Diabetes is a long-lasting or chronic disease and is characterised by high blood sugar (glucose) levels or above typical values. Glucose which accumulates in the blood due to not being absorbed by body cells properly can cause various disorders of the body’s organs. If diabetes is not well controlled, various complications that can endanger the lives of patients can arise.
Glucose is the primary energy source for human body cells. The level of sugar in the blood is controlled by the hormone insulin, which is produced by the pancreas, the organ located behind the stomach. In people with diabetes, the pancreas is unable to produce insulin according to the body’s needs. Without insulin, the body’s cells cannot absorb and process glucose into energy.
Types of Diabetes
In general, diabetes is divided into two types, namely, type 1 and type 2 diabetes. Type 1 diabetes occurs because of the patient’s immune system attacks and destroys the pancreatic cells that produce insulin. This increases blood glucose levels, resulting in damage to body organs. Type 1 diabetes is also known as autoimmune diabetes. The trigger for this autoimmune condition is still not known with certainty. The sharpest allegation is caused by genetic factors of sufferers which are also influenced by environmental factors.
Type 2 diabetes is a type of diabetes that is more common. This type of diabetes is caused by body cells that become less sensitive to insulin so that the insulin produced cannot be used properly (body cell resistance to insulin). About 90-95% of diabetics in the world suffer from this type of diabetes.
In addition to the two types of diabetes, there is a particular type of diabetes in pregnant women called gestational diabetes. Hormonal changes cause diabetes in pregnancy, and blood sugar returns to normal after pregnant women undergo childbirth.
Type 1 diabetes can develop quickly in a few weeks, even just a few days. Whereas in type 2 diabetes, many sufferers do not realise that they have had diabetes for years because the symptoms tend to be non-specific. Some signs of type 1 and type 2 diabetes include:
• Often feel thirsty.
• Frequent urination, especially at night.
• Often feel very hungry.
• Weight loss for no apparent reason.
• Reduced muscle mass.
• There are ketones in the urine. Ketones are a waste product of muscle and fat breakdown due to the body being unable to use sugar as an energy source.
• The view is blurred.
• Wounds that are difficult to heal.
• Frequent infections, such as the gums, skin, vagina, or urinary tract.
Some symptoms can also be a sign that someone has diabetes, including:
• Dry mouth.
• Burning, stiffness, and pain in the legs.
• Erectile dysfunction or impotence.
• Easily offended.
• Experience reactive hypoglycemia, which is hypoglycemia that occurs several hours after eating due to excessive insulin production.
• The appearance of black patches around the neck, armpits and groin, ( acanthosis Nigerians ) as a sign of insulin resistance.
Some people can experience prediabetes, a condition when glucose in the blood is above average, but not high enough to be diagnosed as diabetes. A person suffering from prediabetes can have type 2 diabetes if it is not handled correctly.
Diabetes Risk Factors
Someone will be more prone to type 1 diabetes if he has risk factors, such as:
• Having a family with a history of type 1 diabetes.
• Has a viral infection.
• White people are thought to be more prone to type 1 diabetes than other races.
• Travelling to areas far from the equator (equator).
• Type 1 diabetes mostly occurs at the age of 4-7 years and 10-14 years, although type 1 diabetes can occur at any age.
Whereas in the case of type 2 diabetes, a person will more easily experience this condition if he has risk factors, such as:
• Weight gain.
• Having a family with a history of type 2 diabetes.
• Not active enough. Physical activity helps control body weight, burns glucose as energy, and makes body cells more sensitive to insulin. Less intense physical exercise causes a person more susceptible to type 2 diabetes.
• Age. The risk of developing type 2 diabetes will increase with age.
• Suffers from high blood pressure ( hypertension ).
• Have abnormal cholesterol and triglyceride levels. Someone who has good cholesterol or HDL ( high-density lipoprotein ) levels that are low and high triglyceride levels are more at risk of developing type 2 diabetes.
Especially for women, pregnant women who have gestational diabetes can more easily develop type 2 diabetes. Also, women who have a history of polycystic ovarian syndrome (PCOS) are more prone to type 2 diabetes.
Diagnosis of Diabetes
Symptoms of diabetes usually develop gradually, except for type 1 diabetes whose symptoms can appear suddenly. Because diabetes is often not diagnosed at the beginning of its appearance, people who are at risk for this disease are advised to undergo a routine checkup. Among others are:
• People over 45 years old.
• Women who have had gestational diabetes while pregnant.
• People who have a body mass index (BMI) above 25.
• People who have been diagnosed with prediabetes.
Blood sugar test is a simple test that will be done to diagnose type 1 or type 2 diabetes. The results of blood sugar measurements will show whether a person has diabetes or not. The doctor will recommend the patient to undergo a blood sugar test at a time and with specific methods. Blood sugar test methods that can be undertaken by patients include:
• Blood sugar test when. This test aims to measure blood glucose levels at certain hours at random. This test does not require the patient to fast first. If the results of blood sugar tests show 200 mg / dL or more, the patient can be diagnosed with diabetes.
• Fasting blood sugar test. This test aims to measure blood glucose levels when the patient is fasting. The patient will first be asked to fast for 8 hours, then undergo a blood sample to be measured for his blood sugar levels. Fasting blood sugar test results that show blood sugar levels less than 100 mg / dL indicate normal blood sugar levels. Fasting blood sugar test results between 100-125 mg / dL indicate the patient has prediabetes. While fasting blood sugar test results, 126 mg / dL or more suggest that patients have diabetes.
• Glucose tolerance test. This test is done by asking the patient to fast overnight. The patient will then undergo a fasting blood sugar test. After the test is done, the patient will be asked to drink a particular sugary solution. Then the blood sugar sample will be taken back after 2 hours of drinking the sugar solution. Glucose tolerance test results below 140 mg / dL indicate normal blood sugar levels. Glucose tolerance test results with sugar levels between 140-199 mg / dL indicate prediabetes. Glucose tolerance test results with sugar levels of 200 mg / dL or more indicate the patient has diabetes.
• Hb A1C test ( glycated haemoglobin test ). This test aims to measure the average glucose level of the patient for the past 2-3 months. This test will regulate blood sugar levels that are bound to haemoglobin, which is a protein that functions to carry oxygen in the blood. In the HbA1C test, patients do not need to undergo fasting first. HbA1C results below 5.7% are typical. HbA1C test results between 5.7-6.4% indicate the patient has a prediabetes condition. HbA1C test results above 6.5% indicate the patient has diabetes.
The results of the blood sugar test will be checked by the doctor and informed to the patient. If the patient is diagnosed with diabetes, the doctor will plan treatment steps to be undertaken. Especially for patients suspected of having type 1 diabetes, the doctor will recommend an autoantibody test to determine whether the patient has antibodies that damage body tissue, including the pancreas.
Diabetic patients are required to adjust their diet by increasing consumption of fruits, vegetables, protein from whole grains, as well as low-calorie and fat foods. Diabetes patients and their families can consult with a doctor or nutritionist to manage their daily diet.
To help convert blood sugar into energy and increase cell sensitivity to insulin, diabetic patients are advised to exercise regularly, for at least 10-30 minutes every day. Patients can consult with a doctor to choose appropriate sports and physical activity.
In type 1 diabetes, patients will need insulin therapy to regulate daily blood sugar. Also, some patients with type 2 diabetes are advised to undergo insulin therapy to regulate blood sugar. Additional insulin will be given by injection, not in the form of oral medication. The doctor will adjust the type and dose of insulin used and tell you how to inject it.
In cases of severe type 1 diabetes, your doctor may recommend a pancreatic transplant operation to replace the damaged pancreas. Patients with type 1 diabetes who successfully undergo the process no longer need insulin therapy but must consume immunosuppressive drugs regularly.
In patients with type 2 diabetes, the doctor will prescribe medicines, one of which is metformin, an oral medication that works to reduce glucose production from the liver. Also, other diabetes drugs that work by maintaining glucose levels in the blood so that they are not too high after the patient eats can be given.
Diabetes patients must control their blood sugar in a disciplined manner through a healthy diet, so that blood sugar does not rise to above average. In addition to controlling glucose levels, patients with this condition will also be arranged to undergo an HbA1C test to monitor blood sugar levels during the last 2-3 months.
Several complications that can arise from type 1 and 2 diabetes are:
• Heart disease
• Chronic kidney failure
• Diabetic neuropathy
• Vision impairment
• Hearing disorders
• Wounds and infections in the feet that are difficult to heal
• Skin damage due to bacterial and fungal infections
Diabetes due to pregnancy can cause complications in pregnant women and infants. Examples of complications in pregnant women are preeclampsia. While cases of complications that can arise in infants are:
• Being overweight at birth.
• Premature birth.
• Low blood sugar (hypoglycemia).
• Increased risk of developing type 2 diabetes when the baby has become an adult.
Type 1 diabetes cannot be prevented because the trigger is not yet known. Meanwhile, type 2 diabetes and gestational diabetes can be prevented, namely a healthy lifestyle. Some things you can do to prevent diabetes include:
• Set the frequency and diet to be healthier.
• Keeping your ideal weight.
• Exercise regularly.
• Routinely undergo blood sugar checking, at least once a year.