Understanding Diabetes

What Is Diabetes?

Diabetes is a condition in which blood glucose levels are higher than normal. It occurs when the body does not produce enough insulin or cannot use insulin effectively, a condition known as insulin resistance.

Insulin is a hormone that helps glucose move from the bloodstream into the body’s cells, where it is used for energy. When this process does not work properly, glucose accumulates in the blood.

Persistently high blood glucose can damage blood vessels and organs throughout the body, increasing the risk of complications such as:

๐ Vision loss

๐ Kidney failure

๐ Stroke and paralysis

๐ Coronary artery disease

๐ Nerve damage

Symptoms of Diabetes

A normal fasting blood glucose level is generally around 60-100 mg/dL before breakfast. People whose blood glucose is only slightly elevated may not experience any noticeable symptoms.

When blood glucose rises significantly, symptoms may include:

๐ Frequent and excessive urination: Excess glucose passes into the urine and draws additional water from the body.

๐ Dry mouth, excessive thirst, and increased fluid intake: These symptoms occur because the body loses a large amount of water through urination.

๐ Frequent hunger despite eating more: The body cannot use glucose effectively for energy.

๐ Unexplained weight loss and fatigue: Cells are unable to obtain the energy they need from glucose.

๐ Slow-healing wounds: High blood glucose can impair circulation and reduce the ability of white blood cells to fight infection.

๐ Frequent skin infections: People with diabetes may be more susceptible to bacterial and fungal infections.

๐ Recurrent vaginal yeast infections: Elevated glucose levels can create conditions that encourage fungal growth.

๐ Blurred vision: This may result from temporary fluid changes in the lens, cataracts, or diabetic retinopathy.

Diagnosing Diabetes

Diabetes may be diagnosed using a blood glucose test or a haemoglobin A1C test.

Haemoglobin A1C reflects the average blood glucose level over approximately the previous three months.

A diagnosis may be made when one of the following criteria is met:

1. Random Blood Glucose

๐ Blood glucose of 200 mg/dL or higher, together with typical symptoms of diabetes

This test does not require fasting.

2. Fasting Blood Glucose

๐ Blood glucose of 126 mg/dL or higher after fasting for at least eight hours

3. Haemoglobin A1C

๐ An A1C level of 6.5% or higher

This test does not require fasting.

Depending on the patient’s symptoms and clinical condition, the doctor may repeat the test to confirm the diagnosis.

What Is Prediabetes?

Prediabetes is a condition in which blood glucose is higher than normal but has not yet reached the diagnostic level for diabetes.

Without lifestyle changes, some people with prediabetes may progress to diabetes over the following years, particularly those who:

๐ Are overweight or living with obesity

๐ Do not exercise regularly

๐ Have high cholesterol or triglyceride levels

๐ Have high blood pressure

๐ Have a family history of diabetes

Diagnostic Criteria for Prediabetes

Prediabetes may be identified through either of the following:

๐ Fasting blood glucose of 100-125 mg/dL after fasting for at least eight hours

๐ Haemoglobin A1C of 5.7-6.4%

How to Reduce the Risk of Developing Diabetes

People diagnosed with prediabetes should make lifestyle changes to lower their risk of progressing to diabetes.

1. Achieve a Healthy Body Weight

People who are overweight should adjust their diet and exercise regularly to reduce weight gradually and safely.

Even modest weight loss may improve insulin sensitivity and blood glucose control.

2. Exercise Regularly

Aim for at least 150 minutes of moderate-intensity physical activity per week.

Suitable activities include:

๐ Brisk walking

๐ Cycling

๐ Swimming

๐ Aerobic exercise

๐ Strength training appropriate for individual fitness

3. Avoid Smoking and Limit Alcohol

Smoking increases the risk of cardiovascular disease and worsens complications associated with diabetes.

Alcohol may also affect blood glucose control and should be avoided or limited according to medical advice.

4. Check for Related Conditions

People with prediabetes should also be assessed for conditions that frequently occur together, including:

๐ High blood pressure

๐ High cholesterol

๐ High triglycerides

๐ Excess body weight

These conditions should be managed appropriately to reduce cardiovascular risk.

5. Reduce Sugar, Refined Carbohydrates, and Fried Foods

Limit foods and drinks containing:

๐ Added sugar

๐ Sweetened beverages

๐ Refined flour and starches

๐ High-fat foods

๐ Deep-fried foods

Sugar substitutes may be used when appropriate, but portion size and the overall nutritional quality of the diet remain important.

6. Eat More Vegetables, Whole Grains, and Appropriate Portions of Fruit

Choose foods that provide fibre and nutrients, such as:

๐ Vegetables

๐ Whole grains

๐ Beans and legumes

๐ Fresh fruit in suitable portions

๐ Lean sources of protein

These foods may help improve fullness and support better blood glucose control.

7. Monitor Blood Glucose Regularly

People with prediabetes should generally have their fasting blood glucose or A1C checked at least once a year, or more frequently if recommended by their doctor.

Treatment for Diabetes

People diagnosed with diabetes should follow the same lifestyle recommendations given to those with prediabetes and consult a doctor for further evaluation and ongoing treatment.

Diabetes is a chronic condition that requires long-term management. Poor blood glucose control increases the risk of serious complications.

Treatment may include:

๐ Dietary adjustments

๐ Regular exercise

๐ Weight management

๐ Oral diabetes medicines

๐ Injectable medicines

๐ Insulin therapy

๐ Regular blood glucose monitoring

๐ Management of blood pressure and cholesterol

The treatment plan depends on the type of diabetes, blood glucose level, age, health condition, and risk of complications.

Treatment Targets

General treatment targets may include:

๐ Fasting blood glucose between 70 and 130 mg/dL

๐ Haemoglobin A1C below 7%

๐ Blood pressure within the target range

๐ Cholesterol and triglycerides under control

๐ Body weight maintained within an appropriate range

Individual targets may differ depending on age, pregnancy, other medical conditions, and the risk of low blood glucose. Patients should follow the targets set by their doctor.

Complications of Diabetes

Diabetes complications are more likely when blood glucose is not well controlled. Other factors, including high blood pressure, high cholesterol, and smoking, may further increase the risk.

Short-Term Complications

Acute complications can develop quickly and may require emergency treatment.

Diabetic Ketoacidosis

Diabetic ketoacidosis occurs when the body cannot use glucose properly and begins breaking down fat too rapidly, producing acidic substances called ketones.

Possible symptoms include:

๐ Nausea and vomiting

๐ Abdominal pain

๐ Deep or rapid breathing

๐ Fruity-smelling breath

๐ Severe weakness

๐ Confusion or loss of consciousness

Severe Hyperglycaemia

Extremely high blood glucose can cause severe dehydration, confusion, reduced consciousness, or coma.

Infection

High blood glucose weakens the body’s ability to fight infection and may increase the risk of:

๐ Skin infections

๐ Urinary tract infections

๐ Fungal infections

๐ Severe or slow-healing wounds

Hypoglycaemia

Diabetes medicine or insulin may occasionally lower blood glucose too much.

Symptoms may include:

๐ Sweating

๐ Shaking

๐ Hunger

๐ Dizziness

๐ Palpitations

๐ Confusion

๐ Seizures or unconsciousness in severe cases

Long-Term Complications

Long-term poor blood glucose control may gradually damage blood vessels and nerves.

Possible complications include:

๐ Diabetic retinopathy: Damage to the blood vessels in the retina that may lead to visual impairment or blindness

๐ Diabetic kidney disease: Progressive kidney damage that may eventually lead to kidney failure

๐ Peripheral neuropathy: Nerve damage causing numbness, tingling, burning pain, or reduced sensation, particularly in the feet

๐ Stroke: Damage caused by interruption of blood flow to the brain

๐ Coronary artery disease: Narrowing of the blood vessels supplying the heart

๐ Peripheral artery disease: Reduced blood flow to the legs and feet

๐ Diabetic foot ulcers: Wounds that heal slowly and may become severely infected

These complications can result in permanent disability, loss of limbs, or death.

The Importance of Regular Health Checks

Diabetes may develop without obvious symptoms, particularly during its early stages. Regular health examinations are therefore important, especially for people who:

๐ Are overweight

๐ Have a family history of diabetes

๐ Have high blood pressure or abnormal cholesterol levels

๐ Exercise infrequently

๐ Previously had gestational diabetes

๐ Have polycystic ovary syndrome

๐ Are older adults

Early detection, appropriate treatment, and consistent blood glucose control can significantly reduce the risk of complications and help people with diabetes maintain a good quality of life.

 

Reference :

Kasemrad Hospital Ramkhamhaeng Understanding Diabetes

ArokaGO Providers Kasemrad Hospital Ramkhamhaeng