. Insulin is produced by the pancreas, a small organ near the stomach that also secretes important enzymes that help in the digestion of food.
• Insulin allows glucose to move from the blood into liver, muscle, and fat cells, where it is used for fuel.
• People with diabetes either do not produce enough insulin (type 1 diabetes) or cannot use insulin properly (type 2 diabetes), or both.
• In diabetes, glucose in the blood cannot move into cells, and it stays in the blood. This not only harms the cells that need the glucose for fuel, but also harms certain organs and tissues exposed to the high glucose levels.

Type 1 diabetes:

The body does not produce insulin or produces it only in very small quantities. Symptoms usually appear suddenly and in individuals under 20 years of age. Most cases occur before or around puberty

• Type 1 diabetes comprises about 10% of total cases of diabetes in the United States.
• Type 1 diabetes is typically recognized in childhood or adolescence. It used to be known as juvenile-onset diabetes or insulin-dependent diabetes mellitus.
• Type 1 diabetes can occur in an older individual due to destruction of pancreas by alcohol, disease, or removal by surgery or progressive failure of pancreatic beta cells, which produce insulin.
• People with type 1 diabetes generally require daily insulin treatment to sustain life.

Type 2 diabetes:

The pancreas secretes insulin, but the body is partially or completely unable to use the insulin. This   is sometimes referred to as insulin resistance. The body tries to overcome this resistance by secreting more and more insulin. People with insulin resistance develop type 2 diabetes when they do not continue to secrete enough insulin to cope with the higher demands. The body either makes insufficient amounts of insulin or is unable to use it. Symptoms characteristic of Type II diabetes include repeated infections or skin sores that heal slowly or not at all, generalized tiredness, tingling or numbness in the hands or feet, and itching.

• At least 90% of patients with diabetes have type 2 diabetes.
• Type 2 diabetes is typically recognized in adulthood, usually after age 45 years. It used to be called adult-onset diabetes mellitus, or non–insulin-dependent diabetes mellitus. These names are no longer used because type 2 diabetes does occur in younger people, and some people with type 2 diabetes need to use insulin.
• Type 2 diabetes is usually controlled with diet, weight loss, exercise, and oral medications. More than half of all people with type 2 diabetes require insulin to control their blood sugar levels at some point in the course of their illness.

Complications of diabetes

Both forms of diabetes ultimately lead to high blood sugar levels, a condition called hyperglycemia. Over a long period of time, hyperglycemia damages the retina of the eye, the kidneys, the nerves, and the blood vessels.

• Damage to the retina from diabetes (diabetic retinopathy) is a leading cause of blindness.
• Damage to the kidneys from diabetes (diabetic nephropathy) is a leading cause of kidney failure.
• Damage to the nerves from diabetes (diabetic neuropathy) is a leading cause of foot wounds and ulcers, which frequently lead to foot and leg amputations.
• Damage to the nerves in the autonomic nervous system can lead to paralysis of the stomach (gastroparesis), chronic diarrhea, and an inability to control heart rate and blood pressure with posture changes.
• Diabetes accelerates atherosclerosis, or the formation of fatty plaques inside the arteries, which can lead to blockages or a clot (thrombus), which can then lead to heart attack, stroke, and decreased circulation in the arms and legs (peripheral vascular disease).
• Diabetes predisposes people to high blood pressure and high cholesterol and triglyceride levels. These independently and together with hyperglycemia increase the risk of heart disease, kidney disease, and other blood vessel complications.

Some of the symptoms of diabetes include:

v     Frequent bathroom trips

v     Excessive thirst

v     Extreme hunger

v     Unusual weight lost

v     Increased fatigue

v     Irritability

v     Blurry vision

v     It is in your family tree

The Right Treatment

Once diabetes is diagnosed, treatment consists of controlling the amount of glucose in the blood and preventing complications. Depending on the type of diabetes, this can be accomplished through regular physical exercise, a carefully controlled diet, and medication.

·        Type I diabetes

Require insulin injections, often two to four times a day, to provide the body with the insulin it does not produce. The amount of insulin needed varies from person to person. Typically, several times a day. They can then adjust the amount of insulin injected, physical exercise, or food intake to maintain the blood sugar at a normal level. People with Type I diabetes must carefully control their diets by distributing meals and snacks throughout the day so the insulin supply is not overwhelmed and by eating foods that contain complex sugars, which break down slowly and cause a slower rise in blood sugar levels.

·        Type II diabetes

The basics of treatment are diet control, weight reduction, and exercise. Weight reduction appears to partially reverse the body’s inability to use insulin. A person whose blood sugar level remains high may also require insulin injections. An oral sugar-lowering agent may be prescribed for persons who do not require insulin to control diabetes as well as for people who have trouble injecting themselves or whose diabetes is not controlled by insulin. Moderate exercise, even ten minutes a day, helps people with Type II diabetes maintain a constant level of glucose in the blood and lose weight. This in turn may decrease the amount of medication required.