What is diabetes
- Diabetes mellitus (or diabetes) refers to a collection of metabolic illnesses in which your body is not able to manage the quantity of glucose (sugar) in the blood. In diabetes a chronic elevation of the level of blood sugar (hyperglycemia) occurs, since the hormone Insulin is not secreted in sufficient amounts, or the body cannot utilize the insulin effectively, or both.
- This level of high blood sugar may eventually lead to harm of vital body organs (eyes, kidneys, nerves, heart, blood vessels), therefore, diagnosis and treatment is essential.
Type 1 Diabetes vs. Type 2 Diabetes
Difference between Type 1 and Type 2 Diabetes
Type 1 Diabetes (T1DM)
What happens inside body: The immune system mistakenly destroys insulin-producing β-cells in the pancreas → almost no or very little insulin → absolute insulin deficiency.
Usual age of onset: Often in children/young adults — though can occur at any age.
Treatment typically needed: Lifelong insulin therapy (injections or pump), because body cannot make enough insulin.
Can it be prevented? Usually no — since it’s autoimmune, you can’t reliably prevent it yet.
Type 2 Diabetes (T2DM)
What happens inside body: Body still produces insulin initially — but cells become resistant to insulin, or pancreas fails over time to keep up → relative insulin deficiency + insulin resistance.
Usual age of onset: More common in adults, but increasingly seen in younger people today (due to lifestyle, obesity).
Treatment typically needed: Lifestyle changes (diet, exercise), oral or injectable medicines; some may need insulin if disease progresses.
Can it be prevented? Often yes or risk can be reduced — by healthy diet, maintaining normal weight, physical activity, avoiding tobacco.
Significant detail: In real life, there is no always the black and the white. Others can portray the nature of both - e.g. insulin resistance and decreased secretion of insulin. This is also referred to as hybrid forms or sometimes as the so-called double diabetes.
Why is it that you have diabetes (how do you get it)
Under Type 1: primarily an autoimmune response - your immune system runs an attack and destroys insulin-producing cells in the pancreas. In some cases, it is genetics (some individuals are more prone to it), but it can also be created by environmental factors (infection, and so on).
In Type 2: an interplay between factors - genetics + lifestyle. Risk factors include being overweight/obese, being sedentary, having a poor diet, and also lack of exercise and old age.
Since there is overlap and variability (e.g. body-weight, insulin resistance, pancreas function), except in the case of body-weight, precise cause can be different in individuals.
The way you become diabetic, therefore, depends on the type you have.
Is diabetes permanent curable?
Currently, most cases of diabetes do not have a full-fledged remedy in the usual practice.
In Type 1: the body β-cells are destroyed, so you can be expected to take insulin forever.
In Type 2: lifestyle changes (diet, exercise, weight), medicines may sometimes be able to ensure good control, sometimes needing less medication, but it is more of a management than a cure.
Studies are underway (new drugs, regenerative therapies, gene therapy) - but none of these has so far been agreed to be a universal cure.
How is diabetes diagnosed?
Standard tests/criteria:
- Fasting plasma glucose (blood sugar after 8 hours without eating) 126mg/dL (7.0 mmol/L) and above.
- Or 2-hour post-oral glucose tolerance test 200 mg/dL (11.1 mmol/L) plasma glucose.
- Or random blood sugar ≥ 200mg/dl (11.1 mmol/L) and typical symptoms.
- Or testing HbA1c (glycated hemoglobin) - a level of 6.5% and above is commonly regarded as a diagnostic level of diabetes.
- To separate Type 1 and Type 2 (or hybrids): in addition to clinical presentation, physicians sometimes rely on autoantibody tests (Type 1), and may investigate insulin secretion ability (C-peptide), however, classification can be challenging and false identifications are not insignificant.
Early Symptoms — Warning Signs
The typical symptoms can be:
- Dry mouth and excessive thirst.
- Passive urination (especially at night)
- Unusual hunger
- Experiencing great fatigue/ tiredness despite taking a break.
- Weight loss (particularly in Type 1)
- Blurred vision Delay in healing wounds, skin infections.
- Frequent hunger or cravings
Due to the fact that symptoms are often faint and insidious (particularly Type 2), most individuals are not aware they have diabetes until they are identified during screening or they develop complications.
What will happen when blood sugar is either too high or too low?
High blood sugar (hyperglycemia) - could result in frequent urination, thirst, fatigue, blurred vision. Nerves, eyes, kidneys, blood vessels, increase risk of heart disease, are damaged by chronic hyperglycemia with time.
Low blood sugar (hypoglycemia) - when it is accompanied by insulin or certain medications: may lead to dizziness, sweating, shaking, hunger, confusion - should be treated immediately (fast-acting glucose / meal). (Note: hypoglycemia is a more of a concern in close glucose regulation or insulin treatment - you should be advised in detail by your doctor).
Therapies: Insulin, Lifestyle, and Medicaments.
In the case of Type 1: Insulin is vital- because the body cannot produce an adequate amount. In the absence of insulin, one is likely to experience some severe complications.
In case of Type 2: life style changes (diet, exercise, weight reduction) followed by oral medication or injectable medications; some individuals may end up using insulin.
Nevertheless, not only medicines are required. The management of lifestyle (healthy diet, physical activity, weight control, absence of smoking, etc.) is treated as the key to diabetes management.
The importance of self-care and education.
It has been shown that good practices of self-care such as healthy diet, exercise, regular check-ups, foot/eye care have a great impact on outcomes in diabetic individuals.
Education (disease education, learning how to monitor sugar, diet, lifestyle) are beneficial to reduce complications and enhance the quality of life.
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