DIABETES – TYPES & MANAGEMENT

Diabetes is slowly becoming an epidemic disease. According to WHO current statistics, by 2030 about 98 million people will be suffering from diabetes worldwide. Diabetes is not a disease, rather it is a metabolic disorder which can affect the whole physiological processes. This is characterised by the rise in blood or serum glucose level.

Blood glucose is the main source of energy that is needed by the whole body to function properly. The hormone name Insulin regulates the level of free glucose in the blood and helps it to get into the cells and drive energy. Insulin is produced from the cells situated in the pancreas namely islets of langerhans. Some times the cells get destroyed or at times they are unable to produce adequate insulin required by the body to perform all its metabolic functions. During normal metabolic processes whenever blood glucose rises to its optimum level, the brain gives a signal to the pancreas and insulin is secreted for the effective utilisation of glucose. But if there are any deformities with the islet cells or the produced quantities or even in the insulin receptors present in cells, the blood glucose constantly goes up.

A prolonged period of high blood glucose level can alter the whole body’s mechanism and cause many other degenerative lifestyle diseases, like-cardiovascular diseases, kidney diseases, obesity, etc.

Types:

Generally, diabetes is broadly devised into 4 types :

Type - I Diabetes: In type - I category the islet cells get destroyed with an autoimmune mechanism and the insulin production gets imbalanced. This type is generally seen in children and young adults.

Type - II Diabetes: In this category due to metabolic changes the amount of insulin produced in the body is not sufficient to meet the requirement or the amount that a product is not available to the body due to a fault in the receptors. This type of diabetes is generally co-linked with obesity.

Gestational Diabetes: During the gestational period some women suffer from high blood glucose levels which gets normalised after delivery. But those women are highly susceptible of becoming diabetic in their later life.

Pre-Diabetes: This is an alarming phase. In this phase blood glucose falls under the borderline for at least a period of 3 months. Exercise and dietary modifications are highly recommended for them to save from the worst scenario.

Blood Glucose Level:

Blood glucose levels can go up after a meal, thus checking of the blood glucose at the proper time is important. We can classify it into fasting and the post-meal stage also called postprandial and random.

But these blood glucose levels also can vary depending upon physical and mental stress. Thus, before starting any medical intervention, we have to check the blood sugar levels for the last 3 months, this is also known as HbA1C. This means glycosylated haemoglobin. It is the haemoglobin (iron + protein) that carries oxygen to the body attached with a sugar molecule. Generally haemoglobin is found in the body in this form. Thus, by measuring the level of HbA1C, one can get the picture of blood sugar level over a period of 3 months.

Do you know?

Researchers have found that lowering the HbA1C level by 1% (11 mmol/mol) can reduce the risk of microvascular conditions by 25% along with reducing the following risks-

• Cataract by 19%.
• Heart failure by 16%.
• Peripheral amputation due to degenerative vascular complication by 43%.

Symptoms

Symptoms of type- I diabetes often appear suddenly, but a type -II or even gestational diabetes occurs more gradually and at a slower pace. The common symptoms are as follows-

• Polydipsia (frequent urge of thirst)
• Polyphagia  (frequent urge of hunger)
• Polyuria (frequent urge of urination)
• Fatigue and lethargy
• Sudden weight gain or loss
• Blurred vision
• Delayed wound healing

Management

Lifestyle management is the key of dealing with any degenerative disorder. To manage diabetes the following changes should be incorporated in life-

Diet: While talking about diabetes, the main component of therapeutic lifestyle control (TLC) is the diet. The diet should be rich in fibre, as high fibre diet helps to increase the glycemic response. Apart from that, a diet rich in fibre releases glucose slowly thus, not spike the blood glucose level. Fibre rich diet also gives satiety. For example whole grains and vegetables should be included in the diet.

Diet rich in refined carbs should be excluded as it spikes the blood glucose level instantly.

Exercise: This is another component of TLC management. While exercising the body needs energy in terms of ATP, thus helps to lower the blood sugar levels by increasing the demand.

Apart from this regular exercise also helps to improve the insulin sensitivity along with maintaining the weight.

Regular Monitoring: Regular monitoring helps to keep a check and it also helps us to maintain diet and exercise.

Stress management: Stress condition, in turn, increases the blood glucose level. While suffering from diabetes regular yoga, pranayama helps to reduce the stress and manage it.

Quit smoking: Smoking can increase the risk of insulin resistance by threefold. This also increases the associated disease risk like cardiovascular disease.

Keep an eye on alcohol: Alcohol is the empty calorie diet. 1 ml of alcohol approximately gives 7 kcal. If there is no need of energy in the body the excess amount gets converted into fat and stored in the adipose tissue. This will increase the chance of central obesity and insulin resistance which in turn results in diabetes.

If you are a diabetic always monitor the blood glucose levels and take the necessary measures accordingly, but if you are diagnosed as pre-diabetic, it is high time to change the lifestyle and take precautionary measures. Always take guidance from expert health professionals rather than taking the matter in your own hand.