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Diabetes

Dr.Shivaprasad C

Diabetes


What is diabetes?

Diabetes mellitus commonly referred to as diabetes is a disease characterized by high blood glucose levels.

What is glucose ?

Glucose is a form of sugar present in the blood. It is the principal source of fuel in human body. Energy in our body is derived from three principal sources: carbohydrate, protein and fat. Carbohydrates constitute the main bulk of our standard diets.   Carbohydrates we eat are broken down into glucose.

What is insulin ?

Insulin is a hormone that is produced by the pancreas. If insulin is absent or ineffective glucose accumulates in the blood and blood glucose levels go up.

What happens when blood glucose levels go up?

Accumulation of high levels of glucose in the blood can cause both short term problems (like increased frequency of urination, increased thirst, increased appetite, visual disturbances, and recurrent infections) and long term problems (damage to heart, kidney, retina and other vital organs). Even though there is high level of glucose in the blood that can not be transported with in the cell in deficiency of insulin. The cells are deprived of fuel (glucose) and the cells start malfunctioning.

What are the types of diabetes mellitus and how are they treated ?

Type 1 Diabetes mellitus- Where there is an absolute deficiency of insulin and the patient need to be on life long injections.
Type 2 Diabetes mellitus- There are components of both insulin deficiency and insulin resistance. Can be treated by both oral medicines and injectable insulin.
Gestational Diabetes mellitus (GDM) - Occurs during pregnancy.  There is a small chance that diabetes may continue to persist even after pregnancy. Usually it is treated with lifestyle changes and insulin.
Diabetes Mellitus due to other causes- Damage to pancreas (e.g. chronic pancreatitis), drugs (like steroids), etc.

How do I know if I have diabetes or prediabetes?

Doctors can use either the fasting plasma glucose test (FPG) or the oral glucose tolerance test (OGTT) to detect diabetes or prediabetes. Both require a person to fast overnight. In the FPG test, a person’s blood glucose is measured first thing in the morning before eating. In the OGTT, a person’s blood glucose is checked after fasting and again 2 hours after drinking a glucose-rich drink.

How does the FPG test define diabetes and prediabetes?

Normal fasting blood glucose is below 100 mg/dl. A person with prediabetes has a fasting blood glucose level between 100 and 125 mg/dl. If the blood glucose level rises to 126 mg/dl or above, a person has diabetes.

How does the OGTT define diabetes and prediabetes?

In the OGTT, a person’s blood glucose is measured after a fast and 2 hours after drinking a glucose-rich beverage. Normal blood glucose is below 140 mg/dl 2 hours after the drink. In prediabetes, the 2-hour blood glucose is 140 to 199 mg/dl. If the 2-hour blood glucose rises to 200 mg/dl or above, a person has diabetes.

Could I have diabetes and not know it?

Definitely. People with diabetes don’t often have symptoms. In fact, millions of people have diabetes and don’t know it because symptoms develop so gradually, people often don’t recognize them. Some people have no symptoms at all. Symptoms of diabetes include unusual thirst, a frequent desire to urinate, blurred vision, or a feeling of being tired most of the time for no apparent reason.

Who should get tested for diabetes?

If you are overweight and age 45 or older, you should be checked for diabetes. If your weight is normal and you’re over age 45, you should ask your doctor if testing is appropriate. For adults younger than 45 and overweight, your doctor may recommend testing if you have any other risk factors for diabetes or prediabetes. These include high blood pressure, low HDL cholesterol and high triglycerides, a family history of diabetes, a history of gestational diabetes or giving birth to a baby weighing more than 9 pounds.

What is prediabetes and how is it different from diabetes?

Prediabetes is the state that occurs when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. About 10 percent of people with prediabetes develop type 2 diabetes each year over next 3 years.

Is prediabetes the same as Impaired Glucose Tolerance or Impaired Fasting Glucose?

Yes. Doctors sometimes refer to this state of elevated blood glucose levels as Impaired Glucose Tolerance or Impaired Fasting Glucose (IGT/IFG), depending on which test was used to detect it.

What problems can arise from prediabetes?

People with prediabetes are at higher risk of cardiovascular disease (e.g. heart disease, stroke etc.). People with prediabetes have a 1.5-fold risk of cardiovascular disease compared to people with normal blood glucose. People with diabetes have a 2- to 4-fold increased risk of cardiovascular disease. We now know that people with prediabetes can delay or prevent the onset of type 2 diabetes through lifestyle changes.

Why do I need to know if I have prediabetes?

If you have prediabetes, you can and should do something about it. Studies have shown that people with prediabetes can prevent or delay the development of type 2 diabetes by up to 58 percent through changes to their lifestyle that include modest weight loss and regular exercise. The experts recommends that people with prediabetes reduce their weight by 5-10 percent and participate in some type of modest physical activity for 30 minutes daily. For some people with prediabetes, intervening early can actually turn back the clock and return elevated blood glucose levels to the normal range.

What is the treatment for prediabetes?

Treatment consists of losing a modest amount of weight (5-10 percent of total body weight) through diet and moderate exercise, such as walking, 30 minutes a day, 5 days a week. Don’t worry if you can’t get to your ideal body weight. A loss of just 10 to 15 pounds can make a huge difference. If you have prediabetes, you are at a 50 percent increased risk for heart disease or stroke, so your doctor may wish to treat or counsel you about cardiovascular risk factors, such as tobacco use, high blood pressure, and high cholesterol.

Could I have prediabetes and not know it?

Absolutely. People with prediabetes don’t often have symptoms. In fact, millions of people have diabetes and don’t know it because symptoms develop so gradually, people often don’t recognize them. Some people have no symptoms at all. Symptoms of diabetes include unusual thirst, a frequent desire to urinate, blurred vision, or a feeling of being tired most of the time for no apparent reason.