Diabetes: Causes, Symptoms, Risk Factors, Diagnosis, and Treatment

In Thailand, the original report indicated that approximately 3.5 million people were living with diabetes, with annual treatment costs estimated at 47.596 billion Thai baht.

These figures highlight the importance of preventing and managing diabetes through healthy eating habits, regular physical activity, and appropriate lifestyle modifications.

For individuals already diagnosed with diabetes, following medical advice and attending regular follow-up appointments are essential for controlling the disease, reducing complications, and maintaining a good quality of life.

What Is Diabetes?

Diabetes mellitus is a group of metabolic disorders characterized by persistently elevated blood glucose levels.

This condition occurs when the body does not produce enough insulin or when insulin becomes less effective in regulating blood glucose.

Over time, prolonged high blood sugar levels can affect the normal functioning of various organs and systems throughout the body.

Why Is Insulin Important to the Body?

Insulin is an essential hormone that helps regulate blood glucose levels and allows the body to use glucose as a source of energy.

When we eat, the body breaks down nutrients, including carbohydrates, into substances that can be used for energy, particularly glucose.

Without sufficient insulin, the body cannot effectively transport glucose from the bloodstream into cells, resulting in elevated blood sugar levels.

Insulin is produced and released by the beta cells of the pancreas.

Its primary function is to help glucose enter various tissues and cells, where it is used to generate energy needed for everyday activities.

When insulin production or function becomes impaired, blood glucose levels may increase, contributing to the development of diabetes.

What Are the Four Types of Diabetes?

Diabetes can be classified into four main categories.

1. Type 1 Diabetes

Type 1 diabetes is relatively uncommon, accounting for approximately 5% of diabetes cases in Thailand, according to the original article.

This type develops when the pancreas is unable to produce sufficient insulin.

People with type 1 diabetes require regular insulin injections to prevent insulin deficiency and dangerously high blood glucose levels.

Without appropriate insulin treatment, severe complications may develop, potentially leading to loss of consciousness or sudden death.

Type 1 diabetes is commonly diagnosed in children and adolescents.

2. Type 2 Diabetes

Type 2 diabetes is the most common form of diabetes, accounting for approximately 95% of diabetes cases in Thailand, according to the original article.

It is frequently found among adults aged 45 years and older.

This condition develops when the pancreas cannot produce enough insulin to meet the body's needs and when the body's cells become resistant to insulin.

Type 2 diabetes often does not cause sudden or noticeable symptoms in its early stages.

However, inadequate blood glucose control can eventually lead to serious chronic complications, some of which may become acutely life-threatening.

3. Gestational Diabetes

Gestational diabetes is diabetes diagnosed during pregnancy, typically in the second or third trimester, in women who did not have diabetes before pregnancy.

4. Diabetes Due to Other Specific Causes

This category includes diabetes resulting from other medical conditions or specific underlying causes, such as:

• Genetic abnormalities: Including monogenic diabetes syndromes, such as Maturity-Onset Diabetes of the Young (MODY).

• Medication-related diabetes: Diabetes associated with the use of certain medications.

• Diseases affecting the pancreas: Such as cystic fibrosis and other pancreatic disorders.

What Causes Diabetes?

Diabetes can develop due to a combination of genetic and environmental factors.

Possible contributing factors include:

• Genetics: A family history of diabetes may increase the likelihood of developing the condition.

• Excess weight and obesity: Being overweight, physically inactive, or not exercising regularly may increase diabetes risk.

• Increasing age: The likelihood of developing diabetes generally increases with age.

• Pancreatic disorders: Conditions such as pancreatitis or previous pancreatic surgery may affect insulin production.

• Certain viral infections: Infections such as measles, rubella, and mumps have been identified in the original article as possible factors affecting the pancreas.

• Chronic stress: Long-term stress may contribute to metabolic and hormonal changes.

• Certain medications: Some medications may increase glucose production or reduce the body's response to insulin.

• Pregnancy: Hormones produced by the placenta may interfere with insulin activity, contributing to insulin resistance.

Who Is at Risk of Developing Diabetes?

Certain individuals have a higher likelihood of developing diabetes due to their medical history, physical characteristics, or lifestyle.

Risk factors include:

• Being older than 45 years.

• Having a family history of diabetes.

• Being overweight or having a Body Mass Index (BMI) of 25 kg/m² or higher, or 23 kg/m² or higher for Asian populations.

• Having high blood pressure of 140/90 mmHg or higher.

• Having a history of gestational diabetes.

• Having previously given birth to a baby weighing more than 4 kilograms.

• Having a physically inactive lifestyle.

• Drinking alcohol.

• Smoking.

• Having polycystic ovary syndrome (PCOS).

• Having an HbA1c level of 5.7% or higher.

• Having impaired fasting glucose, with blood sugar levels between 100 and 125 mg/dL.

• Having low high-density lipoprotein (HDL) cholesterol, below 35 mg/dL.

• Having triglyceride levels above 250 mg/dL.

• Having a history of coronary artery disease or cerebrovascular disease.

Individuals with these risk factors should consider undergoing appropriate diabetes screening and discussing preventive measures with a healthcare professional.

How Do You Know If You Have Diabetes?

Diabetes can be identified through blood glucose testing, which is a relatively simple and effective diagnostic method.

Doctors use specific blood glucose and HbA1c criteria to determine whether an individual has prediabetes or diabetes.

Prediabetes

Prediabetes is a condition in which blood glucose levels are higher than normal but have not yet reached the diagnostic threshold for diabetes.

A fasting plasma glucose level between 100 and 125 mg/dL indicates impaired fasting glucose.

Individuals with prediabetes are at increased risk of developing diabetes and should consider lifestyle modifications to reduce disease progression.

Diagnostic Criteria for Diabetes

Diabetes may be diagnosed using the following criteria:

1. Fasting Plasma Glucose (FPG)

A fasting blood glucose level of 126 mg/dL or higher.

2. Random Plasma Glucose

A random blood glucose level of 200 mg/dL or higher, accompanied by symptoms of diabetes.

3. Oral Glucose Tolerance Test (OGTT)

A blood glucose level of 200 mg/dL or higher measured two hours after consuming 75 grams of glucose during an oral glucose tolerance test.

4. Hemoglobin A1c (HbA1c)

An HbA1c level of 6.5% or higher.

What Are the Symptoms of Diabetes?

Symptoms of diabetes may develop gradually and vary depending on the individual's blood glucose levels and overall health.

Common symptoms include:

• Frequent urination: Urinating more often than usual, both during the day and at night.

• Excessive thirst: Feeling unusually thirsty and needing to drink water frequently.

• Fatigue and weight loss: Feeling tired, weak, or losing weight without an obvious explanation.

• Increased hunger: Feeling hungry more frequently and eating more than usual.

• Skin irritation and infections: Experiencing itchy skin, frequent infections, fungal infections, or recurrent vaginal discharge.

• Vision problems: Blurred vision, reduced visual clarity, or double vision.

• Numbness in the hands and feet: Tingling or reduced sensation associated with peripheral nerve damage.

Individuals experiencing these symptoms should consult a healthcare professional for appropriate testing and evaluation.

What Are the Complications of Diabetes?

Poorly controlled diabetes can lead to complications affecting multiple organs and body systems.

1. Eye Complications

Diabetes may contribute to:

• Early development of cataracts.

• Damage to the retina.

• Progressive deterioration of vision.

• Severe visual impairment or blindness.

2. Foot Complications

Diabetes may cause peripheral nerve damage, resulting in numbness in the hands and feet.

Reduced sensation can make injuries more difficult to detect, increasing the risk of foot ulcers, infections, and potentially permanent disability.

3. Kidney Complications

Diabetes can gradually damage the kidneys, potentially leading to:

• Chronic kidney disease.

• Declining kidney function.

• Protein leakage into the urine (proteinuria).

4. Increased Risk of Infections

People with diabetes may be more susceptible to infections because elevated blood glucose levels can affect normal immune function.

5. Ketosis and Related Metabolic Complications

Ketosis and serious metabolic disturbances may occur in individuals with poorly controlled diabetes.

Possible symptoms include:

• Nausea.

• Vomiting.

• Excessive thirst.

• Deep or labored breathing.

• Fever.

• Restlessness or agitation.

6. Cardiovascular and Vascular Complications

Diabetes may contribute to hardening of the arteries and other vascular problems, increasing the risk of:

• High blood pressure.

• Stroke.

• Coronary artery disease.

• Reduced blood supply to the heart.

• Narrowing of blood vessels in the brain.

• Peripheral arterial disease.

7. Sexual Dysfunction

Diabetes may also affect sexual function due to changes involving blood vessels, nerves, and other physiological processes.

How Is Diabetes Treated?

Diabetes is a chronic condition that requires ongoing management.

The primary goals of diabetes treatment are to maintain blood glucose levels as close to the recommended target range as possible, control blood pressure and blood lipid levels, and prevent or delay complications.

Patients should attend regular medical appointments and undergo periodic assessments to monitor their condition.

Diabetes management generally involves two main approaches.

1. Non-Pharmacological Treatment

Non-pharmacological treatment focuses on lifestyle modifications and daily health management.

This may include improving dietary habits, increasing physical activity, maintaining a healthy weight, and following appropriate self-care practices.

2. Pharmacological Treatment

Pharmacological treatment involves the use of medications to help control blood glucose levels.

The appropriate medication and treatment plan should be determined by a physician according to the patient's condition and individual healthcare needs.

Essential Self-Care Practices for People with Diabetes

Individuals living with diabetes should follow appropriate self-care practices to maintain stable blood glucose levels and reduce the risk of complications.

Recommended practices include:

• Choose whole grains: Select carbohydrates from unrefined grains and consume them in appropriate portions.

• Limit unhealthy foods: Reduce foods that are excessively sweet, fatty, or salty. The original article recommends limiting sodium intake to approximately 1,500-2,000 mg per day.

• Eat more fiber: Include vegetables and fruits that are not excessively sweet to increase dietary fiber intake.

• Maintain a healthy weight: Manage body weight appropriately.

• Avoid smoking and alcohol: Stop smoking and avoid alcoholic beverages.

• Exercise regularly: Perform moderate-intensity aerobic exercise for approximately 30 minutes per day, five days per week, according to medical advice and provided there are no contraindications.

• Avoid self-medication: Do not take medications without consulting a doctor, particularly steroids and hormonal medications.

• Learn about diabetes management: Continue improving your understanding of the disease and appropriate self-care practices.

• Manage stress: Maintain emotional balance and practice relaxation techniques to reduce stress.

• Check your feet daily: Examine the feet, including the spaces between the toes and the soles, for wounds or abnormalities.

• Maintain good oral health: Take proper care of the teeth and gums.

• Attend regular follow-up appointments: Monitor treatment outcomes and attend scheduled medical consultations.

• Take prescribed medications consistently: Follow the doctor's instructions regarding medications for diabetes and blood pressure.

• Recognize abnormal blood glucose symptoms: Patients and caregivers should watch for warning signs of blood glucose levels that are too low or too high, such as dizziness, palpitations, or loss of consciousness.

What Is Hypoglycemia (Low Blood Sugar)?

Hypoglycemia is a condition in which blood glucose levels fall to 70 mg/dL or lower.

It may occur in people with diabetes who use certain medications, particularly insulin or some oral glucose-lowering drugs.

Symptoms of Hypoglycemia

Common symptoms include:

• Dizziness or lightheadedness.

• Heart palpitations.

• Loss of consciousness in severe cases.

Some individuals may experience hypoglycemia without noticeable warning symptoms.

How to Manage Hypoglycemia at Home

The appropriate response depends on whether the patient is conscious.

1. If the Patient Is Conscious

The original article recommends the following steps:

• Consume 15-20 grams of sugar or fast-acting carbohydrates.

• Wait 15 minutes.

• Check the blood glucose level again.

• If the blood glucose level remains low, consume another 15-20 grams of sugar and repeat the test.

• Once blood glucose returns to normal, eat a meal or snack as appropriate.

2. If the Patient Is Unconscious

An unconscious patient should be taken to a hospital immediately.

3. Glucagon for Severe Hypoglycemia

Glucagon injections may be used for patients experiencing severe hypoglycemia.

How Can Hypoglycemia Be Prevented?

People with diabetes, especially those using medications that may cause low blood glucose, should monitor their blood sugar levels regularly.

Having a home blood glucose monitoring device can help patients detect abnormal glucose levels.

This practice is known as Self-Monitoring of Blood Glucose (SMBG).

Situations That May Increase the Risk of Hypoglycemia

People with diabetes should be particularly cautious during certain situations, including:

1. Fasting Before Medical Tests

Fasting or avoiding food and water before blood tests may increase the risk of low blood glucose, particularly in patients taking certain diabetes medications.

2. During or After Intense Exercise

Strenuous physical activity may lower blood glucose levels, especially in people using insulin or certain glucose-lowering medications.

3. During Sleep

Hypoglycemia may occur while sleeping, making appropriate blood glucose monitoring and awareness of potential symptoms important.

 

Reference :

Bangkok Hospital Phuket Diabetes

ArokaGO Providers Bangkok Hospital Phuket