Type 1 diabetes used to be known as insulin-dependent diabetes (IDDM), or juvenile-onset diabetes as it often begins in childhood. Type 1 diabetes is an autoimmune condition where the immune system wrongly identifies and subsequently attacks the pancreatic cells that produce insulin, leading to little or no insulin production.
Type 2 diabetes used to be known as non-insulin dependent diabetes (NIDDM) and adult onset diabetes, but it is increasingly common in children, largely due to children being more likely to be obese or overweight. In this condition, the body usually still produces some insulin, but this is not enough to meet demand and the body's cells do not properly respond to the insulin. The later effect is called insulin resistance, where persistently elevated blood glucose has caused cells to be overexposed to insulin, making them less responsive or unresponsive to the hormonal messenger.Prediabetes
Prediabetes is a condition in which the blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. Millions of people worldwide do not know that they have prediabetes. That is why it is important to get screened for prediabetes. If the HbA1C is between 5.7% and 6.4%, or the FPG is more than 110 mg/dL but less than 126 mg/dL, or the OGTT (2-hour glucose test) is between 140 and 199 mg/dL, the condition is termed as prediabetes. Prediabetic persons may develop type 2 diabetes in later life. There is a rule of “thirds” – about one third of prediabetic people will develop diabetes in the next five years, one third will remain prediabetic, while one third will revert to normal.
Those who have prediabetes are at a higher risk of cardiovascular disease. Following proper diet and exercise programmes to control weight can help prevent progression from prediabetes to diabetes and avoid cardiovascular problems. Screening for diabetes and prediabetes should not be delayed; it is better done early rather than late.
Gestational diabetes occurs in pregnancy and typically resolves after childbirth. People who have experienced gestational diabetes do, however, have an increased risk of developing type 2 diabetes after pregnancy.
One of the most important things to remember is that diabetes does not always produce symptoms until the disorder is fairly advanced. If one has a few of the following symptoms, one may suspect diabetes:
1. Diabetes can affect the eyes. High blood sugar levels can cause the lens to swell, and the vision may become blurred or foggy.
2. An affected person may become easily tired for no apparent reason.
3. One may pass urine more frequently than before.
4. Hunger may increase and the person may eat more than usual.
5. There may be weight loss despite a good appetite.
6. A person may become overly thirsty and tend to drink excessive amounts of water. This is because the body tries to compensate for the water lost through the urine.
7. A high blood sugar level makes it hard for the body to fight infections. Wounds do not heal easily, there may be frequent infections of the skin, bladder or gums, and itching in the genital area.
8. There may be numbness or tingling in the hands and feet.
9. The symptoms of type 1 diabetes are more sudden and severe. Children with diabetes complain of tiredness, weakness and may sometimes exhibit irritable behaviour.
The symptoms of type 2 diabetes may be so mild that it may not be noticed for years, and therefore remains untreated. This may lead to complications. As one cannot always rely on symptoms, the only way to know whether one has diabetes is to be screened (tested) for it.
Screening for diabetes is done in a doctor’s office, clinic or laboratory under the supervision of a health-care provider. The health-care provider may do one or several blood tests to look for diabetes. High-risk individuals should be screened for diabetes at regular intervals, beginning at the age of 35 years.
The aim of treatment is to maintain the blood sugar level as close to normal as possible. The type of food and level of physical activity play an important role in controlling blood sugar, as do medicines. Various medicines can be used to treat diabetes. Medicines for diabetes should be prescribed only by a health-care provider. However, it is important for the person with diabetes to understand how the medicines work.
Treatment depends on the type of diabetes, complications, presence of other risk factors, coexisting active medical problem, age and general health at the time of diagnosis. The health-care provider will decide which medicine will work best for the individual patient. The advantages and disadvantages of each of these medicines can be explained by the health-care provider. For treatment to be successful, the patient must carefully manage the diet, be physically active, take oral medication and/or insulin, and be well informed about the disease.