Diabetes

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-Dr.Rashmi


General Info about Diabetes


Diabetes is a wonderful affection, not very frequent among men, being a melting down of the flesh and limbs into urine…. The patients never stop making water, but the flow is incessant, as if from the opening of acqueducts. The nature of the disease, then, is chronic, and it takes a long period to form; but the patient is short-lived, if the constitution of the disease be completely established; for the melting is rapid, the death speedy.

-Aretaeus the Cappadocian,[81-138]

All of us know someone suffering from diabetes. This sums up the prevalence of diabetes. It is, apart from being one of the most prevalent diseases in the world, also a disease that opens up a Pandora's box of many complications. No wonder it is a dreaded disease and people who are diabetic end up getting other medical problems as well. Diabetes is a group of diseases with one thing in common - a problem with insulin. The problem could be that your body doesn't make any insulin, doesn't make enough insulin or doesn't use insulin properly.

The pancreas, which is an organ present in the abdominal cavity of the body, secretes this hormone insulin. This hormone is the key to the way your body processes food because it helps maintain the proper level of a sugar (glucose) in your blood. Glucose is your body's fuel. Cells use glucose to produce energy to grow and function. Glucose is escorted by insulin through your bloodstream and insulin helps in unlocking cells to allow glucose to enter.

In diabetes, lack of insulin or the resistance of your cells to insulin prevents the right amount of glucose from entering your cells. The unused glucose builds up in your blood, a condition called hyperglycemia.

The disease occurs in two types:

Type 1 diabetes: This is the type of diabetes that generally affects young people and requires treatment with insulin.

Type 2 diabetes: This type of diabetes generally develops after age 40. Diabetes can develop gradually, often without symptoms, over many years. It may reveal itself too late to prevent damage. In fact, you may first learn you have diabetes when you develop one of its common complications - heart disease, kidney disease or vision problems. Today, better methods of diabetes control, new medications and easier ways to take insulin enable most people who develop type 1 or 2 diabetes to live a long and healthy life.

What are the causes of Diabetes ?


The various types of diabetes are different disorders with different causes:

Type 1 diabetes This type of diabetes is an autoimmune disease. Your immune system turns on itself and destroys the insulin-producing cells in your pancreas. Although type 1 diabetes usually develops in childhood or teen years, it can appear later.

Type 2 diabetes In this type, your pancreas makes some insulin, but not enough. Your cells also can become resistant to insulin's effects, keeping insulin from escorting enough glucose into your body's cells. Type 2 diabetes generally develops after age 40. However, doctors are seeing a rise in childhood type 2 diabetes that parallels the rise in obesity among youth. A form of type 2 diabetes, gestational diabetes, develops during 2 percent to 5 percent of pregnancies. In gestational diabetes, your body doesn't effectively use the insulin you produce. The cause may be metabolic changes that occur due to the effects of hormones in pregnancy. Gestational diabetes usually disappears after pregnancy, but more than half of women who experience it eventually develop a permanent type 2 diabetes.

What are the symptoms of Diabetes ?


The symptoms are due to persistent high levels of sugar in the circulating blood. These symptoms are

Frequent urination - When blood sugar is too high, your kidneys can't absorb the excess glucose. The glucose leaks into urine, pulling water with it.

Extreme thirst - The process of dehydration makes you thirsty.

Blurry vision - High blood sugar may cause new blood vessels to form and may damage old blood vessels on the retina at the back of your eye.

Weight loss - To make up for the lost fuel, your body burns fat reserves, and you may lose weight.

Fatigue - When your cells don't get enough glucose, their primary fuel source, fatigue results.

Hunger - Burning of fat reserves also may make you hungry.

How can we diagnose Diabetes ?

If you have a family history of diabetes and also suffer from some of the risk factors mentioned above, then it is always advisable to screen yourself regularly to detect diabetes and avoid the serious complications. As the saying goes " Prevention is better than cure". So it is always advisable to screen yourself for diabetes if you stand the risk of suffering from it. If you're at risk of diabetes or have symptoms, you should take the test at a younger age and more frequently.

A fasting plasma glucose test is a simple, reliable test for diagnosing diabetes. After fasting overnight (or for 8 hours), a sample of your blood is drawn to measure the glucose level. Most people have a level between 70 and 100 milligrams of glucose per deciliter of blood (mg/dL).

A level of 126 mg/dL or higher on two tests confirms a diagnosis of diabetes. Your doctor may diagnose diabetes if you have a single very high fasting blood glucose level or a higher glucose level along with diabetes symptoms.

How can Diabetes be treated ?

Controlling blood sugar is the single most important thing you can do to prevent long-term complications of diabetes.

If you have type 1 diabetes, you must take insulin. Before its discovery in 1921, people with type 1 diabetes usually died within a year or two. Today, most people use synthetic insulin, which is chemically identical to human insulin.

If you have type 2 diabetes, you may be able to control your blood sugar with weight control, diet and exercise. Or, you may need to combine these approaches with medication.

Medications to treat type 2 diabetes include:

Sulfonylurea drugs. These medications lower blood sugar levels by stimulating your pancreas to produce and release more insulin. Sulfonylurea drugs that doctors commonly prescribe include glipizide and glyburide.

Metformin This drug decreases the release of glucose stored in your liver.

Acarbose This medication helps decrease the after-meal spike in your blood sugar level by slowing the digestion and absorption of carbohydrates in your intestine.

Insulin sensitizers. These new oral drugs improve your body's response to insulin, making your body more sensitive to the insulin that's already available. These medications can help reduce or eliminate the need for insulin injections in some people.

If you have type 2 diabetes, you may need to start taking insulin if fasting blood glucose levels stay above goals set by your doctor. How much insulin you need depends on your age, weight, exercise level, type of diabetes and how difficult your blood sugar is to control.
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