Diabetes is a condition that impairs the body’s ability to process blood glucose, otherwise known as blood sugar.
Without ongoing, careful management, diabetes can lead to a buildup of sugars in the blood, which can increase the risk of dangerous complications, including stroke and heart disease.
Different kinds of diabetes can occur, and managing the condition depends on the type. Not all forms of diabetes stem from a person being overweight or leading an inactive lifestyle. In fact, some are present from childhood.
Three major diabetes types can develop: Type 1, type 2, gestational diabetes, monogenic diabetes and cystic fibrosis-related diabetes.
Type I diabetes:
Also known as juvenile diabetes, this type occurs when the body fails to produce insulin. People with type I diabetes are insulin-dependent, which means they must take artificial insulin daily to stay alive.
Type 2 diabetes:
Type 2 diabetes affects the way the body uses insulin. While the body still makes insulin, unlike in type I, the cells in the body do not respond to it as effectively as they once did. This is the most common type of diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases, and it has strong linksTrusted Source with obesity.
This type occurs in women during pregnancy when the body can become less sensitive to insulin. Gestational diabetes does not occur in all women and usually resolves after giving birth.
Less common types of diabetes include monogenic diabetes and cystic fibrosis-related diabetes.
Doctors refer to some people as having prediabetes or borderline diabetes when blood sugar is usually in the range of 100 to 125 milligrams per deciliter (mg/dL).
Normal blood sugar levels sit between 70 and 99 mg/dL, whereas a person with diabetes will have a fasting blood sugar higher than 126 mg/dL.
The prediabetes level means that blood glucose is higher than usual but not so high as to constitute diabetes.
People with prediabetes are, however, at risk of developing type 2 diabetes, although they do not usually experience the symptoms of full diabetes.
The risk factors for prediabetes and type 2 diabetes are similar. They include:
a family history of diabetes
having a high-density lipoprotein (HDL) cholesterol level lower than 40 mg/dL or 50 mg/dL
a history of high blood pressure
having gestational diabetes or giving birth to a child with a birth weight of more than 9 pounds
a history of polycystic ovary syndrome (PCOS)
being of African-American, Native American, Latin American, or Asian-Pacific Islander descent
being more than 45 years of age
having a sedentary lifestyle
If a doctor identifies that a person has prediabetes, they will recommend that the individual makes healthful changes that can ideally stop the progression to type 2 diabetes. Losing weight and having a more healthful diet can often help prevent the disease.
How insulin problems develop ?
Doctors do not know the exact causes of type I diabetes. Type 2 diabetes, also known as insulin resistance, has clearer causes.
Insulin allows the glucose from a person’s food to access the cells in their body to supply energy. Insulin resistance is usually a result of the following cycle:
A person has genes or an environment that make it more likely that they are unable to make enough insulin to cover how much glucose they eat.
The body tries to make extra insulin to process the excess blood glucose.
The pancreas cannot keep up with the increased demands, and the excess blood sugar starts to circulate in the blood, causing damage.
Over time, insulin becomes less effective at introducing glucose to cells, and blood sugar levels continue to rise.
In the case of type 2 diabetes, insulin resistance takes place gradually. This is why doctors often recommend making lifestyle changes in an attempt to slow or reverse this cycle.
Lifestyle with Diabetes :
steps a person can take to embrace a lifestyle with diabetes include:
Eating a diet high in fresh, nutritious foods, including whole grains, fruits, vegetables, lean proteins, low-fat dairy, and healthy fat sources, such as nuts.
Avoiding high-sugar foods that provide empty calories, or calories that do not have other nutritional benefits, such as sweetened sodas, fried foods, and high-sugar desserts.
Refraining from drinking excessive amounts of alcohol or keeping intake to less than one drink a day for women or two drinks a day for men.
Engaging in at least 30 minutes exercise a day on at least 5 days of the week, such as of walking, aerobics, riding a bike, or swimming.
Recognizing signs of low blood sugar when exercising, including dizziness, confusion, weakness, and profuse sweating.
Using insulin :
People with type I diabetes and some people with type 2 diabetes may need to inject or inhale insulin to keep their blood sugar levels from becoming too high.
Various types of insulin are available, and most are grouped by how long their effect lasts. There are rapid, regular, intermediate, and long-acting insulins.
Some people will use a long-acting insulin injection to maintain consistently low blood sugar levels. Some people may use short-acting insulin or a combination of insulin types. Whatever the type, a person will usually check their blood glucose levels using a fingerstick.
This method of checking blood sugar levels involves using a special, portable machine called a glucometer. A person with type I diabetes will then use the reading of their blood sugar level to determine how much insulin they need.
Self-monitoring is the only way a person can find out their blood sugar levels. Assuming the level from any physical symptoms that occur may be dangerous unless a person suspects extremely low glucose and thinks they need a rapid dose of glucose.
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How much is too much?
Insulin helps people with diabetes live an active lifestyle. However, it can lead to serious side effects, especially if a person administers too much.
Excessive insulin can cause hypoglycemia, or extremely low blood sugar, and lead to nausea, sweating, and shaking.
It is essential that people measure insulin carefully and eat a consistent diet that balances blood sugar levels as much as possible.
Other medications :
In addition to insulin, other types of medication are available that can help a person to manage their condition.
For type 2 diabetes, a doctor may prescribe metformin in pill or liquid form.
It contributes to:
lowering blood sugar
making insulin more effective
It can also help in weight loss. Having a healthy weight can reduce the impact of diabetes.
As well as diabetes, a person may also have other health risks, and they may need medication to control these. A doctor will advise the individual about their needs.
SGLT2 inhibitors and GLP-1 receptor agonists
In 2018, new guidelines also recommended prescribing additional drugs for people with:
atherosclerotic cardiovascular disease
chronic kidney disease
These are sodium-glucose cotransporter 2 (SGLT2) inhibitors or glucagon-like peptide-1 (GLP-1) receptor agonists.
For those with atherosclerotic cardiovascular disease and a high risk of heart failure, the guidelines advise doctors to prescribe an SGLT2 inhibitor.
While diabetes itself is manageable, its complications can severely impact on daily living, and some can be fatal if not treated immediately.
Complications of diabetes include:
dental and gum diseases
eye problems and sight loss
foot problems, including numbness, leading to ulcers and untreated injuries and cuts
nerve damage, such as diabetic neuropathy
In the case of kidney disease, this complication can lead to kidney failure, water retention when the body does not dispose of water correctly, and a person experiencing difficulties with bladder control.
Regularly monitoring blood glucose levels and moderating glucose intake can help people prevent the more damaging complications of type 2 diabetes.
For those with types 1 diabetes, taking insulin is the only way to moderate and control the effects of the condition
Effects of diabetes in women :
Many of the symptoms of diabetes are common to both men and women, but some features are specific to women.
Oral and vaginal thrush
Women with diabetes may be more likely to experience a yeast infection, or thrush, in the mouth and vagina.
High levels of blood sugar create an ideal breeding ground for the Candida fungus that causes the condition.
dyspareunia, or painful sex
a white coating on the tongue, if the fungus infects the mouth
People with diabetes are more likelyTrusted Source to develop different kinds of infections, with more severe symptoms and a higher chance of complications than people without diabetes.
High blood sugar levels in the body affect the immune system’s ability to respond to pathogens such as bacteria, viruses, and fungi.
Urinary tract infections (UTIs)
Women with diabetes have a higher risk of a urinary tract infection (UTI). In a 2015 review, 12.9 percent of womenTrusted Source studied developed a UTI within the first year of receiving a diagnosis of type 2 diabetes. Only 3.9 percent of men experienced one.
Symptoms of a UTI include:
painful, burning urination
blood in the urine
Anyone with diabetes who has a UTI should seek treatment as soon as possible to prevent further complications, such as a kidney infection.
A higher risk of a UTI or candidiasis can contribute to a lower sex drive, or libido. Other factors can also affect this.
Many people with diabetes develop diabetic neuropathy. This happens when high glucose levels in the blood result in damage to the body’s nerve fibers.
The impact of this varies widely. It includes reduced sensations in the hands, feet, and legs and altered sexual experiences in the vagina.
There may also be:
low lubrication of the vagina
difficulty with arousal of the clitoris and having an orgasm
pain during sex
All these can affect a person’s interest or pleasure in sex.
Polycystic ovarian syndrome (PCOS)
There is a higher chance of having PCOS if a person has diabetes. In PCOS, a hormonal imbalance means the ovaries are unable to release eggs properly. This can affect fertility.
PCOS is not a symptom of diabetes, but a woman with diabetes is more likely to have it than one who does not have diabetes.
Genetic factors may play a role, but there may also be a link between PCOS and insulin production, according to the American Diabetes Association (ADA).
Symptoms includeTrusted Source:
irregularity in the menstrual cycle
increased body weight
If a person receives a diagnosis of PCOS, they should also ask their doctor about screening for diabetes.
Gestational diabetes :
Gestational diabetes is a temporary condition that affects some women during pregnancy.
the need for a cesarian delivery
a risk of tearing in the vagina or between the anus and the vagina
heavy bleeding after delivery
The baby may be born with:
low blood sugar
There may be no symptoms during pregnancy, so testing is important, especially for those who may be at risk.
Dr.Javeed Kakroo is a Microbiologist Certified infection control Auditor Kidney Hospital Srinagar [email protected]