When we eat, our bodies break food down into organic compounds, one of which is glucose. The cells of our bodies use glucose as a source of energy for movement, growth, repair and other functions. But before the cells can use glucose, it must move from the bloodstream into the individual cells. This process requires insulin. Insulin is a hormone produced in the pancreas. When glucose enters our blood, the pancreas should automatically produce the right amount of insulin to move glucose into our cells. In people with diabetes, however, the pancreas either produces too little or no insulin or the cells do not respond appropriately to the insulin that is produced. As a result, glucose builds up in the bloodstream, overflows into the urine, and passes out of the body. The body is thus, unable to utilize its main source of fuel even though the blood contains large amounts of glucose.
There are three main types of diabetes:
- Type 1 Diabetes
- Type 2 Diabetes
- Gestational Diabetes
Type 1 Diabetes
In type 1 diabetes, the body’s immune system attacks the insulin-producing cells in the pancreas and destroys them. The pancreas then produces little or no insulin and so the person with this type of diabetes must take insulin daily to live. Type 1 diabetes develops most often in children and young adults, (previously known as juvenile diabetes) but can appear at any age. The cause of this type of diabetes has been attributed to a number of factors including genetic and environment factors.
Type 2 Diabetes
About 90 to 95 percent of people with diabetes have type 2 diabetes. This form of diabetes is a rapidly growing disease worldwide and is associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and ethnicity. About 80% of people with type 2 diabetes are overweight. Type 2 diabetes is increasingly being diagnosed in children and adolescents. When type 2 diabetes is diagnosed, the pancreas is usually producing enough insulin, but for certain reasons, the body cannot use the insulin effectively- a condition called insulin resistance. After several years, insulin production decreases. The result as in the case of type 1 diabetes is that glucose builds up in the blood and the body cannot make efficient use of its main source of fuel.
Gestational Diabetes
Pregnant women who have never had diabetes before but who have high blood sugar (glucose) levels during pregnancy are said to have gestational diabetes. Scientists believe that hormones from the placenta that help the baby develop can sometimes block the action of the mother’s insulin in her body. Testing for blood glucose levels is thus recommended during pregnancy.
Symptoms of Diabetes Symptoms of both type 1 and 2 diabetes include increased thirst, frequent urination, constant hunger, weight loss, blurred vision, nausea, fatigue, frequent infections, and slow healing of wounds or sores. If not diagnosed and treated with insulin, a person with diabetes can lapse into a life threatening diabetic coma.
The symptoms of type 2 diabetes develop gradually and their onset is not as sudden as in type 1 diabetes. For some people with type 2 diabetes, symptoms are often mild and may go un-noticed, which is why frequent testing for random blood suger levels in the body is recommended.
Tests for Diagnosing Diabetes:
The fasting blood glucose test (taken after at least 8 hours of fasting) is the preferred test for diagnosing type 1 or type 2 diabetes. It is most reliable when done in the morning. However, a diagnosis of diabetes can also be aided by performing any one of the three below tests:
- A random blood glucose test (taken any time of day).
- An oral glucose tolerance test (GTT), which is a test that determine how quickly glucose is cleared from the blood. Gestational diabetes is diagnosed based on glucose values measured during the GTT.
- The HbA1c test, which is used primarily to identify the average blood glucose concentration over prolonged periods of time. This test can be performed to confirm the diagnosis of diabetes, and is also important in monitoring the effectiveness of diabetes management/ treatment in known diabetic patients.
Routine Testing for Diabetics
- FBS & RBS Carried out once a month
- HbA1c Carried out once every 3 months
- Lipid Profile Carried out once every 6 months
- Creatinine Carried out once a year
- Microalbuminuria Carried out once a year if normal, and once every 3 months if abnormal