Diabetes: A Comprehensive Guide to Symptoms, Causes, and Prevention

Diabetes is a chronic disease that causes high blood sugar and is common in all age groups, including children, adolescents, and adults. 

It is estimated that around 422 million of the world’s population are diabetic, and 1.5 million deaths occur directly due to diabetes each year, mostly from diabetes-associated complications such as heart disease, stroke, and kidney disease. 

Diabetes can be preventable by lifestyle modifications (including proper diet, exercise, and maintaining a healthy weight), but in some cases, type 2 diabetes can also be caused by genetic factors, which may be difficult to prevent but can be managed.

In this article, we will discuss everything about diabetes, including its types, symptoms, causes, prevention, treatment, risk factors, and more. 

What Is Diabetes? 

Diabetes, also known as diabetes mellitus, is a chronic disease that occurs due to abnormally high levels of sugar (glucose) in your blood. 

Glucose (sugar) mainly comes from the foods we eat that have carbohydrates, and almost all foods contain some amount of carbohydrates. It is one of the primary sources of energy we use to maintain body functions. 

The cells in your pancreas release a hormone called insulin. Insulin stores glucose in the liver and muscles as glycogen, and when the body needs energy, insulin uses the stored glycogen, converts it back into glucose, and releases it into the bloodstream. 

Once there, insulin regulates the transport of glucose from the bloodstream to the cells in the body for energy production.

But if the pancreas fails to release enough insulin or the body doesn’t use insulin effectively, glucose will not reach body cells. This will result in a buildup or accumulation of glucose (sugars) in your blood, leading to high blood sugar levels and causing diabetes.

Types of Diabetes 

There are three main types of diabetes:

• Type 1 diabetes 
• Type 2 diabetes 
• Gestational diabetes 

Type 1 Diabetes 

Type 1 diabetes is an autoimmune disease, which is also known as early insulin-dependent or juvenile diabetes. 

This type commonly presents in children and young adults but can occur at any age. In type 1 diabetes, your immune system destroys the cells in the pancreas that produce insulin. Hence, the body produces little to no insulin. 

There is no permanent cure for this disease, and since the pancreas is unable to produce insulin, patients with type 1 diabetes have to take insulin throughout their lifetime. Most patients with Type 1 diabetes require multiple insulin injections daily to manage and control their blood sugar level and may require additional insulin to cover increases in blood sugar following meals.

Type 2 Diabetes

Unlike Type 1 diabetes, Type 2 diabetes is a condition in which the pancreas can produce insulin, but the ability of the body cells to use insulin is impaired. 

The pancreas assumes that there is not enough insulin, and to compensate, the pancreas produces more and more insulin. As such, in patients with early Type 2 diabetes, the insulin level in the blood may actually be high, but the insulin does not work properly in the body. Eventually, at some point, the pancreas becomes “over-worked,” and insulin production decreases as the pancreas is unable to cope with the increasing demand. If the pancreatic insulin production continues to drop, patients with Type 2 diabetes may eventually require insulin treatment.

The condition or inability of the body cells to use or respond to insulin is also known as insulin resistance. When glucose (sugar) is not used by insulin, it builds up in the bloodstream, leading to high blood sugar levels. 

Patients with type 2 diabetes need to take medications (either oral medications or insulin) to manage their blood sugar.

Gestational Diabetes 

Gestational diabetes is a type of diabetes that causes high blood sugar during pregnancy, but it commonly goes away after giving birth. 

It can occur due to insulin resistance or insufficient production of insulin by the body during pregnancy. This condition is commonly controllable through diet and exercise. However, if the blood sugar levels continue to be high during pregnancy, patients may need to be on temporary insulin treatment.

Gestational diabetes may progress to type 2 diabetes or increase the risk of developing type 2 diabetes in later stages of life. 

Diabetes Symptoms 

The common symptoms of diabetes type 1 and 2 include: 

• Frequent urination 
• Feeling excessive thirst 
• Feeling excessive hunger
• Blurred vision 
• Weakness or extreme tiredness 
• Weight loss without trying 
• Fruity smell in breath (common in type 1 diabetes)
• A wound or cut that heals slowly 

Causes 

The causes of diabetes include a combination of lifestyle and genetic factors, including: 

• Lack of exercise or physical inactivity 
• Advanced age
• Being overweight/obese 
• Polycystic ovarian syndrome 
• Persistent high blood pressure or untreated hypertension 
• Excessive alcohol consumption 
• High levels of triglycerides 
• Certain ethnicities (i.e., Southeast Asian, Hispanics)
• Family history and genetics 
• Pregnancy 
• Autoimmune disease 
• Damage to the pancreas from surgery or injury
• Hormonal imbalance (such as low thyroid function)

Diagnosis of Diabetes 

There are several blood sugar tests that help diagnose diabetes. These tests measure the amount of sugar (glucose) in your blood. Then, the values are compared with the standard range.

The following tests are used to measure blood glucose levels: 

Random Blood Glucose Test 

A random blood glucose test is a blood test that measures your sugar levels at any time of the day. There are no time or diet restrictions for this test. 

A random blood sugar level higher than 200 mg/dl with symptoms of hyperglycemia (high blood sugar) means that you have diabetes.

Fasting Blood Glucose Test 

As the name indicates, a fasting blood glucose test measures your sugar levels when you have not consumed anything (except water) for at least 8 hours. To take this test, you must fast for 8 hours or overnight.

A fasting blood glucose level higher than 126 mg/dl or more means that you have diabetes. If your fasting blood sugar is between 100 – 125, you have prediabetes. A normal fasting blood sugar should be below 100.

Oral Glucose Tolerance Test 

This test is commonly used to diagnose gestational diabetes. It tells how well your body tolerates (digests) large amounts of glucose. 

The oral glucose tolerance test requires you to fast for 8 hours and drink a sugar solution. Then your blood is withdrawn at different time intervals to measure the amount of glucose. 

A blood sugar level greater than 200 mg/dl after two hours of drinking the sugar solution indicates diabetes.

Glycated Haemoglobin Test (HbA1C) 

Glycated hemoglobin, also known as HbA1C or A1C, is a blood test that measures your average blood glucose levels over a period of 3 months. 

An HbA1C level of 6.5% or more means that you have diabetes. This test is commonly used to diagnose type 2 diabetes. HbA1c level of 5.7 to 6.4 means you have prediabetes. A normal HbA1c should be 5.6 or less.

Insulin Test 

Insulin is a fasting blood test that measures the amount of insulin in your blood after fasting for 8 hours. While this is a less common test, it helps screen various health issues and different types of diabetes, including type 1 and type 2 diabetes, insulin resistance, and hypoglycemia (low blood sugar).

Diabetes Treatment 

The treatment of diabetes involves medications and lifestyle changes. 

Medications 

Patients with type 1 diabetes need to take insulin regularly to maintain their blood sugar levels. Insulin is commonly given by injections 30 minutes before a meal. Some type 1 diabetic patients may also have an insulin pump to help manage their insulin needs.

Patients having diabetes but can produce insulin, for example, in type 2 diabetes, are commonly prescribed oral diabetic medications. 

Metformin (glucophage) is the most widely used medication in type 2 diabetes, given once or twice daily. However, if the blood sugar continues to be high on metformin, other oral medications can be added to metformin to improve blood sugar control.

Diet 

Patients with diabetes should consume a calculated amount of glucose (sugar) and carbohydrates to maintain their sugar levels. For patients who are overweight or obese, adjustments in daily calories may also be needed to help achieve a healthy weight.

It is crucial that diabetic patients consult their doctor or nutritionist to prepare a diet plan that indicates the amount of sugar they can consume in a day based on their condition.

Exercise 

Regular exercise is necessary for patients with diabetes as it helps reduce insulin resistance, digest carbohydrates from food, and manage blood glucose levels. Patients are encouraged to exercise at least 30 minutes three to four times a week.

How To Prevent Diabetes 

You can prevent diabetes by choosing a healthy lifestyle and diet, including: 

• Maintaining a healthy weight
• Regular exercise 
• Reducing the amount of sugar and carbohydrates you eat
• Staying physically active
• Drinking beverages without sugar
• Eating high-fiber foods with fewer carbs and calories
• Avoiding smoking
• Limiting alcohol intake 
• Eating healthy sources of fats and carbohydrates, like fruits, vegetables, unsweetened milk and yogurt, pulses, fish, and unsalted nuts.