Diabetes is a chronic medical condition characterised by elevated levels of glucose (sugar) in the blood. Diabetes is a widespread and serious health condition that requires ongoing attention and care. With proper management and a healthy lifestyle, individuals with diabetes can lead full and productive lives while reducing the risk of complications.

Those with diabetes must work closely with healthcare providers to develop a personalised treatment plan and stay on top of their condition.

What is Diabetes?

Diabetes is a chronic metabolic disorder characterised by high blood glucose levels resulting from inadequate insulin production or the body’s ineffective use of insulin. Insulin, a hormone produced by the pancreas, plays a vital role in regulating blood sugar levels by allowing cells to absorb glucose and produce energy.

Diabetes poses significant health risks such as cardiovascular disease, kidney problems, nerve damage, and vision impairment if not managed properly through medication, diet control, physical activity, and regular monitoring of blood glucose levels.

Common Symptoms of Diabetes

While the type of diabetes can be different, the symptoms are more or less the same:

• Frequent Urination: Excess sugar in the blood leads to increased urination as the body tries to eliminate it.
• Excessive Thirst: Dehydration from frequent urination causes intense thirst.
• Unexplained Weight Loss: Cells can’t access glucose for energy, so the body breaks down fat and muscle.
• Increased Hunger: Cells starve for energy due to insulin resistance.
• Fatigue: Cells’ inability to use glucose leads to reduced energy levels.
• Blurry Vision: High blood sugar can affect the eye’s lens.

Diagnosis and Monitoring

Diabetes is diagnosed and monitored using various blood tests that measure blood sugar levels. The specific tests and diagnostic criteria may vary depending on the type of diabetes suspected, but the most common tests include:

• Fasting Blood Sugar Test: This test measures your blood sugar level after an overnight fast, typically for at least 8 hours. A fasting blood sugar level of 126 milligrams per decilitre (mg/dL) or higher on two separate occasions is indicative of diabetes.
• Oral Glucose Tolerance Test (OGTT): For this test, you’ll fast overnight, and then your blood sugar level will be measured before and two hours after consuming a sugary drink containing a standardised amount of glucose. A blood sugar level of 200 mg/dL or higher two hours after drinking the glucose solution is diagnostic for diabetes.
• Haemoglobin A1c Test: This test provides an average of your blood sugar levels over the past two to three months. An HbA1c level of 6.5% or higher is typically used to diagnose diabetes.
• Random Blood Sugar Test: A blood sample taken at any time, regardless of when you last ate. If your blood sugar level is 200 mg/dL or higher and you have symptoms of diabetes (excessive thirst, frequent urination, unexplained weight loss, etc.), it may indicate diabetes.
• Glycated Albumin (GA) Test: This test measures the percentage of glycated albumin in the blood, providing information about blood sugar control over the past few weeks. It is sometimes used in situations where the HbA1c test may not be accurate (e.g., in people with certain types of anaemia).

Monitoring diabetes is an important aspect of managing the condition effectively. Regular monitoring allows individuals with diabetes and their healthcare providers to track blood sugar levels, make informed treatment decisions, and reduce the risk of complications.

The key components of diabetes monitoring:

• Self-Monitoring of Blood Glucose (SMBG): This involves using a blood glucose metre to check your blood sugar levels at home. Here’s how it works:
  • Prick your finger to obtain a small blood sample.
  • Apply the blood sample to a test strip inserted into the metre.
  • It will provide a numerical reading of your blood sugar level.
• Continuous Glucose Monitoring (CGM): CGM devices continuously measure glucose levels throughout the day and night. They provide real-time data and trends, helping individuals make immediate decisions about insulin dosages, meals, and physical activity.
• HbA1c Testing: The Haemoglobin A1c (HbA1c) test provides an average of your blood sugar levels over the past two to three months. It does not require daily monitoring and provides a broader perspective of overall blood sugar control. Healthcare providers typically use A1c results to assess the effectiveness of diabetes management and make treatment adjustments.
• Urine Ketone Testing: Ketone testing is essential for people with Type 1 diabetes, especially when blood sugar levels are consistently high or during illness. Ketones are produced when the body breaks down fat for energy when there’s insufficient insulin. High ketone levels can indicate diabetic ketoacidosis (DKA), a life-threatening condition. Urine ketone test strips can help detect ketones in the urine.
• Blood Pressure Monitoring: High blood pressure (hypertension) often coexists with diabetes and can increase the risk of complications such as heart disease and kidney problems. Regular blood pressure checks are necessary to ensure it remains within a healthy range. Lifestyle changes and medications may be needed to manage blood pressure.

Diabetes Management Strategies

Now let us come to the actionable – how can you control diabetes?

Diabetes can be managed and controlled in two ways – lifestyle modifications and medication. While lifestyle modifications are suggested for all patients, medications may or may not be prescribed and depend on the severity of diabetes.

Medications

Your doctor may prescribe medication to control diabetes. Insulin therapy is essential in Type 1 diabetes. For Type 2 diabetes, various medications can help manage blood sugar levels. These include oral medications and injectable drugs that either increase insulin production, improve insulin sensitivity or slow down glucose absorption in the gut.

Insulin Therapy: Usually two types of insulin are prescribed for diabetes:

Complications

Diabetes is a complex condition that, if not managed properly, can lead to complications and can greatly affect a person’s quality of life. Proper management is essential to prevent or delay these complications.

Here are some of the most common complications that may arise from diabetes:

• Cardiovascular Disease: Diabetes significantly increases the risk of heart disease and stroke. In heart disease, high sugar levels can cause fatty deposits to build up in the blood vessels, leading to conditions like coronary artery disease, heart attacks, and angina. Diabetes can damage blood vessels increasing the likelihood of clot formation thus leading to a stroke.
• Kidney Disease: High sugar levels and increased pressure can harm the kidneys’ filtering units, potentially causing kidney disease. In more serious situations, it can escalate to kidney failure, which may necessitate the need for dialysis or a kidney transplant.
• Nerve Damage (Neuropathy): High sugar levels can harm nerves, causing symptoms like numbness, tingling, pain, and weakness in the extremities. This is called Peripheral Neuropathy and can lead to foot ulcers. Autonomic Neuropathy affects nerves that control involuntary bodily functions, leading to issues in digestion, heart rate, and blood pressure, affecting the gastrointestinal, cardiovascular, and urinary systems.
• Eye Damage (Retinopathy): Diabetic retinopathy is a condition that affects the blood vessels in the retina, leading to vision problems and blindness. Regular eye exams are essential to identify and treat this condition early. People with diabetes also have an increased risk of developing cataracts and glaucoma, which can further impact their vision.
• Foot Complications: Nerve damage and poor circulation can make it difficult for individuals with diabetes to detect and heal foot injuries. This can lead to the development of ulcers and, in severe cases, amputations.

Living with Diabetes

Diabetes is a chronic disease and living with it can be difficult. Apart from lifestyle modifications and taking medicines, a few other aspects should be considered:

Emotional Well-being: Managing diabetes can be emotionally challenging. Seek support from friends, family, or a mental health professional to live a healthy life while managing this chronic disease.

Diabetes and Pregnancy: Women with diabetes can have healthy pregnancies with careful management and medical supervision.

Travelling with Diabetes: Diabetes patients need to eat at regular intervals to prevent a sudden drop in blood sugar levels. This takes the centre stage while you are travelling. Along with other things, pack healthy snacking options and water to keep yourself full throughout your travel time. Be mindful of time zone changes during international travel.

Sources:

• https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/
• https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-management/
• https://www.healthline.com/health/diabetes/types-of-diabetes
• https://www.heart.org/en/health-topics/diabetes/symptoms-diagnosis–monitoring-of-diabetes
• https://www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/
• https://diabetes.org/diabetes/a1c/diagnosis