According to the International Diabetes Federation (IDF), about 463 million adults aged 20 to 79 years were living with diabetes in 2019. The disease caused 4.2 million deaths that same year. And as of 2014, the global prevalence of diabetes had doubled since 1980, rising from 4.7% to 8.5%.
What is Diabetes?
Diabetes mellitus or diabetes is a chronic condition that affects your body’s ability to process blood sugar (glucose). It either occurs when your pancreas does not make enough insulin or when your body cannot effectively use the insulin produced.
Insulin is a hormone that allows your cells to absorb the sugar in your blood and use it for energy or store it for future use. By doing so, it helps keep your blood sugar levels from getting too high or too low.
Types of Diabetes Mellitus
There are three main types of diabetes, namely type 1 diabetes, type 2 diabetes, and gestational diabetes.
Type 1 diabetes
Type 1 diabetes, previously known as juvenile diabetes or insulin-dependent diabetes, occurs when your body produces little or no insulin.
People with this condition, therefore, require daily administration of insulin to stay alive. Although type 1 diabetes usually appears during childhood or adolescence, it can develop at any age.
Type 2 diabetes
Formerly known as adult-onset diabetes, type 2 diabetes results from your body ineffectively using insulin.
A majority of people with diabetes have type 2. In America, for instance, more than 34 million people have diabetes, of whom 90-95% have type 2. Its signs and symptoms usually develop slowly, hence you may only be diagnosed with the disease several years after onset.
Note: Type 2 diabetes was until recently only seen in adults, but it is now increasingly occurring in children the reason is largely due to the rise in childhood obesity.
Related: An Overview of Type 2 Diabetes
As the name suggests, gestational diabetes develops in some women when they are pregnant and usually goes away once the baby is born.
It is characterized by higher than normal blood sugar levels, but not high enough to be diagnosed as diabetes.
Prediabetes is a condition where your blood glucose levels are above normal but not high enough to be considered type 2 diabetes.
Impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) are two types of prediabetes. And having either puts you at an increased risk of developing type 2 diabetes and cardiovascular disease.
Signs and Symptoms of Diabetes
As mentioned earlier, symptoms of type 2 diabetes develop slowly, usually over several years.
Therefore, people with the condition may not find out they have the disease until they develop diabetes-related health conditions such as heart disease, blurred vision, and foot problems. As for type 1, symptoms can start to show in just a matter of weeks.
Some of the signs and symptoms of diabetes in general include:
- Increased thirst
- Increased hunger
- Frequent urination
- Unexplained weight loss
- Blurry vision
- Slow-healing sores
- Mood swings
Additionally, men with diabetes can suffer from low sex drive, erectile dysfunction (ED), and muscle weakness. Whereas, women may experience urinary tract infections (UTIs), vaginal yeast infection, and dry, itchy skin.
What Causes Diabetes?
Each type of diabetes is associated with different causes.
Type 1 diabetes causes
The exact cause of type 1 diabetes is unknown. However, it’s usually thought to be caused by an autoimmune reaction where your body’s immune system destroys the insulin-producing cells by mistake. Genetics is another possible cause, as is exposure to viruses and other environmental factors.
Type 2 diabetes and prediabetes causes
In both prediabetes and type 2 diabetes, your body cells become resistant to insulin, which results in your body requiring more of it.
At first, your pancreas keeps up with the added demand of insulin but is eventually unable to make enough. Consequently, glucose builds up in your bloodstream since glucose can’t enter your cells without insulin.
The exact cause of insulin resistance is uncertain. However, genes and lifestyle factors are considered risk factors of type 2 diabetes.
Being overweight or obese, for instance, makes you more likely to develop the condition. You’re also more at risk of developing prediabetes if you have a family history of type 2 diabetes.
Gestational diabetes causes
When pregnant, the placenta produces hormones that help maintain your pregnancy. These hormones make your cells less sensitive to the effects of insulin.
Now, all women experience low insulin sensitivity (insulin resistance) during late pregnancy. However, some women can produce enough insulin to overcome it. But for those who can’t, the insulin deficiency results in gestational diabetes.
Genetics and lifestyle factors can also increase your chances of getting gestational diabetes. Women who are overweight or obese may already have insulin resistance when they get pregnant, making them more prone to the disease.
Having a family history of diabetes also puts you at a higher risk of developing gestational diabetes.
Common Risk Factors and Effects of Diabetes
As with the causes, the risk factors for diabetes depend on the type of diabetes.
Type 1 diabetes risk factors
Factors that may increase your risk of getting type I diabetes include:
- Family history. Having a parent or sibling with the condition.
- Age. You’re more likely to develop type 1 diabetes if you’re a child, teenager, or young adult.
- Environmental factors. Say, for instance, exposure to a viral illness that triggers an autoimmune reaction.
- The presence of diabetes-related autoantibodies.
Type 2 diabetes and prediabetes risk factors
You are more likely to develop type 2 diabetes and prediabetes if you:
- Are overweight or obese
- Are 45 years or older
- Have a parent or sibling with type 2 diabetes
- Developed gestational diabetes when you were pregnant or gave birth to a baby weighing more than 9 pounds (4 kilograms)
- Are not physically active
- Have high blood pressure
- Have polycystic ovary syndrome (PCOS), which is a hormonal disorder characterized by menstrual irregularity and obesity
- Have low levels of high-density lipoprotein (HDL) or “good” cholesterol or high levels of triglycerides
Gestational diabetes risk factors
Although any pregnant woman can develop gestational diabetes, you are at higher risk if you:
- Are more than 25 years old
- Have a parent, brother, or sister with type 2 diabetes
- Have prediabetes
- Gave birth to a baby weighing more than 9 pounds or had an unexplained stillbirth
- Are overweight or obese
- Are a black, Hispanic, American Indian, or Asian woman
Long-term complications of diabetes develop gradually. The higher your blood sugar is, and the longer you have diabetes, the higher your risk for complications. Possible complications include:
- Cardiovascular (heart) disease such as heart attack, stroke, and coronary artery disease
- Nerve damage
- Kidney damage (nephropathy)
- Eye damage (retinopathy) and blindness
- Hearing loss
- Foot damage such as infections that heal poorly hence possibly lead to toe, foot or leg amputation
- Skin problems such as bacterial and fungal infections
- Dementia such as Alzheimer’s disease
Gestational diabetes complications
Complications affecting the baby can include:
- Excess growth, where your baby is born weighing higher than normal
- Type 2 diabetes later in life
- Low blood sugar
- Premature birth, i.e., a birth that takes place before the 37th week of pregnancy
- Death, where the baby is stillborn
Complications in the mother can include:
- Preeclampsia, which is a pregnancy complication characterized by high blood pressure
- Increased risk for cardiovascular disease later in life.
- Subsequent gestational diabetes
- Type 2 diabetes later in life
Your doctor may use the following blood tests to diagnose type 1 and type 2 diabetes and prediabetes:
- Hemoglobin A1c test ( HbA1c): indicates your average blood sugar levels for the past 2 to 3 months. It doesn’t require fasting.
- Fasting blood sugar test: measure your blood sugar after fasting overnight (eight hours).
And to diagnose gestational diabetes, your doctor may use the following screening tests:
- Glucose challenge test:Your blood sugar is checked an hour after drinking a syrupy glucose solution.
- Glucose tolerance test:For this test, you fast overnight before your blood sugar level is measured again. You’ll then drink another sugary liquid then have your blood sugar checked every hour for three hours.
Doctors use different oral and injected medications to treat diabetes. Insulin, which you take via injection or pump, is the primary treatment for type 1 diabetes.
Some of the types of insulin used include rapid-acting insulin, short-acting insulin, intermediate-lasting insulin, and long-acting insulin. A lot of people with type 2 diabetes or gestational diabetes also use insulin.
Type 2 diabetes treatment mostly involves lifestyle changes, monitoring your blood sugar, and taking diabetes medications. These medications have different functions, such as:
- Reducing the amount of glucose your liver produces and releases
- Stimulating your pancreas to make and release more insulin
- Slowing down the breakdown process of sugars in the carbohydrates you eat
- Making your tissues more sensitive to insulin
Note: Metformin, whose brand names include Glucophage and Glumetza, is generally the first medication prescribed for type 2 diabetes.
Treatment for gestational diabetes includes dietary changes and exercising, monitoring your blood sugar level, and sometimes insulin or oral medications.
As for prediabetes, treatment primarily involves healthy lifestyle choices. However, if you’re at high risk of diabetes, your doctor can prescribe drugs like metformin. You may also need medications to control blood pressure and cholesterol.
Type 1 diabetes is not preventable. However, you can prevent or delay prediabetes, type 2 diabetes, and gestational diabetes by practicing healthy lifestyle choices, such as:
- Eating healthy and smaller portions
- Engaging in more physical activity
- Losing weight if you’re overweight or obese
- Managing stress since depression can affect diabetes management
You can prevent type 2 diabetes, the most common type of diabetes, by adopting a healthy lifestyle. If left unmanaged, diabetes can lead to severe complications, such as heart disease and kidney failure. So if you suspect you have diabetes or are at risk for the condition, you should be tested.References ⌵
- Mayo Clinic Staff, Diabetes Overview, Aug. 08, 2018
- Diabetes health information, National institute of diabetes and digestive and kidney disease.
- Watson S, Everything You Need to Know About Diabetes, Oct, 2018.
- WHO, What is diabetes?, October 2018.
- Centers for Disease Control and Prevention(CDC), About Diabetes, August 6, 2019.
- WHO, Childhood overweight and obesity, (n.d)