What is Diabetes? Causes, Symptoms, Treatment, and Medications

What is diabetes?

Diabetes is defined as a metabolic disease characterized by high blood sugar levels. Diabetes occurs due to decreased insulin secretion or the body’s reduced ability to use it effectively, leading to a buildup of glucose, or sugar, in the blood.

Insulin is a hormone that helps regulate blood sugar levels and helps transport glucose molecules into cells to be stored or used for energy. Untreated diabetes causes serious complications, such as damage to the nerves, blood vessels, eyes, kidneys, and other body organs.

Types of diabetes and learn What is Diabetes

The type of diabetes varies depending on the cause, and there are three types:

Type 1 diabetes

Type 1 diabetes, also known as childhood diabetes, is an autoimmune disease in which the body’s immune system attacks and destroys the cells in the pancreas, leading to a severe deficiency in insulin production. People with type 1 diabetes typically develop the disease in childhood and require daily insulin. Type 1 diabetes accounts for 10% of all diabetes cases.

Type 2 diabetes

Type 2 diabetes is the most common type and is often associated with obesity. Type 2 diabetes occurs when the body becomes resistant to the hormone insulin, and cells don’t respond to the hormone properly, causing glucose to build up in the blood.

Gestational diabetes

Gestational diabetes is a condition in which blood sugar levels are elevated only during pregnancy. The placenta secretes hormones that inhibit insulin action. Women with gestational diabetes typically recover spontaneously after delivery.

Prediabetes

Prediabetes is a condition in which blood sugar levels are higher than normal, but not as high as those in diabetes. A normal blood sugar level is between 70 and 99 mg/dL, while a fasting blood sugar level for a diabetic is higher than 126 mg/dL. Prediabetes is between 100 and 125 mg/dL. A person with prediabetes is at risk of developing type 2 diabetes, but they do not experience the full symptoms of diabetes.

Causes of diabetes

The causes of diabetes vary depending on the type, and include the following:

Causes of type 1 diabetes

The cause of type 1 diabetes is not completely known, but there are some factors associated with it, such as:
– The body’s immune cells attack and destroy the insulin-producing cells in the pancreas.
– Genetic factors.
– Stimulation of the immune system by a specific virus, which attacks the pancreatic cells.

Causes of type 2 diabetes

Type 2 diabetes is usually linked to both genetics and environmental factors, such as the patient’s lifestyle. Some groups are more susceptible to developing type 2 diabetes than others. Factors that increase the risk of developing type 2 diabetes include:
– Weight gain.
– Advanced age (patient age over 45 years).
– Having diabetes in the family.
– Laziness and lack of movement.
– Having gestational diabetes before.
– Having high blood pressure, high cholesterol, or high triglycerides.
– Some ethnicities are more likely to develop type 2 diabetes than others, such as African Americans.

Causes of gestational diabetes

Gestational diabetes is caused by the following:
– Hormonal changes during pregnancy.
– The placenta secretes hormones that reduce cells’ sensitivity to insulin.
– Weight gain.
– Having gestational diabetes in a previous pregnancy.
– Age over 25 years.
– Having type 2 diabetes in your family.
– Polycystic ovary syndrome.
– Giving birth to a baby weighing more than 4 kg in a previous pregnancy.

Symptoms of diabetes

Diabetes symptoms are often caused by high blood glucose levels. Symptoms can be so mild that they go unnoticed, especially in type 2 diabetes. Some people don’t even know they have diabetes until complications develop. In the case of type 1 diabetes, the symptoms are more obvious and appear quickly, within days or weeks. The symptoms associated with type 1 diabetes are also more severe.

Common symptoms of diabetes

These symptoms are common to all types of diabetes:
– Hunger and fatigue: The body converts food into glucose, which it uses for energy. Glucose can only enter cells with the help of insulin. If the body is unable to produce sufficient insulin or suffers from insulin resistance, cells cannot utilize glucose for energy, resulting in constant hunger and fatigue.
– Constant thirst and frequent urination: A normal person may need to urinate 4–7 times a day, but people with diabetes may need to urinate much more often. This is due to the increased secretion of glucose through the kidneys to get rid of it. Normally, the kidneys return glucose molecules to the bloodstream, but in diabetes, the body gets rid of glucose through the kidneys, and the glucose pulls a lot of fluid with it. The higher the level of glucose in the blood, the more it is excreted through the kidneys and the consequent increase in urine production. The loss of this large amount of fluid increases the feeling of thirst to compensate for it.
– Dry mouth and itchy skin: The patient becomes dehydrated due to frequent urination, as the body uses up a lot of fluids in its attempt to get rid of glucose by producing urine in the kidneys, which leads to dry mouth and lack of skin moisture that causes itching.
– Blurred vision: Changes in fluid levels in the body cause the lens of the eye to swell, change shape, and lose its ability to focus.
– Erectile problems in men: Men with diabetes have decreased sexual desire and erectile dysfunction.

Symptoms of type 1 diabetes

Some symptoms appear more often in people with type 1 diabetes:
– Unintentional weight loss: When the body’s cells don’t receive the energy they need, they resort to using fat and muscle to produce energy, leading to weight loss without changing your diet.
– Nausea and vomiting: When the body burns fat, it produces molecules called ketones, which can accumulate in the blood to a large extent and cause a serious condition called diabetic ketoacidosis. These ketones may cause nausea and vomiting.

Symptoms of type 2 diabetes

Symptoms of type 2 diabetes appear after blood sugar levels have been elevated for a long time. These symptoms include:
– Fungal infections: Fungi feed on glucose, so diabetics are more susceptible to these infections. Fungal infections thrive in warm, moist areas of the body, such as between the fingers, under the breasts, and in or around the genitals.
– Slow wound healing: After prolonged high blood sugar levels, blood circulation becomes affected and slows down, causing nerve damage, which makes it difficult for wounds to heal.
– Numbness in the hands and feet: Numbness is caused by nerve damage called diabetic neuropathy, which results from high blood sugar levels over a long period of time.

Symptoms of gestational diabetes

Pregnant women with gestational diabetes typically show no symptoms. The condition is usually detected during a routine checkup or during a gestational diabetes screening test between the 24th and 28th week of pregnancy. In rare cases, pregnant women may experience increased thirst and a frequent need to urinate.

Diabetes and sexual intercourse

Diabetes negatively impacts sexual intercourse and the sex life of both men and women. The most significant effect is sexual impotence, which leads to nerve weakness and a decrease in blood flow throughout the body, making it difficult to achieve an erection. These sexual problems are most severe if the diabetes is uncontrolled. Treating diabetes-related sexual problems is similar to treating erectile dysfunction in general. Maintaining normal blood sugar levels is essential, as it is possible to avoid erectile dysfunction by doing so. It is also recommended to maintain normal blood pressure and cholesterol levels. Daily exercise is recommended to reduce blood sugar and stimulate blood circulation.

How is diabetes diagnosed?

Anyone at risk for diabetes should have regular checkups to detect the disease early. Pregnant women should also monitor their blood sugar levels during the second and third trimesters of pregnancy. Diabetes is diagnosed based on the following blood tests:
– Fasting blood sugar test: Blood sugar levels are tested after fasting for 8 hours.
– A1C test: This test reveals your blood sugar level over the three months prior to the test.
– Random blood sugar test: Blood sugar levels are measured at any time of day and do not require fasting. Random blood sugar testing is not used alone to diagnose diabetes, as other tests are required. However, it may be used for rapid diagnosis, such as in the case of a type 1 diabetic who requires emergency insulin treatment.

Diagnosis of gestational diabetes

To diagnose gestational diabetes, the doctor performs the following tests on the patient between the 24th and 28th week of pregnancy:
– Glucose challenge test: Blood sugar level is measured one hour after drinking a solution containing sugar.
– Glucose tolerance test: The pregnant woman must fast overnight, then drink a solution containing sugar. Her blood sugar level is measured over a period of 3 hours.

Diabetes treatment

The goal of diabetes treatment is to restore blood sugar levels to normal and prevent complications caused by the disease. Patients must also monitor their cholesterol levels to prevent heart attacks and strokes. To optimally control diabetes, patients should maintain a glycated hemoglobin level below 7% and a blood pressure level below 140/90. Diabetes treatment methods vary, including oral medications and injections.

Type 1 diabetes treatment

Treatment for type 1 diabetes involves replacing insulin deficiency. Patients require insulin therapy several times a day. Some types are given before or after meals.

Type 2 diabetes treatment

Some patients may benefit from diet and exercise to regulate their blood sugar levels, but if these methods don’t work, they may need medication. There are different types of medications for type 2 diabetes, and they differ in their mode of action and dosage. A doctor may prescribe one or more medications depending on the progression of the disease. A type 2 diabetic may also require insulin therapy in certain situations, such as pregnancy or a prolonged hospital stay.

Medications used to treat type 2 diabetes

• Metformin: Helps lower blood sugar levels, increases cell sensitivity to insulin, and aids weight loss.
• Glucagon-like peptide receptor agonists: Prescribed for patients with atherosclerosis and heart disease at risk of heart failure. They increase insulin secretion and reduce sugar entry into the bloodstream. Examples: exenatide, liraglutide.
• Sodium-glucose cotransporter inhibitors (SGLT2): Lower blood sugar independently of insulin, taken orally. Side effects: increased risk of genital and urinary tract infections, increased risk of ketoacidosis. Examples: dapagliflozin, canagliflozin.
• Dipeptidyl peptidase inhibitors (DPP-4): Help lower blood sugar without severe hypoglycemia. Examples: saxagliptin, sitagliptin.
• Sulfonylurea group: Stimulate insulin secretion. Examples: glyburide, glipizide, glimepiride.

Gestational diabetes treatment

Pregnant women should monitor blood sugar levels during the last two trimesters. If high, they should follow a diet and exercise plan. 10–20% may require insulin therapy, which is safe for the fetus.

Tips for living with diabetes

Having a chronic condition like diabetes can be stressful, and it can lead to anxiety. Patients should learn how to manage their condition to improve their quality of life.

Learn more about the disease

Patients should know everything about diabetes and their type. They can talk to their doctor to get the information they need.

Self-monitoring of blood sugar levels

Self-monitoring is very important as it helps regulate meals, physical activity, and monitor medications’ effect on glucose. Devices vary, but all operate on the same principle: a small blood sample from the finger is placed on a test strip.

Patients should ensure hands are clean and test strips valid. Tips:
– Clean hands with soap and water.
– Control needle diameter and depth for comfort.
– Only one drop of blood is required.
– Draw blood from fingertip for accuracy.
– Close needle cap after use.

Maintaining a healthy lifestyle

Diabetics should follow a balanced diet, exercise daily, and take medications on time. Tips:
– Exercise at least 150 minutes per week.
– Avoid saturated fats, trans fats, and refined carbs.
– Eat fruits, vegetables, and whole grains.
– Eat smaller portions.
– Aim to lose 7% of body weight if obese.

Conducting periodic examinations

Diabetics should undergo regular checkups:
– Each visit: measure blood pressure, weight, check feet.
– Twice a year: Measure cumulative sugar.
– Once a year: Cholesterol, foot, dental, eye, urine, and blood tests.

Avoid stress

Stress can raise blood sugar. Learn to control stress and practice relaxation exercises.

Daily care

Check daily for wounds or infections on hands and feet, monitor blood sugar, quit smoking, maintain oral hygiene, and avoid alcohol.

Attention to diet

A proper diet maintains normal blood sugar, prevents complications, and reduces stroke risk.

How can diabetes be prevented?

Prevention focuses on type 2 diabetes:
– Eat a healthy diet rich in vegetables and fruits, low in calories.
– Exercise regularly.
– Maintain or reach ideal weight.

Diabetes complications

Diabetes can lead to:
– Gum and teeth diseases.
– Vision problems.
– Foot problems (numbness, ulcers).
– Heart disease.
– Nerve damage (neuropathy).
– Strokes.
– Kidney disease.
– Hearing loss.
– Skin problems (fungal/bacterial infections).
– Depression.
– Dementia.

Controlling blood sugar and reducing sugar intake helps prevent complications.

What is the course of diabetes?

Course depends on blood sugar control and complications. Complications depend on disease duration. Insulin resistance increases with age, and pancreatic cells weaken, requiring multiple medications over time.

Diabetes-related medications

• Insulin aspart
• Insulin detemir
• Insulin glargine
• Insulin glucilin
• Regular insulin
• Insulin lispro
• Homogeneous insulin
• Tolbutamide
• Acetohexamide
• Tolazamide
• Glyburide (glibenclamide)
• Glipizide
• Glymprid
• Metformin
• Pioglitazone
• Rosiglitazone
• Sitagliptin
• Fenugreek seeds
• Aspartame
• Maltodextrin
• Insulin aspart protamine
• Insulin degludec
• Insulin HM
• Isophane
• Human insulin (Regular)
• Insulin isophane
• Insulin protamine
• Neutral insulin (Regular)
• Insulin R
• Psyllium husk
• Psyllium seeds
• Insulin isophane with human insulin
• Recombinant insulin hormone
• Rapid-acting recombinant human insulin
• Indonesian cinnamon extract
• Amino acids
• Bioflavonoids
• Biotin
• Chromium
• Cysteine
• Glycine
• L-Glutamic acid
• Vitamin B3
• Nicotinic acid
• Retinol
• Vitamin E
• Vitamin C
• Vitamin B12
• Vitamin B9
• Vitamin B6
• Vitamin B2
• Selenium
• Vitamin B1
• Zinc
• Vitamin D
• Rutin (Citrus Flavonoid)
• Beta-sitosterol
• Linoleic acid
• Benfotiamine
• Bran
• Camellia plant
• Hydroxycitric acid
• Ginger
• Grapefruit
• Caffeine
• Polyphenols
• Dandelion
• Cinnamon
• Marjoram
• Senna
• Parsley
• Lemon
• Fennel
• Thyme
• Black seed
• Sage
• Chlorogenic acid
• Coffee
• Garcinia Cambogia Extract
• Gymnema Sylvestrin Extract
• Chromium and Calendula Extract
• Chrome
• Starch
• Bitter Orange
• Honey
• Barley
• Yeast
• Nateglinide
• Repaglinide
• Anagliptin
• Proteinase alpha 1 inhibitor
• Lixisenatide
• Empagliflozin
• Semaglutide
• Dapagliflozin
• Liraglutide
• Bitter gourd
• Corn extract
• Neem tree
• Naked
• Bitter melon
• Salasia
• Black plum
• Ertugliflozin
• Metformin Hydrochloride
• Astercantha longifolia
• Utangan
• Saffron
• Almond
• Tribulus terrestris
• Linagliptin
• Papaya
• Pramelintide
• Glimepiride
• Inulin
• Sitagliptin hydrochloride
• Dapa Max XP
• Itaglip Plus