All you need to know- Diabetes

Diabetes in India
India has the second-highest total population in the world at more than 1.3 billion people. 72.9 million people in India had diabetes as of 2017, which rose from 40.9 million in 2007.
These numbers are expected to rise, too. It’s estimated that there will be 134 million people living with diabetes in India by 2045.
A 2017 study also found that diabetes prevalence was higher in urban areas.
 
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What is Diabetes?
Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose). 
Glucose is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues. 
It's also your brain's main source of fuel.
The underlying cause of diabetes varies by type. 
But, no matter what type of diabetes you have, it can lead to excess sugar in your blood. 
Too much sugar in your blood can lead to serious health problems.

Type of Diabetes
*Type 1 Diabetes 
*Type 2 Diabetes
*Prediabetes
*Gestational Diabetes

Type 1 Diabetes
Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is characterized by deficient insulin production and requires daily administration of insulin. 
In 2017 there were 9 million people with type 1 diabetes; the majority of them live in high-income countries. 
Neither its cause nor the means to prevent it are known.
https://www.who.int/news-room/fact-sheets/detail/diabetes 

Type 2 Diabetes
Type 2 diabetes (formerly called non-insulin-dependent, or adult-onset) results from the body’s ineffective use of insulin. 
More than 95% of people with diabetes have type 2 diabetes. 
This type of diabetes is largely the result of excess body weight and physical inactivity.
Until recently, this type of diabetes was seen only in adults, but it is now also occurring increasingly frequently in children.

Prediabetes
Prediabetes means you have a higher-than-normal blood sugar level. But it’s not high enough to qualify as a diagnosis of diabetes. 
Prediabetes can also lead to other health conditions, including heart disease and stroke.
Fortunately, you can reverse prediabetes. Treatment may include lifestyle modifications, such as diet, exercise, and medication.
A review of long-term data suggest that lifestyle intervention may decrease the risk of prediabetes progressing to diabetes for as long as 10 years. 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4116271/ 

Gestational Diabetes​
Gestational diabetes (GD) is a condition in which a hormone made by the placenta prevents the body from using insulin effectively. 
Glucose builds up in the blood instead of being absorbed by the cells.
GD is not caused by a lack of insulin, but by other hormones produced during pregnancy that can make insulin less effective, a condition referred to as insulin resistance. 
GD usually goes away after the baby is born but increases risk for type 2 diabetes later in life. 

Symptoms of Diabetes
General symptoms of diabetes include;
*increased hunger
*increased thirst
*weight loss
*frequent urination
*blurry vision
*extreme fatigue
*sores that don’t heal
In addition to the general symptoms of diabetes, men  may have a decreased sex drive, erectile dysfunction (ED), and poor muscle strength.
Women with diabetes can also have symptoms such as urinary tract infections, yeast infections, and dry, itchy skin.

Symptoms of Type 1 Diabetes
Symptoms of type 1 diabetes can include:
*extreme hunger
*increased thirst
*unintentional weight loss
*frequent urination
*blurry vision
*tiredness
It may also result in mood changes.

Symptoms of Type 2 Diabetes
Symptoms of type 2 diabetes can include:
*increased hunger
*increased thirst
*increased urination
*blurry vision
*tiredness
*sores that are slow to heal
It may also cause recurring infections. This is because elevated glucose levels make it harder for the body to heal.

Symptoms of Gestational Diabetes
Most women with gestational diabetes don’t have any symptoms. 
The condition is often detected during a routine blood sugar test or oral glucose tolerance test that is usually performed between the 24th and 28th weeks of gestation.
In rare cases, a woman with gestational diabetes will also experience increased thirst or urination.

Risk factors for Type 1 diabetes
*Having a family history (parent or sibling) of Type 1 diabetes.
*Injury to the pancreas (such as by infection, tumor, surgery or accident).
*Presence of autoantibodies (antibodies that mistakenly attack your own body’s tissues or organs).
*Physical stress (such as surgery or illness).
*Exposure to illnesses caused by viruses.

Risk factors for prediabetes and Type 2 diabetes
*Family history (parent or sibling) of prediabetes or Type 2 diabetes.
*Being overweight.
*Having high blood pressure.
*Having low HDL cholesterol (the “good” cholesterol) and high triglyceride level.
*Being physically inactive.
*Being age 45 or older.
*Having gestational diabetes.
*Having polycystic ovary syndrome.
*Having a history of heart disease or stroke.
*Being a smoker.

Risk factors for gestational diabetes
*Family history (parent or sibling) of prediabetes or Type 2 diabetes.
*Being overweight before your pregnancy.
*Being over 25 years of age.

What are the complications of diabetes?
If your blood glucose level remains high over a long period of time, your body’s tissues and organs can be seriously damaged. 
Some complications can be life-threatening over time. These complications can include;
*Cardiovascular issues including coronary artery disease, chest pain, heart attack, stroke, high blood pressure, high cholesterol, atherosclerosis (narrowing of the arteries).
*Nerve damage (neuropathy) that causes numbing and tingling that starts at toes or fingers then spreads.
*Kidney damage (nephropathy) that can lead to kidney failure or the need for dialysis or transplant.
*Eye damage (retinopathy) that can lead to blindness; cataracts, glaucoma.

What are the complications of diabetes?
*Foot damage including nerve damage, poor blood flow and poor healing of cuts and sores.
*Skin infections.
*Erectile dysfunction.
*Hearing loss.
*Depression
*Dementia
*Dental problems.

What are the complications of diabetes?
Complications of gestational diabetes:
In the mother: Preeclampsia (high blood pressure, excess protein in urine, leg/feet swelling), risk of gestational diabetes during future pregnancies and risk of diabetes later in life.
In the newborn: Higher-than-normal birth weight, low blood sugar (hypoglycemia), higher risk of developing Type 2 diabetes over time and death shortly after birth.

How is diabetes diagnosed?​
Diabetes is diagnosed and managed by checking your glucose level in a blood test.
Fasting plasma glucose test: This test is best done in the morning after an eight hour fast (nothing to eat or drink except sips of water)
A1c test: This test, also called HbA1C or glycated hemoglobin test, provides your average blood glucose level over the past two to three months. This test measures the amount of glucose attached to hemoglobin, the protein in your red blood cells that carries oxygen. You don’t need to fast before this test.

Know your numbers
https://www.diabetes.org/diabetes/a1c/diagnosis 

What happens if blood glucose level becomes too low?
Sometimes blood glucose levels drop below where they should be, which is called hypoglycemia. For most people with diabetes, the blood glucose level is too low when it is below 70 mg/dL.
Hypoglycemia can be life threatening and needs to be treated right away. You can treat hypoglycemia by;
*Eat or drink 15 to 20 grams of glucose or carbohydrates right away (eg. ½ cup fruit juice or 1 tablespoon sugar or honey.)
*And then have a full meal irrespective of the time of the day. Unless a full meal is not consumed, the glucose might not return to normal or better levels which is a part of the treatment for hypoglycemia

Managing Diabetes​
With the help of your doctor, you can create a diabetes self-care plan to manage your diabetes. Your self-care plan may include these steps:
*Manage your diabetes ABCs
*Follow a diabetic meal plan
*Get active
*Take your medicines regularly
*Regular check of blood sugar levels

Manage your ABCs
Knowing your diabetes ABCs will help you manage your (A1C) blood sugar,(B) blood pressure, and (C )cholesterol.
Stopping smoking if you smoke will also help you manage your diabetes.
Working toward your ABCs goals can help lower your chances of having a heart attack, stroke, or other diabetes problems.

Follow your diabetes meal plan​
Make a diabetes meal plan with help of a dietician if needed. 
Following a meal plan will help you manage your blood glucose, blood pressure, and cholesterol.
Choose fruits and vegetables, pulses and legumes, whole grains, chicken, fish, lean meats, and nonfat or low-fat milk and cheese. 
Drink water instead of sugar-sweetened beverages.
Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt. 
Learn more about eating, diet, and nutrition with diabetes.

Get Active
Try to get 30 to 60 minutes of physical activity every day.
You can walk, bike, swim, or do anything else that gets your heart rate up. 
Pair that with strength training, like yoga or weightlifting. 
If you take a medication that lowers your blood sugar, you might need a snack before a workout.

Take your medicines regularly
Take your medicines for diabetes and any other health problems, even when you feel good or have reached your blood glucose, blood pressure, and cholesterol goals.
These medicines help you manage your ABCs.
Closely following recommendations on how and when to take it.

Regular check of blood sugar levels
For many people with diabetes, checking their blood glucose level each day is an important way to manage their diabetes. 
Monitoring your blood glucose level is most important if you take insulin. 
The results of blood glucose monitoring can help you make decisions about food, physical activity, and medicines.

Disclaimer: The advice provided is intended for informational purpose only and does not substitute for professional medical advice.  Consult with your doctor if you’re seeking medical advice, diagnoses, or treatment.​