DIABETES – A CLOSER LOOK

Diabetes mellitus (simply called Diabetes) is a metabolic disease where the blood sugar levels are higher than the normal range. Diabetes mellitus is a metabolic condition that prevents your body from properly using the energy from the food you eat because your body can’t make sufficient insulin or because you can’t use it correctly, resulting in high blood glucose levels (Hyperglycemia) that can lead to chronic hyperglycemia is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels.

Type FPG (mg/d L) PPG(mg/d L) A1c (%)
Normal < 100 < 140 5.7
Prediabetes > 100 – < 125 > 140 – < 200 > 5.7 – < 6.5
Diabetes > 126 > 200 > 6.5

(Source: Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes – 2021. Diabetes Care 2021; 44(Suppl. 1):S15-S33)

Blood glucose levels can be ascertained through tests like fasting plasma glucose (FPG) that is done when fasting more than 8 hours. FPG less than 110 mg/dL is considered as normal; a fasting blood sugar ranges between 100 to 125 mg/dL is considered as prediabetes or borderline to develop diabetes, and an FPG range above 126 mg/dL is typically considered as diabetic.

An additional test is called postprandial plasma glucose (PPG). This test should be done 2 hours after a meal and if the results show blood glucose of more than 200 mg/dL then it may be considered a case of diabetes.

In some cases, the doctor may deploy a sensor of Continuous Glucose Monitoring System (CGMS) for 6-14 days. The CGMS is modern technology for diabetes monitoring; the CGM works through a tiny sensor inserted under our skin, usually on the belly or arm. The sensor measures our interstitial glucose level, which is the glucose found in the fluid between the cells. The sensor records the blood glucose level at an interval of 5 minutes and records 288 blood glucose reading per day. After 6-14 days the sensor is removed and basis the report, the doctor prescribes either lifestyle modifications or medications.

The amount of glucose in the bloodstream is regulated by the hormone insulin that is secreted in small amounts by the pancreas. When the amount of glucose in the blood rises to a certain level, the pancreas release more insulin that pushes more glucose into the cells. This causes the glucose levels in the blood to drop.

Insulin also helps to store glucose in fat cells (Adipose tissue) and liver (for later use when we are not eating) and it increases the usage of glucose from the peripheral muscles.

Diabetes is caused if our body cannot produce sufficient insulin or if it cannot utilize insulin properly (Insulin resistance).

Type of diabetes

Gestational diabetes: Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy.

Symptoms of diabetes

Most diabetes patients do not experience any obvious symptom, but some patients may experience weight loss, increased thirst, increased appetite, increased urination, blurry vision, elevated cholesterol levels, elevated blood pressure, sexual problems, numbness and tingling, fatigue, slow healing of wounds, and itchy skin.

Diabetes Complications

High blood glucose for a prolonged period may damage your micro-blood vessels of the eye (retinopathy), kidney (nephropathy), and nerves (neuropathy) and macro-blood vessels of the heart (coronary heart disease), brain (stroke) and lower extremities (peripheral vascular disease).

Prevention and management

Lifestyle changes such as losing weight, eating healthy and engaging in regular, moderate physical activity may reduce the progression of Type 2 diabetes.

The key to eating with diabetes is to eat a variety of healthy foods from all food groups, in the amounts your meal plan outlines.

The food groups are

  • Vegetables
    • nonstarchy: includes broccoli, carrots, greens, peppers, and tomatoes
    • starchy: includes potatoes, corn, and green peas
  • Fruits—includes oranges, melon, berries, apples, bananas, and grapes
  • Grains—at least half of your grains for the day should be whole grains
    • includes wheat, rice, oats, cornmeal, barley, and quinoa
    • examples: bread, pasta, cereal, and tortilla
  • Protein
    • lean meat
    • chicken or turkey without the skin
    • fish
    • eggs
    • nuts and peanuts
    • dried beans and certain peas, such as chickpeas and split peas
    • meat substitutes, such as tofu
  • Dairy—nonfat or low fat
    • milk or lactose-free milk if you have lactose intolerance
    • yogurt
    • cheese
You should follow advice
Exercise

Physical activity is an important component of the treatment plan for those with type 2 diabetes. It’s also important to have a healthy meal plan and maintain the blood glucose level through medications or insulin, if necessary.

Keeping a check on the blood glucose level is essential to preventing long-term complications, such as nerve pain and kidney disease.

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