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Diabetes – Types, Causes, Risk Factors, Treatment & Prevention

Diabetes is a disease that occurs when your blood sugar(glucose) is too high. Insulin, a hormone made by the pancreas, lowers blood glucose.

Diabetes – Types, Causes, Risk Factors, Treatment & Prevention

What is Diabetes?

Diabetes is a disease that occurs when your blood sugar(glucose) is too high. Insulin, a hormone made by the pancreas, lowers blood glucose. Absence or insufficient manufacturing of insulin, or an incapability of the body to correctly use insulin is the reason of diabetes. According to WHO, 1.6 million deaths occur due to diabetes each year. Complications resulting from diabetes like kidney failure, nerve damage, coronary heart disease are common causes of death.

Common types of Diabetes

  • Type 1 Diabetes :  In this type of diabetes, the body does not make insulin because the immune system attacks and destroys cells in the pancreas, where insulin is made. Type 1 diabetes is detected in children and young adults, although it can occur at any age. One needs to take insulin every day to stay alive.
  • Type 2 Diabetes: Type 2 Diabetes is one of the major factors. In this type of diabetes, your body does not make or use insulin well because your body becomes resistant to insulin. Type 2 diabetes can occur usually among middle-aged and older people. It can develop at any age, even in the adolescence.
  • Gestational diabetes: It develops in a few women when they are pregnant. Insulin-blocking hormones produced by the means of placenta cause this type of diabetes. Most of the time, this type of diabetes goes away after the baby is born. However, if diagnosed with gestational diabetes, you have a greater chance of developing type 2 diabetes later in life.

Cause of Diabetes

Different causes are associated with each type of diabetes:

1. Type 1 diabetes:It is caused by genes and environmental factors, such as viruses.

2. Type 2 diabetes: It is caused by several factors, including lifestyle factors, like being overweight or physical inactivity, genes, and insulin resistance.

3. Gestational diabetes: It is caused by the hormonal changes of pregnancy in which hormones produced by the placenta contribute to insulin resistance, which occurs in all women during late pregnancy. Also, lifestyle factors contribute towards gestational diabetes which includes gaining too much weight during pregnancy or having PCOS before pregnancy.

Risk Factors

1. Type 1 diabetes: Factors that may signal an increased risk include Family history, Environmental factors such as exposure to a viral illness.

2. Type 2 diabetes: There could be various factors that can increase the risk of Type 2 Diabetes like:

  • * Being Overweight
  • * Age 45 or older
  • * Physically inactive
  • * High Blood pressure or High Cholesterol
  • * Parent or Sibling with the same condition

3. Gestational diabetes: Some pregnant women are at greater risk than others. Risk factors for gestational diabetes include :

  • * Overweight before pregnancy
  • * Family or personal history
  • * Women older than age 25 are at greater risk

Complications

For Type 1 and Type 2 Diabetes:

  • * Heart disease, Heart attack, and Stroke(Paralysis), Heart failure
  • * Neuropathy: Damage of one or more nerves which results in numbness, muscle weakness, and pain in the affected area, burning feet, non-healing ulcers in feet leading to amputation.
  • * Nephropathy is kidney failure, protein urea(protein in urine)
  • * Retinopathy: Vision loss, Bleeding in the eye
  • * Hearing loss
  • * Increased risk of infection- Urine infection, Kidney infection
  • * Infertility in young females
  • * DKA(Diabetic Keoacidosis)
  • * Skin conditions such as bacterial and fungal infections
  • * Depression

For Gestational Diabetes:  Complications affecting the baby:

  • * Premature birth
  • * Higher-than-normal weight at birth leading to increased risk of complication in delivery/increase cesarean chances
  • * Increased risk for type 2 diabetes later in life
  • * Low blood sugar in the baby after birth
  • * Jaundice – Baby requiring phototherapy, exchange blood transfusion
  • * Stillbirth, intrauterine death of baby

Complications affecting the mother:

  • * High Blood Pressure
  • * Swelling in the legs and feet
  • * Excess protein in the Urine
  • * Worsening of kidney failure, eye problems.

Symptoms 

Some people, especially those with type 2 diabetes, may sometimes not experience symptoms. In type 1 diabetes, signs and symptoms often come on quickly and are more severe. So the signs and symptoms of type 1, type 2, and gestational diabetes are:

  • * Increased thirst
  • * Frequent urination that is 4-5 times at night
  • * Extreme hunger
  • * weight loss despite good hunger
  • * Fatigue
  • * Irritability
  • * Blurred vision
  • * Slow-healing ulcers
  • * Frequent infections, such as gums or skin infections, urine, penile and vaginal infections.

Treatment

Diabetes is treated by few different medications like drugs which are either taken by mouth and some are available as injections.

Type 1 Diabetes:  For type 1 diabetes, insulin is the main treatment which is available in four types depending upon how quickly they start to work:

  • * Rapid-acting insulin starts to work within 15 minutes and its effects last for 3 to 4 hours.
  • * Short-acting insulin begins working within 30 minutes and lasts for atleast 6 to 8 hours.
  • * Intermediate-acting insulin begins to work within 1- 2 hours and goes for 12 to 18 hours.
  • * Long-acting insulin starts to work after few hours of injection and lasts for 24 hours or longer.

Type 2 Diabetes: Diet and exercise can help some people to manage type 2 diabetes but if lifestyle changes aren't enough to lower your blood sugar then you need to take some medications as well which include Biguanides, SGLT2 inhibitors, Glucagon-like peptides, DPP-4 Inhibitors.

Gestational Diabetes: Dietary changes and exercise may help to bring it down. About 10 to 20 percent of women with gestational diabetes will need insulin to lower their blood sugar because insulin is safe for the growing baby. A lot of oral medications are not safe in pregnancy

Prevention:

Type 1 diabetes can't be prevented. However, the same healthy lifestyle choices that help treat type 2 diabetes and gestational diabetes can also help prevent them:

  • * Eat Healthy foods
  • * Losing some weight
  • * Doing more physical activity
  • * Have your blood sugar checked at least once a year to check that you haven't developed type 2 diabetes after the age of 40 years

Reversal

Diabetes can be reversed if controlled with lifestyle changes and medications in an early stage of the disease.

Dr. Abhilasha Jain,
Consultant
Endocrinology

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