What is diabetes?
Diabetes is a chronic condition where there is excess glucose (sugar) in the blood. (Normal level of blood glucose in adults is 70-100 mg/dl in fasting state and less than 140 mg/dl two hours after eating)
What are the types of diabetes?
Type 1 diabetes: It occurs because the insulin-producing cells of the pancreas (beta cells) are damaged. In type 1 diabetes, the pancreas makes little or no insulin. It is the common form of diabetes in people who are under age 30, but it can occur at any age.
Type 2 diabetes (adult onset diabetes): the pancreas makes insulin, but it either doesn’t produce enough, or the insulin does not work properly. It occurs most often in people who are over 40 years old but can occur even in childhood
Impaired glucose tolerance IGT/Prediabetes: Here the blood sugar levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes. Those with this condition are at increased risk for type 2 diabetes.
Gestational diabetes: It occurs when there is a high blood glucose level during pregnancy. Blood glucose levels usually return to normal after childbirth. However, women who have had gestational diabetes have an increased risk of developing type 2 diabetes later in life.
Why does it occur?
It occurs when the pancreas produces little or no insulin at all. Insulin is a hormone, produced by the pancreas which functions to let the blood sugar enter into your body’s cells which utilizes glucose for energy.
Sometimes the insulin is normally produced but it does not work as the cells do not respond to it as they usually do. This condition is called insulin resistance.
What are the risk factors?
Family history of diabetes, obesity, stress, drugs like steroids, diseases of pancreas (such as infection, tumor, surgery), autoimmune diseases, high blood pressure, smoking, history of gestational diabetes.
What are the symptoms?
Increased thirst, increased hunger (especially after eating), frequent urination, unexplained weight loss (even if your appetite is good), tiredness, frequent urinary tract infections etc.
What are the investigations?
Urine glucose, Random Blood Sugar, fasting and postprandial blood sugar levels, HbA1c levels.
| Blood sugar levels | Normal | Impaired glucose tolerance / Pre-diabetes | Diabetes |
| 8 hours fasting (overnight) | 70-100 mg/dl | 101-125 mg/dl | 125 mg/dl and above |
| 2 hours Post prandial | Less than 140 mg/dl | 141-200 mg/dl | 200 mg/dl and above |
| HbA1c | 6 % | 6-6.4 % | 6.5 % and over |
What are the complications of diabetes?
Diabetes overtime can damage various organs like the heart, blood vessels, eyes, kidneys, and nerves.
Increased risk of heart attacks and strokes.
Diabetic neuropathy occurs due to nerve damage in the feet which increases the chance of foot ulcers, infection and may require limb amputation.
Diabetic retinopathy occurs as a result of long-term damage to the blood vessels in the retina causing blindness.
Diabetic nephropathy occurs due to damages to kidney leading to renal/kidney failure.
What are the preventive measures?
Lifestyle modifications to be within the correct BMI (Body Mass Index) range, good diet, proper physical activity.
Regular monitoring of glucose levels in case of prediabetes. Reversal is possible at this stage.
To prevent complications: Keeping good control of sugar levels with HbA1c less than 7%, regular follow ups for retinopathy, neuropathy and nephropathy.
What are the treatment options?
Diet with no sugar, less salt, and oil.
Physical activity like brisk walking for 40mins every day for 5 days in a week
Anti-diabetic drugs
Insulin injections (main line in type 1 diabetes) also in later stages of type 2 diabetes also.