Diabetes: Symptoms, Diagnoses and Treatment
Diabetes is a condition of elevated glucose levels in the blood. A blood glucose level of 72-99 mg/dL after overnight fasting is considered as normal, a glucose level between 100-125 mg/dL is a sign of prediabetes and a glucose level >125 mg/dL is a sign of diabetes. When insulin, a hormone helps the cells to absorb the blood glucose, becomes deficient then the body cells are not able to absorb the glucose from the blood. This results in the accumulation of glucose in the blood. Diabetes is classified into these types:
- Type 1 diabetes (T1D) – The pancreatic cells are not able to produce insulin, which leads to an increase in blood glucose level. It occurs mostly in children and is therefore also referred to as juvenile diabetes.
- Type 2 diabetes (T2D) – Glucose absorbing cells become resistant to insulin, or pancreatic cells do not make sufficient insulin, which causes an increase in blood glucose levels. It can develop in a person of any age but mostly occurs in people >45 years of age.
- Gestational diabetes (GD) – Gestational diabetes only occurs during pregnancy as the placenta releases a large number of hormones. This can result in a high amount of glucose in the blood that cannot be handled by the insulin prepared by the pancreatic cells. In most cases, this condition gets normal after pregnancy. Sometimes, GD persists and may further cause the body to become resistant to insulin and result in T2D. Gestational diabetes also increases the risk of development of T2D in the baby.
Symptoms of Diabetes
Some symptoms of diabetes include:
- Frequent urination
- Increased thirst and hunger
- Blurry vision
- Weight loss
- Cuts or sores that do not heal
- Frequent infections
If left untreated, diabetes may also cause eye damage, nerve damage, hearing loss, heart and kidney diseases, and foot problems.
Diagnosis of Diabetes
In T1D, the symptoms appear rapidly; hence, a person can be diagnosed easily. But, in T2D, the symptoms appear gradually, which makes diagnosis difficult.
Blood glucose level is checked by performing a different blood test, and diagnosis is made depending on the above-mentioned values. Following tests are used to diagnose diabetes:
Fasting serum glucose: This is a single time test in which sugar level is checked after 8-9 hours night fasting (without food and water). The best sample collection time is morning.
A1C test: This test provides the average sugar level for the past months. Fasting is required for this test.
Random plasma glucose test: In this test, the blood test to detect glucose level is done at any time.
Glucose screening test: This test is done to detect GD. Blood is drawn 1 hour after drinking glucose solution. Fasting is not required for this test. In case of high glucose level (>140 mg/dL), glucose tolerance test is prescribed.
Glucose tolerance test: In this test, blood glucose levels are checked after overnight fasting, and two hours after consumption of a glucose solution. For the diagnosis of GD, blood is drawn every hour for 2-3 hours.
Treatment of Diabetes
In T1D, daily insulin injections or an insulin pump is required to survive as insulin is not produced in the body. Regular blood glucose level monitoring is also important. An approach to curing T1D and sometimes T2D is to get a pancreas or islet cell transplant, which eliminates the need for further insulin therapy. Diabetes is generally managed by:
- Keeping a diet rich in whole grains, fruits and vegetables, and avoiding foods high in calories and fats
- Regular exercise
- Losing weight
- Antidiabetic medications – Medications can help to manage the levels of blood glucose in the body. Some commonly used medications are metformin, sulfonylureas (glipizide, glimepiride), meglitinides (repaglinide, nateglinide), thiazolidinedione (pioglitazone) and glucagon-like peptide-1 (GLP-1) receptor agonists (liraglutide, semaglutide). But these medications should be taken only on the prescription of a doctor.