Diabetes mellitus is a group of metabolic disorders characterized by chronic hyperglycemia caused by defects in insulin secretion, insulin action, or both. It affects the metabolism of carbohydrates, fats, and proteins due to the crucial role of insulin as an anabolic hormone. Insufficient insulin levels and/or resistance of target tissues mainly skeletal muscles, adipose tissue, and to a lesser extent, the liver at the level of insulin receptors, signal transduction pathways, or effector enzymes are responsible for these metabolic disturbances.
The severity and presentation of symptoms depend on the type and duration of diabetes. Many patients, especially those with type 2 diabetes, may remain asymptomatic for years. Others, particularly children with absolute insulin deficiency, may experience classic symptoms such as excessive urination (polyuria), excessive thirst (polydipsia), excessive hunger (polyphagia), weight loss, and blurred vision.
If left uncontrolled, diabetes can lead to serious complications, including stupor, coma, and even death most commonly due to diabetic ketoacidosis or, in rare cases, Nonketotic hyperosmolar syndrome.
Types of Diabetes:
Type1 Diabetes:
An autoimmune disease in which the immune system attacks and destroys insulin-producing cells in the pancreas. The exact cause is unknown. This type is usually diagnosed in children and young adults but can develop at any age.
Type2 Diabetes:
The most common type of diabetes, where the body does not make enough insulin or the cells cannot respond properly to insulin. It primarily affects adults, though it is increasingly seen in children.
Prediabetes:
A condition where blood glucose levels are higher than normal but not yet high enough to be diagnosed as type 2 diabetes.
Gestational Diabetes:
Develops during pregnancy due to hormonal changes. Although it usually goes away after childbirth, women who experience gestational diabetes have a higher risk of developing type 2 diabetes later in life.
How Widespread is Diabetes?
Diabetes is a major global health issue. In the United States alone, approximately 37.7 millionpeople are living with the disease, representing about 11% of the total population. Type 2 diabetes accounts for 90 to 95% of all cases worldwide, making it the most common form of the condition.
Symptoms of Diabetes:
The symptoms of diabetes vary depending on the type and severity of the disease, but some are common across most patients. Classic signs include excessive urination, excessive thirst, and excessive hunger. Many patients also experience unexplained weight loss, fatigue, and blurred vision. Diabetes may also cause slow healing of cuts, frequent skin and urinary tract infections, tingling or numbness in the hands and feet, dry mouth, itchy skin, and mood changes. People with type 2 diabetes often develop the condition gradually and may remain symptom-free for years, while type 1 diabetes usually appears suddenly with more noticeable symptoms.
Causes of Diabetes:
Diabetes develops when the body cannot properly produce or use insulin. In type 1 diabetes, the cause is an autoimmune reaction where the immune system destroys the insulin-producing beta cells in the pancreas. The triggers are not fully understood but may involve genetic and environmental factors such as viral infections. In type 2 diabetes, the causes include insulin resistance and a gradual decline in insulin production, strongly linked to obesity, inactivity, poor diet, family history, and aging. Gestational diabetes occurs due to hormonal changes during pregnancy, particularly in women with excess weight or a family history of diabetes. Less common causes include genetic defects, pancreatic disease, hormonal disorders, and the use of medications such as steroids.
Prevention of Diabetes:
Diabetes, particularly type 2 and gestational diabetes, can often be prevented or delayed through lifestyle changes. Eating a healthy diet rich in whole grains, vegetables, fruits, lean proteins, and healthy fats while limiting sugar and processed foods is crucial. Regular exercise such as walking, jogging, or cycling improves insulin sensitivity and helps manage weight. Maintaining a healthy body weight is one of the most effective preventive measures, as obesity is a major risk factor. Avoiding smoking, limiting alcohol intake, and going for regular medical checkups are also important, especially for those with a family history of diabetes.
Diagnosis and Tests:
Diabetes is diagnosed using blood tests that measure glucose levels. The fasting blood sugar(FBS) test measures blood glucose after at least eight hours of fasting, while the oral glucosetolerance test (OGTT) checks blood sugar before and two hours after drinking a glucose solution. The HbA1c test provides the average blood glucose over the past two to three months, and a random blood sugar test can detect high glucose at any time of the day if symptoms are present. To confirm the diagnosis, tests are often repeated on another day. These methods can also detect prediabetes, a warning stage that can often be reversed with lifestyle adjustments.
Conclusion:
Diabetes is a serious and widespread metabolic disorder that continues to rise worldwide. Although type 1 diabetes cannot be prevented, type 2 and gestational diabetes can often be avoided or delayed through healthy lifestyle choices. Early diagnosis, proper treatment, and regular monitoring are essential to prevent severe complications. By maintaining a balanced diet, staying physically active, and managing weight, individuals can significantly lower their risk of developing diabetes and lead healthier lives.
