Diabetes - Dr. Bharat Ratna Pandey

Introduction

Diabetes mellitus is characterized by abnormally high levels of sugar (glucose) in the blood. Diabetes Mellitus is a chronic, lifelong condition that affects your body’s ability to use the energy found in food.

There are 2 major types of Diabetes Mellitus

1. Type 1 Diabetes

2. Type 2 Diabetes

Common differences between type 1 and type 2 diabetes

Type 1 Diabetes	Type 2 Diabetes
Often diagnosed in childhood	Usually diagnosed in over 30 year olds
Not associated with excess body weight	Often associated with excess body weight
Often associated with higher than normal ketone levels at diagnosis	Often associated with high blood pressure and/or cholesterol levels at diagnosis
Treated with insulin injections or insulin pump	Is usually treated initially without medication or with tablets
Cannot be controlled without taking insulin	Sometimes possible to come off diabetes medication

Role of Insulin

Insulin regulates how the body uses and stores glucose and fat. Many of the body’s cells rely on insulin to take glucose from the blood for energy.

Role of Glucose

Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin. When your glucose levels are low, such as when you haven’t eaten in a while, the liver breaks down stored glycogen into glucose to keep your glucose level within a normal range.

Sign & Symptoms

Excessive thirst and increased urination

When you have diabetes, excess sugar (glucose) builds up in your blood. Your kidneys are forced to work overtime to filter and absorb the excess sugar. If your kidneys can’t keep up, the excess sugar is excreted into your urine, dragging along fluids from your tissues. This triggers more frequent urination, which may leave you dehydrated. As you drink more fluids to quench your thirst, you’ll urinate even more.

Fatigue

They include dehydration from increased urination and your body’s inability to function properly, since it’s less able to use sugar for energy needs.

Weight Loss

When you lose sugar through frequent urination, you also lose calories. At the same time, diabetes may keep the sugar from your food from reaching your cells — leading to constant hunger. The combined effect is potentially rapid weight loss, especially if you have type 1 diabetes.

Blurred Vision

High levels of blood sugar pull fluid from your tissues, including the lenses of your eyes. This affects your ability to focus.

Slow-healing sores or frequent infections

Doctors and people with diabetes have observed that infections seem more common if you have diabetes. Research in this area, however, has not proved whether this is entirely true, nor why. It may be that high levels of blood sugar impair your body’s natural healing process and your ability to fight infections. For women, bladder and vaginal infections are especially common.

Tingling hands and feet

Excess sugar in your blood can lead to nerve damage. You may notice tingling and loss of sensation in your hands and feet, as well as burning pain in your arms, hands, legs and feet.

Red, swollen, tender gums

Diabetes may weaken your ability to fight germs, which increases the risk of infection in your gums and in the bones that hold your teeth in place. Your gums may pull away from your teeth, your teeth may become loose, or you may develop sores or pockets of pus in your gums — especially if you have a gum infection before diabetes develops.

Investigations

There are common investigation for Diabetes

Blood Sugar Fasting
Blood Sugar Post Prandial
Blood Sugar Random
HbA1C
Glucose Tolerance Test

Diet and preventing type 2 diabetes

Diet is the most important part of lifestyle change. The adage that you can’t outrun a bad diet is true.

It is much easier to lose weight on a good diet even if youare struggling to do exercise, than it is through exercise if you’re eating apoor diet.

Effective diets to prevent type 2 diabetes are those that donot cause your body to produce a lot of insulin. Carbohydrate has the biggestdemand on insulin and so any diet that helps reduce carbohydrate intake willhelp towards reducing your risk of type 2 diabetes.

Cutting out sugary food and drink and refined grains such aswhite bread and white rice is a good first step.

Modern research has shown that low-fat diets are not ashealthy as they were once believed to be. It is more important to avoidprocessed food rather than trying to avoid fat in foods such as dairy.

Aim to have a balanced diet by basing meals aroundvegetables and include healthy sources of fat such as unsalted tree nuts(walnuts, almonds, hazelnuts), olive oil, avocado, oily fish, meat and full fatdairy.

Exercise to prevent type 2 diabetes

Whilst a good diet is the foundation of good health,exercise is the next important step.

Exercise can help to prevent diabetes in a number ofways.

During exercise, our muscles use any excess sugar inthe blood and the sugar, known as glycogen, that is stored in the muscles andliver.

After exercise is completed, the muscles will gradually replenish their sugar stores by taking in sugar from the blood. This helps lower blood sugar levels and improves insulin sensitivity.

Regular exercise, along with a good diet, can reduce the risk of type 2 diabetes and can help reduce cholesterol levels and high blood pressure.

Even a little extra activity each day can help. Some basic steps can really help to make a difference if they become a regular habit, such as walking to the shops rather using the car or getting off the bus a stop early.

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