Diabetes is
a chronic disease that occurs either when the pancreas does not produce enough
insulin or when the body cannot effectively use the insulin it produces.
Insulin is a hormone that regulates blood sugar. Hyperglycaemia, or raised
blood sugar, is a common effect of uncontrolled diabetes and over time leads to
serious damage to many of the body's systems, especially the nerves and blood
vessels.
Diabetes is due to either the pancreas is not producing enough insulin, or the cells of the
body not responding properly to the insulin produced. There are three main types of
diabetes mellitus:
· Type 1 Diabetes results from the pancreas's failure to produce enough insulin due to loss of beta-cells. This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes". The loss of beta cells is caused by an autoimmune response. The cause of this autoimmune response is unknown.
• Type 2 diabetes begins with insulin resistance, a condition in which cells fail to respond to insulin properly. As the disease progresses, a lack of insulin may also develop. This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes". The most common cause is a combination of excessive body weight and insufficient exercise.
• Gestational diabetes is the third main form, and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels.
Causes of
diabetes
The causes of diabetes depend on the type and are
discussed as follows;
1.
Causes of type 1 diabetes
Type 1 diabetes occurs when your immune
system, the body’s system for fighting infection, attacks and destroys
the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes
is caused by genes and environmental factors,
such as viruses, that might trigger the disease.
2. Causes of
type 2 diabetes
Type 2 diabetes—the most common form of diabetes—is
caused by several factors, including lifestyle factors and genes.
Overweight, obesity, and physical inactivity
You are more likely to develop type
2 diabetes if you are not physically active and are overweight or obese.
Extra weight sometimes causes insulin resistance and is common in people with
type 2 diabetes. The location of body fat also makes a difference. Extra belly
fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at
risk for type 2 diabetes, check out these Body Mass Index (BMI) charts.
i.
Insulin resistance
Type 2 diabetes usually begins
with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin
well. As a result, your body needs more insulin to help glucose enter cells. At first, the
pancreas makes more insulin to keep up with the added demand. Over time, the
pancreas can’t make enough insulin, and blood glucose levels rise.
ii.
Genes and family history
As in type 1 diabetes, certain genes
may make you more likely to develop type 2 diabetes. The disease tends to run
in families and occurs more often in these racial/ethnic groups:
a.
African Americans
b.
Alaska Natives
c.
American Indians
d.
Asian Americans
e.
Hispanics/Latinos
f.
Native Hawaiians
g.
Pacific Islanders
Genes
also can increase the risk of type 2 diabetes by increasing a person’s tendency
to become overweight or obese.
3. Causes of Gestational
Diabetes
Scientists believe gestational diabetes, a type of diabetes that develops
during pregnancy, is caused by the hormonal changes of pregnancy along with
genetic and lifestyle factors.
i.
Insulin resistance
Hormones produced by the placenta NIH external link contribute to insulin resistance, which
occurs in all women during late pregnancy. Most pregnant women can produce
enough insulin to overcome insulin resistance, but some cannot. Gestational
diabetes occurs when the pancreas can’t make enough insulin.
As with type 2 diabetes, extra
weight is linked to gestational diabetes. Women who are overweight or obese may
already have insulin resistance when they become pregnant. Gaining too much
weight during pregnancy may also be a factor
Types of Diabetes
The most common types of diabetes includes;
1.
Type 1 diabetes
Type 1 diabetes (previously known as insulin-dependent,
juvenile or childhood-onset) is characterized by deficient insulin production
and requires daily administration of insulin. The cause of type 1 diabetes is
not known and it is not preventable with current knowledge.
Symptoms include excessive excretion of urine (polyuria),
thirst (polydipsia), constant hunger, weight loss, vision changes, and fatigue.
These symptoms may occur suddenly.
2.
Type 2 diabetes
Type 2 diabetes (formerly called non-insulin-dependent, or
adult-onset) results from the body’s ineffective use of insulin. Type 2
diabetes comprises the majority of people with diabetes around the world, and
is largely the result of excess body weight and physical inactivity.
Symptoms may be similar to those of
type 1 diabetes, but are often less marked. As a result, the disease may be
diagnosed several years after onset, once complications have already arisen.
Until recently, this type of diabetes was seen only in
adults but it is now also occurring increasingly frequently in children.
3.
Gestational diabetes: Gestational diabetes is
hyperglycaemia with blood glucose values above normal but below those diagnostic
of diabetes, occurring during pregnancy.
Women with gestational diabetes are at an increased risk of
complications during pregnancy and at delivery. They and their children are
also at increased risk of type 2 diabetes in the future.
Gestational diabetes is diagnosed through prenatal
screening, rather than through reported symptoms.
Common Symptoms
of Diabetes
Symptoms
of diabetes include
·
increased thirst
and urination
·
increased hunger
·
fatigue
·
blurred vision
·
numbness or
tingling in the feet or hands
·
sores that do not
heal
·
unexplained weight
loss
Diagnosis and treatment
Early diagnosis
can be accomplished through relatively inexpensive testing of blood sugar.
The treatment
of diabetes involves diet and physical activity along with lowering blood
glucose and the levels of other known risk factors that damage blood vessels.
Tobacco use cessation is also important to avoid complications. Interventions
that are both cost-saving and feasible in developing countries include:
- blood glucose control, particularly in type 1 diabetes.
People with type 1 diabetes require insulin, people with type 2 diabetes
can be treated with oral medication, but may also require insulin;
- blood pressure control; and
- foot care.
Other cost saving interventions
include:
- screening and treatment for retinopathy (which causes
blindness)
- blood lipid control (to regulate cholesterol levels)
- screening for early signs of diabetes-related kidney
disease and treatment.
Dietary management of Diabetes
A diabetes
diet is based on eating three meals a day at regular times. This helps you
better use the insulin that your body produces or gets through a medication.
A registered dietician
can help you put together a diet based on your health goals, tastes and
lifestyle. He or she can also talk with you about how to improve your eating
habits, such as choosing portion sizes that suit the needs for your size and
activity level.
Recommended foods
Make your
calories count with these nutritious foods. Choose healthy carbohydrates,
fiber-rich foods, fish and "good" fats.
Healthy
carbohydrates
During
digestion, sugars (simple carbohydrates) and starches (complex carbohydrates)
break down into blood glucose. Focus on healthy carbohydrates, such as:
·
Fruits
·
Vegetables
·
Whole grains
·
Legumes, such as beans and peas
·
Low-fat dairy products, such as milk and cheese
Avoid less healthy carbohydrates,
such as foods or drinks with added fats, sugars and sodium.
Fiber-rich foods
Dietary fiber
includes all parts of plant foods that your body can't digest or absorb. Fiber
moderates how your body digests and helps control blood sugar levels. Foods high
in fiber include:
·
Vegetables
·
Fruits
·
Nuts
·
Legumes, such as beans and peas
·
Whole grains
Heart-healthy
fish
Eat
heart-healthy fish at least twice a week. Fish such as salmon, mackerel, tuna
and sardines are rich in omega-3 fatty acids, which may prevent heart disease.
Avoid fried fish and fish with high
levels of mercury, such as king mackerel.
Good fats
Foods
containing monounsaturated and polyunsaturated fats can help lower your
cholesterol levels. These include:
·
Avocados
·
Nuts
·
Canola, olive and peanut oils
But don't overdo it, as all fats are
high in calories.
Foods to avoid
Diabetes
increases your risk of heart disease and stroke by accelerating the development
of clogged and hardened arteries. Foods containing the following can work
against your goal of a heart-healthy diet.
·
Saturated fats. Avoid high-fat dairy
products and animal proteins such as butter, beef, hot dogs, sausage and bacon.
Also limit coconut and palm kernel oils.
·
Trans fats. Avoid trans fats found
in processed snacks, baked goods, shortening and stick margarines.
·
Cholesterol. Cholesterol sources
include high-fat dairy products and high-fat animal proteins, egg yolks, liver,
and other organ meats. Aim for no more than 200 milligrams (mg) of cholesterol
a day.
·
Sodium. Aim for less than
2,300 mg of sodium a day. Your doctor may suggest you aim for even less if you
have high blood pressure.
Prevention of
Diabetes
Diabetes
prevention is as basic as eating more healthfully, becoming more physically
active and losing a few extra pounds. It's never too late to start. Making a
few simple changes in your lifestyle now may help you avoid the serious health
complications of diabetes in the future, such as nerve, kidney and heart damage.
Consider
these diabetes prevention tips from the American Diabetes Association;
1. Get more physical activity
There are many benefits to regular
physical activity. Exercise can help you:
·
Lose weight
·
Lower your blood
sugar
·
Boost your
sensitivity to insulin — which helps keep your blood sugar within a normal range
Research shows that aerobic exercise
and resistance training can help control diabetes. The greatest benefit comes
from a fitness program that includes both.
2. Get plenty of fiber
Fiber may help you:
·
Reduce your risk of
diabetes by improving your blood sugar control
·
Lower your risk of
heart disease
·
Promote weight loss
by helping you feel full
Foods high in fiber include fruits,
vegetables, beans, whole grains and nuts (Evert, 2019).
3. Go for whole grains
It's not clear why, but whole grains
may reduce your risk of diabetes and help maintain blood sugar levels. Try to
make at least half your grains whole grains.
Many foods made from whole grains
come ready to eat, including various breads, pasta products and cereals. Look
for the word "whole" on the package and among the first few items in
the ingredient list.
4. Lose extra weight
If you're overweight, diabetes
prevention may hinge on weight loss. Every pound you lose can improve your
health, and you may be surprised by how much.
5. Skip fad diets and just make healthier choices
Low-carb diets, the glycemic index
diet or other fad diets may help you lose weight at first. But their
effectiveness at preventing diabetes and their long-term effects aren't known.
And by excluding or strictly limiting a particular food group, you may be
giving up essential nutrients and often craving such foods. Instead, make
variety and portion control part of your healthy-eating plan.





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