What is Diabetes and its Complications?
Is anyone know the taste of Sweet Poison? Yes- every human being is knowing the taste of sweet poison and its name is Diabetes or Sugar or Diabetes Mellitus (DM). This deadly disease affected and still affects so many individuals (Male/Female) in this world. A continuous increased sugar level slowly-slowly damaged other organs as well without knowing you which is the main striking feature of it.
What is the Diabetes?
Diabetes is metabolic disorder and in this blood glucose level increased, abnormalities in carbohydrate, fat and protein metabolism. As a result, it causes defects in secretion of insulin and sensitivity with insulin or both”.
The Diabetes word originated from a Greek word, which meant a “Siphon”. Aretus the Cappadocian, who is a Greek doctor named this condition diabainein. He illustrated a patient who was passing too much urine (polyuria) — like a siphon. Thus, the term is coined as Diabetes.
In the simple term diabetes is a disease where the sugar level increases or decreases in our blood. It mainly happens due to the defects in the pancreas B-cell of Langerhans. As a result, the pancreas is unable to secrete insulin or it secretes little insulin and the body is unable to pick up it.
Diabetes has several names like Diabetes mellitus (DM), Sugar etcetera.
Types of diabetes:
Diabetes is mainly three types:
(1) Type- 1 Diabetes: It is also called insulin-dependent diabetes (IDD).
(2) Type- 2 Diabetes: It is also called non-insulin-dependent diabetes (NIDD).
(3) Gestational diabetes: It only occurs in women during the pregnancy period.
(1) What is type-1 diabetes: First of all, It is an autoimmune disease and in this human immune system of the body mistakenly destroys the insulin-making beta cells of Langerhans in the pancreas. It is usually detected in children (fatty especially) and adolescents but nowadays it is diagnosed with young folks as well. As a result, more children were diagnosed in the past and diagnosing at presently with Type-1, so extra care is needed for obese children.
For so many years plenty of papers was published on diabetic research but the pathogenesis of type-1 is still not identified. However, diabetic researchers believe that it might be due to genetics and environmental factors which leads to either lowered insulin action or dropped insulin secretion at a certain level.
(2) What is type-2 diabetes: Nowadays Type-II diabetes is the most common disease in this world. The adult’s ages fall between 28 to 35 were most affected by this lifestyle disease. It occurs when the sensitivity of target tissues to insulin is decreased.
(3) What is Gestational diabetes (GD): GD simply means diabetes during the pregnancy period. In the past several studies were conducted but still, the pathophysiology of diabetes is unknown. In many studies, it was mentioned that GD occurs during pregnancy because of insulin signalling pathway inside the body was dysregulated and affected somehow. In addition, it also happened due to the use of steroid medicines and the long-term use of psychiatric drugs.
Causes and Risk Factors of Diabetes:
(1) Family history of Diabetes: This is a very important cause of it because if any family member has diabetes, others have more chances to get this deadly disease. We need to be more cautious and keep checking time to time their blood sugar level. Besides, eating habits must be changed, and do not eat more potatoes, sweets, rice, and avoid eating junk food as well. You can drink Tea but it should be limited.
(2) Genetically: It is playing a crucial role in having this dangerous disease. Any person can get this disease if anyone has diabetes-causing genes in their family.
(3) Body Weight: Weight of the body is the biggest cause and risk factor to diagnose diabetes. Fatty people are more prone to get both types of DM. Nowadays, fatty children are more susceptible to getting type-1, and the incidence rate is high at present.
(4) Alcohol: Excessive use of alcohol is a risk factor for DM. It can damage the liver and B-cells of Langerhans present in the liver, so once liver damage more chances to get diabetes. Please try to get rid of your alcohol drinking habit. Instead of drinking alcohol, better to drink any fruit juice For instance Guava, Orange, Apple, Kiwi etc.
(5) Smoking: It is found that smoking (Cigarette and Bidi) is a possible factor to get any type of diabetes. If anyone doing it, please tell him/her to leave it and get rid of the smoking.
(6) Physical Exercise: Exercise is very necessary to combat DM. Any form of exercise of your body is very-very important to maintain the glucose level under the control. Any diabetic person can do any physical exercise for instance- Yoga, Gym, Running, Cycling, playing sports etcetera.
(7) Diet plan: To manage diabetes at a great level, every diabetic patient must make a schedule for breakfast, lunch, and dinner. They must include those eating items in their diet which does not increase the sugar level. For their diet plan they must consult a Dietician, Clinical Pharmacist (Doctor of Pharmacy), and Physician (Diabetologist) (For more detail, please visit For Diabetes Patient — Your’s Own Blogs (healthdhana.com).
Diagnosis: All types of diabetes diagnoses are made based on plasma blood level. The plasma blood level is mainly judged on fasting blood sugar level, post-prandial blood sugar level, and finally HbA1C level. In the HbA1C level, three months of blood sugar level need to check.
Signs & Symptoms:
Polyuria. Polyuria means excessive urination.
Polydipsia. It means Excessive thirst.
Polyphagia. This patient Feels too hungry.
Unexplained weight loss
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The wound heals very slowly
Numbness/tingling in the legs or hands
Feel Weakness after working
Irritability
Treatment options:
Pharmacological: There are several medications available to treat DM. Important medications are given below:
Biguanides: Metformin is the main drug of choice in this class of medication. This is a very effective medication for type-2 diabetes.
Mechanism of Action (MOA): It enhances insulin sensitivity of both hepatic and peripheral (muscle) tissues. It permits for more uptake of glucose inside these insulin-sensitive tissues.
Side Effects: Abdominal discomfort, Stomach upset, Diarrhea, Anorexia, and a metallic taste.
Sulfonylurea: It is another class of medication. Glyburide and Glipizide are the two main drugs in this class. Glyburide is the long-acting sulfonylurea and Glipizide is the short-acting sulfonylurea.
Mechanism of Action (MOA): It acts by stimulating the pancreatic secretion of Insulin.
Side Effects: Hypoglycaemia, Weight gain etcetera.
Thiazolidinediones: Pioglitazone, Rosiglitazone, etc. are the medicine of this class.
These PPAR-Y agonists, a nuclear transcription factor important in fat cell differentiation and fatty acid metabolism.
Mechanism of Action (MOA): It enhances insulin sensitivity in muscle, liver, and fat tissue indirectly.
Side effects: Weight gain, myalgia, mild anaemia, and headache.
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Alpha-Glucosidase Inhibitors: Acarbose, Miglitol, and Guar gum are the main medicine of this class.
Mechanism of Action (MOA): These agents prevent the breakdown of sucrose and complex carbohydrates in the small intestine thereby prolonging the absorption of carbohydrates.
Thus, the net effect is a reduction in the postprandial glucose concentrations while fasting glucose levels are relatively unchanged.
Side effects: Abdominal discomfort, and diarrhoea etcetera.
Insulin: Insulin is mainly recommended for Type-1 Diabetes. Insulin has so many types of variety. These are mentioned below:
Rapid Acting Insulin: The administration happens subcutaneously 15 mins before or immediately after a meal. It acts within 15–30 minutes.
Example- Insulin Aspart, Lispro
Intermediate Acting Insulin: Intermediate-acting insulin preparations are usually given once or twice a day.
– Onset: 1–3-hour, Peak: 5–8-hour, Duration: up to 18 hours.
Example: NPH (Neutral Protamine Hagedorn)
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Short-Acting Insulin: It is advised to take 30–45 mins before meals.
– It acts within 30 minutes to 1hours.
Example: Regular Insulin
Long-Acting insulin: This analogue is produced by substitution of glycine for asparagine at position B30.
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– It works when rapid-acting insulin stop working, then long-acting insulin lowers the blood glucose level.
– Injected subcutaneously once daily at bedtime. It is initiated at an average dose of 10 units once daily and is subsequently adjusted according to patient need, to a total daily dose ranging from 2–100 units.
Example: Insulin glargine, Ultra Lente insulin, and insulin detemir.
Non-Pharmacological:
– Protein diet
– Meal planning
– Eating Snacks between short intervals
– Weight reduction
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– Physical Exercise
– Yoga
– Running
– Cycling
Golden Tricks to Manage Diabetes: Sugar or Diabetes or DM disease cannot be a cure but it can be managed. There is no medicine come till now which cure it. However, there is plenty of medicine that can control diabetes. These medicines especially bring down the blood glucose level at the normal range. There are some golden tricks to manage diabetes which mentioned below:
1. Check your sugar level daily
2. Check your fasting sugar level in the morning before taking food (empty stomach).
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3. Check your Post-Prandial blood sugar level in the morning after two hours of taking the first food/meal.
4. Try to do HbA1C test every three months.
Complications:
Diabetic retinopathy
Diabetic nephropathy
Diabetic neuropathy
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Lower Limb Amputation
Heart-disease like stroke, heart attack
Blood vessels damage
Take Away:
(1) When any person on this planet diagnoses with this disease, please do not take any kind of Stress or Tension like how it happens? Why does it happen this young age or old age? How my blood glucose reading comes more than the normal range? What will happen in the future? Etcetera; Please leave all these questions because diabetes is a complex disease, and no one knows who will be next to diagnose this deadly disease. Please be calm and think diabetes is a manageable disease and I will manage it. I am enough strong to control this disease.
(2) Physical exercise is key to managing Diabetes.
(3) Do not eat sweet food, sweets, and other sweet items because sugar levels will be skyrocketed, so please avoid taking them.
(4) Sugar level monitoring is mandatory every day, every week, and every month. Please do according to your comfort and write a record, and save the lab values in a notebook, notepad, mobile phone, and laptop.
(5) If sugar level increases beyond the normal range consult your family physician and reach out to the nearby hospital.
(6) Say NO to Sugar or Abundance Sweet fruit or food.
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Conclusion: Diabetes is called a sweet poison so do not take it lightly. It is a complex disease and treatment depends upon how well you are managing it. The complication of this disease is very high so after diagnosis of the disease, the patient must be aware of it and control the blood sugar level.