Diabetes
Diabetes is a chronic condition that occurs when the body cannot produce enough insulin or cannot use insulin and is diagnosed by raised levels of glucose in the blood. Insulin is a hormone produced in the pancreas, which is required to transport glucose from the bloodstream into the body’s cells where it is used as energy. The lack or ineffectiveness of insulin in a person leads the glucose to keep circulating in the blood. Over time, the resulting high levels of glucose in the blood (known as hyperglycaemia) causes damage to many tissues in the body, leading to the development of disabling and life-threatening health complications.
| Fasting Blood Sugar Level (mg/dl) | Less than 100 | Greater than or equal to 126 |
| Post Meal Sugar Level (mg/dl) | Less than 140 | Greater than 200 |
| Hemoglobin A1C % | Less than 5.7% | Greater than 6.4% |
Three main types of diabetes
Type 1 Diabetes
Type 1 Diabetes is caused by an autoimmune reaction, in which the body’s immune system attacks the insulin producing beta cells in the pancreas. As a result, the body can no longer produce the insulin it needs. The disease can affect people of any age, but onset usually occurs in children or young adults. People with Type 1 Diabetes need insulin every day to control the levels of glucose in their blood.
Excessive thirst and a dry mouth
Excessive thirst and a dry mouth
Extreme hunger
Extreme hunger
Bed wetting
Bed wetting
Frequent and abundant urination
Frequent and abundant urination
Sudden weight loss
Sudden weight loss
Blurred vision
Blurred vision
Lack of energy, extreme tiredness
Lack of energy, extreme tiredness
Type 2 Diabetes
Type 2 Diabetes is the most common type of diabetes. It usually occurs in adults, increasingly in children and adolescents. In Type 2 Diabetes, there is a combination of inadequate production of insulin and the body’s inability to respond fully to insulin (insulin resistance). Many people with Type 2 Diabetes remain unaware of their condition for a long time and may take years to be recognised. However, during this time, the body is already being damaged by excess blood glucose.
The rise of Type 2 Diabetes in population is associated with ageing populations, economic development, increasing urbanisation, less healthy diets and reduced physical activity. Majority of the Type 2 Diabetes patients do not have symptoms and in contrast to people with type 1 diabetes, most people with type 2 diabetes do not require daily insulin treatment to survive. The main treatment of Type 2 Diabetes is the adoption of a healthy diet and increased physical activity.
Excessive thirst and a dry mouth
Excessive thirst and a dry mouth
Lack of energy, extreme tiredness
Lack of energy, extreme tiredness
Sexual issues
Sexual issues
Frequent and abundant urination
Frequent and abundant urination
Blurred vision
Blurred vision
Tingling ornumbness in hands and feet
Tingling ornumbness in hands and feet
Recurrent fungal infections in the skin
Recurrent fungal infections in the skin
Slow-healing wounds
Slow-healing wounds
Gestational Diabetes
Hyperglycaemia, which is first detected at any time during pregnancy is classified as either Gestational Diabetes Mellitus or Diabetes Mellitus in pregnancy.
Women with slightly elevated blood glucose levels are classified as having Gestational Diabetes, which tends to occur from the 24th week of pregnancy, whilst women with substantially elevated blood glucose levels are classified as having Diabetes Mellitus in pregnancy. Women with Hyperglycaemia during pregnancy can control their blood glucose levels through a healthy diet, gentle exercise and blood glucose monitoring.
Gestational Diabetes normally disappears after birth. However, women who have been previously diagnosed are at higher risk of developing Gestational Diabetes in subsequent pregnancies and Type 2 Diabetes later in life. Babies born to mothers with Gestational Diabetes also have a higher risk of developing Type 2 Diabetes in their teens or early adulthood.
The criteria for Diabetes during pregnancy is different.
| Fasting Blood Sugar | Greater than or equal to 92 mg/dl |
| After 1 hour of meal | Greater than or equal to 180 mg/dl |
| After 2 hours of meal | Greater than or equal to 153 mg/dl |
Impaired glucose tolerance and impaired Fasting Glucose (Pre Diabetes)
People with raised blood glucose levels that are high enough to be diagnosed as diabetes are considered to have impaired glucose tolerance (IGT) and impaired fasting glucose (IFG). These conditions are often described as prediabetes as they represent a high risk of transiting to diabetes.
Impaired glucose tolerance is diagnosed following a glucose tolerance test. This involves measuring the blood glucose concentration two hours after a drink containing 75g of glucose. In impaired glucose tolerance, the glucose level is higher than normal, but not high enough to make a diagnosis of diabetes (i.e. between 7.8 and 11.1mmol/l (140 to 200 mg/dl)). Impaired fasting glucose is diagnosed when the fasting glucose level is higher than normal, but not high enough to make a diagnosis of diabetes (between 5.7 and 7 mmol/L (100 and 125 mg/dl)). Raised levels of HbA1c in the nondiabetic range can also be used to identify people at risk of developing Type 2 Diabetes.
People with intermediate Hyperglycaemia are at increased risk of developing Type 2 Diabetes. This shares many characteristics with Type 2 Diabetes and is associated with advancing age and the body’s inability to use the insulin it produces. Not everyone with intermediate Hyperglycaemia goes on to develop Type 2 Diabetes.
Risk Factors
- Family history of diabetes
- Overweight
- Unhealthy diet
- Physical inactivity
- Increasing age
- High blood pressure
- Ethnicity
- Impaired glucose tolerance (IGT)
- History of gestational diabetes
- Poor nutrition during pregnancy
- Environmental factors
- Exposure to viral infections
Diabetes
Complications
Diabetes
Complications
Eyes
Oral health
Cardiovascular disease
Blood vessels
Kidneys
Pregnancy complications
Nerve damage
Lower-limb amputation
Diabetic foot
Diabetes
Management
Diabetes
Management
Know your target
Eat a balanced and healthy diet
Reduce the amount of fat and salt in the diet, especially saturated and trans fats. Include more fruits, vegetables and high-fibre foods in the diet.
Physical activity
Exercise helps us achieve and maintain a healthy weight, control diabetes, elevated cholesterol and high blood pressure.
Keep track
Check the blood sugar levels regularly using glucometer at home and A1C once in three months.
Limit takeaway and processed foods
'Convenience meals' are usually high in salt, fat and kilojoules.
Undergo important tests
Examine eyes, kidneys, liver, lipids, feet and nerves once a year.
Stabilize yourself
If you experience palpitations, sweating and nervousness due to low sugar, consume a piece of candy, drink milk or fruit juice.
Be proactive
Visit the doctor on regular basis and not only in emergency conditions.
Golden rules
Be physically active, keep a healthy weight and a healthy diet, maintain healthy cholesterol levels, keep blood pressure down, regulate blood sugar levels and quit smoking.
Take action
If there is need take insulin, do not delay starting. Poor control will lead to complications.
Dietary Advice
Dietary Advice
Do's
- Take timely meals
- Have breakfast always
- Include grains like Oats, Legumes, Brown Rice, Whole
- Grain Bread and Cereals, Bulgar and Freekeh in diet
- Consume more fruits, vegetables and salads
- Drink 2 to 2.5 litres of water daily
Don’ts
- Limit excessive salt intake
- Avoid fatty and fried foods
- Limit the intake of beverages, sweets, cakes, biscuits, processed meat etc.
Foods to be included
- Cucumber
- Onion
- Tomato
- Cabbage
- Lettuce
- Vegetable Soups and Juice
- Vegetables like Cabbage
- Cauliflower
- Beans
- Spinach
- Bitter Gourd
- Radish
- Carrot and Gooseberries.
Foods to be avoided
- Sweets and Bakery items
- Fried Food
- Soft Drinks
- Chocolates
- Custard
- Juices
- Canned Food
- Whole Milk and Milk Products
- Sugar
- Jam
- Organ Meat and Alcoholic Drinks
Physical Activity
Excersise per week
Jogging
Cycling
Walking
Swimming
Medication
Medication under doctors’ advice only
No self-medication
Medication includes oral agents and injectables including insulin
Keeping numbers in target is more important than number of medications