Diabetes

The symptoms of diabetes can vary depending on the level of hyperglycemia and specific type. Those with prediabetes, gestational diabetes, or type 2 diabetes may experience few to no symptoms early on.

In type 1 diabetes, symptoms tend to develop rapidly and be pronounced as little to no insulin is produced by the body. Common signs include:

• Increased thirst
• Frequent urination
• Unintentional weight loss
• Fatigue
• Mood changes
• Blurred vision
• Ketones are detected in the urine, indicating the breakdown of muscle and fat tissues
• Slow-healing sores
• Recurrent infections

Both type 1 and type 2 diabetes can present at any age. However:

• Type 1 diabetes often manifests during childhood or adolescence due to autoimmune destruction of pancreatic beta cells.
• Type 2 diabetes is traditionally diagnosed more in those over 40 years old.

However, the tendency of obesity and sedentary lifestyles has increased type 2 diabetes among youth in recent decades.

• If you think you or your child may have diabetes. If you notice any possible diabetes symptoms, contact your health care provider. The earlier the condition is diagnosed, the sooner treatment can begin.
• If you’ve already been diagnosed with diabetes. After you receive your diagnosis, you’ll need close medical follow-up until your blood sugar levels stabilize.
• If you or your child are experiencing possible symptoms of diabetes, it’s essential to schedule an appointment with your healthcare provider as soon as possible. Early diagnosis allows treatment to begin promptly.
• If you have already received a diagnosis of diabetes, your medical team will create a treatment plan specific to your needs. In the beginning, expect frequent appointments to monitor your blood glucose levels and adjust your care accordingly. Your provider will conduct tests and educate you on self-management skills. Controlling blood sugar takes dedication and may require several months of tailored therapy. Once your numbers are stable in the target range, follow-ups can space out as you gain independence in long-term control.

To fully comprehend diabetes and its effects, one must first know how the human body regulates blood sugar levels through natural processes. 

How insulin works

Insulin is a hormone that comes from a gland behind and below the stomach called the pancreas.

• The pancreas releases insulin into the bloodstream.
• Once in circulation, insulin lets sugar enter cells by binding to insulin receptors and facilitating the transport of glucose molecules from the bloodstream into cells.
• This lowers the sugar in the bloodstream as glucose moves from blood to cells.
• As blood sugar levels drop due to insulin ushering glucose into cells, the pancreas senses the decrease and reduces its secretion of insulin to maintain appropriate blood glucose control and prevent hypoglycemia.

The role of glucose

Glucose, a type of sugar, provides an important energy source for muscles and tissues throughout the body.

• Glucose is derived from two primary sources – dietary carbohydrates consumed as food and endogenous production by the liver.
• After meals, absorbed glucose enters circulation and is shuttled into cells with the aid of insulin for utilisation or storage.
• The liver plays a key role in maintaining glucose homeostasis. It stores glucose as glycogen and can also generate new glucose through gluconeogenesis during periods of fasting. This helps regulate blood glucose within the typical physiological range.
• The specific causes of most diabetes subtypes remain unclear. However, all forms result in hyperglycemia due to insufficient insulin production or impaired insulin sensitivity. Genetic and environmental influences may contribute to the development of type 1 and type 2 diabetes through complex interactions that are not entirely understood.

In all types, blood glucose goes too high due to the lack of insulin secreted from the pancreas, or cells do not respond to this yet. Moreover, both type 1 and type 2 diabetes may be caused by a mix of genes we inherit and things in our environment. That is why scientists and doctors do not know exactly the cause and still need to learn more about it.

The risk factors for diabetes depend on whether a person has type 1, type 2 or gestational diabetes.

Family history plays an important role. Type 1 diabetes often runs in families because of genes. Where you live and what you’re exposed to may also increase your chance of type 1 diabetes, but scientists still have more to learn.

Nevertheless, if someone in your family has type 1 diabetes, your doctor may carefully test you for antibodies (proteins in the blood)  even if you do not yet. The reason is that these antibodies link to damage to the insulin-making cells, raising your risk factor for diabetes.

Furthermore, your ethnicity can impact type 2 diabetes risk, too. Some groups like Hispanics, Blacks, Asians, and Native Americans tend to have higher rates, possibly due to genes and lifestyle habits.

Finally, being obese is a significant risk factor. People who are overweight are more likely to develop prediabetes and diabetes during pregnancy. Extra weight significantly increases the chances of type 2 diabetes.

While type 1 diabetes cannot be prevented, healthy lifestyle modifications can help reduce the risk or slow the progression of prediabetes, type 2 diabetes, and gestational diabetes.

• Focus on nutritious whole foods like fruits, vegetables, whole grains, and foods lower in fat/calories. Eating various healthy options makes it easier to stick to over time.
• Aim for at least 150 minutes of moderate exercise like brisk walking each week. Break it up into smaller sessions if needed. Physical activity has wide-ranging benefits.
• If overweight, losing as little as 7% of body weight through a balanced diet and exercise changes can meaningfully lower diabetes risk. Maintaining a healthy weight long-term supports overall wellness.
• During pregnancy, consult your health provider on appropriate weight gain. In the postnatal period, prioritise sustainable lifestyle habits.

In some cases, medications may assist with prediabetes management. However, lifestyle is most important for prevention and should remain the foundation of any treatment approach.

It’s advised that those with prediabetes check their blood sugar annually to monitor for potential progression to type 2 diabetes. Ongoing screening allows early intervention if needed.