What is diabetes
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Sharing Hope and Knowledge: Diabetes Care and Information

What is diabetes?  

Diabetes is a chronic disease that affects the body’s ability to regulate blood sugar (glucose) levels.

→ Glucose is an important source of energy for the cells in our body. 

→ Insulin is a hormone produced by the pancreas, helps regulate the amount of glucose in the blood.

Types of diabetes?  

Let’s look into the different description of the three types of diabetes: 

Types

Description

Onset

Treatment

Type 1 Diabetes

Autoimmune disease where the immune system attacks insulin-producing cells in the pancreas, resulting in low insulin production

Childhood or early adulthood

Lifelong Insulin Therapy

Type 2 Diabetes

Most common type; body becomes resistant to insulin or doesn’t produce enough; often linked to lifestyle factors

Usually in adulthood

Lifestyle changes, oral medications, injectable medications, insulin (if necessary)

Gestational Diabetes

Develops during pregnancy in women without prior diabetes diagnosis; resolves after childbirth, but increases risk of type 2 diabetes later in life

During pregnancy

Blood sugar monitoring, healthy eating, exercise

Common Symptoms of Diabetes

Here are some common symptoms associated with diabetes:

Excessive thirst (polydipsia):
 Once there’s too much glucose in the blood, the kidneys have to work harder to filter and absorb the excess sugar. When they can’t keep up, the excess sugar is excreted into the urine, dragging along fluids from the tissues, which makes you feel “parched” or dehydrated,” and you need to drink more fluids than usual.

Frequent urination (polyuria): This point is related to the above, as mentioned. As you drink more fluids to quench your thirst, you’ll urinate more frequently.

Unexplained weight loss: 
If the body isn’t effectively getting glucose from your blood into your cells, it starts burning fat and muscle for energy instead, causing weight loss.

Fatigue: 
Glucose is the primary energy source for cells. When glucose isn’t efficiently delivered to cells, you lack energy and feel tired.

Blurred vision: 
High blood sugar levels can cause the lens in the eyes to swell, changing your ability to see and causing blurry vision.

Slow wound healing: 
High blood sugar levels can affect blood flow and cause nerve damage, which can slow down wound healing. It can also impair the immune system, making it harder to fight off bacteria invading a wound.


Increased hunger (polyphagia): 
If the body can’t use glucose properly, it will need more fuel for cellular function. This induces persistent hunger sensations, even following a meal.

Tingling or numbness: 
High blood sugar levels can cause damage to the nerves (diabetic neuropathy), leading to tingling or numbness in the hands and feet.

Dry skin and itching: 
High blood sugar levels can lead to dehydration, leading to dry skin and itchiness. Also, nerve damage can disrupt the normal functioning of sweat glands, making the skin dry and itchy.

Recurrent infections:
 High blood sugar levels can weaken the immune system’s ability to fight infections. The most common is yeast infections, as the high glucose fuels yeast growth.

**It’s important to note that symptoms can vary depending on the type and progression of diabetes, and some individuals with type 2 diabetes may not experience noticeable symptoms in the early stages.

A Practical Approach to Measuring Blood Glucose Levels

Knowing how to manage your diabetes is vital. 
Here are a few guides that may be helpful in understanding your blood glucose level better. 

There are two primary ways to measure your blood glucose level:

Knowing how to manage your diabetes is vital. 
Here are a few guides that may be helpful in understanding your blood glucose level better. 

There are two primary ways to measure your blood glucose level:

(A) At Home: blood glucose metre

First, you’ll insert a test strip into the metre. Then, you’ll use a lancing device to prick your finger (or another approved area) to get a drop of blood. After you have a drop of blood, you’ll apply it to the test strip. The metre will then read the test strip and display a number that represents your current blood glucose level.

As for where to buy a blood glucose metre, they are widely available at most pharmacies and can also be ordered online from various retailers. The exact process may vary slightly depending on the model of the blood glucose metre you’re using, so it’s important to read the instructions that come with your specific metre.

(B) At a Healthcare Facility 

If you’re getting a blood glucose test at a healthcare facility, a healthcare professional will draw a sample of blood, usually from a vein in your arm. This sample will then be analyzed in a lab to determine your blood glucose level. This is typically done during a fasting glucose test, an oral glucose tolerance test, or an HbA1c test. 

  • A fasting glucose test is used to diagnose diabetes and measures the amount of sugar (or glucose) in your bloodstream after a period of not eating. 
  • Glucose Tolerance Test is given to pregnant people between 24-28 weeks of gestation. It measures blood sugar before and after you drink a sweet liquid that contains between 50-100 grams of fast-acting sugar. 
  • A1c, haemoglobin A1c, HbA1c or glycohemoglobin test (all different names for the same thing) is a blood test that measures your average blood sugar over the last 2-3 months

Healthy individuals have the following normal blood sugar levels:

  • When fasting, between 4.0 and 5.4 mmol/L (72 to 99 mg/dL) 
  • 2 hours after eating, up to 7.8 mmol/L (140 mg/dL)

Diabetes patients should aim for the following blood sugar levels:

  • Before meals : 4 to 7 mmol/L for people with type 1 or type 2 diabetes
  • After meals : under 9 mmol/L for people with type 1 diabetes and under 8.5mmol/L for people with type 2 diabetes

From Genes to Lifestyle: Exploring the Factors that Contribute to Diabetes

A combination of factors influences the development of type 2 diabetes, including both non-modifiable (uncontrollable) and modifiable (controllable) risk factors.

Here are some reasons why someone might be at risk of developing type 2 diabetes:

Obesity and Body Composition: 
Being overweight or obese is a significant risk factor for type 2 diabetes. According to researchers, this is the primary risk factor. Not everyone with prediabetes is overweight or obese. However, if you are overweight or obese, your risk for prediabetes does increase. Excess weight, especially around the abdomen (central obesity), plays a part in insulin resistance and impaired glucose metabolism. Adipose tissue produces hormones and substances that can interfere with insulin activity.

Age: 
The risk of type 2 diabetes increases with age, particularly after the age of 45. This is partly due to the natural aging process and changes in the body’s metabolism over time.

Family History and Genetics: Having a family history of type 2 diabetes increases your risk. Certain genetic variations can also make individuals more susceptible to developing the condition. However, having a family history doesn’t guarantee that you will develop diabetes, as lifestyle factors play a significant role.

Unhealthy Diet: 
Consuming a diet high in processed foods, saturated fats, sugary beverages, and refined carbohydrates contributes to the risk of developing type 2 diabetes. Poor dietary choices can lead to weight gain, insulin resistance, and elevated blood sugar levels.

Sedentary Lifestyle: 
Leading a sedentary lifestyle, with little physical activity, increases the risk of type 2 diabetes. Regular exercise improves insulin sensitivity, helps maintain a healthy weight, and supports overall metabolic health. 

Gestational Diabetes: 
Women who have experienced gestational diabetes during pregnancy have an increased risk of developing type 2 diabetes later in life.

Other Health Conditions: 
Certain medical conditions, such as polycystic ovary syndrome (PCOS), high blood pressure (hypertension), and metabolic syndrome, are associated with an elevated risk of developing type 2 diabetes.

From Head to Toe: The Impact of Type 2 Diabetes on Your Body

Type 2 diabetes is not just a matter of managing blood glucose levels with medication. Neglecting its proper management can lead to serious consequences.

Here are a few examples of potential complications that can arise:

(A) Cardiovascular Problems

Diabetes hastens plaque accumulation in arteries, resulting in narrower and hardened arteries and an increased risk of coronary artery disease, heart attacks, and peripheral arterial disease. Diabetes and hypertension work together to damage blood arteries, putting strain on the heart and increasing the risk of heart disease, heart failure, and stroke. 

Abnormal cholesterol levels:
Type 2 diabetes frequently causes adverse changes in cholesterol levels, which contribute to atherosclerosis and increase the risk of cardiovascular problems.

Obesity: Type 2 diabetes and obesity usually coexist, increasing the risk of heart disease, high blood pressure, and other cardiovascular problems. Insulin resistance and chronic inflammation are connected with type 2 diabetes and accelerate the development of arterial plaques, decrease blood vessel function, and raise the risk of cardiovascular disease.

(B) Stroke

Diabetes helps to accelerate the progression of atherosclerosis, narrowing blood arteries and increasing the risk of stroke. High blood pressure, which is frequent among diabetics, is also a substantial risk factor for stroke. Diabetes can promote irregular blood clotting, rendering patients more vulnerable to blockages in brain blood arteries. Small vascular disease, caused by diabetes-related damage to tiny brain blood arteries, increases the risk of stroke even more.
Furthermore, people with Type 2 Diabetes frequently have other risk factors such as obesity, high cholesterol, and a sedentary lifestyle, all of which contribute to their increased stroke risk. Diabetes and related risk factors must be managed well to reduce the risk of stroke.

(C) Nerve Damage (Neuropathy)
A condition caused by consistently high blood sugar levels that damage the nerves. Diabetic neuropathy can affect different types of nerves, including sensory, motor, and autonomic nerves, leading to various symptoms and complications. Peripheral neuropathy is common, primarily affecting the nerves in the feet, legs, hands, and arms, resulting in numbness, tingling, pain, or loss of sensation. Autonomic neuropathy impacts the nerves controlling involuntary functions, causing digestive, urinary, cardiovascular, and sexual issues. Diabetic neuropathy increases the risk of complications such as foot ulcers, infections, and delayed wound healing.

(D) Kidney Damage (Nephropathy)
Prolonged elevation of blood sugar levels increases blood pressure and protein leakage. Consistently high blood sugar levels damage the small blood vessels in the kidneys, impairing their ability to filter waste effectively. The combination of diabetes and hypertension further strains the kidneys. Diabetic nephropathy can cause proteinuria, where the kidneys leak excessive protein into the urine, indicating kidney damage.
If left untreated, diabetic nephropathy can progress to chronic kidney disease (CKD) and, in severe cases, kidney failure. 

(E) Eye Problems (Retinopathy)
Type 2 diabetes can
damage the blood vessels in the retina, leading to retinal complications. The weakened blood vessels may leak fluid and blood, causing vision problems. Non-proliferative retinopathy involves fluid leakage and microaneurysms, while proliferative retinopathy involves abnormal blood vessel growth and potential bleeding, leading to vision loss or blindness if untreated. Proper diabetes management, including controlling blood sugar, blood pressure, and cholesterol levels, regular eye exams, and early intervention, is essential to prevent or slow the progression of diabetic retinopathy. Laser therapy and medications may be used for treatment and to prevent further vision loss.

(F) Foot Complications
Consistently high blood sugar levels can lead to peripheral neuropathy, causing a loss of sensation and difficulty detecting injuries. Diabetes also impairs blood circulation, delaying wound healing and increasing the risk of infections. Weakened immune response further raises susceptibility to infections. Nerve damage can result in foot deformities like Charcot’s foot, leading to instability. Complications of foot ulcers, if not properly managed, can include severe infections, cellulitis, or gangrene, potentially requiring amputation to prevent the spread of infection. 

(G) Skin Conditions
Consistently high blood sugar levels can impair the function of blood vessels, leading to reduced blood flow to the skin and poor oxygen and nutrient delivery. This can result in dry, itchy skin and slow wound healing. Additionally, diabetes can affect the nerves, leading to decreased sensation in the skin. Without proper sensation, individuals may not notice injuries, leading to delayed or inadequate treatment and an increased risk of infections. Furthermore, diabetes can weaken the immune system, making it harder for the body to fight off infections and resulting in more severe skin complications. 

(H) Increased Infection Risk
Diabetes compromises the immune system, and high blood sugar levels damage the immune system, limiting its capacity to effectively fight infections. It causes low blood flow and nerve damage, which result in poor circulation, decreased sensation, and delayed wound healing, making individuals more susceptible to infections, specifically skin infections, urinary tract infections, and recurrent yeast infections.

(I) Mental Health Challenges

The fluctuation of blood sugar levels has an impact on mood and energy levels. The stress and worry associated with self-care management, and the potential complications can contribute to increased stress, anxiety, frustration, and depression straining one’s mental health. The presence of comorbidities, such as obesity and cardiovascular problems, can further compound the mental health challenges.

It’s important to note that with proper management and lifestyle modifications, the risk and impact of these complications can be significantly reduced. Regular medical check-ups, blood sugar monitoring, medication adherence, a balanced diet, regular exercise, and maintaining a healthy weight are crucial for effectively managing type 2 diabetes and minimizing the potential complications.

Mastering Blood Glucose Control: Expert Tips for Balancing Your Levels

Maintaining balanced blood glucose levels is essential for managing diabetes and promoting overall health. Here are some tips to help you balance your blood glucose levels.

Lose excess weight or maintain a healthy weight. Losing weight can reduce insulin resistance, improving blood glucose control. 

Balance your meals with protein, fat, fiber, and carbohydrates. The combination of nutrients will help balance your blood sugar by preventing spikes and crashes. Avoid or limit sugary drinks, processed foods, unhealthy fats, and refined carbohydrates. 

  • Carbs: Try to focus on whole grains (like brown rice, whole wheat bread, and quinoa) and lower glycemic index (GI) foods.
  • Protein: Choose lean proteins (like skinless chicken, fish, or plant-based proteins like lentils and chickpeas)
  • Include high-fibre foods such as whole grains, fruits, vegetables, and legumes in your meals.

Portion Control: Don’t need to be on a very low carb diet or avoid carbs in your diet but portion control of carbs is important as all carbs whether ‘’sugary’’ or not, will raise blood sugar. Also, choose complex and low GI carbs when possible. For example, whole grain instead of ‘white’ grain.

Your best buddies are vegetables:
Increase your consumption of non-starchy veggies. This can assist to keep blood sugar levels stable. Aim for at least 25g of fibre in a day for better blood sugar. 

Regular Meal Times: Establish regular meal times and spacing between meals to provide a consistent pattern for your body. Avoid skipping meals, as it can lead to imbalances in blood sugar levels.

Stay Hydrated: Drink plenty of water throughout the day to stay hydrated and support optimal bodily functions. Avoid sugary drinks that can rapidly raise blood sugar levels.

Prioritise strength training: As strength training can help to gain and build muscle. Muscle uses glucose for energy therefore focus on body composition (increasing muscle mass and decreasing fat) rather than just weighing scale and BMI. Aim for at least 150 minutes of moderate activity per week (about 30 minutes or more per day) and two days of strength training per week.

Monitor Blood Sugar Levels: Regularly check your blood sugar levels as advised by your healthcare provider. This helps you understand how your body responds to different foods, activities, and medication, allowing for better adjustments in your diabetes management plan.

Get Adequate Sleep: This is an area that often gets neglected! Studies have shown that inadequate sleep decreases insulin sensitivity, raises cortisol, increases oxidative stress and worsen inflammation. The result is elevated blood sugar. So do your best to make sleep a priority.

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