Diabetes mellitus, commonly referred to as diabetes, is a chronic metabolic disorder characterized by high levels of glucose (sugar) in the blood. It occurs when the body does not produce enough insulin, does not respond to insulin effectively, or does both. Insulin is a hormone produced by the pancreas that helps regulate blood sugar by enabling glucose to enter cells where it is used for energy.
There are three main types of diabetes:
- Type 1 diabetes is an autoimmune condition where the immune system attacks insulin-producing beta cells in the pancreas. This leads to little or no insulin production.
- Type 2 diabetes: a metabolic disorder where the body becomes resistant to insulin or the pancreas does not produce enough insulin. This is the most common type of diabetes.
- Gestational diabetes: a form of diabetes that develops during pregnancy and usually resolves after childbirth, although it increases the risk of developing type 2 diabetes later in life.
Why Do People Develop Diabetes?
Diabetes results from a combination of genetic, environmental, and lifestyle factors. These factors vary depending on the type of diabetes.
Causes of diabetes
1. Type 1 Diabetes
The exact cause of type 1 diabetes is unknown, but it is believed to involve a combination of genetic predisposition and environmental triggers, such as:
- Genetic factors: Certain genes and family history increase the likelihood of developing type 1 diabetes.
- Autoimmune Reaction: The immune system mistakenly attacks the pancreas, destroying insulin-producing cells.
- Environmental Triggers: Viral infections or other unknown environmental factors may initiate the autoimmune process.
2. Type 2 Diabetes
Type 2 diabetes develops over time and is influenced by several factors, including:
- Genetics: A family history of diabetes increases the risk.
- Obesity and Overweight: Excess body fat, especially around the abdomen, can cause insulin resistance.
- Physical Inactivity: Lack of regular exercise contributes to insulin resistance.
- Unhealthy Diet: High intake of processed foods, sugary beverages, and low-fiber diets can lead to obesity and impaired glucose tolerance.
- Age: Risk increases with age, particularly after 45 years.
- Polycystic Ovary Syndrome (PCOS): Women with PCOS are at higher risk.
- Ethnicity: Certain ethnic groups, such as African Americans, Hispanics, Native Americans, and Asian Americans, have a higher prevalence.
3. Gestational diabetes
Gestational diabetes occurs due to hormonal changes during pregnancy, which impair the body’s ability to use insulin effectively. Factors that increase the risk include:
- Being overweight or obese before pregnancy
- A history of gestational diabetes in a previous pregnancy
- Having a family history of type 2 diabetes
- Being older than 25 during pregnancy
Symptoms of diabetes
The symptoms of diabetes vary depending on the type and severity of the condition. In some cases, especially in type 2 diabetes, symptoms may be mild or absent for years.
Common Symptoms of Diabetes:
- Frequent urination (polyuria): High blood sugar levels cause the kidneys to filter and excrete excess glucose, leading to increased urination.
- Excessive thirst (Polydipsia): Loss of fluid through urination triggers thirst.
- Unexplained weight loss: The body begins to break down fat and muscle for energy due to the lack of insulin.
- Extreme hunger (polyphagia): Despite eating more, the body’s cells are deprived of glucose.
- Fatigue: Lack of insulin or insulin resistance leads to insufficient energy for the body’s needs.
- Blurred vision: High blood sugar levels can cause swelling in the eye lenses, affecting vision.
- Slow-healing wounds and frequent infections High blood sugar impairs the immune system and blood circulation.
- Tingling or numbness in hands and feet (peripheral neuropathy): Prolonged high blood sugar can damage nerves.
Specific Symptoms by Type:
- Type 1 Diabetes: Symptoms can appear suddenly and may include nausea, vomiting, and stomach pain due to diabetic ketoacidosis (DKA), a life-threatening complication.
- Type 2 Diabetes: Symptoms develop gradually and may include dark patches of skin (acanthosis nigricans) in areas like the neck and armpits.
- Gestational Diabetes: Often asymptomatic, but high blood sugar levels may cause excessive thirst or frequent urination.
Complications of diabetes
If left untreated or poorly managed, diabetes can lead to severe complications, including:
- Cardiovascular Disease: Increased risk of heart attacks, strokes, and atherosclerosis.
- Kidney Damage (Nephropathy): Prolonged high blood sugar can damage the kidneys’ filtering units.
- Eye Damage (Retinopathy): Diabetes can cause blindness by damaging the retina.
- Nerve Damage (Neuropathy): affects sensation and can lead to ulcers and infections, especially in the feet.
- Foot Problems: Poor circulation and neuropathy can lead to ulcers and, in severe cases, amputation.
- Skin Conditions: Increased susceptibility to bacterial and fungal infections.
- Hearing Impairment: Higher risk of hearing loss.
- Alzheimer’s disease: Possible increased risk due to vascular damage and inflammation.
Prevention and management
Preventing Type 2 diabetes and gestational diabetes:
- Healthy Diet: Focus on whole foods, including fruits, vegetables, whole grains, and lean proteins.
- Regular Exercise: Aim for at least 150 minutes of moderate aerobic activity per week.
- Weight Management: Maintain a healthy weight through diet and exercise.
- Limit sugar and refined carbs: Reduce the intake of sugary drinks and processed foods.
- Regular Health Screenings: Monitor blood sugar levels, especially if you are at high risk.
Managing diabetes:
- Medication: insulin therapy for type 1 diabetes and oral medications or insulin for type 2.
- Blood Sugar Monitoring: Regularly check glucose levels to manage and adjust treatment.
- Healthy Lifestyle Choices: Maintain a balanced diet and stay physically active.
- Stress Management: Chronic stress can affect blood sugar levels.
- Education: Learn about diabetes to make informed decisions about your health.
Diabetes is a complex condition with a range of causes and symptoms. Understanding the types of diabetes and their associated risk factors can help individuals prevent or manage the disease effectively. Early diagnosis and proper management are crucial in preventing complications and maintaining a high quality of life. With advancements in medical science and lifestyle interventions, living well with diabetes is more achievable than ever.
