Diabetes – Signs, Symptoms and Management

Caleb Ihuarulam

Caleb Ihuarulam

Diabetes is a health condition affecting the body’s ability to regulate blood sugar or glucose levels properly.

Insulin (a hormone responsible for regulating blood sugar) helps the body break down carbohydrates in food to glucose (sugar). The glucose is released into the bloodstream. Glucose is transported through the blood to the cell, absorbed and used for energy.

With diabetes, insulin is deficient. Either the pancreas makes little to no insulin, or the body cannot use the insulin produced properly. When this occurs, glucose builds up in the bloodstream, causing elevated blood sugar levels (hyperglycaemia).

This condition affects people of all ages and can be primarily managed with medications and lifestyle changes.

Types of Diabetes

There are three main types of diabetes: Type 1, Type 2 and gestational diabetes.

Type 1 Diabetes

Type 1 diabetes is also known as insulin-dependent, juvenile or child-onset diabetes. It is an autoimmune disorder where the immune system mistakenly attacks and destroys insulin-producing beta cells in the pancreas. As a result, the body loses its ability to produce insulin. It is typically diagnosed in childhood or adolescence but can also develop in adults.

Symptoms 

The symptoms of Type 1 diabetes mostly appear suddenly. Some of these include:

  • Rapid weight loss
  • Frequent urination (polyuria)
  • Increased thirst (polydipsia)
  • Increased hunger (polyphagia)
  • Bed-wetting (nocturnal enuresis)
  • Fatigue
  • Blurry vision

Causes 

The exact cause of the autoimmune response is unknown. However, two factors that contribute to Type 1 diabetes are:

  • Genetics: People who have a parent, sibling or any other family history of type 1 diabetes have a higher risk of developing it.
  • Environmental factors: Environmental triggers such as exposure to viruses and chemicals can trigger an autoimmune response. This can happen over months or years, leading to a complete insulin deficiency.

Diagnosis 

The diagnosis can be done using any of the following tests:

Blood Glucose Test: These tests are used to check the amount of sugar in the blood. A random blood sugar test result of 200 mg/dL or higher or a fasting blood sugar test of 126mg/dL or higher indicates the possibility of diabetes.

Blood sugar values are expressed in milligrams of sugar per deciliter (mg/dL) or millimoles of sugar per litre (mmol/L) of blood.

Urinalysis: These tests are used to check for protein in your urine. High protein in the urine mean that the person has Type 1 diabetes.

Treatment and Management

There is no cure for Type 1 diabetes. However, managing the condition is done through any of these medical practices and recommendations:

  • Insulin Therapy: People with Type 1 diabetes cannot produce insulin, so they need to be given insulin via daily injections, pens or a pump. The doctor will determine the type of insulin therapy required for each case.
  • Regular Monitoring: Monitoring blood sugar levels helps patients adjust insulin doses or lifestyle choices when necessary.
  • Lifestyle Changes: Diabetic patients are encouraged to eat foods low in sugar and processed carbohydrates. Foods high in nutrients and fibre are also recommended. Regular exercise and physical activity also help reduce your blood sugar levels.

Children with Type 1 diabetes will need to see a pediatric endocrinologist.

Type 2 Diabetes

Type 2 diabetes is the most common type of diabetes. It occurs when the body either resists the effects of insulin or doesn’t produce enough insulin to maintain normal glucose levels. This used to be common in adults, as it often develops in people 45 years and older. However, there has been a recent increase in recorded cases among children and teens.

Symptoms 

The symptoms of Type 1 and 2 diabetes are similar in most cases, but here are some signs of Type 2 diabetes:

  • Rapid weight loss
  • Frequent urination (polyuria)
  • Increased thirst (polydipsia)
  • Frequent hunger (polyphagia)
  • Fatigue due to insufficient glucose absorbed into the body’s cells
  • Blurry vision
  • Slow-healing cuts and wounds
  • Numbness and tingling in your hands and feet
  • Patches of darker skin on creases of the neck, armpit or groin
  • Urinary tract infections (UTIs) and vaginal yeast infections in women

Causes 

Type 2 diabetes is mainly caused by insulin resistance. This usually manifests in two ways:

  • Low glucose absorption: Your muscles, fat, and liver cells do not respond to insulin as they should. This results in high blood sugar levels.
  • High insulin production: When your body cells aren’t responding to insulin appropriately, your pancreas produces more insulin, increasing insulin levels .

Some risk factors that contribute to insulin resistance include:

  • Family history
  • Lifestyle – a poor diet and lack of physical activity
  • Obesity or being overweight
  • Excess body fat, especially in your belly and around your organs
  • Age – 45 years and older
  • Pre-Diabetes.
  • Having Polycystic Ovarian Syndrome (PCOS)
  • Having high blood pressure.

Diagnosis 

Blood testing is the most common way of diagnosing Type 2 diabetes. Your doctor will order the following tests:

  • Blood Glucose Test:
  • Random Blood Sugar Test: 200 mg/dL or higher indicates diabetes.
  • Fasting Blood Sugar Test: Less than 100 mg/dL is healthy. 100 to 125 mg/dL is diagnosed as pre-diabetes. 126 mg/dL or higher on two separate tests is diagnosed as diabetes.
  • Oral Glucose Tolerance Test: Less than 140 mg/dL after two hours is considered healthy. 140 to 199 mg/dL is diagnosed as pre-diabetes. 200 mg/dL or higher after two hours suggests diabetes.

Treatment and Management

Here are ways to manage it and prevent further complications.

  • Regular Blood Sugar Monitoring: Monitoring blood sugar levels will help patients understand their glucose levels. Medical practitioners can observe trends and adjust the treatment plan accordingly. Patients can test their blood sugar at home with a glucometer and record the results.
  • Eat healthily: Create a balanced diet with a variety of nutritious foods. Whole grains, fruits and vegetables are great options. A registered dietitian can help recommend a personalised meal plan.
  • Prioritise physical activity: Regular exercise helps improve the body’s insulin sensitivity and overall well-being.
  • Oral medication: Medications like Metformin are recommended as most people with type 2 diabetes usually do not need insulin therapy. The type of medication, the dosage and if insulin therapy is needed may change over time. Take medications as prescribed.
  • Routine checkup: Patients should visit the doctor regularly for checkups and to review the management plan.

At Reliance Health, we partner with Platos health to help enrollees with diabetes manage their symptoms better. Platos Health shared with us key steps involved in managing diabetes.

Gestational Diabetes

Gestational diabetes develops during pregnancy. Hormonal changes can contribute to the body’s inability to produce enough insulin. This leads to  increased risk of complications during pregnancy. They are also at risk of developing Type 2 diabetes later in life.

Symptoms 

Most women are usually asymptomatic, but some of the common symptoms of gestational diabetes include:

  • Increased thirst and hunger
  • Frequent urination
  • Fatigue

Causes 

Here are some risk factors that contribute to gestational diabetes:

  • Family history.
  • Insulin resistance: During pregnancy, the placenta releases hormones that interfere with insulin function in the body. Insulin resistance increases the body’s need for insulin. Pregnant women with gestational diabetes cannot overcome insulin resistance because their pancreas cannot produce enough insulin to regulate blood glucose.
  • Hormonal imbalance
  • Pre-diabetes
  • Pre-existing medical conditions like Polycystic Ovarian Syndrome (PcOS) and heart conditions are more susceptible to gestational diabetes.

Diagnosis 

It is usually diagnosed through prenatal screening between 24 and 28 weeks of pregnancy and goes away after the baby is born in some instances. Any of the following tests is usually requested by the doctor:

  • Glucose Screening (Challenge) Test: A sweet liquid will be given to the patient. After an hour, a blood test will be taken. If 140mg/dL or higher, the patient will be required to return for an oral glucose tolerance test.
  • The oral Glucose Tolerance Test (OGTT) measures fasting blood glucose within 8 hours.  Patients are required to drink a sweet liquid, after which the healthcare professional draws blood every 2 to 3 hours.

Treatment and Management

Pregnant women diagnosed with gestational diabetes will need more frequent checkups during pregnancy. Prenatal visits are an essential management strategy in pregnancy.

  • Diet: Make healthy food choices. Focus on fruits, vegetables, and whole grains. Watch portion sizes.
  • Blood Sugar Monitoring: Regular monitoring, especially during antenatal visits, would help to track glucose levels and adjust management strategies.
  • Regular Physical Activity: Regular exercise, like brisk walking, lowers blood sugar levels and reduces chances of weight gain while increasing sensitivity to insulin. Check with the doctor about appropriate physical activity to partake in during pregnancy.

Women with diabetes typically have more prenatal visits to check fetal growth (via ultrasound), monitor weight gain, and discuss how well sugar is being controlled. Do not hesitate to communicate concerns with the obstetrician.

How Hypertension Affects Diabetes

Hypertension might not cause diabetes directly, but it can increase the risk of developing diabetes – Type 1, Type 2 and gestational. Studies show that they both share some common causes, such as:

  • Sedentary lifestyle (lifestyle with little to no exercise) with excessive calorie intake
  • Obesity
  • Inflammation
  • Oxidative stress
  • Insulin resistance

Diabetes increases the risk of heart disease by two to three times over ten years and chronic kidney disease by one in every three people. Atherosclerosis, caused by a buildup of cholesterol in the arteries, damages them, resulting in high blood pressure and blood vessel damage in the kidneys and nephrons. When untreated, it can lead to heart attacks and kidney failure. High blood pressure also increases the risk of gestational diabetes complications and contributes to insulin resistance.

Diabetes-related Complications

Type 1 and 2 diabetes can increase your risk of developing health conditions that affect major organs of the body, including.

  • Cardiovascular diseases like heart attack and stroke.
  • kidney disease
  • Nerve damage that leads to tingling, pain, or numbness in the legs.
  • Diabetic retinopathy and vision problems such as cataracts, glaucoma and blindness.
  • Numbness and foot ulcers can lead to possible amputation when left untreated.
  • Hearing loss
  • Skin conditions, like dry skin and bacterial and fungal infections.
  • Sexual dysfunction.
  • Alzheimer’s disease and other types of dementia
  • Depression

It can also lead to severe complications in pregnancy, such as:

  • Pre-eclampsia is pregnancy-induced high blood pressure that can lead to organ damage.
  • Stillbirth/miscarriage
  • Increased birth weight of the baby
  • Hypoglycemia and seizures in newborns.
  • Premature birth
Conclusion 

Navigating diabetes requires a comprehensive approach. Consider factors such as the type, symptoms, causes, and diagnosis. Individuals will live healthier lives if they are equipped with the right knowledge and understand how to manage it. Always consult a healthcare professional(s) for personalised guidance.

Healthcare plans from Reliance Health provide access to care, including medication management for several chronic conditions. For Diabetes, we partner with Platos Health to give you the required medical hands to manage your condition. You can access this plan as part of your overall healthcare package from Reliance Health. Click here to get started, or send the link to your HR.  

 

Terms Related To Diabetes

  1. Insulin: A hormone the pancreas produces that regulates blood sugar levels by facilitating glucose uptake into cells. People with diabetes may need insulin injections or insulin pumps to control their blood sugar.
  2. Glucose: A sugar in the bloodstream that serves as the body’s primary energy source. Elevated levels of glucose in the blood are a characteristic of diabetes.
  3. Hypoglycemia: A condition where blood sugar levels drop too low, leading to symptoms such as shakiness, confusion, and, in severe cases, loss of consciousness. It is typically a side effect of medication or excessive insulin.
  4. Hyperglycemia: A condition characterised by abnormally high blood sugar levels, which can lead to symptoms like excessive thirst, frequent urination, and fatigue.
  5. A1C (Glycated Hemoglobin): A blood test measuring average blood sugar levels over the past 2-3 months. It is a common tool for assessing diabetes control.
  6. Complications of Diabetes: Chronic conditions can develop due to poorly managed diabetes, including heart disease, neuropathy, retinopathy, and kidney disease.
  7. Pancreas: An organ in the abdomen that regulates blood sugar levels by producing insulin and other hormones.
  8. Glucometer: A portable device used to measure blood sugar levels, typically by pricking a finger to obtain a small blood sample.
  9. Ketones: Chemical substances produced when the body breaks down fat for energy when insufficient insulin is available. High levels of ketones can be a sign of diabetic ketoacidosis (DKA), a life-threatening condition.
  10. Hypertension: High blood pressure is a common comorbidity with diabetes and can increase the risk of heart disease and other complications.
  11. Neuropathy: Nerve damage can result from prolonged high blood sugar levels, leading to numbness, tingling, and pain, especially in the extremities.
  12. Retinopathy: A condition that affects the blood vessels in the eye’s retina and can lead to vision problems or blindness if left untreated.
  13. Nephropathy: Kidney disease associated with diabetes, which can progress to kidney failure if not well managed.
  14. Metformin: A common oral medication that lowers blood sugar levels in people with type 2 diabetes.
  15. Dietitian: A healthcare professional who specialises in nutrition and can help individuals with diabetes create personalised meal plans.
  16. Endocrinologist: A medical specialist who focuses on diagnosing and treating endocrine system disorders, including diabetes.

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Caleb Ihuarulam

Caleb Ihuarulam

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