Diabetes: Type 1, Type 2 – Symptoms, Causes, Treatment & Prevention
Diabetes is called the “silent killer”. It is a widely prevalent condition, and its incidence is on the rise worldwide.
Across the world, it is estimated that the number of people who had diabetes went up to 422 million in 2014- from 108 million in 1980. It has risen from 108 million in 1980 to 422 million in 2014. For the same period, the incidence of the disease for people over 18 years of age rose from 4.7% to 8.5%. (18)
In India, 8.7% of the total population is diabetic, according to the World Health Organization. Diabetes has also shown the maximum growth in prevalence rates among all non-communicable diseases between 1990 and 2016. (1,2)
So how can we keep diabetes at bay? And how can we identify its symptoms? Let us take a thorough look at it.
- What is Diabetes?
- Types of Diabetes
- Diabetes Symptoms
- Diabetes Diagnosis and Tests
- What Causes Diabetes?
- Diabetes Risk Factors
- Diabetes Complications
- Diabetes in Pregnancy
- Diabetes in Children
What is Diabetes?
Have you got a cut or a wound that is refusing to heal? Are you experiencing drastic weight loss without any explanation? Do you urinate frequently? These can be symptoms of high blood sugar.
Diabetes Mellitus or DM is commonly known as diabetes. The term encompasses a group of metabolic disorders which are characterized by high blood sugar levels over an extended period. If left untreated, diabetes can lead to a wide range of complications, including cardiovascular diseases, stroke, kidney diseases, diabetic foot ulcers and retinal damage. (3)
According to the International Diabetes Federation, 425 million people worldwide have diabetes of 2017, with type 2 diabetes being the most prevalent form of diabetes (almost 90%). Type 2 constitutes nearly 9% of the total global population, with both men and women being affected similarly. (4)
Diabetes comes in three forms- type 1 and type 2 diabetes, and gestational diabetes. However, in day to day life, diabetes type 2 is called “diabetes”. (5)
Types of Diabetes
There are four types of diabetes:
1. Type 1 diabetes
It occurs when the pancreas cannot produce enough insulin, hence failing to regulate blood glucose levels. Patients with type 1 diabetes have to take insulin injections daily to stay healthy. This type of diabetes is not associated with weight gain. Earlier, it used to be called “juvenile diabetes.” (6)
Type 1 diabetes is an autoimmune disease. It means that for some reason, our immunity system attacks the cells in the pancreas, which leads to the destruction of beta cells that produce insulin. Over time, with sustained damage, the pancreas can no longer produce sufficient insulin, and hence, the patient has to depend on insulin injections. (6)
2. Type 2 diabetes
It is the most common type of diabetes. It is a chronic condition, and people develop type 2 diabetes when their body develops insulin resistance. This means that their cells fail to respond to insulin properly, which in turn adversely affects their blood sugar levels. (7)
As the disease progresses, the body may start to produce less insulin with time. There is no cure for type 2 diabetes, but you can manage it by staying healthy, monitoring the foods you eat and exercising regularly. (7)
Earlier, it used to be called “adult-onset diabetes”. However, more children have been diagnosed with type 2 diabetes now- possibly due to the rise in childhood obesity and lack of physical activity. Though different reasons cause its onset, it is similar to type 1 diabetes as both results in high blood sugar levels and resultant complications. (8)
The name itself is self-explanatory. It is characterised by high blood sugar levels- but not as high as those observed in diabetic patients. It is also called “borderline diabetes”. Pre-diabetes increases the chances of getting heart disease, but if you lead a healthy and active lifestyle, you can stop or slow down the slide into diabetes. (19)
But where do you draw the line between pre-diabetes and diabetes proper? Check with your doctor to know. If your fasting sugar levels are within the 100-125 range, and your post-breakfast sugar levels are in the 140-199 range, you are likely to have pre-diabetes. However, to make sure, the doctor can also prescribe the Hemoglobin A1C test, which checks the blood sugar levels for the last 3 months to rule out temporary irregularities. If your A1C results are in the 5.7%-6.4% range, you are pre-diabetic. (19)
4. Gestational Diabetes
This is a condition in which a woman without diabetes shows high blood sugar levels during pregnancy. It does not have many symptoms. However, if left untreated, pregnant women can develop depression, have birth complications and need a caesarean section while giving birth. (9)
Babies born to mothers whose gestational diabetes go untreated can be obese and may develop type 2 diabetes. Doctors advice losing weight before pregnancy and staying active before and during pregnancy to prevent gestational diabetes. (9)
So how do you know if you have diabetes? It is always good to get checked by your doctor and check your blood sugar levels. However, you should look out for some signs- so that you are not blindsided by it.
While you have to talk to your doctor to understand what type of diabetes you have, you must know whether you have high blood sugar levels. The symptoms of high blood sugar are:
- Frequent urination
- Increased hunger
- Increased thirst
- Blurred vision
- Unexplained weight loss
- Recurrent infections
- Wounds that refuse to heal
Symptoms in Women
- Diabetes affects men and women equally. However, women with diabetes are more likely to develop UTI or yeast infections. Due to high blood sugar levels, some women may not be able to empty their bladder completely- which creates a conducive environment for germs to thrive in. (20)
- Menstrual problems are also observed in women with diabetes. While it is difficult to gauge your sugar levels before and during your periods, diabetics may experience longer or heavier periods. Also, periods often result in food cravings, which makes it difficult to control blood sugar levels. (20)
- Diabetes may also affect your fertility and sex drive. Diabetic women have a low sex drive and may find it difficult to get pregnant. (20)
Symptoms in Men
- For men, too, lack of a sexual drive is common when they have diabetes. (21)
- Similarly, high blood sugar levels may lead to damage in blood vessels which are necessary to achieve or maintain an erection. While erectile dysfunction is common for many men in middle age and afterwards, it is always good to talk to your doctor and see if it is a manifestation of a deeper problem or not. (21)
- Diabetic men may also get urinary tract infections frequently. (21)
So if you feel that you see an incidence of one or more of these signs, visit your doctor and get checked immediately. (10)
Blood sugar can be high periodically- when under some physical or mental stress. Or after ingesting sugary foods or even as a result of some medications. However, to ensure that it is indeed diabetes, you have to check your blood sugar regularly and visit a doctor who will prescribe the appropriate tests for you.
But then, what causes chronic high blood sugar levels? What are the causes of diabetes? Let us find out.
Diabetes Diagnosis and Tests
The doctor may prescribe one or more of the following to check if you have diabetes:
Hemoglobin A1C Test
For Type 1 and Type 2 diabetes, the doctor may order for a Hemoglobin A1C test. This test does not require fasting, and it identifies the blood sugar levels for three months or so. If you test for 6.5% or higher for two separate tests, you are diabetic. However, it may not be accurate if the person has any abnormalities in their haemoglobin, or is pregnant. (22)
Fasting Blood Sugar Test
This blood test is done after the person has been fasting for at least 8 hours. If your blood sugar levels are below 100 mg/dL, you are not diabetic. Pre-diabetics clock in around 100-125 mg/DL, while diabetics show levels beyond 125mg/dL. If your values are more than 125mg/dL on two separate tests, you are diabetic. (22)
Oral Glucose Tolerance Test
This is done after the fasting test. After checking fasting sugar levels, the person is to drink a sugary liquid and will be tested every 2 hours. If the levels read below 140 mg/dL, it is normal. Pre-diabetics show a blood sugar level of 140-199 mg/dL, while diabetics show a level more than 200 mg/dL.
Random Blood Test
Regardless of when you ate last, a random blood test showing more than 200 mg/dL blood sugar levels usually indicates diabetes. (22)
Even if you keep track of your blood sugar levels at home with over-the-counter devices, definitely visit a doctor to know for sure whether you have diabetes or not. If you are diabetic, follow the guidance of the doctor to monitor your blood sugar levels.
What Causes Diabetes?
Causes of type 1
It is not known what causes type 1 diabetes. As explained earlier, this happens when the pancreas cannot produce sufficient insulin. This happens when our own immunity system attacks and destroys the beta cells in the pancreas which produce insulin. Scientists are still not clear as to why this happens, but they suspect that a number of genetic and environmental factors are at play here. (11)
Causes of type 2
Type 2 diabetes is called a “lifestyle disease” which is usually the result of a lack of sufficient physical activity and is caused by a sedentary and unhealthy lifestyle. When you develop type 2 diabetes, your body is also at the risk of developing a host of other complications- especially heart diseases, high blood pressure and diseases related to blood vessels. (11)
Type 2 diabetes begins with insulin resistance. This means that the cells in the liver, muscle and fat do not respond to the insulin the body produces. As a result, your body cannot absorb blood sugar effectively. This leads to high blood glucose levels. However, the body produces more insulin to help the organs absorb blood sugar, but over time, it falls behind the amount required, and the blood sugar levels stay high. (12)
Causes of gestational diabetes
During pregnancy, the body releases a number of hormones. Some hormones may lead to the buildup of blood sugar levels. Usually, the pancreas produces enough insulin to manage that, but in many women, it is the other case. When the pancreas cannot produce enough insulin to control the blood sugar buildup in the body of a pregnant woman, they develop gestational diabetes. (13)
While type 1 diabetes is autoimmune diabetes, you can keep type 2 diabetes (and to some extent, gestational diabetes) at bay if you lead an active and healthy lifestyle and follow a healthy diet. So let us take a look at ways to prevent diabetes.
Diabetes Risk Factors
It is commonly known that in order to know if you are diabetic, you must take blood sugar tests. However, there are also some vulnerable groups who are more likely to get diabetes (22):
- People with a BMI more than 25, and exhibiting other risk factors like high blood sugar levels, heart diseases, polycystic ovary syndrome or with a family history of diabetes.
- Women with gestational diabetes
- People over 45 years of age
- Prediabetic people.
- People who have an unhealthy lifestyle- especially those who eat junk food on a regular basis and are not physically active.
If you belong to any of the above-mentioned groups, make sure to check with your doctor about diabetes tests.
As said earlier, diabetes is basically incurable. Over time, it can result in a lot of complications. Here are some long term effects of diabetes:
Heart diseases are a major cause of death among diabetics because people with diabetes have a higher chance of developing heart diseases. Moreover, high blood sugar levels may also damage blood vessels, which can result in further complications. Diabetics may also suffer from strokes more often. (23)
2. Loss of feeling and effect on nerves
Diabetes can damage your nerves. If you experience numbness or tingling feeling, check with your doctor. Other symptoms include constipation or diarrhoea, pain and loss of feeling in legs. (24)
3. Problems in feet
You must check your feet for signs of diabetic foot. Diabetes reduces blood supply to your feet (because it is the farthest from your heart), which may lead to your feet having sores, cuts or blisters that don’t heal.
Apart from numbness, untreated sores in the feet can lead to gangrene, which has to be amputated. It is a fairly common occurrence, so make sure that you are careful about not getting cuts and infections on your feet.
Keep your feet covered, and keep them dry and clean. (24)
4. Problems in eyes
Diabetes may damage the blood vessels in your eye and lead to problems in the retina. If you are diabetic, make sure you check your eyes regularly.
Diabetics may experience sight problems- which, if left untreated, may even lead to blindness. If you feel like you see floating shapes, or are experiencing blurred or reduced visibility and sensitivity to light, check with your doctor immediately. (24)
5. Toxic shock syndrome
Diabetes are also at increased risk of developing toxic shock syndrome (TSS).
TSS refers to a collection of syndromes that may affect multiple systems in the body. This happens when certain bacterial infections release the toxins in your blood and thereby, affect your internal organs.
This can lead to severe complications. While more common in children and the elderly, TSS is also more likely to affect people with diabetes. (25)
Diabetes in Pregnancy
Diabetic women can have a safe birth and pregnancy. However, they have to be extra careful and have to follow their doctor’s guidance to the T. Since the fetus’ organs are developed in the first two months of pregnancy, high blood sugar levels in the mother may lead to complications later. (20)
If you are diabetic and are pregnant, you have a greater chance of developing toxaemia or preeclampsia during the second half of your pregnancy, when the blood pressure increases and there is too much protein in your urine. The only “cure” for toxaemia is to give birth. So you must check with your doctor, follow a strict diet and activity plan and take all the necessary medicines to make sure you and your baby stay safe and healthy. (26)
Diabetes in Children
As said earlier, type 1 diabetes was earlier known as “juvenile diabetes” because it was more predominant in children. The child’s pancreas does not produce enough insulin, which results in elevated blood sugar levels. (7)
However, e are seeing more children being prediabetic or diabetic because of high blood sugar levels. This may be related to child obesity, and increased uptake of junk and processed food and an overall less active lifestyle.
Girls are more prone to develop diabetes type 2, and there are certain demographic sections (American Indian, African-American, Asian, or Hispanic/Latino) who show a propensity toward it. If your child shows signs of insulin resistance, or you have a history of diabetes in your family- you should talk to your doctor for diagnosing and chalking out a lifestyle plan for her. Moreover, make sure that your children stay away from sugary, junk and processed food and get enough physical activity. (27)