What is diabetes? What causes diabetes?
Diabetes, often referred to by doctors as
diabetes mellitus, describes a group of metabolic diseases in
which the person has high blood glucose (blood sugar), either because insulin
production is inadequate, or because the body's cells do not respond properly to
insulin, or both. Patients with high blood sugar will typically experience
polyuria (frequent urination), they will become increasingly thirsty
(polydipsia) and hungry (polyphagia).
There are three types of diabetes:
1) Type 1 Diabetes
The body does not produce insulin. Some people may refer to
this type as insulin-dependent diabetes, juvenile diabetes, or
early-onset diabetes. People usually develop type 1 diabetes
before their 40th year, often in early adulthood or teenage years.
Type 1 diabetes is nowhere near as common as type 2 diabetes.
Approximately 10% of all diabetes cases are type 1.
Patients with type 1 diabetes will need to take insulin
injections for the rest of their life. They must also ensure proper
blood-glucose levels by carrying out regular blood tests and following a special
diet.
Between 2001 and 2009, the prevalence of type 1 diabetes among
the under 20s in the USA rose 23%, according to SEARCH for Diabetes in Youth
data issued by the CDC (Centers for Disease Control and Prevention).
2) Type 2 Diabetes
The body does not produce enough insulin for proper function,
or the cells in the body do not react to insulin (insulin resistance).
Approximately 90% of all cases of diabetes worldwide are of
this type.
Some people may be able to control their type 2 diabetes
symptoms by losing weight, following a healthy diet, doing plenty of exercise,
and monitoring their blood glucose levels. However, type 2 diabetes is typically
a progressive disease - it gradually gets worse - and the patient will probably
end up have to take insulin, usually in tablet form.
Overweight and obese people have a much higher risk of
developing type 2 diabetes compared to those with a healthy body weight. People
with a lot of visceral fat, also known as central obesity, belly fat, or
abdominal obesity, are especially at risk. Being overweight/obese causes the
body to release chemicals that can destabilize the body's cardiovascular and
metabolic systems.
The risk of developing type 2 diabetes is also greater as we
get older. Experts are not completely sure why, but say that as we age we tend
to put on weight and become less physically active. Those with a close relative
who had/had type 2 diabetes, people of Middle Eastern, African, or South Asian
descent also have a higher risk of developing the disease.
Men whose testosterone levels are low have been found to have a
higher risk of developing type 2 diabetes. Researchers from the University of
Edinburgh, Scotland, say that low testosterone levels are linked to insulin
resistance.
Figure: Measuring the glucose level in blood
3) Gestational diabetes
This type affects females during pregnancy. Some women have
very high levels of glucose in their blood, and their bodies are unable to
produce enough insulin to transport all of the glucose into their cells,
resulting in progressively rising levels of glucose.
Diagnosis of gestational diabetes is made during pregnancy.
The majority of gestational diabetes patients can control their diabetes
with exercise and diet. Between 10% to 20% of them will need to take some kind
of blood-glucose-controlling medications. Undiagnosed or uncontrolled
gestational diabetes can raise the risk of complications during childbirth. The
baby may be bigger than he/she should be.
Scientists from the National Institutes of Health and Harvard
University found that women whose diets before becoming pregnant were high in
animal fat and cholesterol had a higher risk for gestational diabetes, compared
to their counterparts whose diets were low in cholesterol and animal fats.
What is Prediabetes?
The vast majority of patients with type 2 diabetes initially
had prediabetes. Their blood glucose levels where higher than
normal, but not high enough to merit a diabetes diagnosis. The cells in the body
are becoming resistant to insulin.
Studies have indicated that even at the prediabetes stage, some
damage to the circulatory system and the heart may already have occurred.
Diabetes - A Metabolism Disorder
Diabetes (diabetes mellitus) is classed as a metabolism
disorder. Metabolism refers to the way our bodies use digested food for energy
and growth. Most of what we eat is broken down into glucose. Glucose is a form
of sugar in the blood - it is the principal source of fuel for our bodies.
When our food is digested, the glucose makes its way into our
bloodstream. Our cells use the glucose for energy and growth. However, glucose
cannot enter our cells without insulin being present - insulin makes it possible
for our cells to take in the glucose.
Insulin is a hormone that is produced by the pancreas. After
eating, the pancreas automatically releases an adequate quantity of insulin to
move the glucose present in our blood into the cells, as soon as glucose enters
the cells blood-glucose levels drop.
A person with diabetes has a condition in which the quantity of
glucose in the blood is too elevated (hyperglycemia). This is because the body
either does not produce enough insulin, produces no insulin, or has cells that
do not respond properly to the insulin the pancreas produces. This results in
too much glucose building up in the blood. This excess blood glucose eventually
passes out of the body in urine. So, even though the blood has plenty of
glucose, the cells are not getting it for their essential energy and growth
requirements.
Why is it called Diabetes Mellitus?
Diabetes comes from Greek, and it means a "siphon". Aretus the
Cappadocian, a Greek physician during the second century A.D., named the
condition diabainein. He described patients who were passing too much water
(polyuria) - like a siphon. The word became "diabetes" from the English adoption
of the Medieval Latin diabetes.
In 1675, Thomas Willis added mellitus to the term, although it
is commonly referred to simply as diabetes. Mel in Latin means "honey"; the
urine and blood of people with diabetes has excess glucose, and glucose is sweet
like honey. Diabetes mellitus could literally mean "siphoning off sweet water".
In ancient China people observed that ants would be attracted
to some people's urine, because it was sweet. The term "Sweet Urine Disease" was
coined.
Controlling Diabetes - Treatment is Effective and
Important
All types of diabetes are treatable. Diabetes
type 1 lasts a lifetime, there is no known cure. Type 2 usually lasts a life
time; however, some people have managed, through a lot of exercise, diet and
excellent body weight control to get rid of their symptoms without medication.
Researchers from the Mayo Clinic Arizona in Scottsdale showed
that gastric bypass surgery can reverse type 2 diabetes in a high proportion of
patients. They added that within three to five years the disease recurs in
approximately 21% of them. Yessica Ramos, MD., said "The recurrence rate was
mainly influenced by a longstanding history of Type 2 diabetes before the
surgery. This suggests that early surgical intervention in the obese, diabetic
population will improve the durability of remission of Type 2 diabetes."
Patients with type 1 are treated with regular insulin
injections, as well as a special diet and exercise.
Patients with Type 2 diabetes are usually treated with tablets,
exercise and a special diet, but sometimes insulin injections are also required.
If diabetes is not adequately controlled the patient has a
significantly higher risk of developing complications.
Complications linked to badly controlled
diabetes:
- Eye complications - glaucoma, cataracts,
diabetic retinopathy, and some others.
- Foot complications
- neuropathy, ulcers, and sometimes gangrene which may require that the foot be
amputated
- Skin complications - people with diabetes are
more susceptible to skin infections and skin disorders
- Heart
problems - such as ischemic heart disease, when the blood supply to the
heart muscle is diminished
- Hypertension - common in
people with diabetes, which can raise the risk of kidney disease, eye problems,
heart attack and stroke
- Mental health - uncontrolled
diabetes raises the risk of suffering from depression, anxiety and some other
mental disorders
- Hearing loss - diabetes patients have a
higher risk of developing hearing problems
- Gum disease -
there is a much higher prevalence of gum disease among diabetes patients
- Gastroparesis - the muscles of the stomach stop working
properly
- Ketoacidosis - a combination of ketosis and
acidosis; accumulation of ketone bodies and acidity in the blood.
-
Neuropathy - diabetic neuropathy is a type of nerve damage
which can lead to several different problems.
- HHNS (Hyperosmolar
Hyperglycemic Nonketotic Syndrome) - blood glucose levels shoot up too
high, and there are no ketones present in the blood or urine. It is an emergency
condition. - Nephropathy - uncontrolled blood pressure can lead to kidney
disease
- PAD (peripheral arterial disease) - symptoms may
include pain in the leg, tingling and sometimes problems walking properly
-
Stroke - if blood pressure, cholesterol levels, and blood
glucose levels are not controlled, the risk of stroke increases significantly
- Erectile dysfunction - male impotence.
-
Infections - people with badly controlled diabetes are much
more susceptible to infections
- Healing of wounds - cuts
and lesions take much longer to heal
