All you need to know about Diabetes: Types, Symptoms & Tests

So what is Diabetes? Are there different types? What causes this? Is there a permanent treatment for diabetes?

Diabetes often referred to 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.

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There are three types of diabetes:

1)Type 1 diabetes

In this type, 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 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.

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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 type 2.

Some people may be able to control their type 2 diabetes symptoms by losing weight, following a healthy diet, doing plenty of exercises, and monitoring their blood glucose levels. However, type 2 diabetes is typically a progressive disease - it gradually gets worse - and the patient may end up having to take medications, including insulin, at some point in time.

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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.

Also read about - Cardiovascular health tips

Being overweight, physically inactive and eating the unhealthy food all contribute to our risk of developing type 2 diabetes.
Men whose testosterone levels are low have been found to have a higher risk of developing type 2 diabetes.

3) Gestational diabetes

This type affects women 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 for an otherwise healthy individual for the first time, during pregnancy.

A majority of patients with gestational diabetes 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 increase the risk of complications during childbirth. The baby may be bigger than he/she should be.

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Then, what is prediabetes?

A vast majority of patients with type 2 diabetes initially have prediabetes. Wherein their blood glucose levels were higher than normal, but not high enough to merit a diabetes diagnosis. The cells in the body become resistant to insulin.

Can you see any signs or symptoms of diabetes?

It is possible to have diabetes with mild symptoms or without developing any symptoms at all. Such cases can leave some people with diabetes unaware of the condition and undiagnosed. This happens in around half of the people with type 2 diabetes.

The most common signs and symptoms of diabetes are:

Frequent urination
Have you been urinating more frequently than before? Do you notice that you spend most of the day going to the toilet? When there is too much glucose (sugar) in your blood you tend to urinate more often.

If your insulin is ineffective, or not there at all, your kidneys cannot filter the glucose back into your blood. The kidneys will take water from your blood in order to dilute the glucose - which in turn fills up your bladder.

Excessive thirst
If you are urinating more than usual, you will need to replace that lost liquid. You will be drinking more than usual. Have you been drinking more than usual lately?

Intense hunger
As the insulin in your blood is not working properly or is not there at all, and your cells are not getting their energy, your body may react by trying to find more energy - food. You will end up feeling hungry.

Weight gain
This could be a result of the above symptom (Intense hunger).

Unusual weight loss
This is more common among people with Diabetes Type 1. As your body is not making insulin it will seek out another energy source (the cells aren't getting glucose). Muscle tissue and fat will be broken down for energy. As Type 1 is of a more sudden onset and Type 2 is much more gradual, weight loss is more noticeable with Type 1.

Increased fatigue
If your insulin is not working properly or is not there at all, glucose will not enter your cells and provide the necessary energy. This leaves you feeling tired and listless.

Irritability
Irritability can be due to your lack of energy.

Blurred vision
This can be caused by tissue being pulled from your eye lenses. This affects your eyes' ability to focus. With proper treatment, this can be treated. There are severe cases where blindness or prolonged vision problems can occur.

Cuts and bruises don't heal properly or quickly
Do you find cuts and bruises take a much longer time than usual to heal? When there is more sugar (glucose) in your body, it's ability to heal can be undermined.

Increased skin and/or yeast infections
When there is more sugar in your body, its ability to recover from infections is affected. Women with diabetes find it especially hard to recover from bladder and vaginal infections.

Itchy skin
A feeling of itchiness on your skin is sometimes a symptom of diabetes.

Gums are red and/or swollen - Gums pull away from teeth
If your gums are tender, red and/or swollen this could be a sign of diabetes. Your teeth may become loose as the gums pull away from them.

Frequent gum disease/infection
As well as the previous gum symptoms, you may experience more frequent gum disease and/or gum infections.

Sexual dysfunction among men
If you are over 50 and experience frequent or constant sexual dysfunction (erectile dysfunction), it could be a symptom of diabetes.

Numbness or tingling, especially in your feet and hands
If there is too much sugar in your body your nerves could become damaged, as could the tiny blood vessels that feed those nerves. You may experience tingling and/or numbness in your hands and feet.

Types of Blood Tests to diagnose diabetes:

One of three blood tests can be used to confirm a diagnosis of diabetes:

• Fasting plasma glucose (FPG) levels - a blood test after 8 hours of no eating

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• Glycosylated haemoglobin (HbA1c) - to measure a marker of the average blood glucose level over the past 2-3 months
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• Oral glucose tolerance testing (OGTT) - a test used less frequently that measures levels before and 2 hours after consuming a sweet drink (concentrated glucose solution).

Glycosylated haemoglobin is often abbreviated to A1C, and this blood test is also used in the monitoring of diabetes management.

To make an initial diagnosis, an HbA1c reading must be 6.5% or higher. An A1C result between 5.7% and 6.4% indicates prediabetes and a risk of type 2 diabetes.

The HbA1c is the preferred blood test for diagnosis because - while it is more expensive than the FPG test - it has advantages, including:

• Greater convenience (no need for fasting)
• Less day-to-day variation during stress and illness.

When the fasting plasma glucose test is used to confirm symptoms, diabetes is diagnosed at levels equal to or above 126 mg/dL (7.0 mmol/L).

For oral glucose tolerance testing, the plasma glucose levels after 2 hours need to be equal to or above 200 mg/dL (11.1 mmol/L) for a diabetes diagnosis.

Another blood test is the random plasma glucose test - taken regardless of time and eating - which diagnoses diabetes if the level is at least 200 mg/dL (11.1 mmol/L).

What's the treatment for diabetes?

Type 2 diabetes has a number of drug treatment options to be taken by mouth known as oral antihyperglycemic drugs or oral hypoglycemic drugs.

Oral diabetes drugs are usually reserved for use only after lifestyle measures have been unsuccessful in lowering glucose levels to the target of an HbA1c below 7.0%, achieved through an average glucose reading of around 8.3-8.9 mmol/L (around 150-160 mg/dL).

The lifestyle measures that are critical to type 2 diabetes management are diet and exercise, and these remain an important part of treatment when pills are added.

However, people with type 1 diabetes cannot use oral pills for treatment, and must instead take insulin.

Article by Dr.Vighnesh Y, M.D (Internal Medicine, Dip. Rheumatology)
Consultant Physician, CallHealth

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