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Report ProblemDiabetes
Also known as Diabetes Mellitus, Hyperglycemia, High Blood SugarOverview
Diabetes requires lifelong commitment towards following a healthy lifestyle, taking medicines on time, and getting regular checkups to detect any complications.
Key Facts
- Type 1 diabetes: Children below 15 years of age
- Type 2 diabetes: Adults between 20 to 80 years of age
- Both men and women
- Pancreas
- Eyes
- Nerves
- Feet
- Heart
- Kidneys
- Reproductive system
- Metabolic syndrome
- Hypothyroidism
- Hemochromatosis
- Pancreatitis
- Cystic fibrosis
- Infections
- Cushing Syndrome
- Biguanides: Metformin
- Sulfonylureas: Glimepiride & Glipizide
- Thiazolidinediones: Pioglitazone
- Meglitinides: Repaglinide & Nateglinide
- Alpha-glucosidase inhibitors: Acarbose & Miglitol
- DPP-4 inhibitors: Sitagliptin & Saxagliptin
- Incretin mimetics: Exenatide, Liraglutide & Dulaglutide
- Rapid acting insulin: Lispro & Glulisine
- Short acting insulin: Insulin regular & Semilente
- Intermediate acting insulin: Lente & Insulin Isophane
- Long acting insulin: Ultralente & protamine zinc
- Ultra-long acting insulin: Glargine, Detemir & Degludec
- Insulin pumps
- Transplants
- Bariatic surgery
- Diabetologist
- Dietician
- Endocrinologist
Symptoms Of Diabetes
Irrespective of the types, some of the common symptoms of diabetes include:
- Frequent urination
- Excessive thirst
- Sudden losss of weight
- Increased hunger
- Blurry eyesight
- Bedwetting
- Lack of energy/fatigue
- Delayed healing of cuts and other injuries
- Dry skin
- Fungal infections
Causes Of Diabetes
Type 1 diabetes
Type 2 diabetes
Other types of diabetes
As the name suggests, prediabetes is a condition where the blood glucose levels are higher than normal but not high enough to be classified as diabetes. In simple terms, it is a stage that, if left ignored, can develop into type 2 diabetes and diabetes-related complications. This is the reason why it is also known as ‘non-diabetic hyperglycaemia’ or ‘intermediate hyperglycaemia’. There are no clear symptoms of prediabetes, so you may have it and not know it. However, early treatment with lifestyle modifications can actually help to keep your blood glucose levels within the normal range.
Gestational diabetes mellitus (GDM), defined as diabetes diagnosed during pregnancy, affects a significant proportion of pregnant women worldwide. Women usually develop gestational diabetes between the second or third trimester of pregnancy. The risk of developing this condition during your future pregnancies may also be higher. It also increases the risk of brain and spinal cord anomalies, obesity and glucose intolerance (diabetes) in the child. Due to the major repercussions in mother and baby, it is important for every pregnant woman to be aware of GDM.
As the name implies, monogenic diabetes results from a single gene rather than the contributions of multiple genes and environmental factors as seen in type 1 and type 2 diabetes. It is much less common and represents 1.5–2% of all cases. It is often misdiagnosed as either type 1 or type 2 diabetes. These monogenic forms present a broad spectrum from neonatal diabetes mellitus (or ‘monogenic diabetes of infancy’), maturity onset diabetes of the young (MODY) and rare diabetes associated syndromic diseases.
Risk Factors For Diabetes
Depending upon the type, there are several risk factors for diabetes. These include:
1. Type 1 diabetes
Although there are not many risk factors of type 1 diabetes, some factors that are known to up the risk include:
- Presence of certain types of genes
- Environmental triggers or a virus (any sort of infection or bacteria), which can initiate an autoimmune reaction
- Presence of autoantibodies (antibodies that mistakenly attack your own body’s tissues or organs)
- Geographic location (certain countries, such as Finland and Sweden, have higher rates of type 1 diabetes)
- Family history of diabetes
2. Type 2 diabetes
Although type 2 diabetes is common in adults, it is also seen in older children due to childhood obesity becoming more common. The list of factors that increase the risk of type 2 diabetes include:
- Being overweight or obese
- Being a smoker
- Family history of diabetes
- Family history of high cholesterol, hypertension or cardiovascular disease
- Having a sedentary lifestyle
- Suffering from polycystic ovarian syndrome (PCOS)
- Suffering from prediabetes
- Being pregnant
- Recurrent wounds/ulcers, which fail to heal
- Stress
- History of diabetes in pregnancy
- History of impaired glucose tolerance
3. Gestational diabetes
According to the IDF, women with prior GDM are at a 7.4-fold risk of type 2 diabetes compared to women with normal blood glucose levels during pregnancy. This risk is higher 3 to 6 years post delivery. Certain factors that put you at high risk of gestational diabetes include:
- BMI (Body Mass Index) that exceeds 30
- Excessive weight gain during pregnancy
- Family history of diabetes
- History of giving birth to a baby weighing 4.5kg or more
- Expecting more than one baby (twins/triplets)
- Family history of hypertension
- History of miscarriages or stillbirth
- History of conditions related to insulin resistance or polycystic ovarian syndrome (PCOS)
- History of habitual smoking
- Giving birth to a child with congenital abnormality
Diagnosis Of Diabetes
1. Random blood sugar test
- Normal: Less than 140 mg/dl
- Prediabetes: Between 140 and 200 mg/dl
- Diabetes: Greater than or equal to 200 mg/dl
- Pregnant women: Greater than or equal to 200 mg/dl
2. Fasting plasma glucose test (FPGT)
- Normal: Less than 100 mg/dl
- Prediabetes: Between 100 mg/dl to 125 mg/dl
- Diabetes: Greater than or equal to126 mg/dl
- Pregnant women: Between 90-140 mg/dl
3. Postprandial blood glucose (PPBG) test
- Normal: Less than 140 mg/dl
- Impaired glucose tolerance (prediabetes): Between 140 and 200 mg/dl
- Diabetes: Greater than or equal to 200 mg/dl
4. Hemoglobin A1c (HbA1c) test
- Normal: Less than 5.7%
- Prediabetes: Between 5.7% to 6.4%
- Diabetes: Greater than or equal to 6.5%
- Pregnant women: Between 6% to 6.5%
5. Oral glucose tolerance test (OGTT)
- Normal : Less than 140 mg/dl
- Prediabetes: Between 140 mg/dl to 199 mg/dl
- Diabetes: Greater than or equal to 200 mg/dl
- Pregnant women: Greater than or equal to 200 mg/dl
Watch this video to know why blood glucose tests are important for diabetics as well as non-diabetics.
6. Other tests
Get your blood pressure checked at every doctor’s visit or twice every month. You should also self monitor your blood pressure and maintain a blood pressure diary if you have high blood pressure coexisting with diabetes.
To keep a tab on your blood pressure (BP) level, get a digital BP monitor.
2. Eye examination
Prevention Of Diabetes
With simple lifestyle changes such as diet control, staying active, keeping a tab on your weight and staying away from vices, you can lower your risk of type 2 diabetes. Here are a few tips to get started.
1. Make healthy food choices
- Switch to oils with high volume of monounsaturated fats & polyunsaturated fats like olive oil, canola oil, soybean oil or rice bran oil. Limit intake to one tablespoon a day.
- Restrict intake of foods with high glycemic index like white breads, white rice, fatty foods, and soda.
- Consume foods with low glycemic index like multigrain flour, whole grains, daals, most fruits, non-starchy vegetables and carrots.
- Limit consumption of fast food such as chips, processed foods, etc.
2. Watch your weight
3. Exercise regularly
4. Manage stress better
Finding it hard to deal with stress? Try our wide-range of stress management products.
5. Go for regular health check-ups
6. Quit smoking
Celebs affected
Specialist To Visit
If you have been experiencing symptoms such as tingling sensation or numbness of the limbs, feeling excessively hungry or thirsty, or unexplained weight loss, then it is wise to consult following specialists:
- Endocrinologist
- Diabetologist
- Nephrologist
- Neurologist
- Podiatrist
- Dentist
- Ophthalmologist
- Dietician
Treatment Of Diabetes
A. Oral antidiabetics
1. Biguanides
2. Sulphonylureas
3. Thiazolidinediones
4. Meglitinides
5. Alpha-glucosidase inhibitors
6. DPP-4 inhibitors
7. Incretin mimetics
B. Insulin injections
- Rapid Acting insulin (Examples: lispro, glulisine, etc)
- Short Acting insulin (Examples: insulin regular, semilente)
- Intermediate Acting insulin (Examples: lente, insulin Isophane, etc)
- Long Acting Insulin (Examples: ultralente, protamine zinc)
- Ultra-Long Acting Insulin (Examples: glargine, detemir, degludec, etc)
C. Insulin pumps
D. Transplants
E. Bariatric surgery
Here’s more on what weight loss surgery is and who can go for it.
Home-care For Diabetes
Diet in diabetes
Whether you’re trying to prevent or control diabetes, your nutritional needs are virtually the same as everyone else, so no special foods are necessary. However, certain modifications in terms of quantity and type of food might be required.
1. Eat more
- Healthy fats from nuts, olive oil, fish oils, flax seeds, or avocados
- Fruits and vegetables—ideally fresh, the more colorful the better; whole fruit rather than juices
- High-fiber cereals and breads made from whole grains
- Fish and shellfish, organic chicken or turkey
- High-quality protein such as eggs, beans, low-fat dairy, and unsweetened yogurt
2. Eat less
- Trans fats from partially hydrogenated or deep-fried foods
- Packaged and fast foods, especially those high in sugar, baked goods, sweets, chips, desserts
- White bread, sugary cereals, refined pastas or rice
- Processed meat and red meat
- Low-fat products that have replaced fat with added sugar, such as fat-free yogurt
3. Choose high-fiber, slow-release carbs
Carbohydrates have a big impact on your blood sugar levels—more so than fats and proteins—so you need to be smart about what types of carbs you eat. Limit refined carbohydrates like white bread, pasta, and rice, as well as soda, candy, packaged meals, and snack foods. Focus on high-fiber complex carbohydrates—also known as slow-release carbs. They are digested more slowly, thus preventing your body from producing too much insulin.
Dr. Beena Bansal (MBBS, MD, DM, Endocrinology) tells us about some simple ways to curb our food cravings. Watch the video now!
Fruits in diabetes
There is mixed perception about intake of fruits for diabetes. Some people believe that diabetics should completely cut down fruits from their diet while some think that one can include as much fruits as they want in their diet as it doesn’t have any impact on blood glucose level. However, neither is true. It is best to include fruits as an integral part of your daily meal plan while keeping a tab on the carbohydrate content. Here is a quick guide to help you out with your daily needs of fruits:
Whole fruits
- 1 small apple
- 1 small chickoo
- 1 small orange
- 1 small guava
- 1 small pear
- Half banana
- 1 slice mango
- 1 cup papaya
- 3/4th cup muskmelon
- 1 ¼ cup watermelon
Watch the video to know more about which fruits to eat and which fruits to avoid.
Exercise in diabetes
Exercises are designed to help people with diabetes avoid problems which can result from unwise exercise choices. Aerobic activity is one of the effective exercise options to control diabetes. When done at moderate intensity it raises your heart rate and makes you sweat thereby helping you to maintain an optimum blood glucose level.
Some of the common forms of aerobic exercises are:
- Brisk (fast-paced) walking
- Light jogging
- Bike riding
- Playing tennis or badminton
- Swimming/ water aerobics
- Gymming
Complications Of Diabetes
Insulin deficit, if left unchecked over the long term, can cause damage to many of the body’s organs, leading to disabling and life-threatening health complications such as:
Gestational Diabetes Mellitus (GDM)
- Preeclampsia (characterized by high blood pressure)
- Need for cesarean sections
- Polyhydramnios (excessive amniotic fluid)
- Oligohydramnios (deficiency of amniotic fluid)
- Hyperinsulinemia (high insulin level)
- Macrosomia (the baby who is significantly larger in size than normal)
- Shoulder dystocia (infant’s shoulder gets lodged in the mother’s pelvis during delivery)
- Neonatal hypoglycemia (low blood glucose level)
- Respiratory distress syndrome (immature lungs)
- Stillbirth
Alternative Therapies For Diabetes
Ayurveda
- Powdered Jamun seeds can be taken with water or buttermilk (chaach).
- Methi (Fenugreek) seeds are taken with water 15-20 minutes before each meal. Methi has soluble fibers that slow down the digestion and absorption of glucose.
- Bael leaves are squeezed to prepare fresh juice that can be taken along with a pinch of black pepper.
- Dalchini (Cinnamon) in powdered form can be taken with water as it helps in improving sugar as well as cholesterol level.
- Concentrated amla juice taken along with bitter gourd juice, helps in releasing more insulin.
- Karela (Bitter gourd) juice is recommended to be taken every morning.
Homeopathy
Yoga
Acupuncture
Massage therapy
Living with Diabetes
1. Learn about the condition
2. Take care of your mental health
- Indulging in some relaxation techniques like meditation or yoga.
- Talking to your friends or family about your stress.
- Trying out a new hobby like gardening, dancing, playing a music instrument, etc.
- Spending some “ME” time by doing things you like such as reading a book or taking a stroll in a park.
3. Be ready to tackle emergencies
Here's more on what to eat when the blood sugar dips.
4. Diabetes care plan
1. Lifestyle tips such as eating a healthy diet and exercising regularly without fail. A diet rich in proteins, complex carbohydrates, healthy fats and fibre is the key to keep your blood glucose levels in control. Ensure to get a minimum of 150 minutes of moderate intensity exercises such as brisk walking per week.
Frequently Asked Questions
References
- IDF DIABETES ATLAS. Ninth edition 2019. International Diabetes Federation (IDF).
- Understanding A1c Diagnosis. American Diabetes Association (ADA).
- Varma PP. Prevalence of chronic kidney disease in India - Where are we heading?. Indian J Nephrol. 2015;25(3):133-135.
- Kharroubi AT, Darwish HM. Diabetes mellitus: The epidemic of the century. World J Diabetes. 2015;6(6):850-867.
- Maiorino MI, Bellastella G, Esposito K. Diabetes and sexual dysfunction: current perspectives. Diabetes Metab Syndr Obes. 2014;7:95-105
- Pandey A, Tripathi P, Pandey R, Srivatava R, Goswami S. Alternative therapies useful in the management of diabetes: A systematic review. J Pharm Bioallied Sci. 2011;3(4):504-512.
- Prediabetes - Your Chance to Prevent Type 2 Diabetes. Centers For Disease Control and Prevention (CDC). Last reviewed June 2020.
- Sapra A, Bhandari P. Diabetes Mellitus. [Updated 2021 Jun 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan.
- Diabetes, Gum Disease, & Other Dental Problems. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Last reviewed by Sep, 2014.