DIABETES EXPLAINED: EVERYTHING YOU NEED TO KNOW

Although diabetes is manageable for many people, living with diabetes is still not easy and is a complex condition. Diabetes Everything You Need To Know, takes an in-depth look at the disease, its causes and symptoms, and how to manage the different types effectively on a day to day basis. This blog is a must-read for anyone who wants to understand this disease better.

Undiagnosed diabetes is a severe disease. Millions of people worldwide have diabetes, but many don't know it because the symptoms are often mild or mistaken for other conditions.

Diabetes is a disease that affects how your body uses glucose (blood glucose ). Glucose provides the cells in both muscle and tissue with energy. It also provides your brain with fuel.

Everyone experiences diabetes differently, so if you are concerned about your health or experience unexplained symptoms, please discuss your fears with a healthcare professional. We strive to help our readers better understand diabetes and what it means to live with diabetes.

What is diabetes?

Diabetes is a condition where the cells in your body cant take up sugar (glucose) into its cells, resulting in an excess amount of glucose within the bloodstream.

If you have diabetes, either:

• Your pancreas produces insulin, but your body's cells don't respond to it and can't use it as they usually should.
• Or your pancreas doesn't make any insulin or not enough insulin.

The role of insulin in the absorption of glucose

During digestion, your body breaks down the food you eat into various nutrient sources. The body converts the carbohydrates from pasta, bread, rice, potatoes, etc., into glucose, a simple sugar that serves as a vital energy source.

The pancreas secretes insulin and glucagon, which directs the muscle and fat cells to uptake glucose. Cells get energy from glucose or convert it into fat for long-term storage.

Insulin and glucagon work together to maintain a condition known as homeostasis, in which the conditions inside the body remain constant. When glucose levels are too high, the pancreas secretes more insulin. When blood sugar levels drop, the pancreas releases glucagon to raise them.

If there's not enough insulin available, these glucose molecules accumulate in the bloodstream resulting in an increased blood sugar level called hyperglycemia.

By monitoring blood sugar levels and maintaining an appropriate balance, your body can function correctly. This equilibrium allows the cells to get enough energy while preventing nerve damage caused by continuous elevations in blood sugar.

Diabetes in the USA

Plus-minus, 34 million people of all ages have diabetes in the U.S. (About one in every ten people). Approximately 3% of U.S. adults (about one in every five) are unaware that they have diabetes. An increase in age has been linked to higher numbers of diagnosed diabetes. 26% of adults aged 65 and older (about one in every four) have diabetes.

Management of diabetes

Early diagnosis of diabetes. A person's health is likely to decrease the longer they live with undiagnosed and untreated diabetes. For those diagnosed with diabetes, cost-effective interventions are possible. Irrespective of the type of diabetes they may have. These treatments to control blood glucose include: medications, physical activity, planned diet, and the control of lipids and blood pressure.

 This reduces cardiovascular risk and other complications. Regular screening for damage to the feet, eyes, and kidneys to assist early treatment is recommended. Standards and protocols can strengthen diabetes management. Anyone can combine diabetes and cardiovascular disease management. 

Initial diabetes symptoms and signs

Hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar) are the only two initial diabetes symptoms.

Hyperglycemia (uncontrolled diabetes)

Hyperglycemia, or excess blood sugar, is a symptom that characterizes diabetes. It can affect pregnant women with gestational diabetes and people with type 1 and type 2 diabetes.

Insufficient insulin production and the resistance to the actions of insulin, or both, can cause diabetes to develop. Low insulin production is a common problem for people with diabetes.

However, it can occasionally affect people who do not have diabetes. Usually, only seriously ill people are involved, such as those who recently had a stroke, heart attack, or a severe infection.

Hyperglycemia can be potentially dangerous if blood glucose remains high for long periods. 

Hyperglycemia signs

• Increased thirst
• Increased urination
• Blurred vision
• Headache
• Nausea
• Sores that heal slowly
• Frequent infections, such as vaginal infections, gums, or skin infections 
• Presence of ketones in the urine (ketones are a byproduct of the breakdown of fat and muscle when there is not enough insulin available)
• Fatigue

How to prevent hyperglycemia

• Be vigilant of what you eat. Take note of how snacking and eating sugary foods or carbohydrates can affect your blood sugar levels.
• Monitor your blood sugar level daily – using a device to check your levels at home so that you can spot an increase early.
• Stick to your treatment plan – remember to take your insulin or other diabetes medication as recommended by your doctor.
• Take extra care when you're ill – your care team can provide you with some vital information that outlines what you can do to keep your blood sugar level under control during an illness.
• Be as active as possible – getting regular exercise can help stop your blood sugar level from rising. It is always better to check with your doctor first if you're taking diabetes medication, as some medicines can lead to hypoglycemia if you exercise too much.

Hypoglycemia

A low blood sugar level also called hypoglycemia or a "hypo," drops blood glucose below acceptable levels.

It commonly affects people with diabetes, especially if they take insulin.

A low level can be dangerous if not treated quickly, but you can usually treat it easily without the assistance from a doctor.

Hypoglycemia signs

• Sweating.
• Feeling tired.
• Dizziness.
• Feeling hungry.
• Tingling lips.
• Feeling shaky or trembling.
• Fast or pounding heartbeat (palpitations).
• Easily irritated, tearful, anxious, and moody.
• Turning pale.

You may also experience other symptoms if your low sugar level is not treated, such as:

• Shakiness.
• Passing out or collapsing.
• Irritability.
• Feeling sleepy.
• Blurred vision.
• Difficulty concentrating.
• Slurred speech or clumsiness.
• Passing out or collapsing.
• Seizures or fits.
• Overall Weakness.
• Confusion.

A Hypo can also happen while you're sleeping. Hypo may cause you to wake up during the night. It can also cause damp sheets (from sweat), tiredness, and headaches in the morning.

How to prevent hypoglycemia

You can lower your risk of having a Hypo attack by doing the following:

• Be aware of the signs of a low sugar level to help you treat it quickly.
• Always carry a sugary treat such as fruit juice, some glucose tablets, or some sweets with you. If you have a glucagon injection kit, make sure it's on you at all times.
• Skipping meals is a bad idea.
• Check your blood sugar level regularly.
• When consuming alcohol, be cautious. Do not consume vast amounts of alcohol; keep an eye on your blood sugar levels frequently, and eat a carbohydrate snack afterward.
• Have a tiny snack high in carbohydrates before bed if your blood sugar level drops too low while you're asleep (nocturnal hypoglycemia).
• When exercising, eating a carbohydrate snack before you start can help reduce the risk of hypo. If you take some type of diabetes medicine, your doctor may recommend you take a lower dose before or after intense exercise.

Low blood sugar level if you are not a diabetic

If you have low blood glucose levels, but you, do not have diabetes,

Possible causes include:

• After eating, your body releases too much insulin (called reactive hypoglycemia or postprandial hypoglycemia).
• Not eating (fasting) or malnutrition.
• Complications of pregnancy.
• Gastric bypass (weight loss surgery).
• Medical conditions include hormone levels, pancreas, liver, kidneys, adrenal glands, or heart problems.
• Some medicines, including quinine (taken for malaria).

See a G.P. if you think you keep getting low blood sugar level symptoms. Your doctor can perform simple tests to check if your blood sugar level is low and determine what's causing it.

If you keep getting a low glucose level, talk to your diabetes care team about things you can do to help prevent it.

Pre-diabetes

Many people have blood glucose levels in the normal range but not high enough to be diagnosed with diabetes.

Pre-diabetes conditions in which your blood sugar levels are higher than usual but not high enough to be classified as diabetes. If your blood glucose level is higher than the normal range, you will have an increased risk of developing diabetes.

Diabetes will progressively worsen if left untreated. Diagnosis needs to happen as early as possible. 

Three main types of diabetes:

Type 1, Type 2, and Gestational diabetes (diabetes while pregnant).

Type 1 diabetes

An autoimmune reaction can cause type 1 diabetes (the body attacks itself by mistake) that stops your body from making insulin.

Type 2 diabetes

Type 2 diabetes drastically reduces how the body regulates and uses glucose to fuel cells. Excess sugar circulates the bloodstream. type 2 diabetes is a chronic disease. After a while, high blood sugar levels can lead to circulatory, nervous, and immune systems disorders.

Gestational diabetes

Although not life-threatening, Gestational diabetes occurs during pregnancy and can resolve after the baby is delivered. Women with gestational diabetes are at an higher risk of complications during pregnancy and delivery. Gestational diabetes are more prone if family members also have it. These women and possibly their children are also at increased risk of type 2 diabetes in the future.

Causes of gestational diabetes

Closer to the end of term, hormones (estrogen, cortisol, and human placental lactogen) made by the placenta can block or make your cells more resistant to insulin. 

Your pancreas will increase its insulin production to accommodate for this, but sometimes it can't keep up.

The glucose challenge test, commonly known as the one-hour glucose tolerance test, assesses your body's reaction to glucose. The glucose challenge test is only done during pregnancy to screen for gestational diabetes. 

Diabetes risk factors are different for each type

Risk factors for type 1 diabetes

• Having a family history of Type 1.
• Presence of autoantibodies (Immune system attack).
• pancreas injuries (due to infection, tumor, surgery, or accident).
• Physical stress (such as surgery or illness).
• Exposure to diseases caused by infection, tumor, surgery, accident or viruses that affect the pancreas 

Risk factors for pre-diabetes and type 2 diabetes

• Low high-density lipoprotein cholesterol (the "good" cholesterol) and high triglyceride levels.
• Being overweight
• Being physically inactive.
• A smoker.
• Being Native-American, African-American, Asian-American, Hispanic, or Pacific Islander.
• Having high blood pressure.
• Having gestational diabetes 
• Giving bearth to a baby weighing 9 pounds or more.
• Being age 45 or older.
• Having a history of stroke  or heart disease.
• Having polycystic ovary syndrome.

Risk factors for gestational diabetes

• Closer to the end of term, hormones (estrogen, cortisol, and human placental lactogen) made by the placenta can block or make your cells more resistant to insulin. 
• Family history of pre-diabetes or Type 2 diabetes.
• Being overweight before your pregnancy.
• Being African-American, Asian-American, Hispanic, or Native-American.
• Being over 25 years of age.

Symptoms of diabetes

Early signs of type 1 diabetes

Type 1 diabetes symptoms appear suddenly and progress swiftly over several weeks. This form of diabetes, previously known as juvenile diabetes, generally begins in childhood or adolescence. On the other hand, Type 1 diabetes may also develop later in life.

Early signs of type 2 diabetes

Although many people with type 2 diabetes won't show any symptoms for many years, their symptoms sometimes develop slowly. Few people with type 2 diabetes have no signs or symptoms until complications develop.

Early signs of gestational diabetes

• Dry mouth and constant thirst.
• A lack of energy and extreme fatigue.
• Tingling in the hands and feet.
• Urge to urinate.
• Severe nausea after eating (maybe even vomiting).
• Intense cravings for sweet drinks and foods.
• Blurred vision.

Diagnosis

The glycated hemoglobin (A1C) test diagnoses type 1, 2, and gestational diabetes. This blood test reveals your average glucose level in your blood during the previous two to three months.

Results can be interpreted as follows:

• Below 5.7% is in the normal range.
• 5.8% to 6.4% is pre-diabetes.
• 6.5% or higher on two different tests indicates diabetes.

If the A1C test isn't accessible, or if you have any restrictions that interfere with an A1C test, your doctor may employ one of the following tests to establish diabetes:

1. Random blood glucose level test. 
2. Fasting blood sugar test. 
3. Oral glucose tolerance test.

Diabetic ketoacidosis (DKA)

Diabetic ketoacidosis, also known as DKA, builds acids in your blood. It can happen when your blood sugar levels are too high for too long. DKA is a severe complication of diabetes and can be life-threatening.

You can get DKA if you have a high level of ketones in your blood or urine. You can check your ketone levels using a home-testing kit.

Symptoms usually start over 24 hours, but they can happen faster. DKA results from the body's natural breaking down fat and muscle to generate energy. DKA can result in a diabetic coma.

DKA usually affects people with type 1 diabetes and can be treated.

Symptoms of DKA

• Stomach pain.
• Shortness of breath.
• Nausea and vomiting.
• Excessive thirst.
• Weakness or fatigue.
• Confusion.
• Frequent urination.
• Scented breath.

Causes of DKA

• Missing an insulin injection.
• Not injecting an adequate amount of insulin. 
• Illness or infection. 
• A clog in your insulin pump.

Hyperosmolar hyperglycemic (HHS)

Hyperglycemic hyperosmolar syndrome (HHS) is also known as Hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Diabetic hyperglycemic hyperosmolar syndrome (HHS) is a complication of type 2 diabetes. It involves extremely high glucose levels without the presence of ketones.

HHS occurs when the blood glucose of a person with diabetes becomes too high (hyperglycemia) for a long time. The extra sugar passes into the urine, which causes the person to urinate frequently. because of the frequent urination, they lose a lot of fluid, which leads to severe dehydration (extreme thirst).

Severe dehydration is caused by the body trying to get rid of excess blood glucose. It usually affects people with type 2 diabetes.

Symptoms of HHS

Hyperosmolar hyperglycemic can take days or weeks to develop. 

Possible signs and symptoms include:

• A blood glucose level of 600 milligrams per deciliter (mg/dL) or 33.3 millimoles per liter (mmol/L) or higher.
• Increased urination.
• Excessive thirst.
• Dry mouth.
• Vision loss.
• Drowsiness, confusion.
• Convulsions.
• Warm, dry skin without sweating.
• Fever (usually over 101F.).
• Hallucinations.
• Coma.

Causes of HHS

• A heart attack or stroke.
• Not taking medication to manage diabetes.
• Infection or illness such as urinary tract infection or pneumonia. 
• Certain medications—such as steroids or diuretics—can cause the syndrome.

Consult your doctor if your blood glucose is persistently higher than the target range recommended or if you have signs or symptoms of diabetic hyperosmolar syndrome.

Other types of diabetes

Type 1, Type 2, and gestational diabetes are the main ones but there is a range of other types of diabetes.

These types of diabetes are rare, with about 2% of people affected by them. These rare types of diabetes include:

• Neonatal diabetes (occurs in babies during the first six months)
• Cystic fibrosis-related diabetes
• Different types of monogenic diabetes
• Diabetes caused by rare syndromes
• Steroids and antipsychotics induced diabetes.
• Diabetes caused by surgery or hormonal imbalances

Unfortunately, many people with rarer types of diabetes are misdiagnosed, leading to delays in getting the proper treatment.

Short Video

How to lower blood sugar levels naturally

Blood glucose control and management are essential for people with diabetes, as chronically high blood glucose levels can lead to life threatening complications.

The following are some simple and evidence-based methods for reducing blood glucose levels naturally and in addition to controlling your glucose absorption.

Exercise

Regular exercise may assist you in achieving and maintaining healthy body weight while also improving insulin sensitivity.

Your cells can more easily use the available sugar in your bloodstream by increasing your insulin sensitivity.

Taking frequent sitting breaks for a few minutes is a good idea for office workers. Squatting or leg raises, for example, or simply walking are all excellent options.

Manage your carb intake

Your carb intake strongly influences your blood glucose levels as your body breaks carbs down into sugars, mainly glucose. Studies show that eating a low-carb diet helps reduce blood glucose levels and prevent blood glucose spikes.

Stay hydrated

Water may help rehydrate the body, decrease blood glucose levels, and lower diabetes risk. Estimated 20% of daily fluid intake comes from food, and the rest from drinks. Men should drink at least 3.7 liters (0.977 gallons) of water per day and women at least 3 liters (0.792 gallons) of water.

You've undoubtedly heard the recommendation to consume eight glasses of water each day. That's easy to remember, and it's a reasonable goal.

By drinking water and other beverages when thirsty, most healthy individuals can maintain their hydration levels. For some people, less than eight glasses each day may be enough. However, for other individuals, more might be required.

You will know if you take enough fluids if you rarely feel thirsty and your urine is colorless or light yellow.

You might need to modify your total fluid intake based on several factors:

Environmental factors

Warm or humid weather makes you sweat, and you will then require more fluids. Dehydration can occur at high altitudes.

Overall health

Your body loses fluids during fever, vomiting, or diarrhea. Increase your water intake or use oral rehydration solutions. Urinary tract infections and urinary tract stones are just two examples of health issues that might require more fluid intake. On the other hand, Bladder illnesses can also do very well with increased fluid intake.

Portion control

Monitoring your serving sizes by implementing portion control can help you regulate your calorie intake and maintain a moderate weight.

Fiber-rich diet

There are two types of fiber— insoluble and soluble.

1. Soluble fiber dissolves in water and includes plant pectin and gums. 
2. Insoluble fiber doesn't dissolve in water. It provides plant cellulose and hemicellulose.

A high fiber diet minimizes blood glucose lows and improves your body's ability to regulate blood sugar levels.

The recommended daily fiber intake is about 14 grams for every 1,000 calories.

Foods high in fiber include fruit, vegetables, whole grains, and legumes.

Manage stress levels

When stressed, your body releases glucagon and cortisol hormones, which cause blood sugar levels to rise.

A significant decrease in stress levels while also lowering blood sugar levels has been linked to exercising, meditation, and other relaxation techniques. Among individuals with chronic diabetes, yoga and mindfulness-based stress reduction may also aid in the repair of insulin secretion difficulties.

Enough quality sleep

The quantity of sleep is just as important as the quality. The National Sleep Foundation recommends that adults need at least 7–8 hours of quality sleep per night.

Sleep deprivation increases the levels of the hormone cortisol, which plays an essential role in blood sugar management.

Sleeping poorly and not getting enough rest can impact blood sugar levels and insulin sensitivity, posing a danger of developing type 2 diabetes.

Adding specific foods to your diet

Some of the food products advertised to have anti-diabetes properties include:

• Apple cider vinegar. 

According to older studies, Apple cider vinegar may lower blood sugar levels by delaying the stomach's emptying following a meal.

• Cinnamon. 

Cinnamon improves insulin sensitivity and reduces carbohydrate breakdown in the digestive tract. As per some studies, cinnamon moderates the rise in blood sugar after a meal.

• Berberine. 

Berberine is: 

an organic hetero-pentacyclic compound

an alkaloid antibiotic

an botanical anti-fungal agent and

an berberine alkaloid. 

According to studies, this compound stimulates enzymes' breakdown of glucose, encourages your tissue's use of sugar, and increases insulin production.

• Fenugreek seeds

These seeds may support blood sugar management due to their high fiber content, which delays stomach emptying and subsequently prevents your blood sugar levels from spiking.

Please discuss this with your doctor before adding these foods to your diet.

• Eat chromium and magnesium-rich foods

High blood sugar levels and diabetes can be linked to micronutrient deficiencies.

Chromium is vital for carb and fat metabolism. It might enhance the impact of insulin, which can assist with blood sugar control.

Increase in magnesium also show to benefit blood sugar levels. In people with diabetes, magnesium deficiencies may cause insulin resistance and glucose tolerance problems.

• Monitor blood sugar levels

Checking your blood sugar levels and recording them in a diary helps you adapt meals and drugs as needed to control your blood sugar levels better.

The Food and Drug Administration (FDA) regulates supplements differently than prescription medications. It's critical to get supplements that an independent lab has evaluated for purity and ingredient content.

If you're already taking blood-sugar-lowering medications, please discuss herbal supplements with your doctor, as your medicine may negatively interact with them.

Low glycemic index

Different carbohydrate-containing foods affect blood sugar levels differently. These effects quantify the measurement known as the glycemic index. 

What is the glycemic index (G.I.)?

It's how fast the carbohydrates are broken down and digested into the blood. Also, how much power and speed it has to raise your glucose level.

Glycemic index <50=Low, 50-70=Med, >70= High

If you have diabetes, your blood sugar increases when you eat carbohydrates. The number of carbs you consume at a meal or in a snack mainly determines what your blood sugar will do. 

The G.I. divides foods into low, medium, and high and ranks them on a scale of 0–100. On the other hand, the glycemic index provides only a portion of the picture. It doesn't tell you how high your blood sugar will rise after eating that food. 

To fully comprehend a food's impact on blood sugar, you must first understand how quickly glucose enters the bloodstream and how much glucose per serving it can provide.

Low glycemic Load

The glycemic load, a separate measure, does both by giving you a more accurate picture of a food's real-life effects on your blood sugar.

What is the glycemic load?

Glycemic load is the concentrated amount of carbohydrate or carbohydrate in food.

Glycemic load <10=Low, 10-20=Med, >20=High

Watermelon, has a glycemic index of 72. But a serving of watermelon has a low glycemic load of only 4.

Choosing to eat good sources of carbs can help you control your blood sugar.

The following link provides a general food list index with Glycemic indexes and loads. It will give you a more accurate picture of a food's real-life impact on your blood glucose.

Suggestion

Strive to consume foods with a Glycemic index less than 50 and a Glycemic load less than 10 on the scale. (Please discuss with your health care provider before changing your diet).

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