Diabetes is a chronic condition that affects the body’s ability to absorb energy from food over time. The World Health Organization has recently classified diabetes into three types, type 1 diabetes, type 2 diabetes, and gestational diabetes.
All types of diabetes have something in common. Normally, the body breaks down the sugar and carbohydrates it consumes into a specific type of sugar, called glucose. Glucose provides energy for the body’s cells, but the cells need a hormone in the blood called insulin to absorb glucose and convert it into energy. In people with diabetes, the body cannot provide enough insulin, or the insulin it secretes cannot do its physiological job, or both.
If cells are unable to absorb glucose, then glucose builds up in the blood. High blood glucose can damage the kidneys, heart, eyes, or tiny blood vessels in the nervous system. Therefore, if diabetes is not treated, it can eventually lead to heart disease, stroke, kidney disease, blindness, and damage to the nerves in the feet.
Type 1 diabetes
Type 1 diabetes is also known as insulin-dependent diabetes. It used to be called juvenile or childhood type diabetes because it occurs more often in children.
Type 1 diabetes is caused by an autoimmune problem. The body produces antibodies that attack its own pancreas. people with type 1 diabetes have a damaged pancreas that cannot produce insulin.
This type of diabetes can also be genetically related, or it can be caused by the pancreas being able to produce insulin normally, but there is a defect in one of the islet B cells.
There are many risks associated with type 1 diabetes. These risks start with damage to the tiny blood vessels in the eyes, nerves, and kidneys, called diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy, respectively. In severe cases, there is an increased risk of heart disease and stroke.
Treatment for type 1 diabetes includes increasing insulin, which is insulin injected into adipose tissue. Methods of injecting insulin include:
- Syringe injection
- Insulin pens with pre-filled medications and fine needles
- Jet syringe, which sprays insulin into the skin via high-pressure air
- Insulin pump, a device that infuses insulin through an infusion hose into a catheter under the skin in the abdomen
A periodic test called a glycated hemoglobin glucose test assesses glucose levels in the blood over the past three months. This test can be used to determine the overall control of glucose levels and the risk of complications of diabetes, such as organ damage.
People with type 1 diabetes need to make significant lifestyle modifications, such as:
- Frequent testing of blood glucose levels
- Rationalizing diet
- Practice exercise routines
- Using insulin or taking other medications as needed
People with type 1 diabetes can also lead long, active lives if they carefully monitor their glucose levels, make lifestyle changes, and follow their treatment plans.
Type 2 diabetes
By far the most common type of diabetes is type 2 diabetes, which accounts for 95% of all adults with diabetes, and about 26 million American adults have been diagnosed with type 2 diabetes.
Type 2 diabetes used to be known as adult-onset diabetes, but with the increase in obese and overweight children, more and more adolescents now have type 2 diabetes. type 2 diabetes is also known as non-insulin-dependent diabetes.
The symptoms of type 2 diabetes are not as pronounced as those of type 1 diabetes.
Type 2 diabetes is also associated with an increased risk of heart disease and stroke.
People with type 2 diabetes have a pancreas that produces some insulin, but does not produce enough to meet the body’s needs, or the body’s cells are insulin resistant. Insulin resistance, or lack of sensitivity to insulin, occurs mainly in fat cells, liver cells, or muscle cells.
People with obesity, those who weigh 20% above their ideal weight, are at very high risk of developing type 2 diabetes and related complications. Insulin resistance is present in people with obesity. Because of insulin resistance, the pancreas needs to work excessively to produce more insulin. But even then, not enough insulin is produced to maintain normal blood glucose levels.
There is no cure for diabetes, but type 2 diabetes can be controlled by managing your weight, getting balanced nutrition, and getting more exercise. Unfortunately, type 2 diabetes has a tendency to progress and requires frequent use of medications for diabetes.
The glycosylated hemoglobin test is a blood test that assesses the level of glucose in the blood over the past three months. Regular testing of glycated hemoglobin can be used to monitor the role of diet, exercise, and medications in controlling blood sugar and preventing organ damage. Glycosylated hemoglobin testing can usually be done several times a year.
Gestational diabetes
Diabetes that is triggered by pregnancy is called gestational diabetes (pregnancy leads to some degree of insulin resistance). Gestational diabetes is usually diagnosed in the middle or late stages of pregnancy. Because excessive blood glucose levels in the mother reach the fetus through the placental circulation, gestational diabetes must be controlled so that the fetus can grow and be healthy.
Data from the National Institutes of Health (NIH) show that the probability of developing gestational diabetes during pregnancy ranges from 2% to 10%. Gestational diabetes puts pregnant women at risk for developing type 2 diabetes later in life. About 10% of people with gestational diabetes will develop type 2 diabetes in the future, and the disease can occur weeks, months, or years after delivery.
Diabetes in pregnancy will result in a higher risk for the unborn fetus compared to the mother. The risks to the fetus include abnormal weight gain before birth, abnormal breathing at birth, and the risk of future obesity or diabetes. Risks to the pregnant woman include cesarean section, heart, kidney, nerve, and eye damage due to an oversized fetus.
Treatment during pregnancy includes:
- Working closely with your medical team
- Planning the diet to ensure adequate nutrition during pregnancy, but not excessive fat or calories
- Exercise daily
- Control your weight during pregnancy
- Use insulin to control blood glucose levels, if needed
Other types of diabetes
Some special conditions can cause rare forms of diabetes. For example, pancreatic disease, certain surgeries, and medications or infections can also cause diabetes. These types of diabetes account for 1% to 5% of all cases of diabetes.