By Dr. Cristhian Vallejo Zambrano.
Mr. Ney Moreira Briones. Medical Student
The World Health Organization (WHO) is on alert, as diabetes is one of the most prevalent diseases worldwide. It is one of the main causes of dialysis, heart attacks, strokes, sexual dysfunction, blindness and other complications.
As physicians think about the best way to combat this disease, we have agreed that the first step is explaining the risks, complications, and causes to the public. In this article we will explore what diabetes is, prediabetes, the most common types of diabetes, how to diagnose it, and its complications.
What is Diabetes?
Diabetes is a clinical disease where there is a deficiency of a hormone called insulin, or a resistance to it. When someone has an absolute deficiency of insulin it means that they have low levels, whereas if one has a relative deficiency it means that even though they have enough insulin, the hormone cannot act correctly due to a resistance which does not allow it to function properly in our bodies.
Insulin allows sugar to enter our cells. Sugar or glucose is responsible for giving us energy, but it is not the only nutrient that does so. Lipids, ketone bodies, and other essentials in our body give us energy as well. However, when we have a low amount of insulin or it is not working properly, one will have high blood sugar levels and will also be persistently inflamed.
Most Frequent Types of Diabetes
Type I: This type is the one in which there is a deficiency of insulin in the body. It’s generally autoimmune, which means that there are autoantibodies that attack the organ that produces insulin, the pancreas. In the pancreas there are cells called beta cells, these beta cells are the ones that have the capacity to produce insulin, and when these cells are attacked by antibodies (which means that our body recognizes these cells as foreign and destroys them), it causes an insulin deficiency. It is most commonly diagnosed in children, adolescents, or young adults.
Type II: In the case of type two, insulin resistance is the main cause, at first. Why? Mainly because of obesity, since when we are overweight there is a series of counterregulatory hormones which decrease the function of insulin. At first, our pancreas reacts by releasing more insulin, but we become more and more resistant and eventually the amount of insulin decreases. Over time, in addition to resistance, insulin deficiency usually occurs. The probability of developing type two diabetes is higher if you are 45 years of age or older, have a family history of diabetes or are overweight or obese.
Signs and Symptoms
Diabetes is generally a silent disease. This is why we recommend our readers get regular medical check-ups and always ask for testing of blood sugar levels. This is especially important for patients with metabolic diseases (obese, hypertensive, sedentary, etc). However, there are certain symptoms that are typical in diabetes, for instance:
Polyuria - Excessive urination - When sugar levels exceed 180 mg/dl in our body, the kidney filters it and gets rid of it. Glucose takes water with it, so as we are filtering a lot of sugar, this sugar is accompanied by water, causing the patient to urinate a lot.
Polydipsia - Excessive thirst - Many patients with excessive thirst drink soda, which increases the sugar intake again and causes a vicious circle.
Polyphagia - Increased appetite - Due to the expulsion of sugar in the urine, the caloric uptake of sugar is lost and we quickly become hungry again.
Diagnosis: Do I Have Diabetes or Prediabetes?
Prediabetes: This condition means we have a higher risk of having diabetes in the next 3 to 5 years. How do you know if you’re prediabetic? Through the following laboratory studies:
Fasting glucose: (100-125 mg/dl) – Some guidelines take values from 110 to 125; however, the closer to 125 you are, the more likely you are to develop diabetes later.
Glycosylated hemoglobin (HbA1C): (6-6.5) - This is a special type of hemoglobin that measures your blood glucose in the last three months. Some guidelines include values as low as 5.7.
Oral glucose tolerance test (OGTT): (140-199) - This test allows us to get a head start, why? Because many times when fasting, your glucose is fine or at the limit, but when we eat something with sugar it’s altered. So for this test they make you eat something sugary and then take your blood sugar after 2 hours to see how your sugar levels have changed.
Diabetic retinopathy: Damage to the retina that eventually leads to blindness or decreased visual acuity.
Diabetic neuropathy: Very sharp pains in the lower limbs; in addition to vasculopathy (damage to blood vessels) - There are ulcers that become infected, don’t heal, and these patients can end up as amputees.
Atherosclerosis: Atheroma plaques form because the cells in the blood vessels (called endothelial cells) are usually inflamed. These plaques eventually begin to grow, obstructing the vessel, or rupture, causing heart attacks, strokes or vascular disease.
How do we avoid complications? The best treatment to avoid complications is to change lifestyle habits and correctly follow pharmacological treatment. Exercise at least 3 to 5 times a week for at least 30 to 40 minutes a day. Any exercise is better than no exercise.
Get an appointment with your primary care physician as soon as possible. Remember that it is better to be safe than sorry!