Diabetes And Its Management
by Akash Mishra web designerFor thirty-four-year old Rekha, the
symptoms began with excessive thirst and hunger. She paid this no heed,
believing it to be nothing more than a change in her eating and drinking habit.
Frequent urination followed this. Rekha tossed it aside by applying simple
logic. The more she will drink the more she will feel like going to the
washroom.
It was not until she began feeling tired
and losing weight, Rekha started to think about something else at work. She
became irritable. Her eyes blurred every now and then. Soon skin infections and
slow healing wounds joined on the list of her problems. Rekha couldn't take it
anymore and she quickly visited a doctor. The doctor diagnosed her with
diabetes.
What is diabetes?
The term diabetes is the reduced version of
the full name diabetes mellitus. Diabetes is a type of condition in which the
body fails to utilize the ingested glucose properly. There could be two reasons
for this: Lack of hormone insulin. Because the insulin which is available is
not working effectively.
Diabetes is the fastest growing long term
disease that almost affects millions of people all around the world.
When food is taken, our body breaks it down
to smaller components. Sugars and carbohydrates are thus broken down into
glucose for the body to utilize them as an energy source. The liver is also
able to manufacture glucose.
In normal persons, the hormone insulin,
which is made by the pancreas, regulates how much glucose is in the blood. When
there is excess glucose, insulin stimulates cells to absorb glucose from the
blood. Insulin secreted by pancreas also stimulates the liver to absorb and
store any excess glucose. Insulin release is triggered after a meal. This time
period when there is a rise in blood glucose. When blood glucose levels fall,
insulin levels fall too.
Glucagon is a second hormone manufactured
in the pancreas opposite. It stimulates the liver to release glucose when
necessary.
Symptoms of diabetes
The main symptoms of diabetes are
polydipsia, polyphagia, and polyuria, meaning increased thirst, increased
hunger and increased frequency of urination.
Other symptoms are:
l Weight loss or gain
l Fatigue
l Irritability
l Blurred vision
l Slow-healing wounds
l Nausea
l Skin infections
l Darkening of skin in areas of body creases
l Breath odor that is fruity or sweet
Types of diabetes
There are two major types of diabetes.
These are type 1 and type 2 diabetes. The other types of diabetes are less
common. They include gestational diabetes or pregnancy-induced diabetes.
Type 1 diabetes
Here the body's immune system destroys the
beta cells of the pancreas. These cells are responsible to produce insulin.
This results in a severe lack of insulin. Without insulin, the blood glucose
levels rise uncontrollably. This can go on to damage the body's organs.
It is often known as insulin-dependent
diabetes. It starts in children and in the young. Hence it is also termed
juvenile diabetes or early-onset diabetes. Type 1 is less common than type 2.
About 10% of the diabetic population has type 1 diabetes.
Treatment for this type of diabetes is
insulin injections that are needed for the rest of the person’s lifetime.
Type 2 diabetes
Type 2 diabetes is where the pancreas does
not produce enough insulin to meet the body's own needs.
It usually develops gradually over time.
Most people with the condition may be unaware of their disease. This is
especially true at early stages as there may be no specific symptoms. Type 2
diabetes is often associated with obesity. Obesity-related diabetes is referred
to as maturity-onset diabetes. This is because it is more common in older
people.
Gestational diabetes or diabetes during pregnancy
Some women may develop high blood sugar
during their pregnancy. Their pancreas fails to produce enough insulin to
absorb all of it. This is known as gestational diabetes. It affects around 4 to
5% of pregnant women.
Pregnant women with this type of condition
may or may not have pre-existing type 1 or type 2 diabetes. In most cases,
gestational diabetes develops during the second trimester of pregnancy and
disappears after the baby is born.
This type of condition can increase the
risk of health problems developing in an unborn baby. Thus it is important to
detect it early. Treat it appropriately.
Treatment of gestational diabetes is
usually the regular insulin injections as oral pills.
Secondary diabetes
Around 1 to 2% of all diabetics may develop
this condition. This could be caused due to a pancreatic disease like chronic
pancreatitis, pancreatectomy, cystic fibrosis, or pancreas cancer. Some drugs
such as thiazide diuretics, corticosteroids, atypical antipsychotics, protease
inhibitors used in HIV infection may raise the risk of diabetes.
Diagnosis
Doctors diagnose diabetes by performing a
blood test. The test usually reveals high blood glucose.
Management
Diabetes is characterized by high and
uncontrolled blood sugar and a lack of insulin. There are several approaches to
managing diabetes.
Type 1 diabetes
These patients respond only to insulin
injections. There is no cure for type 1 diabetes. Symptoms can still be
eliminated by adequate physical exercise and by adopting a healthy diet.
Insulin needs to be taken at regular intervals to keep the blood glucose level
steady.
Insulin cannot be taken orally. The
digestive juices would damage it if taken orally. Injections these days have
become simple and painless. Some people need it twice a day. Some need it three
times a day.
These individuals need a healthy diet. Diet
should be free of all kinds of simple sugars and saturated fats. The aim is to
maintain healthy body weight. Regular exercise also stimulates insulin release.
Alcohol contains excess simple sugars and
hence should be taken in a restricted manner.
Type 2 diabetes
The primary advice in the initial stages is
diet, weight management, and regular activity. It will first be managed with a
drug called Metformin.
There are now several other drugs used for
this type such as sulphonylureas, thiazolidinediones and other newer agents
like Vildagliptin. Eventually, some type 2 diabetics will end up needing
insulin therapy. This is because this is a progressive disease.
Diabetes in those undergoing surgery and
pregnant women
Pregnant women with diabetes undergoing
surgery or illness cannot be managed by oral anti-diabetic drugs. They need to
be given insulin injections.
Among pregnant women the oral anti-diabetes
drugs are not given as they may lead to damage to the unborn fetus.
For effective management always reach out
to a good endocrinologist or diabetologist such as Dr.
Ambrish Mithal who is an expert in diabetes management.
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Created on Jul 25th 2019 07:31. Viewed 554 times.