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What is Diabetes? - Understanding the biggest epidemic of modern times!

According to WHO (World health organisation), nearly 50 million people in India suffer from Diabetes and the number is expected to raise to more than 75 million by 2030

All of you must have heard of Diabetes or even experienced its many problems first hand in yourself or your own relatives.

But have you wondered what exactly this common yet confusing illness is? Who gets it and what are its exact symptoms? And what can you do to take care of yourself and your loved ones if you are diagnosed with it?

I have decided to upload a series of articles tackling Diabetes and its many aspects. Let us start with the first article of the series. Basic, yet important for the future articles - What is diabetes?

So, what exactly is Diabetes?

Diabetes in simple terms is a disease where the body is unable to utilise starches, carbohydrates and sugars leading to high amounts of glucose circulating in the blood.

As you all know the food we eat is made of macro nutrients like carbohydrates, fats, proteins and micronutrients like vitamins and minerals.

Carbohydrates which constitute the bulk of our food are broken down to smaller units called glucose which are absorbed by the body and utilised by all the tissues and cells as energy.

This utilisation of glucose requires a very important hormone called insulin which is produced by an organ called pancreas

Insulin is the key that allows cells to use glucose molecules to produce energy!

So every time you eat food, insulin is released into the blood to help all the cells of your body to use the digested glucose.

Whenever this system does not work properly, the glucose is not used and its levels in the blood go on increasing. This is called diabetes.

There are many reasons for this system to not work and based on these reasons we have different types of diabetes

Type 1 diabetes : This is a disease where the pancreas completely fail to produce insulin. Also called juvenile diabetes or insulin dependant diabetes. Usually starts in childhood itself and the person will require to take insulin injections for life.

Type 2 Diabetes: It happens when

  • the insulin produced by your pancreas is not enough to take care of your body’s needs or

  • your cells have become resistant to the insulin produced by your body.

It could be inherited, could be due to bad lifestyle practices or rarely no specific reason.

This is the common type which you see in a lot of people around you. Most of us Indians will have at least one relative with this type of Diabetes. This starts later on in life usually in middle age or beyond. But sometimes it can start earlier also.

Gestational Diabetes: This is the type of Diabetes that occurs in pregnancy. Most of the times it gets resolved once the baby is born. But it increases the risk of the mother to develop diabetes later on in her life and if not controlled properly could lead to complications in the baby.

There are other rarer forms of diabetes which are caused due to inflammation or surgery of the pancreas which directly affects insulin production.

Can Diabetes be cured?

Since it is a problem with the primary production of insulin in the body, Diabetes cannot be cured. But it can definitely be controlled. There are many safe medications available which help to reduce blood glucose levels. This combined with a healthy lifestyle, good diet control and certain simple precautions, can help diabetics live a fulfilling and normal life.

What are the symptoms of Diabetes?

  1. Tiredness and weakness – Since the cells and tissues are not able to utilise the glucose properly to give energy.

  2. Repeated infections of skin, urinary tract etc– Since the unused glucose is circulating in the blood, it attracts bacteria and other germs easily.

  3. Excess Urination - The excess glucose in the blood is removed by the kidneys in the urine

  4. Feeling too thirsty – Since more water is going out with the glucose in the urine, the body gets easily dehydrated.

  5. Feeling too hungry – Since the body is not getting sufficient energy, the brain keeps giving hunger signals to compensate.

  6. Tingling, burning/ numbness of feet – The circulating high glucose levels affect the nerve endings especially in the legs and feet causing these symptoms.

  7. No specific symptoms – In many cases there need not be any specific symptoms and the only indication could be high blood sugar levels seen in the lab tests

What are the long term effects of Diabetes?

If this high circulating blood glucose levels are left unchecked or untreated, it can affect the blood vessels and nerves, causing some major complications like

  1. Kidney problems – The glucose molecules cause changes in the small blood vessels inside the kidneys over a period of years, affecting the ability of the kidneys to excrete the waste products from our body. This can eventually lead to kidney failure and the need for dialysis or kidney transplant.

  2. Heart problems – similarly the small blood vessels inside the heart can also be blocked due to persistent high blood glucose levels leading to heart attack and heart failure.

  3. Stroke – Blockage of small blood vessels inside the brain can lead to stroke (sudden loss of function of specific parts of the body)

  4. Vision problems – the glucose molecules can react with the structures in the eye causing blurred vision, cataract, high pressure inside the eye (glaucoma), weakness of nerves at the back of the eye (retina)

  5. Diabetic Foot – Since diabetes weakens the blood vessels and nerves, even a small injury to the toes or feet can become infected and not heal well.

Indian diabetic risk score – Find out your risk of developing Diabetes!

This is a scoring system developed by doctors in India after examining varied populations all over the country.

You can refer to this and calculate the score for yourself and your family members. If your score is above 60, you will need to get yourself screened for diabetes by regular health checkups atleast once a year. If you are not sure about your score, do have a chat with your family doctor about your risk for diabetes today!

Hope this article clarified your basic doubts about what exactly is diabetes. We’ll be back with the next article in this series soon.

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