Diabetes, also commonly referred to as the sugar disease, has become very common in today’s word. According to the report released by CDC in 2017, there are over 30 million adults with diabetes in the United States.

The same report also estimates that over 84 million adults with prediabetes in the United States.

According to the World Health Organization, diabetes contributes to a high number of strokes, kidney failure, blindness, heart attacks, and lower limb amputation.

In 2016, diabetes was directly linked to an estimated 1.6 million deaths.

Diabetes is a group of metabolic disorders that cause high concentrations of blood sugar or blood glucose in the body. People with prediabetes also have abnormally high levels of blood sugar, although they have not yet developed diabetes.

According to the CDC, failure to get treatment for prediabetes will lead to the development of diabetes within 5 years.

Diabetes occurs when the pancreas does not produce enough or any insulin, or when the body cannot effectively use the insulin it produces.

Insulin is a hormone that helps glucose pass from the blood through to the cells to be used as energy, thereby helping regulate blood sugar in the body.

When insulin is not produced, the glucose cannot pass through the cell membranes and therefore it remains in the bloodstream.

Too much blood sugar can cause serious damage. In many cases, diabetes starts gradually and many people do not even realize that they have diabetes.

In this article, we are going to look at the causes of diabetes, some of the warning signs of diabetes, as well as how the disease is diagnosed and treated.

But first, let’s start by looking at the different types of diabetes.

TYPES OF DIABETES

There are different types of diabetes. These include:

Type 1 Diabetes

It was previously known as insulin-dependent, juvenile or childhood-onset diabetes, owing to the fact that this type of diabetes is usually detected during childhood. It is an auto-immune disease.

In type 1 diabetes, the body does not produce insulin because its immune system attacks and destroys the cells in the pancreas that produce insulin.

People with this type of diabetes require a daily administration of insulin to survive hence the name, insulin-dependent diabetes.

Type 2 Diabetes

This type of diabetes was previously called non-insulin-dependent, or adult-onset. It is a condition where the body ineffectively uses insulin because the cells have become resistant to insulin.

It is the most common type of diabetes as it accounts at least 90%of all diabetes cases.

People with this type of diabetes can often initially manage their condition through regular exercise and practicing a healthy, balanced diet.

However, since diabetes is usually progressive, a high percentage of those with type 2 diabetes will require oral medication and/or insulin at a later stage.

Gestational Diabetes

It is characterized by elevated blood sugar level (hyperglycemia) and it occurs in one in 25 women, without previous history of diabetes, when they are pregnant.

It usually comes with high risk of complication for both mother and child.

The mothers always end up giving birth to high birth weight babies weighing 4kgs or more. This type of diabetes resolves after birth.

However, both the mother and the child risk having Type 2 Diabetes in future.

Pre-Diabetes

This happens when a person has high blood sugar levels above normal range but not high enough to constitute diabetes. It is sometimes referred to as borderline diabetes.

The normal range for blood sugar is between 70-90 milligrams per deciliter whereas for those with diabetes have blood sugar higher than 126 mg/dl.

People with pre-diabetes have blood sugar range of between 100-125 mg/dl. These people are at risk of getting Type 2 Diabetes.

Other Types Of Diabetes

There are types of diabetes which are less common. They are monogenic diabetes and cystic fibrosis-related diabetes.

Monogenic Diabetes include conditions such as neonatal diabetes and maturity-onset diabetes of the young (MODY), which refers to any of several hereditary forms of diabetes.

These are usually caused by gene mutations that affect the body’s production of insulin.

WHAT ARE THE CAUSES OF DIABETES?

Diabetes is a chronic disease that occurs when there is little or no production of insulin in the body by the pancreas, or when the body does not respond to insulin.

Insulin is the hormone responsible for helping glucose get into the body cells to be used for energy.

The exact cause depends on the type of diabetes.

However, all types of diabetes have one thing in common – the inability to properly manage the body’s insulin/glucose balance.

Let’s look at the causes of different types of diabetes.

Type 1 Diabetes

Type 1 Diabetes occurs when the body’s immune system views the insulin-producing cells (beta cells) as a threat and kills them.

As a result the body is left with very little or no insulin to function normally.

This is referred as an autoimmune reaction as the body attacks itself and produces antibodies that destroy the beta cells.

The cause for this reaction is still unknown and apart from possible genetic predisposition, viral or bacterial infection and chemical toxins in food are believed to be triggers.

When a person with Type 1 diabetes experiences the first symptoms, most of the beta cells in the pancreas have already been destroyed.

There are various risk factors that contribute to the development of Type 1 diabetes. These include:

  • Family history – a person is at risk of developing Type 1 diabetes if their parent or sibling has the disease.
  • The presence of damaging immune cells (autoantibodies) increases the chances of getting the disease as these autoantibodies will fight and destroy the insulin producing cells in the pancreas.
  • Race – Certain ethnicities are more predisposed to type 1 diabetes. For instance, in the United States, Caucasians are more likely to suffer from type 1 diabetes compared to African-Americans and Hispanic Americans.
  • Environmental factors such as exposure to toxins and chemical compounds, viral infections, not breastfeeding, drinking cow’s milk and rapid weight gain in infants are all potential causes for Type 1 Diabetes. Toxins found in food and water may activate autoimmune mechanisms in genetically susceptible individuals, which in turn might result in pancreatic cell death. An example of such toxins is arsenic which occurs naturally in the environment.

Pre-Diabetes And Type 2 Diabetes

Pre-diabetes, which can led to Type 2 Diabetes, and Type 2 Diabetes occurs when the body is unable to use insulin effectively.

The cells develop resistance to insulin and the pancreas is unable to make enough insulin to overcome the resistance.

Therefore, instead of glucose moving into the cells in the body, it builds up in the blood stream.

It is still uncertain why exactly this happens, but there are some known predisposing factors.

Some overwhelming factors include being overweight and a family history of Type 2 Diabetes.

However not everyone who has Type 2 Diabetes is overweight.

By the time one is diagnosed with Type 2 Diabetes, 50% of the beta cells in the pancreas have already been destroyed.

It may take years before the diagnosis is made and before that the buildup of the glucose in the bloodstream exposes one to cardiovascular disease.

The following factors increase the risk of one developing Type 2 Diabetes:

  • Obesity/being overweight. The more fatty tissues one has, the more resistant cells are to insulin.
  • A family history of diabetes
  • Although it has not been completely prove, people of south Asian descent, African, Africa-Caribbean, black American and Hispanic are more likely to have Type 2 Diabetes.
  • High blood pressure
  • Risk of developing Type 2 Diabetes increases as one gets older.
  • A history of gestational diabetes and giving birth to a baby weighing 4Kg or more.
  • Polycystic ovarian syndrome (PCOS)
  • Depression
  • Physical inactivity. Physical activity helps one control their weight. It also uses up glucose as energy and make the cells more sensitive to insulin.
  • High cholesterol
  • Smoking
  • Acanthosis nigricans

Recent studies have also linked Type 2 diabetes to chronic hepatitis C infection, poor sleep quality, impaired lung function, gout, infertility, obesity in children, early or late menopause, job insecurity and irregular shift work, drinking sugary beverages, and being on antiretroviral treatment for HIV/AIDS.

Gestational Diabetes

This occurs in 2-10% of all pregnancies and it usually disappears after giving birth. However, these women are always at risk for developing Type 2 diabetes.

Although the cause of this type of Diabetes is unclear, it is attributed to the weight gain during pregnancy and also a family history of diabetes.

Weight gain and the changing hormonal balance makes it more difficult for the body to keep up with its need for insulin.

This may result to gestational diabetes.

Consequently as the pregnancy develops, the placenta produces insulin blocking hormones which may cause the pregnant woman’s glucose level to raise up if there is not enough insulin to counteract this effect.

Though it may be temporary, untreated gestational diabetes can damage the health of both the baby and the mother.

The mother risks giving birth to a baby with high weight, congenital heart , central nervous system abnormalities, and skeletal muscle malformations. Risk factors for gestational diabetes include;

  • Being overweight
  • Having pre-diabetes
  • Family history of Type 2 diabetes
  • History of gestational diabetes
  • Hormone disorder such as polycystic ovary syndrome
  • High blood pressure
  • Age
  • Previously giving birth a baby that weighed at least 4.5 kg or had a birth defect
  • Early onset of menstruation
  • Thyroid dysfunction during pregnancy

WARNING SIGNS OF DIABETES

Here, we are going to look at some of the warning signs of Type 2 diabetes, since it is the most common type of diabetes.

Like I mentioned earlier, the symptoms of diabetes appear gradually, and many people do not know that they have diabetes until it is too late.

Some of the signs that you might have type 2 diabetes include:

Frequent Urination

As the levels of glucose in your blood increase, the kidneys step in to try and get rid some of this excess glucose from the blood.

This means you have to urinate more often to get rid of this excess urine, especially during the night.

Extreme Thirst

This is another common warning sign of diabetes. The high blood glucose level is enough to cause thirst on its own.

However, this is made worse by the fact that you are losing a lot of water due to frequent urination.

This results in a person feeling thirstier than usual, and drinking water does not quench the thirst.

Increased Hunger

Normally, when you eat, the food is converted to glucose, which then provides energy for your body.

However, when you have diabetes, your body’s ability to absorb glucose from the blood is compromised, and therefore the body assumes that you do not have glucose to fuel it.

This triggers a constant hunger as your body tries to look for more fuel. Sometimes, you might even start losing weight despite eating more.

Fatigue

Since your body is unable to efficiently absorb glucose from the body, there isn’t enough glucose to keep your cells energized.

This can result in fatigue.

Numbness and Pain in the Limbs

People with diabetes also tend to experience numbness or a tingling sensation in the feet, toes, hands, and fingers.

This is caused by diabetic neuropathy, or damage of the nerves due to diabetes.

In many cases, this happens after years of living with diabetes, though it can also appear as an early warning sign.

Slow Healing Wounds

If you have diabetes, wounds take so long to heal, regardless of how small they are.

This is usually because diabetes causes a narrowing of the blood vessels, resulting in nutrients and white blood cells taking much longer to get to the wound.

Additionally, diabetes also compromises the immune system, making it harder for the body to fight infections.

Blurry Vision

Excess glucose in the blood affects the tiny blood vessels within the eye and cause some fluids to seep into your eye lenses. The changing levels of fluid in your body also contribute to this.

As a result, your eye lenses swell up and change their shape, resulting in blurred vision.

In most cases, this blurry vision will resolve by itself. It is advisable to see an eye doctor immediately so that they can determine the cause of the blurriness.

Dark Patches on the Skin

People with diabetes also develop dark, velvety discolorations on the skin, especially in the neck, armpits, and groin region.

These patches are caused by the excessive insulin in your blood.

If you start seeing any of the above symptoms, you should seek medical advice right away.

DIAGNOSIS OF DIABETES

Anyone exhibiting symptoms linked to diabetes or is at risk for the disease should be tested.

Diagnosis is usually done by simply testing the blood sugar levels.

Women are always routinely tested for gestational diabetes during their pre-natal visits in their second or third trimester.

The following tests are used for screening diabetes

Finger Prick Test or the Fasting Plasma Glucose Test (FPGT)

This the most common and easiest test of them all and it can be done at a clinic or a pharmacy.

The doctor or nurse will prick the finger with a lancet to drawn blood for testing.

A small drop of blood is then added onto the testing strip of a glucose meter.

The meter reads the strip and then displays a number which is the blood glucose level. A level of 126 mg/dl or more indicates that one has diabetes.

A fasting blood glucose test might be done to confirm diagnosis. This is usually done after one has fasted for eight hours.

Oral Glucose Tolerance Test

This test is normally done after two hours when one has had a sugary drink that contains 75g of glucose. Blood-glucose levels must be previously measured before having the drink.

The aim of this test is to check your body’s response to sugar intake and the production of insulin. A level of 200 mg/dl glucose in your blood (or higher) indicates that you have diabetes.

The Glycated Hemoglobin (Hba1c) Test

HbA1c refers to glycated hemoglobin.

When hemoglobin, a protein in your red blood cells, combines with the glucose in your blood, it becomes glycated.

The HbA1c test measures the levels of glycated hemoglobin in your blood. The aim of this test is to give an indication of the levels of glucose in your blood over the past 3 months.

This is because the red blood cells have a lifespan of about 3 months.

The results show a percentage of the glycated hemoglobin in your blood.

The higher the reading, the more likely you are to have diabetes. Any reading above 6.5% is confirmation of diabetes.

Pregnant women can also be tested for gestational Diabetes using the glucose challenge test and the Oral Glucose Tolerance Test (OGTT).

With the Glucose challenge test, a health care professional will draw blood 1 hour after drinking a sweet liquid containing glucose.

One does not need to fast for this test. If blood glucose is too high, 135mg/dl to 140mg/dl or more, one may need to return for an oral glucose tolerance test while fasting.

With OGTT, blood glucose is measured after fasting for at least 8 hours.

First, a health care practitioner will draw blood. Then one will have to drink a liquid containing glucose.

For diagnosing gestational diabetes, blood will be drawn every hour for 2 to 3 hours.

If two or more of the hourly tests show a high blood glucose level, it means that you gestational diabetes.

TREATMENT OF DIABETES

Type 1 Diabetes

There exists no cure for Type 1 Diabetes and those affected have to live with the disease while managing it.

Due to the extensive advancement on optimal management of Type 1 Diabetes, people with this disease have a shot at quality life.

With Type 1 Diabetes it means that the body is producing very little or no insulin in the body thus administration of artificial insulin will be required.

Therefore the only recommended treatment for Type 1 Diabetes is insulin.

Immediately diagnosis is made, one is supposed to start insulin treatment and this will go on for the rest of their life.

Most things change after diagnosis and one has to make adjustments due to the disease.

One will be required to master the tools used in administering insulin, syringes, insulin pens and pumps, since they will have to do it on their own.

In addition to taking Insulin, one’s lifestyle will also be affected.

They will need to live a healthy, active lifestyle that includes a balanced, nutritious diet.

Type 2 Diabetes

With Type 2 Diabetes, lifestyle change is mandatory.

One’s lifestyle and/or medication will have to work together to bring the level of blood glucose under control.

One is advised to consult a personal dietitian who will help in coming up with a personal eating program that fits your needs and preferences that does not compromise a healthy diet.

This will be a lifetime adjustment.

The key principles of medical management are:

  • Regular blood-glucose self-monitoring as a part of daily living.
  • Prescription of diabetes medication or even insulin.
  • Learning how and when to make adjustments in your medication doses to prevent high or low blood-glucose levels.
  • Learning about complications that may result from diabetes and how to prevent, identify and treat them.

Gestational Diabetes

Normally, gestational diabetes is managed by eating a healthy diet and being physical fit.

However, there is a small percentage of pregnant women diagnosed with the disease, who have to use insulin injection throughout their pregnancies.

Women with Gestational Diabetes are advised to;

  • Maintain a healthy weight.
  • Eat small portions of food.
  • Include fiber-rich carbohydrates in their meals.
  • Meals should be lightly cooked and low in fat.
  • Opt for foods with a high fiber content.
  • Avoid foods and drinks that contain large amounts of sugar.

By following these directions, they will be able to carry the baby to term without minimal or no complications.

After the baby is born, Gestational diabetes disappears.

DIABETES COMPLICATIONS

High blood sugar levels damages organs and tissues throughout your body.

The higher the levels of glucose in your blood and the longer you live with diabetes, the more likely you are to develop complications.

Complications that may arise due to diabetes include;

  • Heart disease
  • Stroke
  • Kidney disease
  • Eye problems
  • Dental disease
  • Nerve damage
  • Foot problems
  • Hearing loss
  • Skin conditions
  • Depression
  • Alzheimer’s disease
  • In gestational diabetes complications include still birth, miscarriage, high weight baby, risk of developing Type 2 Diabetes, and low blood sugar for the baby.

Whilst there is no preventive measures for Type 1 Diabetes, other diabetes can be prevented. Type 2 which accounts for 85-90% of all cases worldwide can be prevented or delayed by maintaining a healthy lifestyle.

This can be archived by engaging in physical activities, maintaining normal body weight and eating a healthy, balanced diet.

A healthy diet constitutes eating foods with high fiber content, whole grains and choosing fats with low cholesterol levels.

Avoiding sugary beverages and eating less red meat and other sources of saturated fats will keep the disease at bay.

Smoking is also associated with causing diabetes, therefore it is advised to stop smoking.

WRAPPING UP

Diabetes has become a menace all over the world, with a very high number of people suffering from the disease.

Considering that a high number of those with diabetes do not even know they have the disease, the best thing to do is to be very observant and seek medical advice immediately you notice any of the warning signs associated with diabetes.

In addition, you can reduce the risk of developing the condition by having a balanced, healthy diet, exercising regularly, watching your weight, avoiding bad habits such as smoking, and generally living a healthy lifestyle.

Diabetes Warning Signs