Diabetes is one of the most common chronic diseases in the world. Young and old, from all walks of life — for people living with the disease, diabetes is always at the forefront of their minds.
Diabetes is a disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism (breaking down) of carbohydrates and elevated levels of glucose in the blood and urine. It is a lifelong condition that causes a person’s blood sugar level to become too high. Most of the glucose in your body comes from the food you eat. When food is digested, sugar enters your bloodstream. Moving sugar from your bloodstream to your body’s cells requires a hormone (insulin). Insulin comes from a gland located behind the stomach (pancreas). Your pancreas secretes insulin into your bloodstream when you eat. As insulin circulates, it allows sugar to enter your cells — and lowers the amount of sugar in your bloodstream. As your blood sugar level drops, so does the secretion of insulin from your pancreas.
When you have pre-diabetes, this process begins to work improperly. Instead of fueling your cells, sugar builds up in your bloodstream. High blood sugar occurs when your pancreas doesn’t make enough insulin or your cells become resistant to the action of insulin, or both, this is what may subsequently lead to full blown diabetes.
There are two main types of diabetes:
- Type 1 diabetes – where the body’s immune system attacks and destroys the cells that produce insulin
- Type 2 diabetes – where the body doesn’t produce enough insulin, or the body’s cells don’t react to insulin.
Type 2 diabetes is far more common than Type 1, around 90% of all adults with diabetes have Type 2.
Many more people have blood sugar levels above the normal range, but not high enough to be diagnosed as having diabetes. This is sometimes known as pre-diabetes. If your blood sugar level is above the normal range, your risk of developing full-blown diabetes is increased.
It’s very important for diabetes to be diagnosed as early as possible because it will get progressively worse if left untreated. There’s good news, however. Progression from pre-diabetes to Type 2 diabetes can be avoided. Eating healthy foods, incorporating physical activity in your daily routine and maintaining a healthy weight can help bring your blood sugar level back to normal. Pre-diabetes affects adults and children. The same lifestyle changes that can help prevent progression to diabetes in adults might also help bring children’s blood sugar levels back to normal.
Unfortunately, Pre-diabetes generally has no signs or symptoms. The exact cause of pre-diabetes is unknown. But family history and genetics appear to play an important role. Inactivity and excess fat — especially abdominal fat — also seem to be important factors.
What is clear is that people with pre-diabetes don’t process sugar (glucose) properly anymore. As a result, sugar accumulates in the bloodstream instead of doing its normal job of fuelling the cells that make up muscles and other tissues. Research indicates that pre-diabetes is often associated with unrecognized heart attacks and can damage your kidneys, even if you haven’t progressed to type 2 diabetes.
Type 2 diabetes
One possible sign that you may be at risk of Type 2 diabetes is darkened skin on certain parts of the body. Affected areas can include the neck, armpits, elbows, knees and knuckles.
Classic signs and symptoms that suggest you’ve moved from pre-diabetes to Type 2 diabetes include:
- Increased thirst
- Frequent urination
- Blurred vision
The same factors that increase the risk of developing Type 2 diabetes increase the risk of developing pre-diabetes. These factors include:
- Being overweight is a primary risk factor for pre-diabetes. The more fatty tissue you have — especially inside and between the muscle and skin around your abdomen — the more resistant your cells become to insulin.
- Waist size. A large waist size can indicate insulin resistance. The risk of insulin resistance goes up for men with waists larger than 40 inches and for women with waists larger than 35 inches.
- Dietary patterns. Eating red meat and processed meat, and drinking sugar-sweetened beverages, is associated with a higher risk of pre-diabetes. A diet high in fruits, vegetables, nuts, whole grains and olive oil is associated with a lower risk of pre-diabetes.
- The less active you are, the greater your risk of pre-diabetes. Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin.
- Although diabetes can develop at any age, the risk of pre-diabetes increases after age 45. This may be because people tend to exercise less, lose muscle mass and gain weight as they age.
- Family history. Your risk of pre-diabetes increases if you have a parent or sibling with type 2 diabetes.
- Although it’s unclear why, people of certain races — including African-Americans, Hispanics, Native Americans, Asian-Americans and Pacific Islanders — are more likely to develop pre-diabetes.
- Gestational diabetes. If you developed gestational diabetes while pregnant, you and your child are at higher risk of developing pre-diabetes. If you gave birth to a baby who weighed more than 9 pounds (4.1 kilograms), you’re also at increased risk of pre-diabetes.
- Polycystic ovary syndrome. This common condition — characterized by irregular menstrual periods, excess hair growth and obesity — increases women’s risk of pre-diabetes.
- People with a certain sleep disorder (obstructive sleep apnoea) have an increased risk of insulin resistance. People who work changing shifts or night shifts, possibly causing sleep problems, also may have an increased risk of pre-diabetes or Type 2 diabetes.
A Few Things You Might Not Know About Diabetes
- About one third of all people with diabetes do not know they have the disease.
- Type 2 diabetes often does not have any symptoms.
- Only about five percent of all people with diabetes have type 1 diabetes.
- If you are at risk, type 2 diabetes can be prevented with moderate weight loss (10–15 pounds) and 30 minutes of moderate physical activity (such as brisk walking) each day.
- A meal plan for a person with diabetes isn’t very different than that which is recommended for people without diabetes.
- Diabetes is the leading cause of blindness in working-age adults.
- People with diabetes are twice more likely to develop heart disease than someone without diabetes.
- Good control of diabetes significantly reduces the risk of developing complications and prevents complications from getting worse.
- Bariatric surgery can reduce the symptoms of diabetes in obese people.
Bottom Line: Seeing as a third of people with diabetes do not know they have it, it’s important to simply go in for a test that takes no longer than half an hour. Tests available include:
- Fasting Plasma Glucose –This blood test is taken in the morning, on an empty stomach. A level of 126 mg/dl or above, on more than one occasion, indicates diabetes.
- Casual or Random Glucose – This blood test can be taken anytime during the day, without fasting. A glucose level of 200 mg/dl and above may suggest diabetes.
If any of these test results occurs, testing should be repeated on a different day to confirm the diagnosis. If a casual plasma glucose equal to 200 mg/dl or above is detected, the confirming test used should be a fasting plasma glucose or an oral glucose tolerance test.