What is Diabetes?

Having a high blood sugar level in your blood is called diabetes. Normally the blood sugars are regulated by the insulin secretion from the pancreas in a healthy person.

Types of diabetes

  • Type 1 diabetes - Mainly seen in children and young adults (5-10%)
  • Type 2 diabetes - Most common diabetes seen in adults (85-90%)
  • Gestational diabetes - Usually seen after 3months of gestation and usually resolve after delivery of the baby. It is estimated to occur between 5 and 15% of pregnant woman
There are various other causes of diabetes due to pancreatic diabetes, Maturity onset diabetes of young (MODY), mitochondrial diabetes, diabetes associated with various syndromes etc. All these account for 1-2% of the total diabetes.

Symptoms of Diabetes

You may experience various symptoms in diabetes which are mainly related to the poorly controlled blood sugars. These include
  • Increased urination
  • Increased thirst
  • Increased Appetite
  • Lethargy
  • Weight loss
  • Blurred vision
  • Non healing wounds
Normal Prediabetes Diabetes
Fasting (FBS)
<100mg%
100-125mg%
≥126mg%
Post Prandial blood sugars (PPBS)
<140mg%
140-199
≥200mg%
HbA1c
≤5.6%
5.7-6.4%
≥6.5%
You may experience various symptoms in diabetes which are mainly related to the poorly controlled blood sugars. These include

Complications of diabetes

Uncontrolled blood sugars can affect any organ in your body. It usually takes a few years for complications to develop. The most common associated diseases due to diabetes include
  • Neuropathy - This consists of pain,burning, numbness, absent sensation, foot infections which begins in the foot and gradually spread upwards
  • Nephropathy - It usually presents with swelling in face and foot progressing to end stage kidney disease resulting in dialysis and renal transplant
  • Retinopathy - This is a treatable cause of reduction in vision
  • Coronary artery disease - Presents as chest pain, breathlessness on doing activities and sudden death
  • Strokes
  • Peripheral artery disease - causes pain and cramps in legs on walking
Also uncontrolled high blood sugars can cause dangerous states with diabetic ketoacidosis and hyperosmolar coma

Treatment options

  • Diet and Exercise are cornerstones to any diabetic management
  • Drug therapy depends on the type of diabetes and your current medical conditions.
  • Type 2 diabetes patients atleast in the initial period can be treated with oral drugs.
  • Insulin is absolutely necessary in Type 1 diabetes seen in children and young adults.

Foot care

Diabetes can be dangerous to your feet. Even a small cut can produce serious consequences. Diabetes may cause nerve damage that takes away the feeling in your feet. Diabetes may also reduce blood flow to the feet, making it harder to heal an injury or resist infection. Diabetic foot ulcers are the leading cause of losing a toe, foot or leg.
  • Inspect your feet daily
  • Never walk barefoot
  • Use appropriate fitting shoes/sandals with adequate cushioning over pressure points
  • Bathe feet in lukewarm, never hot, water
  • Moisturize your feet
  • Cut nails carefully
  • Never treat corns or calluses yourself
  • Wear clean, dry socks
  • Shake out your shoes and feel the inside before wearing
  • Keep your feet warm and dry
  • Do not smoke

Hypoglycemia on drugs/insulin

Any blood sugar less than 70mg% is known as hypoglycaemia. It usually occurs when patients miss/delay meals or reduce their meal content.
Any blood sugar less than 70mg% is known as hypoglycaemia. It usually occurs when patients miss/delay meals or reduce their meal content. Then giving 15grams of carbohydrate(glucose, sugars, 3-4 glucose biscuits, 3-4toffees etc) immediately to the patient and repeating the blood sugars after 10-15minutes. If still low repeat the above procedure. If patient is comatose, immediately take him/her to the nearby hospital and give injection dextrose intravenously.

Digital technology in diabetes

1. Continuous Glucose Monitors(CGM)

This is a sleek device inserted on the back of your arms or over the abdomen. This device monitors your blood glucose and has the advantage of replacing finger pricks in the flash devices like Abott libre CGM. The data generated from CGM is extremely valuable and gives a summated graph of the last 14 days. Fine tuning of medications while avoiding hypoglycemia is easier when using CGM’s. Also the new parameter “Time in range” or TIR is a better predictor of glycemic control than the currently used HbA1c.

2. Insulin Pumps
These are devices which look like the old pagers. It has insulin storage area and a tubing that delivers insulin to the body through the infusion set attached to the body. These pumps have various settings where you can adjust the basal insulin requirement and the bolus(meal time) requirements . Newer Insulin pumps like the Medtronic 780G by integrating data from CGM have a more sophistaced algorithm which automatically helps to autocorrect high sugars and at the same time avoid hypoglycemias( low sugars) . Hence these are called as artificial pancreas. These are truly a boon to children and adults with Type 1 Diabetes , Advanced Type 2 diabetes , Pancreatic diabetes etc where there is wide fluctuations in the blood sugars.

Health Tips & Info

What is the cause of diabetes?

– Reduced production of insulin
– Impaired action of insulin produced