DIABETES - An Overview
Glucose is a vital component of body. It is known as a source of energy for the cells which results in the formation of muscles and tissues of the body. It serve as the major energy source for brain cells. But if blood sugar get increased it can cause complications in the brain. Diabetes mellitus is known as a complex, long term, metabolic disease which comes into action when the body comes into the stage of high blood sugar level due to either inability of body cells to respond insulin or inadequate production of insulin or both. Due to high blood sugar, the damages occurs to nerves, blood vessels. It leads to the series of complications like heart disease, kidney disease, stroke, dental disease, depression blindness and problems in pregnancy.
Types of diabetes
1. Type-I diabetes is the condition when no insulin is produced in the body. There are only 10% cases worldwide of type-I. It is also known as insulin dependent or juvenile diabetes as it develops in early teenage years or adulthood. It happens when immune system destroys cells the pancreatic cells known as beta cells. These beta cells are responsible for the production of insulin. The people suffering from this disease take insulin injections throughout their life.
2. Type-II diabetes comes into action when the human body cannot produce required amount of insulin to run proper functioning of body. It is most common type of diabetes which occurs in 90% cases worldwide. It is a big health issue these days and will gradually increase if not taken seriously. It is different from type-I in only one thing; the immune system does not destroy the beta cells. The beta cells of pancreas get affected by either by some disease or an injury to the pancreas.
3. Gestational Diabetes - There is one more type of diabetes known as gestational diabetes found in pregnant women. This is observed in the women which have very high levels of blood sugar. These type of patients suffers from diabetes because their body cells are not able to produce sufficient insulin. If it is not diagnosed on time there can be a risk of complications during childbirth. The size of baby can be much bigger than the regular size during birth. It was observed that women with the rich in animal fat and cholesterol before pregnancy were more prone for the gestational diabetes, as compared to the women with less animal fat or cholesterol. Sometimes patients recover after pregnancy and sometimes this get converted into type II diabetic condition.
Causes of Diabetes
Causes of Type 1 Diabetes
Genetic Factors - Heredity is important factor upon which it depends that who is likely to develop type-1 diabetes. The most important thing which passes from parent to child is genes, which carries the information/instructions to the body for the production of proteins, needed for the body's proper function. There are certain sets of genes responsible for the protection from type 1 diabetes, which can vary different population called as gene variants. Some gene variants carry information of proteins production called human leukocyte antigens (HLAs) on white blood cells. These are associated to the development of type 1 diabetes. HLA genes produces some proteins responsible to determine that whether the immune system recognizes a cell as part of the body or as foreign material. By the use of genetic testing the types of HLA genes carried by a person can be identified and also can show the detail of other genes linked to diabetes. However, most genetic testing is done in a research setting and is not yet available to individuals. Scientists are studying how the results of genetic testing can be used to improve type 1 diabetes prevention or treatment.
Autoimmune Destruction of Beta Cells - In type 1 diabetes, white blood cells called T cells attack and destroy beta cells. The problem with this disease is, most of the beta cells have been destroyed before diagnosis, due to which the patient is totally dependent upon insulin treatment to survive.
Effect of Environmental - There are lots of environmental factors upon which type 1 diabetes generally depends, such as viruses, foods and toxins. Reports showed that in some patients which are genetically susceptibility to diabetes, the environmental factors plays a boosting part for the autoimmune destruction of beta cells. Whereas in some reports it was observed that the environmental factors even after diagnosis, plays an ongoing role in diabetes.
Viruses and infections - There are no reports on a virus causing diabetes by itself, but the relation is observed between these two because in some cases during or after a viral infection the diagnosis of type 1 diabetes occurs, suggesting a link between the two. The name of viruses linked with type 1 diabetes are cytomegalovirus, coxsackievirus B, rubella, adenovirus and mumps. The various ways are known for describing the ways through which these viruses destroy beta cells or boost an autoimmune cytomegalovirus which significantly damage the beta cells.
Breastfeed practices - The infants receiving vitamin D supplements or breastfed infants are less prone to type 1 diabetes in comparison infants exposed to the cow's milk and cereal proteins.
Causes of Type 2 Diabetes
Genetic susceptibility - If we talk about the susceptibility to type 2 diabetes the genes play an important role as some genes alone or in combinations may induce or reduce the risk for developing the disease. Although there is no information of many gene variants that increase susceptibility to type 2 diabetes, but certain known genes affect production of insulin. The best example is the TCF7L2 gene variants increases the susceptibility to type 2 diabetes.
Obesity and lack of physical activity - The major reason of development of type 2 diabetes is lack of physical inactivity and obesity. The caloric intake imbalance and lack of physical activity can lead to obesity. This is major reason for insulin resistance, which is common in people with type 2 diabetes. The presence of excess fat in abdominal area can be a big risk for insulin resistance, type 2 diabetes and heart or blood vessel disease. The patients with type 2 diabetes can reduce the risk of complications by doing physical activity regularly and by doing diet control with taking less calories or low fat food.
Insulin Resistance - Among the people who are overweight or obese, the insulin resistance is a common problem. Due to such problem the muscles and liver cells does not respond properly to insulin due to which the pancreas is forced to produce extra insulin. This all depend upon the beta cells which are producing enough insulin to control the blood glucose levels to the normal range. But if insulin production become irregular due to beta cell dysfunction, the glucose level rises which leads to prediabetes or diabetes.
Abnormal Glucose Production by the Liver - The irregular increase in glucose production by liver is also a big reason for production of high blood glucose levels. The production of hormone glucagon by liver occurs when blood glucose and insulin levels are low. This hormone helps in stimulations of liver to produce glucose and release it into the blood. If there is increase in blood glucose there is increase in insulin levels as well, which leads to the fall in production of glucagon. The excess glucose in the liver is stored for further use results to the higher glucagon levels for longer time. The increased glucagon levels in result stimulate liver to produce more glucose, which results to the increase in blood glucose levels.
Beta Cell Dysfunction - The beta cell dysfunction is major factor behind the type 2 diabetes. If the insulin secretion level is not normal, the beta cell impairment can occur. Glucose toxicity can be another factor responsible for the damage of beta cells and the condition is known as glucose toxicity. In the early life if there is malnutrition, it is also a cause of beta cell dysfunction.
Age - The growing age is also a risk factor in developing type 2 diabetes, because with the increase in the age, the weight of body increases generally and physically activity decreases. Due to which the risk of diabetes increases with the age.
Causes of Gestational Diabetes
- If the pregnant women is obese and suffering from high blood pressure can be a victim of gestational diabetes.
- If the pregnant women possess some medical complications, may have risk of gestational diabetes.
- If a lady has given the birth to an obese child before i.e. greater than 9 kg.
- If already given a birth to child who is stillborn or may be suffering from some birth problems.
- Experienced the problem of gestational diabetes in earlier pregnancies.
- If the problem of diabetes is hereditary or already present in family.
- If the age is more than 30 years during pregnancy.
Symptoms of Diabetes
Symptoms of Type 1 Diabetes
1. High Blood Sugar
The symptoms associated with type-1 (high blood sugar) are as following:
- Feeling very thirsty, hungry and tired all the time
- Trouble in clear vision
- Intense numbness in the feet
- Unplanned weight loss
- Frequent urination
- Breathing disorder (Deep and sometime rapid breathing), Fruity breath odor
- Dryness in skin
- Stomach pain, nausea or vomiting
2. Low Blood Sugar
The condition of low blood sugar is also known as hypoglycemia, can occur in patients of diabetes who are taking insulin. With the fall in blood sugar level below 70 milligrams per deciliter (mg/dL), the symptoms appears:
- Feeling hungry
- Nervousness and fear
- Rapid heartbeat (palpitations), shaking, sweating and weakness
Symptoms of Type 2 Diabetes
There are no specific symptoms of type 2 diabetes. If appear, they are different and vary person to person.
- There will be increase in thirst
- The person feels hungry after meals
- The feeling of dryness in mouth
- The person may feel vomiting and nauseous
- Frequent and increased urination
- Person may feel weakness or tiredness
- The vision will go blur
- Tingling in the hands or feet
- The repetitive infections of skin, urinary tract and vagina
- Slow healing of sores
Symptoms of Gestational diabetes
There are no specific symptoms for gestational diabetes in pregnant women. If a women is pregnant the test for gestational diabetes id compulsory and a part of prenatal care.
Diagnosis of Diabetes
The various tests for type 1 and type 2 diabetes and pre-diabetes are as following:
Test for Glycated hemoglobin (A1C)
This blood test indicates the level of sugar for past the past two to three months but does not show daily fluctuations. It is calculate the blood sugar percentage associated with hemoglobin. If the blood sugar level is high there will be more hemoglobin attached with sugar. This is used to detect type 2 diabetes and pre-diabetes. It is not recommended for the diagnosis of type 1 diabetes or gestational diabetes. The A1C test is more easy and getting popular these days because it does not require fasting. This can be done at any time of the day.
If the percentage of this test is high then the person's blood glucose level is also high. The normal range of A1C test is below 5.7 percent. If the percentage of A1C is 5.7 to 6.4 percent, that indicates pre-diabetes. If the level is 6.5 percent or above the person is diagnosed as diabetic.
Fasting blood sugar test
This type of sugar test is done after an overnight fast. If the blood sugar level in fasting is less than 100 mg/dL, is normal. And if fasting blood sugar level varies from 100 to 125 mg/dL, is known as pre-diabetic stage. If it is 126 mg/dL or higher on two separate tests, is diagnosed as diabetic stage.
Random blood sugar test
In this type of blood sugar testing a blood sample can be taken at a random time. If the random blood sugar level measures 200 milligrams per deciliter (mg/dL) or higher, the patient is diagnosed as diabetic.
Oral glucose tolerance test
After fasting overnight the sample is collected and blood sugar level is measured. After that the sugary liquid is given to the patient and blood sugar levels are analyzed periodically for the next two hours. If blood sugar level is less than 140 mg/dL than it is normal. If level exceeds than 200 mg/dL after two hours shows diabetes. If the reading is between 140 and 199 mg/dL, it indicates pre-diabetes.
Tests for gestational diabetes are as following:
To evaluate high risk factors for gestational diabetes the following teats are recommended:
Initial glucose test
This blood glucose test is done by drinking a glucose solution syrup. After one hour later, the blood test is done to analyze blood sugar level. If blood sugar level is below 140 mg/dL, it is usually considered normal. If blood sugar level exceeds from normal, it shows the higher risk of gestational diabetes.
Glucose tolerance test
The blood sample is collected from the patient who fast overnight. Then the fasting blood sugar level is measured. Then after drinking a glucose solution syrup, containing a higher concentration of glucose. After that the blood sugar level is checked after every hour for a period of three hours. Out of three readings, if two are observed higher than the normal values the person is diagnosed with gestational diabetes.