There are 4 types of Diabetes

  • Type 1 Diabetes Mellitus(T1DM) – It is also known as Insulin-dependent Diabetes Mellitus or Juvenile diabetes, It’s due to the destruction of Beta Cells(Insulin Producing cells in the pancreas) in Pancreas. It mostly seen in children.
  • Gestational Diabetes – Symptoms of diabetes and high blood sugar during pregnancy.
  • Diabetes Insipidus – It is due to deficiency of Vasopressin which is also known as Antidiuretic Hormone (An endocrine hormone who regulates our body fluid & urine production), The symptoms of Diabetes Insipidus are the same as Diabetes Mellitus but there is nothing to do with blood glucose in Diabetes Insipidus.
  • Type 2 Diabetes Mellitus(T2DM) – It is also known as Non-Insulin dependent diabetes Mellitus, it’s due to decreasing production of insulin or insulin resistance in the body. It mostly seen in the adult.

Type 2 Diabetes Mellitus is the most common diabetes which comprises 85% to 90% of diabetes in adulthood. So, we will discuss Type 2 Diabetes Mellitus below. If you want to know more, please visit my blog page or my youtube channel(link is provided at the end of this blog)

Know Type 2 Diabetes Mellitus

Type 2 Diabetes Mellitus (T2DM) is a metabolic disorder mostly seen in the adult. It is defined as Increase glucose level in the blood due to resistance of insulin or inadequate production of insulin in the body. T2DM is known as the silent killer and is the greatest risk factor for cardiovascular diseases, stroke, and kidney diseases. There are approximately 28 million people in the US affected by diabetes and 80 million people having pre-diabetes.

Cause/Risk factor/ Etiology of Type 2 Diabetes Mellitus

Type 2 Diabetes Mellitus is mostly associated below factors these are also the main cause of Diabetes.

  • Obesity (80% of people with diabetes is obese)
  •  High sugar consumption
  •  Sedentary lifestyle
  • Age (older adult)
  • Infection of the pancreas or any disorder of the pancreas
  • Autoimmune disease
  • Hypertension
  • Family history (genetic factor)
  • Polycystic ovarian syndrome

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Pathophysiology of Type 2 Diabetes Mellitus

Type 2 Diabetes Mellitus is a combination of Insulin resistance and inadequate insulin production. Insulin resistance is mainly for excess fatty acid in the blood and inadequate insulin production is for Destruction or dysfunction of Beta cells.

Genetic factors or environmental factors (Diseases, microbes, Sedentary lifestyle, dietary factors, obesity) can cause damage or destruction of beta-cells in the pancreas. This leads to decreased insulin secretion and excess fatty acids in the blood (mainly due to obesity) cause insulin resistance.

We all know that glucose is the ultimate source of energy for body cell but, insulin helps glucose to enter into the body cell, it acts as a pathway for glucose. In Type 2 Diabetes Mellitus body develops resistance to insulin or beta cells of the pancreas does not produce enough insulin to help glucose to get into cells so, blood glucose level continuously rises and cells starved for glucose.

Body systems required energy to run so, in the absence of glucose fat is broken down by the body for the source of energy. During catabolism of fat, ketone bodies release to blood, which causes diabetic ketoacidosis (It is a life-threatening condition need immediate treatment). It is mostly associated with people who stop or discontinue the treatment of diabetes.

Insulin act like a key to Glucose while entering into the cell

Signs and Symptoms of Type 2 Diabetes Mellitus

Most people with Type 2 Diabetes Mellitus do not notice that they have the disease because diabetes is normally asymptomatic in the early stage. the common signs and symptoms include in early-stage are

  • Excessive thirst
  • Excessive urination
  • Weakness
  • Numbness and tingling of the hand
  • yeast infection on skin
  • Late healing of wounds

These are the early warning signs of diabetes, as the disease progressed diabetes can cause neuropathy, nephropathy, retinopathy, and peripheral gangrene.

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Laboratory Investigations for Diabetes

To confirm you Diabetes doctor initially advised 2 blood test known as FBS(Fasting Blood Sugar Test) and PPBS(Post Prandial Blood Sugar Test). FBS is done in an empty stomach and PPBS done 2 hours after eating.

The reason behind these tests is to know the blood sugar value before eating and after eating food. FBS range from 60mg/dl to 110mg/dl, any value above 110mg/dl indicates high blood sugar. PPBS range from 90mg/dl to 140mg/dl, any value between 140 mg/dl to 200mg/dl is considered as pre-diabetes and any value above 200mg/dl considered as Diabetes.

The doctor also does a HbA1c test for the confirmation of high blood sugar. HbA1c means Glycated hemoglobin is a form of hemoglobin that is chemically linked to sugar, it gives an average value of your blood sugar of the past 3 months. HbA1c value should be below 6.5 if its value is above 6.5 then you may have diabetes.

Complications of Type 2 Diabetes Mellitus

Acute Complications of Diabetes

Sudden onset complications of diabetes which need immediate treatment.

  • Hypoglycemia – It is defined as Abnormally lower glucose level, It is common in diabetic people but need urgent treatment. Signs and symptoms are Sweeting, feeling agitated. In extreme hypoglycemia, it leads to unconsciousness, coma, seizure, and brain damage.
  • Diabetic ketoacidosis(DKA) – When fatty acids are used as fuel by the body in the absence of insulin it releases ketones into blood, which drops blood PH (Acidosis). Kidney tries to excrete ketones by urine and produce excessive urine, it causes severe dehydration. DKA is a medical emergency which required immediate treatment otherwise, it leads to unconsciousness, hypotensive shock, and death.
  • Hyperglycemic hyperosmolar state – When there is poor glucose control, the blood glucose level continuously increases. The kidney increases the production of urine to excrete extra amount of glucose through urine. It causes dehydration and increases blood osmolarity which needs immediate fluid replacement.

Chronic Complications of Diabetes

The slow progressive complications of diabetes

Micro Vascular Disease (Microangiopathy) – It is defined as damage to small blood vessels in the body, which leads to

  1. Diabetic neuropathy – A decrease sensation to lower-limb and upper-limb especially in finger and toes, it can make prone to injury. It’s caused by peripheral nerve damage, which progressively affects other nerves.
  2. Diabetic nephropathy – Damage to the kidney by damaging nephrons of the kidney, which requires life long dialysis.
  3. Diabetic retinopathy – Damage to retina of the eye, which can cause poor vision and blindness.
  4. Diabetic encephalopathy – Destruction of tiny blood vessels in the brain can cause damage to the brain. Which leads to dementia and other cognitive dysfunction.
  5. Diabetic cardiomyopathy – Continuous poor sugar control damage tiny coronary arteries of heart, which eventually leads to heart failure.
  6. Erectile dysfunction – Men with diabetes have a problem in erection 10 to 15 years before than non-diabetic peoples.
  7. Gum diseases

Macro Vascular Disease (Macroangiopathy) – It is defined as damage to larger blood vessels in the body, which leads to

  1. Ischemic stroke – Due to the damage of the carotid artery.
  2. Coronary artery disease – It leads to myocardial infarction (Heart attack).
  3. Peripheral vascular disease – Affect blood supply to the periphery.
  4. Atherosclerosis – Hardening of blood vessels.
  5. Diabetic foot – In a combination of neuropathy and peripheral vascular disease there is damage to tissue, which leads to infection, necrosis, and gangrene.
  6. Female infertility

T2DM can be preventable by lifestyle modification like a healthy diet, less sugar consumption, quit smoking, reduce alcohol intake and physical exercise.

People with diabetes also can reduce complications through lifestyle modification. The above-listed complications are not due to pathophysiology of diabetes these complications are only due to high blood sugar. So, you can easily avoid complications of diabetes and can live a healthy life with diabetes by regular medication, prescribed diet, and an active lifestyle.

How to prevent Diabetes

There is no specific cure for diabetes. So, it’s better to prevent diabetes from occurring. Before you start reading this paragraph, let me clear your thinking that “sugar not only the cause of Diabetes”. It’s now a myth that only extra sugar in diet causes diabetes.

I am not saying that you can eat as much sugar you want, I am saying there is a lot of factors causing diabetes as I mentioned before. The most effective way to prevent diabetes is by modifying your lifestyle as well as diet.

Lifestyle modification for diabetes in the sense, always be active and stay away from a sedentary lifestyle. At least 2 hours of active exercise per day can make a great difference. Active exercise in the sense you can try morning walk, cycling, swimming, etc.

Stay away from bad habits like smoking, drug abuse, excess alcohol intake, etc. These thinks are not only causing diabetes but they can disturb all of our body systems and can cause serious health effects. For motivation to read one of my articles on Heath effects of smoking, you can actually realize what you are doing. Click here to read.

Always search for organic foods and stay away from processed foods. Eat more fruits and vegetables(Try to eat at least 60% of your whole diet). Consume less carbohydrate and fat, you can replace them with organic proteins.

Maintain your weight. As I mentioned before obesity is the greatest risk factor for diabetes, not only diabetes obesity is the ultimate reason for all most all non-communicable diseases. That’s why it’s very important to get in shape.

Diabetic Diet/ Diet in Diabetes

What type of food should I eat when I have diabetes?

Fruits – apple, bananas, melon, berries grapes, and oranges. (Note – Strictly avoid drinking fruit juice in diabetes, its good to eat whole fruit)

Vegetables – Eat nonstarchy vegetables like Carrots, broccoli, tomato, etc. avoid starchy vegetables like white potato, corn, and green peas.

Eat whole grains

Protein – Egg white, meat and fish without skin(avoid red meat), Nuts, and beans.

Limit dairy products like milk, butter, cheese.

Eat HDL(High-density lipoprotein) limit LDL( Low-density lipoprotein ), Stop eating trans fat(Fried food) and limit Saturated fat(Usually remain solid in the room temperature examples are vegetable oil, butter, cheese, etc). Eat unsaturated fat (Remain liquid in the room temperature examples are sunflower oil, olive oil, mustard oil, etc).

You can still enjoy Your Meal by replacing your regular foods with low sugar foods. Some examples are listed below.

  • Eat brown rice instead of White rice
  • Sweet potatoes instead of White potato
  • Low sugar bran flakes instead of corn flakes
  • Pears instead of corn
  • Whole wheat pasta instead of regular pasta
  • Whole grain bread instead of white bread

A must-read article Top 24 Health effects of Smoking | you will even afraid to touch cigarettes

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