The body is usually able to break down sugars and carbohydrates into glucose using insulin. When the body doesn't produce enough insulin or can't use the insulin it produces, it is known as diabetes. Diabetes is a chronic condition that affects the body's ability to use the energy found in food, leading to an excess of sugar in the blood. Too much sugar in the blood left uncontrolled can lead to serious health problems including cardiovascular disease, nerve damage, kidney, foot and eye damage, hearing problems, depression and skin conditions.
WHAT CAUSES DIABETES MELLITUS?
There are 4 types of diabetes, type 1 and type 2, prediabetes and gestational diabetes. Each type has its own cause.
- Type 1 diabetes – the cause of this type of diabetes is unknown, but is believed to be a combination of genetic susceptibility and environmental factors. It is thought to be the result of a faulty immune system attacking and destroying insulin-producing cells in the pancreas. This type can develop at any age but is common among children and adolescents.
- Prediabetes & Type 2 diabetes – these types are caused by cells becoming resistant to the action of insulin. As a result, the pancreas cannot overcome the resistance and sugar builds up in the bloodstream. Type 2 is the more common type. It may also develop at any age but is more common in those over 40 years old.
- Gestational diabetes – this type of diabetes occurs during pregnancy. Due to the hormones that are produced by the placenta, the cells become more resistant to insulin.
The following risk factors may increase your chances of developing type diabetes:
- Being overweight
- Having a family history of diabetes
- Having high blood pressure
- Having abnormal cholesterol levels
- Being inactive
WHAT ARE THE SYMPTOMS?
Depending on how elevated the sugar level in the bloodstream is, symptoms may vary. Those with prediabetes or type 2 diabetes may not experience symptoms in the beginning but later will experience the same symptoms as those with type 1 diabetes including:
- Frequent urination
- Extreme thirst
- Extreme hunger
- Unexplained weight loss
- Blurred vision
- Frequent infections
- Sores that heal slowly
How is diabetes diagnosed?
To test for type 1, type 2 diabetes, or prediabetes Dr Kenaope may do a blood test called Glycated haemoglobin (A1C) test, which measures the percentage of blood sugar attached to the oxygen-carrying protein (called haemoglobin) in the red blood cells. Some conditions can, however, affect the outcomes of this test and make the results inaccurate. In these cases, your physician may use the following to test for diabetes:
- Random blood sugar test – a blood sample may be taken to test how much sugar is present in the blood.
- Fasting blood sugar test – a blood sample is taken after fasting for a night to test if the blood sugar level is still high even when your last meal was hours ago.
- Oral glucose tolerance test – this test is done by taking a sample of blood after fasting and then again after a sugary liquid to test the levels of blood sugar and how they change.
If Dr Kenaope believes that you may have type 1 diabetes, he will need to test your urine for the presence of ketones. You will then be tested for destructive immune system cells that may be causing diabetes.
Treatment will vary depending on which type of diabetes you have been diagnosed with. For gestational diabetes, your physician will emphasise the importance of maintaining blood sugar levels during pregnancy to ensure a healthy baby and delivery. Treatment may thus involve maintaining a healthy diet, exercise and insulin or oral medications. Dr Kenaope may also need to be present during labour to make sure delivery goes well and that your blood sugar levels are controlled.
Those with prediabetes will be advised to make changes towards a healthy lifestyle to prevent the development of type 2 diabetes. Exercise and a healthy diet can drastically improve your control of blood sugar levels and delay or prevent the development of the condition. If a particular medication for the cardiovascular disease, fatty liver disease or polycystic ovary syndrome is contributing towards the development of diabetes, your physician may help change your medications to control blood sugar levels.
If diagnosed with type 1, treatment may involve insulin, frequent blood sugar checks, and carbohydrate counting. Treatment for type 2 would then include lifestyle changes, monitoring of blood sugar while taking medications, insulin or a combination of both.
In both cases, insulin may be given through either a pump of injection. Using a fine needle and syringe or an insulin pen, insulin may be injected straight into the bloodstream to regulate the level of blood sugar. In other cases, an insulin pump in which insulin is pumped into the bloodstream through a catheter inserted into the abdomen may be more suitable.