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with Diabetes

Living with Diabetes: What is it?

You have been diagnosed with diabetes, or you are just curious about diabetes? You would like to have basic and clear information all in one place? This is what we are aiming at with this web page: from elementary definitions to get you started to insights about the disease itself, we hope that you can find the relevant information that will provide you with a better understanding of this condition. 

What is diabetes mellitus? 

First of all, diabetes mellitus, often just called ‘diabetes’, is a chronic, metabolic disease, which means that it is a long-lasting disease that affects the way food is digested inside the body. As food is processed into small molecules that can be used as a source of energy by the body’s cells, carbohydrates mainly turn into glucose, which is released into the bloodstream. 

The amount of sugar in the blood, called the glycemia, is regulated by insulin, a hormone produced by the pancreas, an abdominal organ. To put it simply, insulin acts like a key that makes blood sugar enter the body’s cells, hence lowering blood sugar. This effect is said to be hypoglycemic. 

In case of diabetes, either insulin production is insufficient, or your body is unable to use the insulin it makes as well as it should, a phenomenon called insulin resistance. In either case, there is an excess of sugar in your bloodstream that can cause serious harm.1

I heard that there are different kinds of diabetes. Is that so?

Indeed, though we should rather say that there are different types of diabetes. 
The most common form is known as type 2 diabetes: about 90% of diabetes cases belong to type 2. It usually occurs in adults, when resistance to insulin develops, or when the production of insulin becomes insufficient. For years, symptoms can go unnoticed, hence the necessity of blood sugar tests in at risk people, especially when considering that type 2 diabetes can be delayed, or even prevented thanks to healthy lifestyle measures.2,3 
Type 1 diabetes, once called juvenile diabetes (or insulin-dependent diabetes) occurs when the pancreas produces no insulin, or very little. It is thought to be due to an autoimmune reaction (the immune system attacks the body by mistake), and it roughly affects 5% of diabetes patients. Unlike type 2 diabetes, most cases develop quickly and are diagnosed in children, teenagers or young adults, but it can develop at any age. Type 1 diabetes cannot be prevented, and it requires taking insulin every day to survive.2,4 
Other types of diabetes exist, but on this website, the main focus is on type 2 diabetes. For any further questions about diabetes and its other forms, please check with your physician. 

I heard that there are different kinds of diabetes. Is that so?

Symptoms include: 

– excessive urination both in terms of quantity and frequency, a condition known as polyuria; 
– excessive and constant thirst, known as polydipsia; 
– constant hunger (or polyphagia); 
– weight loss; 
– blurry vision; 
– fatigue. 

Patients might also have numb or tingling hands or feet, have dry skin, sores that heal slowly, and they might become prone to infections.2,5,6

Between type 2 and type 1 diabetes, symptoms may be similar, but they are often more subdued, or even absent, in type 2 patients. As a consequence, type 2 diabetes may go unnoticed for years, with its diagnosis occurring once complications have arisen.2,5

Are there any complications to diabetes? 

Alas, yes, and they are quite serious. When diabetes is poorly managed, health-threatening complications can develop. Acute complications such as a coma can occur when blood glucose gets abnormally high, or seizures or loss of consciousness when it gets abnormally low (after too high a dose of anti-diabetic medication, for instance). 
Meanwhile, over time diabetes can harm the heart, blood vessels, eyes, kidneys, and nerves. It can also increase the risk of stroke and heart disease. The combination of a reduced blood flow and nerve damage can result in foot ulcers and infection, finally leading to amputation. In the eye, damage to the retina can cause blindness. It is also one of the leading causes of kidney failure.2

Consequences : Diabetes ca lead to complications in many parts of the body

Adapted from WHO “Diabetes consequences” infographic7

Is diabetes a common condition? 

Once again, the answer is yes. In fact, according to a World Health Organization survey, as many as 422 million adults were living with diabetes in 2014, worldwide. This represents 8.5% of the adult population, and this proportion has nearly doubled since 1980 (4.7% back then).2
In the US alone, 30.3 million adults have diabetes, and it is estimated that 1 in 4 of them don’t know they have it.1
It is also estimated that diabetes caused directly 1.5 million deaths worldwide in 2012, and an additional 2.2 million deaths by high blood glucose increasing the risk of cardiovascular and other diseases.2 

Are there any risk factors for type 2 diabetes, and am I at risk? 

In type 2 diabetes, risk factors are rather well-known. The strongest ones are excess body fat, and overweight and obesity. A higher waist circumference and body mass index have been identified as risk factors too, while dietary habits are also Involved (high intake of saturated fats, sweetened beverages, lack of fiber, bad dietary habits during childhood…).
Smoking is also an important risk factor, even 10 years after smoking cessation, but a lot of other criteria can play a role: ethnicity, a family history of diabetes, previous gestational diabetes in women, or older age for men and women alike…2

How is diabetes diagnosed?

Diagnosis relies on blood sugar tests, sometimes in different situations: when fasting, before and after drinking a glucose-containing liquid, the A1C test measuring your average blood sugar over the past 2 to 3 months, or a random blood sugar test. In case of diabetes types other than type 2, other tests are required.8 

Desdites and cardiovascular disease

A close link exists between diabetes and cardiovascular disease (CVD), which is the most prevalent cause of morbidity and mortality in diabetic patients. Cardiovascular (CV) risk factors such as obesity, hypertension and dyslipidemia are common in patients with diabetes, placing them at increased risk for cardiac events. Therefore, targeting CV risk factors in patients with diabetes is critical to minimize the long-term CV complications of the disease.9 

References:

  1. CDC. Basics – Diabetes. 2019. Available at https://www.cdc.gov/diabetes/basics/diabetes.html Accessed on 08 July 2019. 
  2. WHO. Global report on diabetes. 2016. 
  3. CDC. Type 2 Diabetes – Basics – Diabetes. 2019. Available at https://www.cdc.gov/diabetes/basics/type2.html Accessed on 08 July 2019. 
  4. CDC. Type 1 Diabetes – Basics – Diabetes. 2019. Available at https://www.cdc.gov/diabetes/basics/type1.html Accessed on 08 July 2019. 
  5. WHO. FAQs -Frequently Asked Questions on Diabetes. 2016. 
  6. CDC. Symptoms – Basics – Diabetes. 2019. Available at https://www.cdc.gov/diabetes/basics/symptoms.html Accessed on 08 July 2019. 
  7. WHO. Diabetes infographic. 2016. Available at https://www.who.int/diabetes/global-report/WHD2016_Diabetes_Infographic_v2.pdf Accessed on
    08 July 2019. 
  8. CDC. Getting Tested – Basics – Diabetes. 2019. Available at https://www.cdc.gov/diabetes/basics/getting-tested.html Accessed on 08 July 2019. 
  9. Diabete and cardiovascular disease. Benjamin M Leon and al. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4600176/