Diabetes and Sugar - Article Example

DIABETES What is Diabetes? The food we eat is broken down into sugars. The main sugars are called glucose and this is used by the body as fuel in order to produce energy. Glucose is absorbed by the bloodstream and the body produces the hormone insulin in order to transport the glucose to the cells which use them for energy. Diabetes mellitus or diabetes is a metabolism disorder wherein an abnormality in the functioning of insulin inhibits the glucose from producing energy. Specifically, diabetes develops when insulin is not produced; if insulin is produced, it either does not work properly or it is not enough. These correspond to the two types of diabetes: Type 1 and Type 2 diabetes. Type 1 Diabetes Type 1 diabetes is a chronic condition wherein the body stops making insulin causing the blood glucose to go very high. The glucose just builds up in the bloodstream unless insulin is injected; this is why it is often called insulin-dependent diabetes. It is also known as juvenile or early onset diabetes because it typically develops in children and young adults. Cause The exact cause of Type 1 diabetes is not known at this point but researchers suspect that it may be triggered by viral or environmental factors in genetically susceptible people. Such factors were thought to cause an auto-immune response; that is, the body produces antibodies that mistakenly attack the cells that produce the insulin. Symptoms Some people do not have symptoms before being diagnosed with diabetes through a routine medical check-up. However, there are some indications to watch out for such as: Feeling hungry and thirsty a lot of time and urinating more often; Feeling tired or fatigued; Unexplained weight loss; Blurry eyesight; A tingling feeling in the feet or losing feeling in the feet; Symptoms of hyperglycemia (high blood sugar) such as: rapid breathing, dry skin, dry mouth, flushed face, fruity breath odor, nausea, vomiting, and stomach pain; Symptoms of hypoglycemia or low blood sugar (especially for people taking insulin) such as: headache, hunger, palpitations, shaking, sweating, weakness. Type 2 Diabetes Type 2 diabetes is also known as maturity onset or late onset diabetes because it typically develops in adults 40 years old and above. With Type 2 diabetes, the illness gradually develops over the course of several weeks or months because the body still produces insulin. However, the insulin produced is not enough or the cells in the body are not able to use them properly. This development is called “insulin resistance”. Cause Several factors may significantly increase the risk of a person developing Type 2 diabetes. This includes genetics, low levels of physical activity, poor diet, and excess body weight especially around the waist. The latter is due to the fact that fat interferes with the body’s ability to use insulin. Overweight people are not the only ones at risk, though; thin people may still develop Type 2 diabetes especially the elderly. Symptoms Not all people who develop Type 2 diabetes have symptoms but those who do often report the following: blurred vision, erectile dysfunction, fatigue, infections that heal slowly or recur, frequent infections, increased appetite and thirst, and increased urination. Complications of Diabetes The symptoms tend to develop quickly in Type 1 diabetes and more gradually in Type 2 diabetes. After treatment, symptoms are relieved. Without treatment, however, the patient may be putting himself or herself at risk of complications. Very high blood glucose level A very high glucose level, if left untreated, can cause dehydration, drowsiness and serious illnesses that could be life-threatening. High glucose level in the bloodstream can result to ketosis or the formation of acids. The resulting dehydration can trigger a fatal coma. Long-term complication If the blood glucose is higher – even mildly – than normal for a long period of time, it can damage the blood vessels. This can lead to the following complications: Hardening of the arteries (artheroma) that can result to poor blood circulation, angina, heart attacks, and stroke; Eye problems due to damage to the small arteries of the eye’s retina; Kidney damage that can lead to kidney failure; Nerve damage which can lead to impotence and foot sores or foot ulcers (both also due to poor circulation). Treatment complications Taking too much insulin can severely depress blood glucose levels (hypoglycemia). This can make the patient confused and unwell and possibly lapse into a coma. Emergency treatment includes sugar, sweet drinks, or a glucagon injection. The patient is then made to eat a starchy snack. Tests Diabetes can be diagnosed by the following blood tests: Fasting blood glucose level – if blood glucose is higher than 126 mg/dL on two occasions, diabetes is diagnosed; Random blood glucose level – if blood glucose level is higher than 200mg/dL and the patient exhibits some of the symptoms of diabetes, diabetes may be suspected and a fasting test must be undertaken for confirmation; Oral glucose tolerance test – blood glucose that registers higher than 200 mg/dL after two hours of administering the test confirms diabetes; Ketone testing – urine test for ketones is usually done if Type 1 diabetes is suspected. The patient should be able to test and monitor their own blood sugar at home in order to adjust their insulin, diet and exercise to the right amount and prevent serious complications. Generally speaking, blood glucose levels should be between 80 to 120 mg/dLbefore meals and between 100 to 40 mg/dL at bedtime. A glucometer can give the patient an accurate blood sugar reading. Treatment The immediate goal of treatment is to keep blood glucose as near to normal as possible. But treatment and management of the condition does not stop there; the patient also has to be concerned about long-term goals which include reducing symptoms, leading a healthy lifestyle and preventing diabetes-related complications. Keeping blood glucose near normal Healthy diet Low fat, high-fiber diet with plenty of starchy fruits and vegetables is recommended for people with diabetes. The patient should be able to balance the amount of insulin with the amount of food. The patient is advised to eat at about the same time each day and to be consistent with the types of food they eat to prevent blood glucose from becoming too high or too low. Medications to treat diabetes If diet and exercise do not help maintain near-normal blood glucose levels, medications may be prescribed and may be taken with insulin. Some of the common types include: Biguanides (Metformin) that makes the liver produce less glucose and less glucose is absorbed from the bloodstream. Sulfonylureas (like glimepiride, glyburide, and tolazamide) helps the pancreas produce more insulin. Thiazolidinediones (such as rosiglitazone) helps cells absorb more blood glucose in the presence of insulin. Injectible medications (including exenatide and pramlintide) may help lower blood sugar. Meglitinides (including repaglinide and nateglinide) helps the pancreas to respond accordingly to blood glucose levels in the blood. Alpha-glucosidase inhibitors (such as acarbose) decrease carbohydrate absorption to lower glucose levels after meals. Insulin People with diabetes, especially those with Type 1 diabetes, require 2 to 4 insulin injections every day to help bring down the blood glucose levels in their blood stream. Insulin may also be delivered through a pump but it is not available in pill or oral form. There are several preparation of insulin differing in how fast they start working and how long they last. Doctors are better positioned to advise patients on which type of insulin preparations to opt for and how often. Doses may also need to be adjusted when the patient is exercising, is sick, is travelling or eating more or less food and calories. Reducing risk factors Reducing risk factors can help keep complications from developing. Keep blood pressure down by having it checked regularly; If the patient is a smoker, the patient would need to quit; The patient has to exercise regularly to control the amount of sugar in the blood, to burn off excess fat, and to prevent cardiovascular diseases. Thirty minutes of brisk walking at least five times a day is the minimum required. The patient should check their foot everyday for sores or foot ulcers and must wear the right shoes to avoid getting infections. The patient must lose the excess weight if they are overweight Early detection and treatment of complications Regular medical check-ups are necessary in order to detect early signs of complications. Such tests may include checking for blood glucose, HbA1c, cholesterol, blood pressure, eye checks, urine tests, foot checks, blood tests and other general medical tests. The doctor may recommend medications to reduce the chances of developing other health conditions in people who are particularly susceptible. ACE or ARB inhibitors may be recommended for those with high blood pressure and signs of kidney problems. Statin may be prescribed for those with abnormal cholesterol levels. Aspirin is usually advised to prevent heart disease. Read More