Diabetes

What is Diabetes?

Diabetes is a chronic metabolic disorder characterized by elevated blood glucose (blood sugar) levels due to defects in insulin production, insulin action, or both. Insulin is a hormone produced by the pancreas that allows glucose from food to enter cells and be used for energy.

Types of Diabetes

Type 1 Diabetes

• The body does not produce insulin
• Accounts for 5-10% of all diabetes cases
• Typically diagnosed in children, adolescents, or young adults
• Requires lifelong insulin therapy
• Autoimmune disease where the immune system attacks insulin-producing beta cells

Type 2 Diabetes

• The body produces insulin but cells don't respond properly (insulin resistance)
• Accounts for 90-95% of all diabetes cases
• Often develops in adults, increasingly seen in younger populations
• Strongly associated with obesity, physical inactivity, and poor diet
• Can often be managed with lifestyle changes and oral medications

Gestational Diabetes

• Develops during pregnancy
• Affects approximately 2-10% of pregnancies
• Increases risk of complications for mother and baby
• Usually resolves after delivery but indicates higher risk for type 2 diabetes later in life

Symptoms

Diagnosis

Diabetes can be diagnosed through several blood tests:

• Fasting Plasma Glucose (FPG): Blood sugar after at least 8 hours of fasting

  • Normal: < 100 mg/dL
  • Prediabetes: 100-125 mg/dL
  • Diabetes: ≥ 126 mg/dL

• Hemoglobin A1C (HbA1c): Reflects average blood sugar over 2-3 months

  • Normal: < 5.7%
  • Prediabetes: 5.7-6.4%
  • Diabetes: ≥ 6.5%

• Oral Glucose Tolerance Test (OGTT): Measures blood sugar before and 2 hours after consuming a glucose drink

  • Normal: < 140 mg/dL after 2 hours
  • Prediabetes: 140-199 mg/dL
  • Diabetes: ≥ 200 mg/dL

Management

Medical Nutrition Therapy

• Carbohydrate counting: Consistent carbohydrate intake helps manage blood sugar
• Glycemic index awareness: Choose low-GI foods for better glucose control
• Regular meal timing: Eat at consistent times to avoid blood sugar spikes
• Balanced nutrition: Emphasis on vegetables, lean proteins, and healthy fats

Physical Activity

• Aerobic exercise: At least 150 minutes per week (brisk walking, swimming, cycling)
• Resistance training: 2-3 times per week to improve insulin sensitivity
• Post-meal activity: Light walking after meals helps lower postprandial glucose

Medications

• Oral hypoglycemics: Metformin, sulfonylureas, DPP-4 inhibitors, GLP-1 agonists
• Insulin therapy: Various types including rapid-acting, long-acting, and combination formulations
• Other injectables: GLP-1 receptor agonists for weight management and glucose control

Complications

Good glucose control can prevent or delay complications:

Microvascular Complications

• Retinopathy: Eye disease affecting the retina
• Nephropathy: Kidney disease
• Neuropathy: Nerve damage, especially in feet and hands

Macrovascular Complications

• Cardiovascular disease: Heart attack, stroke
• Peripheral vascular disease: Reduced blood flow to limbs

References

1. American Diabetes Association. (2024). Standards of Care in Diabetes - 2024. Diabetes Care, 47(Supplement 1), S1-S308.

2. World Health Organization. (2023). Diabetes. Retrieved from https://www.who.int/news-room/fact-sheets/detail/diabetes

3. Centers for Disease Control and Prevention. (2023). National Diabetes Statistics Report. Retrieved from https://www.cdc.gov/diabetes/data/statistics-report/index.html

4. National Institute of Diabetes and Digestive and Kidney Diseases. (2023). Diabetes Overview. Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview

5. International Diabetes Federation. (2021). IDF Diabetes Atlas, 10th edition. Retrieved from https://diabetesatlas.org/