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What is Diabetes

In Diabetes Mellitus (DM) pancreas is no longer able to make insulin, or when the body cells cannot use insulin efficiently. So less insulin is available to lower the blood glucose level, leading to excessive sugar in your blood. Too much sugar in your blood can lead to serious health problems. Glucose is the main source of energy for the cells, muscles, tissues and brain.

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What is insulin?

All types of foods having carbohydrate are broken down into glucose in the blood. Insulin is a hormone which is produced by the pancreas and it facilitates glucose entry from the bloodstream into the cells in order to produce energy.

  • The insulin circulates, enabling sugar to enter your cells.
  • Insulin lowers the amount of sugar in your bloodstream.
  • As your blood sugar level drops, secretion of insulin from your pancreas also decreases as a positive feedback mechanism and vice versa.

Role of Glucose

Glucose comes from two major sources: food and your liver.

  • Sugar ingested in form of some food is absorbed into the bloodstream, where it enters cells with the help of insulin.
  • Some of this sugar enters your liver, where it is processed and stored in form of glucose and glycogen.
  • When your glucose levels are low, such as when you haven’t eaten in a while, the liver breaks down stored glycogen into glucose to keep your glucose level within a normal range.

Types of Diabetes

Reversible Diabetes

  1. Prediabetes
  2. Gestational Diabetes

Irreversible Diabetes

  1. Type 1 Diabetes
  2. Type 2 Diabetes
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Prediabetes

Doctors label Prediabetes when your blood sugar levels are relatively higher than normal, but not enough high to be labelled as diabetes. Prediabetes can lead to diabetes unless appropriate measures are taken to prevent its progression.

 Gestational Diabetes Mellitus (GDM) 

If a pregnant woman develops diabetes then it is termed as GDM. It usually disappears after pregnancy but these women and their children are at more risk to develop type 2 diabetes.

Causes of gestational diabetes

  • During pregnancy, the placenta produces hormones to keep going pregnancy.
  • These hormones make your cells more resistant to insulin.
  • Normally, the pancreas responds by producing enough extra insulin to overcome this resistance.
  • But sometimes pancreas can’t keep up. When this happens, too little glucose gets into your cells and too much stays in the blood, resulting in gestational diabetes.

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Type 1 Diabetes

In type 1 very little or no insulin is produced by cells of the pancreas (Islets of Langerhans). That is why these patients need daily insulin injections to maintain glucose level. Type 1 diabetes can occur at any stage of life but commonly found in children and adolescents.

Causes of Type 1 Diabetes

  • Exact cause unknown
  • Genetic susceptibility
  • Environmental factors
  • Weight is not considered as a factor in type 1 DM
  • Immune system can attack & destroy insulin-producing cells
  • This leaves you with little or no insulin
  • Instead of being transported into cells, sugar accumulates in the bloodstream

Risk Factors For Type 1 Diabetes

  • The exact cause of type 1 diabetes is unknown
  • Family history may risk increase of type 1diabetes if a parent or sibling has type 1diabetes.
  • Environmental factors such as exposure to a viral illness
  • The presence of damaging immune system cells (Autoantibodies) but not everyone with these Autoantibodies develops diabetes

Difference Between Type 1 & 2 Diabetes

Type 2 Diabetes 

Type 2 is more common than type 1 and found in adults. In this type, a sufficient amount of insulin is produced by the pancreas but the body cells can’t use this insulin in order to maintain glucose level.

Causes of Pre-diabetes & Type 2 Diabetes

  • Pre-diabetes can lead to Type 2 Diabetes
  • Type 2 Diabetes leads to cellular resistance to the action of insulin, and pancreas is unable to make enough insulin to overcome this resistance.
  • Sugar builds up in the bloodstream instead of moving into cells where it’s needed for energy.
  • Type 2 diabetes and being overweight has strong association among each other but not everyone with type 2 is overweight.

Risk Factors for Pre-Diabetes &Type 2 Diabetes

  • The more fatty tissue you have, the more resistant your cells can show to insulin.
  • The less active and sedentary habits you have, the greater risk you may have to develop pre-diabetes & type 2 diabetes.
  • Family history can increase risk if your parent or sibling has type 2 diabetes.
  • Your risk increases with age because you tend to do less exercise, lose muscle mass and gain.
  • Your risk to develop pre-diabetes and type 2 diabetes increases after gestational diabetes episode.
  • If pregnant mothers with gestational diabetes give birth to a baby weighing more than 9 pounds (4 kilograms), then mother is at more risk to develop type 2 diabetes after pregnancy.
  • Women having polycystic ovary syndrome which is characterized by irregular menstrual periods, excess hair growth and obesity have increased risk of diabetes.
  • Persons having high blood pressure (More than140/90 mm Hg) have an increased risk of type 2 diabetes.
  • Persons having low levels of high-density lipoprotein (HDL), or “good,” cholesterol have a higher risk of type 2 diabetes.

Symptoms of DM

  1. Fatigue
  2. Blurry vision
  3. Extreme fatigue
  4. Frequent Urination
  5. Feeling very thirsty
  6. Weight loss (type 1)
  7. Delayed wound healing
  8. Feeling very hungry (although you are eating)
  9. Tingling, pain, or numbness in the hands/feet (type 2)
  10. Frequent infections, such as gums, skin infections and vaginal infections
  11. Presence of ketones in the urine (ketones are the by-product of the breakdown of muscle and fat that happens when enough insulin is not available.
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Treatment of Diabetes

  1. Healthy life style
  2. Oral hypoglycemic
  3. Insulin injections
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Low Blood Sugar Level

The term hypoglycemia or low blood sugar is used when a patient has blood sugar < 70 mg/dL

Causes of Hypoglycemia

  1. Too much insulin
  2. Less food intake
  3. Too much exercise, or too little
  4. Overdose of your diabetes tablets
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Complications of Diabetes

  • Chest pain/Angina
  • Hearing impairment
  • Atherosclerosis & Stroke
  • Myocardial Infarction (MI)
  • Eye damage (retinopathy)
  • Kidney damage (nephropathy) 
  • Male erectile dysfunction
  • Excess of sugar can injure the walls of capillaries supplying these nerves, especially of your legs and can present with tingling sensations, numbness, burning or pain like sensations at the tips of the toes or fingers.  
  • Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications like serious infections, delayed wound healing, toe or foot or leg amputation.
  • Longstanding uncontrolled diabetes patients have a higher tendency for Depression-like symptoms.

Diabetic Foot

It is a long-term/chronic complication of diabetes in which the patient develops peripheral arterial disease and/or sensory neuropathy.

Delayed Wound Healing

Wounds in diabetic patients have delayed wound healing tendency due to decreased blood supply and can lead to new injury due to decreased sensory sensations

Diabetic Nephropathy

Long standing Diabetes can lead to Diabetic nephropathy or kidney disease. High blood glucose levels can damage kidneys (nephron) that filters your blood. The damaged filter becomes ‘leaky’ and lets protein spell into urine.

Diabetic Nephropathy (Effects On Sturcture of Nephron)

Diabetic Retinopathy

Long-standing diabetes can lead to Diabetic retinopathy or eye disease. It can lead to the damage of blood vessels of the light-sensitive tissue at the back of the eye (retina). Initially patient has no symptoms or only mild vision problem

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