Diabetes

Overview

Diabetes is a group of diseases that affect how the body uses blood sugar (glucose) for energy. Glucose is a crucial source of fuel for the body's muscles and tissues, as well as the brain. Different types of diabetes exist, with type 1 and type 2 being the most common. Type 1 diabetes is a chronic condition in which the pancreas fails to produce enough insulin, a hormone that regulates the movement of sugar into the cells. It typically appears during childhood or adolescence and requires lifelong insulin therapy to manage blood sugar levels. Type 2 diabetes, once known as adult-onset diabetes, occurs when the body becomes resistant to insulin and/or the pancreas doesn't produce enough insulin. It is more common in older adults, but the increasing number of children with obesity has led to more cases in younger people. Type 2 diabetes can often be managed through a combination of healthy eating, regular physical activity, and maintaining a healthy weight. In some cases, oral medication or insulin treatment may be necessary. In both types of diabetes, if blood sugar levels remain uncontrolled over time, it can lead to serious health complications. Managing diabetes through proper treatment, diet, and lifestyle changes is essential to prevent or minimize these complications.

Understanding the disease

Symptoms

Symptoms of diabetes can vary depending on the type and severity of the condition. Common symptoms of type 1 and type 2 diabetes include:

1. Feeling more thirsty than usual.
2. Urinating often.
3. Losing weight without trying.
4. Presence of ketones in the urine.
5. Feeling tired and weak.
6. Feeling irritable or having other mood changes.
7. Having blurry vision.
8. Having slow-healing sores.
9. Getting a lot of infections, such as gum, skin, and vaginal infections. In the case of type 2 diabetes, symptoms often develop slowly and may not be noticeable for years. Some people, especially with prediabetes or gestational diabetes, may not have any apparent symptoms. It's essential to see a healthcare provider if you notice any symptoms of diabetes or if you have concerns about the condition. They can perform blood sugar screenings and determine the appropriate course of action. Remember, early detection and management are crucial in managing diabetes effectively.

Risk Factors

The risk factors for developing diabetes, including prediabetes and type 1 diabetes, are as follows:

1. Weight: Being overweight or obese is a main risk factor.
2. Waist size: A large waist size, indicating insulin resistance, increases the risk.
3. Diet: Consuming red meat, processed meat, and sugar-sweetened beverages raises the risk.
4. Inactivity: Lack of physical activity increases the risk.
5. Age: The risk increases after age 35 for prediabetes and type 2 diabetes.
6. Family history: Having a parent or sibling with diabetes raises the risk.
7. Racial and ethnic factors: Certain races and ethnicities, such as Black, Hispanic, Native American, and Asian people, have a higher risk for type 2 diabetes. For type 1 diabetes:
8. Family history: Having a parent or sibling with type 1 diabetes increases the risk.
9. Genetics: Certain genes can increase the risk of developing type 1 diabetes.
10. Geography: The prevalence of type 1 diabetes tends to be higher away from the equator.
11. Age: It can appear at any age but is more common in children between 4 and 7 and 10 to 14 years old. Remember, maintaining a healthy lifestyle, including regular physical activity and a balanced diet, can help reduce the risk of developing diabetes.

Development

Type 1 and Type 2 diabetes develop due to different primary issues in the body's regulation and use of sugar. In Type 1 diabetes, the pancreas does not produce enough insulin, a hormone that regulates the movement of sugar into the cells. In Type 2 diabetes, the pancreas produces insulin, but the cells respond poorly to it and take in less sugar.

Assessment and Diagnosis

Triage

You should see a doctor if you or your child exhibit any signs or symptoms of diabetes, such as increased thirst, frequent urination, increased hunger, fatigue, blurry vision, darkened skin, unintended weight loss, or frequent infections. It is important to diagnose diabetes early to prevent serious complications. Diabetes screening is recommended for children who have started puberty or are at least 10 years old, who are overweight or obese, and who have at least one other risk factor for type 2 diabetes. If you've already been diagnosed with diabetes, you should seek close medical follow-up until your blood sugar levels stabilize.

Diagnosis

To diagnose diabetes, a healthcare provider will typically perform several tests to evaluate blood sugar levels and identify any abnormalities. The following tests are commonly used:

1. Glycated hemoglobin (A1C) test: This blood test measures your average blood sugar level over the past 2-3 months, indicating the overall blood sugar control. An A1C level of 6.5% or higher on two separate tests suggests diabetes.
2. Oral glucose tolerance test: This test involves fasting overnight, then drinking a sugary liquid at the healthcare provider's office or a laboratory testing site. Blood sugar levels are checked periodically for the next two hours. A blood sugar level of 200 mg/dL (11.1 mmol/L) or higher generally indicates diabetes.
3. Random blood sugar test: This test is performed at any time, regardless of when you last ate. A blood sugar level of 200 mg/dL (11.1 mmol/L) or higher may suggest diabetes, but it is not as reliable as the A1C or oral glucose tolerance tests. In addition to these tests, healthcare providers may also use additional tests to distinguish between type 1 and type 2 diabetes, as treatment strategies for each type differ. It is essential to consult with a healthcare provider for an accurate diagnosis and appropriate treatment plan.

Management and Treatment

Complications

Some potential complications of diabetes include uncontrolled high blood sugar (hyperglycemia), uncontrolled high blood pressure (hypertension), being a smoker, high blood cholesterol, obesity, a family history of diabetes and kidney disease, fluid retention, a rise in potassium levels in the blood, heart and blood vessel disease (cardiovascular disease), damage to the blood vessels of the light-sensitive tissue at the back of the eye (diabetic retinopathy), reduced number of red blood cells to transport oxygen (anemia), foot sores, erectile dysfunction, diarrhea, bone and mineral disorders, and other problems related to damaged nerves and blood vessels. Additionally, people with prediabetes or type 2 diabetes are more likely to develop complications if they are overweight or obese. Long-term complications of diabetes can be disabling or even life-threatening and may include heart and blood vessel disease, kidney disease, eye damage, skin conditions, slow healing, hearing impairment, sleep apnea, foot damage, and pregnancy complications.

Treatment

For type 2 diabetes, the primary treatments involve lifestyle changes, such as maintaining a healthy weight, exercising regularly, and managing cholesterol and blood pressure. Additionally, medications or insulin therapy may be recommended if diet and exercise aren't enough to control blood sugar levels. Metformin may be prescribed for people with prediabetes to reduce the risk of developing type 2 diabetes. However, there's no cure for type 2 diabetes. It's important to work closely with a healthcare provider to develop a personalized management plan.

Preparing for medical consultation

To prepare for an appointment for diabetes, follow these steps:

1. Be aware of any pre-appointment restrictions: When you make the appointment, ask if you need to do anything in advance, such as restricting your diet before a fasting blood sugar test.
2. Write down any symptoms you're experiencing: Include any symptoms that may seem unrelated to diabetes.
3. List key personal information: Note any major stresses or recent life changes, and bring a record of your glucose results if you're monitoring your glucose values at home.
4. Make a list of allergies and medications: Include all medications, vitamins, and supplements you're taking.
5. Record your family medical history: Note any relatives who have had diabetes, heart attacks, or strokes.
6. Bring a family member or friend: Someone who accompanies you can help remember important information and provide support.
7. Write down questions to ask your healthcare provider: Discuss aspects of your diabetes management, blood sugar monitoring, insulin therapy, low blood sugar, and high blood sugar treatment.
8. Be prepared for referrals: Ask your healthcare provider for a referral to a certified diabetes care and education specialist and a registered dietitian for additional education on managing diabetes. By following these steps, you can ensure that you're well-prepared for your diabetes appointment and can make the most of the time with your healthcare provider.