Diabetes, the Life Sentence

 Diabetes

Due to it being a forever preventable punishment, diabetes is much like a life sentence for a crime on your body. 

Definition

The World Health Organization's definition of diabetes is for a single raised glucose reading with symptoms, otherwise raised values on two occasions, of either: 

• A fasting plasma glucose ≥ 7.0 mmol/L. 
• A glucose tolerance test, two hours after the oral dose a plasma glucose ≥ 11.1 mmol/L. 
• A random blood sugar of greater than 11.1 mmol/L  in association with typical symptoms.
• A glycated hemoglobin (HbA_1c) of ≥ 48 mmol/mol..

World Health Organization defines prediabetes as a fasting glucose range of 6.1-6.9 mmol/L. 

There are two main of diabetes: 

• Type 1 diabetes is characterized by the loss of the insulin-producing cells of the pancreas, leading to insulin deficiency. This type is often caused by the immune system attacking the body. Normally discovered at a young age, though can be discovered later. 
• Type 2 diabetes is characterized by insulin resistance, which may be combined with relatively reduced insulin secretion. Appears in middle to late age, however these days found even in kids. 

As of 2019, an estimated 463 million people had diabetes worldwide accounting for 8.8% of the adult population. Type 2 diabetes makes up about 90% of all diabetes cases. The prevalence of the disease continues to increase, most dramatically in low- and middle-income nations. Diabetes is the 7th-leading cause of death globally. 

Diabetes can lead to disabilities like stroke, heart attack, cancers, dementia, ulcers or amputation of legs, blindness, kidney failure, infertility, depression, anxiety, and premature death.

Causes

As we talked about Obesity is the main cause of diabetes due to Insulin resistance, which is the inability of cells to respond adequately to normal levels of insulin, and occurs primarily within the muscles, liver, and fats. The fat cells deposit in the muscles and liver hence obstructing insulin from carrying it is function on those cells to absorb the glucose in the blood. The pancreas grows in size to produce more insulin to compensate for the insensitivity, however, fat cells start destroying the pancreas and reducing the secretion of insulin.

Leptin, the hormone for storing fat, also contributes to insulin resistance during aging or during exposure to a high-fat diet whereby the body becomes resistant to leptin and fails to restrain food intake, leading to obesity and diabetes. 

Diabetes happens in pregnancy because pregnancy hormones interfere with the action of insulin leading to resistance, henceforth diabetes especially in obese mothers. The child may get some complications like being big and malformations of the heart and nervous systems.

Diabetes can be caused by some drugs like the ones for asthma. It can be caused by alcohol-related pancreas damage and cancers of the pancreas and other glands of the body.

Genetics have been linked with type 1 diabetes and to some extent type 2 diabetes especially early onset of type 2 in youth. 

Normally when we sleep, the body produces the stress hormone (cortisol) which is responsible for releasing more sugar in the blood and presentations at night like over urinating, thirst, and hunger with weight loss. It is a sign of a potential for diabetes.   

People with type 1, normally get diagnosed after presenting in an emergency as a critical condition where they are gasping for air, thirst, urinating a lot, abdominal pain, and weakness. The condition is diabetic keto acidosis because the body especially the brain has started using the acidic ketones (fat cells) due to the lack of glucose since there is no insulin at all. There have been people with type 2 diabetes who develop diabetes keto acidosis, found in people of African origins. 

Diabetes can lead to serious situations or even death through a person being dehydrated (the body lacking enough water) and/ or not enough sugar in the body because of taking too much insulin treatment or sleeping on an empty stomach so that insulin uses all the sugar hence leading to lack of sugar in the blood.

Therapy

Type 1 diabetes needs insulin permanently. Insulin was discovered in 1922, initially from insulin from pigs currently lab-made human insulin. Type 2 can be treated with medications including insulin and other drugs which either increase the sensitivity of the body to insulin or increase the production of insulin from the pancreas. Those drugs have been shown to help with diabetes with varying degrees in even leading to weight loss, however, they have side effects including weight gain, muscle pains, and in the case of insulin a potentially fatal overdose. 

However, there are lifestyle modifications that can treat diabetes (type 2 mainly) and prevent it in the case of prediabetes.

1. Eating food with less carbohydrates, high proteins, and a lot of fiber.
2. Avoiding processed fatty food.
3. Avoid sugary drinks like Soda and fruit juices.
4. Drinking enough water.
5. Walking at least 30 minutes a day.
6. Sleeping on time and not eating food before going to bed.
7. Managing stress through meditation. 
8. Avoid taking a lot of alcohol and smoking. 
9. Take your medication especially insulin if type 1 diabetes as instructed.
10. If affordable, acquire a continuous glucose monitor device. 

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