Diabetes mellitus What we need to know

What is diabetes?

Diabetes mellitus Is a chronic, metabolic disease that causes an increase in blood sugar (glucose) levels.

Most of the food you eat is broken down into glucose and excreted in the blood. Glucose is vital to your health because it is an important source of energy for the cells that make up your muscles and other tissues and is a major source of energy for your brain.

Normally, when your blood sugar level rises, the pancreas responds Insulin. Insulin is a hormone produced by the beta cells of the pancreatic islets; It is considered to be the main anabolic hormone in the body and regulates the absorption of glucose from the blood into the liver, adipose and skeletal muscle cells. Beta cells are sensitive to blood sugar levels - they secrete insulin in response to high glucose levels and inhibit insulin secretion when blood glucose levels are low. Insulin enhances glucose uptake and metabolism, thereby lowering blood sugar levels.

If you have diabetes, your body either does not make enough insulin or cannot use the insulin it produces effectively. When there is not enough insulin in the body or the cells stop responding to insulin, excess blood sugar remains, which over time can lead to serious health problems such as heart disease, vision loss and kidney disease.

There are several different types of diabetes. Are forms of chronic diabetes Type 1  და Type 2 diabetes; Belongs to potentially reversible forms of diabetes Prediabetes და Gestational diabetes:

Type 1 diabetes Is an autoimmune disease in which the immune system attacks and destroys the cells of the pancreas that are involved in the production of insulin. It is unclear what causes this process. About 10% of people with diabetes have type 1 diabetes. The symptoms of the disease often develop rapidly. It is usually found in young people (children and adults).

Type 2 diabetes It develops when your body becomes resistant to insulin and a large amount of glucose accumulates in the blood. With type 2 diabetes, your body is unable to maintain normal blood sugar levels. The disease occurs in about 90-95% of people with diabetes (mostly in adults, but more and more often in children, adolescents and young adults). Sometimes with type 2 diabetes, there are no symptoms, so if you are at risk, it is important to constantly monitor your blood sugar levels.

Being overweight or obese increases the risk of developing the disease. Type 2 diabetes can be prevented or "delayed" by a healthy lifestyle - weight loss, healthy eating and physical activity.

Prediabetes Occurs when your blood sugar level is above normal, but it is not high enough to diagnose type 2 diabetes. Prediabetes increases the risk of developing type 2 diabetes, heart disease and stroke.

Gestational diabetes Is high blood sugar levels during pregnancy. This type of diabetes is caused by placental insulin-blocking hormones. Gestational diabetes develops in pregnant women who have never had diabetes before. If you have gestational diabetes, your baby may be at high risk of developing health problems. Gestational diabetes usually disappears after the baby is born, but the risk of developing type 2 diabetes increases in the future. Your little one will have a higher risk of developing obesity in childhood or adolescence and is more likely to develop type 2 diabetes later.

Symptoms of diabetes

The symptoms of diabetes vary depending on how high the blood glucose level is. Some people, especially those with prediabetes or type 2 diabetes, may not have symptoms. In type 1 diabetes, the symptoms appear faster and more severely.

General symptoms of diabetes:

  • Feeling of strong hunger;
  • Feeling strong thirst;
  • Lose weight;
  • Frequent urination;
  • Deterioration of vision;
  • Extreme fatigue;
  • Ulcers that do not heal.

In addition to the general symptoms of diabetes, men with diabetes may have impaired libido, erectile dysfunction, and muscle weakness.

Even women with diabetes may also have frequent urinary tract infections, fungal infections, and dry, itchy skin.

Symptoms of Type 1 Diabetes:

  • Feeling of strong hunger;
  • Feeling strong thirst;
  • dry mouth;
  • Unintentional, unreasonable weight loss;
  • Frequent urination;
  • Urination at night;
  • Impaired vision;
  • Fatigue;
  • Mood swings;
  • Ketones in urine (ketones are a by-product of the breakdown of muscle and fat);
  • Fatigue.

Symptoms of Type 2 Diabetes:

  • Feeling of strong hunger;
  • Feeling strong thirst;
  • Frequent urination;
  • Impaired vision;
  • Fatigue;
  • Ulcers that heal slowly;
  • Ketones in urine (ketones are a by-product of the breakdown of muscle and fat);
  • Tingling sensation in the hearts of the hands and feet;
  • Common recurrent infections (eg skin infections)

Gestational diabetes

Most women with gestational diabetes have no symptoms. The disease is diagnosed during a routine sugar test or glucose tolerance test. In rare cases, there is a strong thirst and frequent urination.

What Causes Diabetes?

The role of insulin

Insulin is a hormone produced by the pancreas.

  • The pancreas secretes insulin into the blood.
  • Insulin circulates in the blood and promotes the uptake of glucose by cells.
  • Insulin lowers your blood sugar levels.
  • Insulin secretion from the pancreas decreases with a drop in blood sugar levels.

The role of glucose

  • Glucose is an energy source for the cells that make up muscle and other tissues.
  • Food and liver are the source of glucose.
  • Glucose is absorbed into the bloodstream and assimilated by cells with the help of insulin.
  • Your liver stores and produces glucose.
  • When your glucose levels are low (e.g. when you do not eat for a long time), the liver breaks down stored glycogen into glucose to maintain normal levels of glucose in the body.

Causes of Type 1 Diabetes

The exact cause of type 1 diabetes is unknown. It is known that your immune system - which normally fights harmful bacteria or viruses - attacks and destroys insulin-producing cells in your pancreas, resulting in either little or no insulin being produced in the body and instead of being transported to the cells, glucose accumulates in the blood.

Type 1 diabetes is believed to be caused by a combination of genetic predisposition and environmental factors, although exactly what factors are being discussed is still unclear.

Causes of prediabetes and type 2 diabetes

In prediabetes (can cause type 2 diabetes) and type 2 diabetes, your cells become insulin resistant and the pancreas fails to produce enough insulin to overcome this resistance. Instead of being transferred to the cells, glucose accumulates in the blood.

The exact cause is still unknown, although it is believed that genetic and environmental factors play an important role in the development of type 2 diabetes. Being overweight is closely linked to the development of the disease, although not all people with type 2 diabetes are overweight.

Causes of gestational diabetes

During pregnancy, the placenta produces hormones to maintain pregnancy. These hormones make cells more resistant to insulin. Normally, the pancreas produces extra insulin to overcome this resistance. But sometimes it fails to produce enough insulin. In this case, a very small amount of glucose is absorbed by the cells and a very large amount of glucose remains in the blood, leading to gestational diabetes.

Risk factors

Risk factors for developing diabetes depend on the type of diabetes.

Type 1 diabetes

Although the exact cause of type 1 diabetes is unknown, factors that may indicate an increased risk of developing the disease include:

  • Family history. The risk of developing the disease increases if a family member has type 1 diabetes.
  • Environmental factors. Viral disease is likely to play a role in the development of type 1 diabetes.
  • Autoantibodies. Sometimes family members of people with type 1 diabetes are tested for autoantibodies to diabetes. If you have these autoantibodies, it means you have a risk of developing type 1 diabetes. But not everyone who has these autoantibodies develops diabetes.
  • Geography. Some countries, such as Finland and Sweden, have a high prevalence of type 1 diabetes.

Prediabetes and type 2 diabetes

Researchers do not fully understand why some people develop prediabetes and type 2 diabetes, while others do not. It is clear that certain factors increase the risk of developing the disease, including:

  • Weight. The more adipose tissue you have, the more resistant your cells become to insulin.
  • Passive lifestyle. The less active you are, the greater your risk. Physical activity helps you control your weight, consume glucose for energy, and make your cells more sensitive to insulin.
  • Family history. Your risk increases if a family member has type 2 diabetes.
  • Age. Your risk increases with age. This can be caused by the fact that with age you exercise less, your muscle mass decreases and you gain weight.
  • Gestational diabetes. If you develop gestational diabetes during pregnancy, your risk of developing prediabetes and type 2 diabetes increases. If you give birth to a baby who weighs more than 4 pounds, you are also at risk for developing type 2 diabetes.
  • Polycystic ovary syndrome, Characterized by irregular menstrual periods, menopause and obesity - increases the risk of developing diabetes in women.
  • High blood pressure.
  • Abnormal levels of cholesterol and triglycerides. If you have low levels of high-density lipoprotein (HDL), or high levels of cholesterol and triglycerides, your risk of developing type 2 diabetes is higher.

Gestational diabetes

Some pregnant women are at greater risk of developing the disease than others. Risk factors for gestational diabetes include:

Age. Women over the age of 25 are at risk.

History. Your risk increases if you have prediabetes or if a close family member has type 2 diabetes. You are also at high risk if you had gestational diabetes during a previous pregnancy, if you gave birth to a very overweight baby or if you had unexplained stillbirths.

Weight. Being overweight before pregnancy increases the risk of developing gestational diabetes.


High blood sugar levels damage organs and tissues throughout the body. The higher the blood sugar level and the longer it is maintained, the greater the risk of complications.

Complications associated with diabetes include:

  • Heart disease, heart attack and stroke;
  • Neuropathy;
  • Nephropathy;
  • Retinopathy and vision loss;
  • Hearing loss;
  • Foot injury - infections and ulcers that do not heal;
  • Skin diseases - bacterial and fungal infections;
  • Depression;
  • Dementia.

Uncontrolled gestational diabetes can cause problems that affect both the mother and the baby. Complications that affect a child may include:

  • Premature birth;
  • Overweight at birth;
  • Increased risk of developing type 2 diabetes in the future;
  • Low blood sugar levels;
  • Jaundice;
  • Stillbirth.

The mother may develop complications such as preeclampsia or type 2 diabetes. She may also need a caesarean section.

There is also an increased risk of maternal gestational diabetes during future pregnancies.

Diabetes can cause serious health complications, but you can manage the condition with medication and lifestyle changes.


For the prevention of diabetes:

  • Walk or bike for at least 150 minutes a week;
  • Exclude saturated and trans fats from the diet, along with refined carbohydrates;
  • Eat more fruits, vegetables and whole grains;
  • Enjoy small favors;
  • Try to lose 7% of your body weight if you are overweight or obese.

Type 1 diabetes is impossible to prevent.

Diabetes in children

Children can get both type 1 and type 2 diabetes. Blood sugar control is especially important in young people because the disease can damage important organs such as the heart and kidneys.

Type 1 diabetes

The autoimmune form of diabetes often begins in childhood. One of the main symptoms is frequent urination. Children with type 1 diabetes may begin to wet the bed despite toilet training.

Extreme thirst, fatigue and hunger are also signs of this condition. It is important that children with type 1 diabetes be treated immediately. The disease can cause high blood sugar and dehydration, which can be referred to an ambulance.

Type 2 diabetes

The first type of diabetes was called "juvenile diabetes" because type 2 was very rare in children. Now, as more children suffer from excess weight or obesity, type 2 diabetes becomes more common in this age group.

About 2% of children with type 40 diabetes have no symptoms.

Untreated type XNUMX diabetes can lead to lifelong complications including heart disease, kidney disease and blindness. Healthy eating and exercise will help your child regulate their blood sugar levels and prevent these problems.


Anyone who has symptoms of diabetes or is at risk of developing the disease should undergo diagnostic tests for diabetes.

Regular testing for gestational diabetes is necessary in the second or third trimester of pregnancy.

Diagnostic tests for type 1 diabetes include:

  • Determining blood sugar levels
  • Determining blood sugar levels on an empty stomach
  • Determination of glycated hemoglobin (HbA1C). Glycated hemoglobin determines the average blood sugar level for the last 2-3 months. The higher the blood sugar level, the more glucose is bound to hemoglobin. A glycated hemoglobin level equal to or greater than 6,5% indicates diabetes. If you have already been diagnosed with diabetes, glycated hemoglobin should be checked regularly as it is a more important marker of therapeutic adequacy than the circadian dynamics of blood sugar.
  • Autoantibodies to pancreatic insulin-producing cells: A test that distinguishes type 1 diabetes from type 2 diabetes.
  • Ketones in urine: Ketones are a product of fat metabolism. In diabetes, they accumulate in the blood because cells can not use glucose as an energy source and begin to break down more fat. Ketones in the urine are more commonly found in type 1 diabetes.

Diagnostic tests for type 2 diabetes include:

  • Determining blood sugar levels
  • Determining blood sugar levels on an empty stomach
  • Glucose Tolerance Test: This test is used less often than others. Its purpose is to determine blood sugar levels before and after carbohydrate loading.
  • Glycated Hemoglobin (HbA1C)

Diagnosis of gestational diabetes

Your doctor will likely assess your risk factors for developing gestational diabetes in early pregnancy:

If you are at high risk for gestational diabetes - For example, if you were obese in early pregnancy, had gestational diabetes during a previous pregnancy, or have a diabetic mother, father, sibling or child - your doctor may perform diagnostic tests for diabetes at your first prenatal visit.

If you are at moderate risk for gestational diabetes, A gestational diabetes screening test will likely be performed in the second trimester - typically 24 to 28 weeks of pregnancy.

Your doctor may use the following screening tests:

  • Glucose test (at 1 hour intervals): If your blood sugar level is higher than normal, it just means that you are at high risk of developing gestational diabetes. Your doctor will order the following test to determine if you have gestational diabetes:
  • Glucose tolerance test.


An important part of managing diabetes is maintaining a healthy weight through a healthy diet and physical activity.

Type 1 diabetes Treatment includes insulin injections or the use of an insulin pump, constant monitoring of blood sugar levels, and counting of carbohydrates taken. Treatment of type 2 diabetes It mainly involves lifestyle changes, constant monitoring of blood sugar levels, along with antidiabetic medications, insulin, or both.

For some patients who have type 1 diabetes, a pancreas transplant may be a treatment option. If you have a successful pancreas transplant, you will no longer need insulin therapy. However, transplantation is not always successful and the procedure involves serious risks.

Gestational diabetes Controlling blood sugar levels during pregnancy is essential to keeping your baby healthy and preventing complications during childbirth. In addition to a healthy diet and exercise, your treatment plan may include regular monitoring of your blood sugar levels and, in some cases, the use of insulin or oral medications.

Your doctor will also monitor your blood sugar levels during childbirth. Because if your blood sugar level rises, your baby may produce large amounts of insulin - which can lead to lower blood sugar levels at birth.

If you have Prediabetes, A healthy lifestyle (healthy diet and physical activity) will help you to normalize your blood sugar levels and prevent the development of type 2 diabetes.

Sometimes medications like metformin are also an option!

If you are at high risk for diabetes, including when your prediabetes gets worse or you have cardiovascular disease, fatty liver disease or polycystic ovary syndrome, sometimes medical treatment (e.g. metformin, statins, etc.) is also resorted to.

Signs of dangerous blood sugar levels

Because many factors can affect your blood sugar levels, sometimes problems that require urgent care can arise, such as:

Hyperglycemia (High blood sugar). Blood sugar levels can rise for a number of reasons, including overeating, illness, or not taking medications that lower glucose levels. Check your blood sugar level as directed by your doctor and observe the signs and symptoms of high blood sugar - frequent urination, strong thirst, dry mouth, blurred vision, fatigue and nausea. If you have hyperglycemia, you will need to change your diet plan, medications, or both.

Diabetic ketoacidosis (Increased levels of ketones in your urine) Signs include: loss of appetite, weakness, vomiting, fever, stomach pain, and a sweet odor in the mouth.

This condition is more common in type 1 diabetes.

Hyperglycemic hyperosmolar non-ketotic syndrome. Signs and symptoms of a life-threatening condition include high blood sugar above 600 mg / dL (33,3 mmol / L), dry mouth, extreme thirst, fever, drowsiness, confusion, vision loss, and hallucinations. Hyperosmolar syndrome is caused by high blood sugar levels.

It is manifested in people with type 2 diabetes and is often preceded by some disease.

Hypoglycemia (low blood sugar). If you are taking medications that lower your blood sugar, including insulin, your blood sugar can drop for a variety of reasons, including skipping meals and engaging in more than normal physical activity. Blood sugar levels drop if you take too much insulin or other medication that promotes insulin secretion by the pancreas.

Check your blood sugar regularly and watch for signs and symptoms of low blood sugar - sweating, shivering, weakness, hunger, dizziness, headache, blurred vision, heart palpitations, irritability, slurred speech, drowsiness, dizziness and drowsiness. Low blood sugar is treated with fast-absorbing carbohydrates such as fruit juice or glucose tablets.

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