Diabetes

Diabetes

1. Definition of Diabetes and Hyperglycemia

• Diabetes Mellitus: A chronic metabolic disorder characterized by high blood glucose (hyperglycemia) due to defects in insulin secretion, insulin action, or both.
• Hyperglycemia: Refers to elevated blood glucose levels, which can lead to long-term damage to various organs if uncontrolled.

2. Types of Diabetes

• Type 1 Diabetes (T1D):
• Subtype: Latent Autoimmune Diabetes of Adults (LADA): A slow-progressing form of autoimmune diabetes.
• Usually occurs in younger individuals and is characterized by an autoimmune destruction of pancreatic beta cells.
• Type 2 Diabetes (T2D):
• More common in adults, characterized by insulin resistance and relative insulin deficiency.
• Gestational Diabetes:
• Occurs during pregnancy due to hormonal changes leading to insulin resistance. It usually resolves after childbirth but increases the risk of T2D later in life.
  
  
  
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3. Causes of Diabetes

• Type 1 Diabetes:
• Genetic Factors: Predisposition due to inherited genes (e.g., HLA-DR/DQ alleles).
• Autoimmune Factors: The immune system mistakenly attacks beta cells in the pancreas.
• Type 2 Diabetes:
• Genetic Factors: Family history and polygenic inheritance.
• Constitutional Factors: Obesity, poor diet, physical inactivity.
• Insulin Resistance: Cells become less responsive to insulin, increasing blood glucose.
• Gestational Diabetes:
• Hormonal Factors: Placental hormones cause insulin resistance.
• Constitutional Factors: Obesity, family history of diabetes, advanced maternal age.

4. Pathophysiology

• Type 1 Diabetes:
• The immune system attacks pancreatic beta cells, leading to an absolute deficiency of insulin. Glucose cannot enter cells, resulting in hyperglycemia.
• Type 2 Diabetes:
• Insulin resistance in peripheral tissues (muscle, fat, liver) leads to reduced glucose uptake. The pancreas tries to compensate by producing more insulin, but eventually, beta-cell dysfunction occurs.

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5. Clinical Manifestations

• Type 1 Diabetes:
• Polydipsia (excessive thirst), polyuria (frequent urination), weight loss, fatigue, blurred vision.
• Type 2 Diabetes:
• Fatigue, frequent infections, blurred vision, slow-healing wounds, darkened skin (acanthosis nigricans), often asymptomatic in early stages.

6. Diagnosis

• Fasting Plasma Glucose (FPG) ≥ 126 mg/dL.
• Oral Glucose Tolerance Test (OGTT): 2-hour plasma glucose ≥ 200 mg/dL.
• HbA1c: ≥ 6.5% for diabetes diagnosis.
• Random Plasma Glucose ≥ 200 mg/dL with classic symptoms.

7. Treatment

• Non-Pharmacological:
• Diet and Lifestyle Modifications: Healthy eating (low sugar, balanced diet), regular exercise, weight management.
• Pharmacological:
• Insulin Therapy: Required for Type 1 and sometimes for advanced Type 2.
• Oral Hypoglycemics:
• Metformin: Reduces glucose production in the liver.
• Sulfonylureas: Stimulate insulin release from the pancreas.
• DPP-4 Inhibitors: Enhance insulin secretion and reduce glucagon levels.
• SGLT-2 Inhibitors: Increase glucose excretion through urine.
• GLP-1 Agonists: Slow gastric emptying and enhance insulin secretion.

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8. Tips for a Healthy Pancreas and Liver

• Pancreas:
• Maintain a balanced diet low in processed sugars.
• Avoid alcohol and smoking.
• Include antioxidant-rich foods like berries and leafy greens.
• Liver:
• Maintain a healthy weight to avoid fatty liver.
• Drink plenty of water and limit alcohol intake.
• Incorporate liver-friendly foods such as garlic, turmeric, and green tea.

9. Tips to Maintain Insulin Levels

• Maintain a consistent exercise routine.
• Choose low-glycemic index foods (whole grains, vegetables).
• Eat meals at regular intervals to prevent glucose spikes.
• Get adequate sleep to prevent insulin resistance.

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FAQs on Diabetes

1. What is diabetes?
Diabetes is a chronic condition where the body either doesn’t produce enough insulin (Type 1 diabetes) or can’t effectively use the insulin it produces (Type 2 diabetes), leading to high blood sugar levels.

2. What are the types of diabetes?
There are three main types of diabetes:

• Type 1: The immune system attacks insulin-producing cells in the pancreas.
• Type 2: The body becomes resistant to insulin or doesn't produce enough.
• Gestational Diabetes: Occurs during pregnancy and usually resolves after childbirth.

3. What causes diabetes?
Type 1 diabetes is caused by an autoimmune reaction, while Type 2 diabetes is typically due to a combination of genetics and lifestyle factors such as obesity, inactivity, and poor diet.

4. What are the common symptoms of diabetes?
Symptoms include excessive thirst, frequent urination, unexplained weight loss, fatigue, blurred vision, slow healing of wounds, and frequent infections.

5. How is diabetes diagnosed?
Diabetes is diagnosed through blood tests that measure blood sugar levels, such as the fasting blood glucose test, oral glucose tolerance test, and HbA1c (glycated hemoglobin) test.

6. How is diabetes managed?
Diabetes management includes lifestyle changes like healthy eating, regular physical activity, monitoring blood sugar levels, and medications like insulin (for Type 1) or oral hypoglycemics (for Type 2).

7. Can diabetes be prevented?
Type 1 diabetes cannot be prevented, but Type 2 diabetes can often be prevented or delayed by maintaining a healthy weight, eating a balanced diet, staying active, and avoiding smoking.

8. What are the complications of untreated diabetes?
Untreated diabetes can lead to serious complications like heart disease, stroke, kidney failure, nerve damage (neuropathy), vision problems (retinopathy), and poor wound healing, which may lead to amputations.

9. Is gestational diabetes permanent?
Gestational diabetes usually resolves after pregnancy, but it increases the mother’s risk of developing Type 2 diabetes later in life. Regular follow-up and healthy lifestyle choices are recommended.

10. What are some lifestyle changes to manage or prevent diabetes?
Maintaining a balanced diet low in processed sugars and refined carbohydrates, engaging in regular physical activity, avoiding smoking, reducing stress, and keeping a healthy weight are key lifestyle changes for managing or preventing diabetes.