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DIABETES

Diabetes is a long term disease characterized by an increased blood glucose level (aka hyperglycemia) in the body.

Diabetes is the major cause of blindness, kidney failure, heart attacks, stroke and limb amputations  in the world.

According to the International Diabetic Federation (IDF) report, 537 million are diagnosed with diabetes, where 6.7 million deaths occurred in 2021, i.e, 1 in every 5 seconds.

Despite of all these dreadful complications, the good news is that diabetes is preventable and controllable with proper & regular guidance for a healthy life ahead.

Blood glucose is the main source of energy in our body and is the primary fuel of brain. Normally our blood glucose level is controlled within a narrow range by the balanced work of certain factors that increase blood glucose level ( like intestinal absorption, gluconeogenesis, liver glycogenolysis) and factors that decrease blood glucose level (like uptake by peripheral tissues, glycolysis, glycogenesis). When the blood glucose level goes up i.e, during hyperglycemia, the gland, pancreas secretes a hormone called insulin which in turn helps in the uptake of blood glucose by liver and skeletal muscles. In short, insulin act as an entry ticket for glucose in blood to enter into the cell, to provide energy to function normally.

In diabetes, there may be deficiency or decrease in production of insulin or low sensitivity to the action of insulin due to which glucose from blood cannot enter into cells meanwhile the glucose level in blood rises up leading to hyperglycemia.

This hyperglycemia can lead to both acute problems (like diabetic ketoacidosis and hospitalization) and long term or chronic problems (affecting eyes, kidney, overall blood circulation affecting other organs).

Diabetes is a greek word meaning siphon (to pass through) and mellitus is latin word meaning sweet. According to American Diabetes Association, diabetes mellitus is defined as a group of metabolic disorders characterized by hyperglycemia due to defective insulin secretion, action or both.

  • TYPE 1 DIABETES

Occurs due to autoimmune destruction of insulin producing cells of pancreas, leading to insulin deficiency. Common in childhood and early adulthood.

  • TYPE 2 DIABETES

Most common type which is associated with insulin resistance. There is reduced insulin sensitivity and an inability to produce sufficient insulin to overcome this resistance.

  • HYBRID FORMS OF DIABETES

Like slowly evolving immune-mediated type & ketosis-prone types.

  • OTHER SPECIFIC TYPES

Like monogenic defects, endocrine and exocrine disorders, drug induced, infection related, uncommon forms of immune mediated types.

  • UNCLASSIFIED DIABETES
  • HYPERGLYCEMIA 1ST DETECTED DURING PREGNANACY

Due to the action of placental hormones, pregnancy induced insulin resistance occurs, which results in inadequate insulin secretion.

  • DIABETES MELLITUS IN PREGNANCY

Type 1 or 2 first diagnosed during pregnancy

  • GESTATIONAL DIABETES MELLITUS

Hyperglycemia below diagnostic levels for diabetes in pregnancy

  • Genetic factors
  • Environmental factors like reduced exposure to microorganisms in early childhood limiting immunity maturation, certain drugs, chemicals, virus infections like mumps, coxackie, CMV, EBV, rubella, retroviruses.
  • Age
  • Obesity
  • Pregnancy
  • Sedentary lifestyle
  • Unhealthy dietary practice – High saturated fat and reduced dietary fibre intake, early feeding of cow’s milk leading to type1 diabetes, smoked and cured meats and excess coffee intake.
  • Malnutrition
  • Smoking & excessive alcohol intake
  • Stress
  • Metabolic disturbances
  • Ethnicity