What is Diabetes?

Diabetes is a long-term health condition that impacts the way your body handles sugar (glucose). Normally, when you eat, your body converts food into glucose, which is used by your cells for energy. To get glucose from your bloodstream into your cells, your body relies on insulin—a hormone produced by the pancreas.

When someone has diabetes, either the pancreas doesn’t produce enough insulin, or the body can’t use insulin the way it should. This leads to a buildup of sugar in the bloodstream, which can cause various health issues over time. Without proper management, elevated blood sugar levels can damage important organs like the heart, kidneys, eyes, and nerves.

Diabetes requires lifelong management, which can include changes to diet, physical activity, and sometimes medications or insulin therapy to help control blood sugar levels.

Types of Diabetes?

Diabetes comes in several forms, each with unique characteristics and management needs. Understanding these types is essential for effective treatment and prevention.

Type 1 Diabetes

Type 1 diabetes occurs when the body’s immune system mistakenly attacks the insulin-producing cells in the pancreas, leaving the body unable to produce sufficient insulin. As a result, blood sugar levels increase. While this type of diabetes is commonly diagnosed in children and young adults, it can develop at any age. People with Type 1 diabetes need to rely on daily insulin therapy, either through injections or an insulin pump, to manage their blood sugar.

Type 2 Diabetes

Type 2 diabetes is the most common form, accounting for about 90% of all diabetes cases. In this type, the body doesn’t use insulin effectively (insulin resistance) or doesn’t produce enough insulin. Lifestyle factors such as poor diet, lack of physical activity, and genetics contribute to its development. It’s more common in adults but is increasingly seen in younger people due to rising obesity rates. Management includes lifestyle changes, oral medications, and sometimes insulin therapy.

Gestational Diabetes

Gestational diabetes occurs during pregnancy when hormonal changes make the body less responsive to insulin. While it usually resolves after childbirth, it increases the risk of developing Type 2 diabetes later in life for both the mother and child. Monitoring blood sugar levels and maintaining a healthy diet and exercise routine are crucial during pregnancy.

Less Common Types of Diabetes

• Latent Autoimmune Diabetes in Adults (LADA): Often misdiagnosed as Type 2 diabetes, LADA is a slow-progressing form of Type 1 diabetes that occurs in adults over 30. It shares features of both Type 1 and Type 2 diabetes.
• Maturity-Onset Diabetes of the Young (MODY): A rare genetic form that typically appears before the age of 25. MODY affects insulin production due to a gene mutation and often runs in families.
• Neonatal Diabetes: Occurs in infants under six months old. It’s caused by genetic mutations affecting insulin production and can be transient or permanent.
• Type 3c Diabetes: Develops when the pancreas is damaged by diseases like pancreatitis or cystic fibrosis, affecting its ability to produce insulin.
• Steroid-Induced Diabetes: Prolonged use of steroid medications can increase blood sugar levels, leading to diabetes. Adjusting medication and monitoring blood sugar can help manage this type.

Recognizing the symptoms of diabetes—such as increased thirst, frequent urination, unexplained weight loss, and fatigue—is vital for early diagnosis. Effective diabetes treatment varies by type but may include change in lifestyle, medications, and insulin therapy. Understanding these types helps in the prevention and management of diabetes, ultimately reducing the risk of complications like heart disease and nerve damage.

What Causes Diabetes

Understanding the causes of diabetes is crucial for its prevention and management. While the underlying issue in all types of diabetes is high blood sugar levels, the reasons for this elevation differ among the various forms of the disease.

Causes of Type 1 Diabetes

Type 1 diabetes is an autoimmune condition where the body’s immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. This destruction leads to a complete lack of insulin production. The exact cause is not fully understood, but several factors are believed to contribute:

• Genetic Factors: Certain genes may increase the susceptibility to Type 1 diabetes.
• Environmental Triggers: Exposure to specific viruses or other environmental elements might trigger the autoimmune response in genetically predisposed individuals.

Research studies such as TrialNet are working to identify precise causes and potential preventive measures for Type 1 diabetes.

Causes of Type 2 Diabetes

Type 2 diabetes, the most common form, develops due to a combination of lifestyle factors and genetics. The primary issue is insulin resistance, where the body’s cells don’t use insulin effectively. Over time, the pancreas can’t produce enough insulin to maintain normal blood glucose levels. Key contributing factors include:

• Overweight and Obesity: Excess body fat, particularly around the abdomen, can cause insulin resistance.
• Physical Inactivity: Lack of regular exercise contributes to weight gain and reduces insulin sensitivity.
• Genetic Predisposition: A family history of Type 2 diabetes increases risk. Certain ethnic groups are more prone to developing the condition according to the NIDDK.NIH, including African Americans, Hispanics/Latinos, Native Americans, Asian Americans, Pacific Islanders, and Native Hawaiians.

Insulin Resistance Explained

Initially, the pancreas compensates for insulin resistance by producing more insulin. However, as insulin resistance increases, the pancreas can’t keep up, leading to elevated blood glucose levels.

Causes of Gestational Diabetes

Gestational diabetes occurs during pregnancy and is thought to result from hormonal changes alongside genetic and lifestyle factors. The placenta produces hormones that can lead to insulin resistance. If the pancreas can’t produce enough insulin to overcome this resistance, blood sugar levels rise. Factors contributing to gestational diabetes include:

• Hormonal Changes: Pregnancy hormones can interfere with insulin’s effectiveness.
• Excess Weight: Being overweight before pregnancy or gaining too much weight during pregnancy increases the risk.
• Genetic Factors: A family history of diabetes and belonging to certain ethnic groups heightens the likelihood of developing gestational diabetes.

Other Causes of Diabetes

Beyond the common types, diabetes can also result from:

• Genetic Mutations: Certain gene mutations can cause monogenic diabetes forms like neonatal diabetes and maturity-onset diabetes of the young (MODY). These mutations affect the pancreas’s ability to produce insulin.
• Pancreatic Damage: Conditions such as pancreatitis, pancreatic cancer, or trauma can impair insulin production by damaging the pancreas.
• Hormonal Disorders: Diseases causing hormonal imbalances, like Cushing’s syndrome, acromegaly, or hyperthyroidism, can lead to insulin resistance and diabetes.
• Medications: Some drugs may affect insulin production or function, including:
  • Steroids: Used to treat inflammatory conditions.
  • Certain Diuretics: Also known as water pills.
  • Anti-Seizure Medications: Used for epilepsy and other conditions.
  • Psychiatric Drugs: Certain medications for mental health conditions.
  • HIV Treatments: Some antiretroviral therapies.
  • Anti-Rejection Drugs: Used post-organ transplantation.
  • Statins: While they can slightly increase diabetes risk, they are important for reducing “bad” LDL cholesterol and protecting against heart disease.

Consult your healthcare provider for guidance if you’re concerned about medications affecting your blood sugar levels.

Multiple factors contribute to the development of diabetes, ranging from genetic predispositions to lifestyle choices and other health conditions. Recognizing these causes can aid in the prevention of diabetes and enable early intervention. Maintaining a healthy weight, engaging in regular physical activity, and monitoring your blood sugar levels are effective strategies to reduce your risk. If you have a family history of diabetes or other risk factors, consider discussing screening and preventive measures with your healthcare professional.

Symptoms of Diabetes

Diabetes symptoms can vary based on how elevated your blood sugar levels are, and sometimes people with certain types—like prediabetes, gestational diabetes, or Type 2 diabetes—might not experience any noticeable symptoms at first. However, for those with Type 1 diabetes, symptoms often appear suddenly and can be more intense.

Common symptoms associated with both Type 1 and Type 2 diabetes include:

• Increased thirst and dry mouth.
• Frequent urination, especially at night.
• Unintended weight loss, even without changes to your diet.
• Fatigue and feeling constantly tired or weak.
• Blurred vision or difficulty focusing.
• Slow-healing sores or frequent infections (e.g., skin, gums, or vaginal).
• Presence of ketones in the urine, which are produced when the body breaks down fat due to a lack of insulin.
• Numbness or tingling in the hands or feet.

Type 1 diabetes can develop at any age but is often diagnosed in children or teenagers. On the other hand, Type 2 diabetes tends to develop later in life, although it is increasingly being seen in younger individuals due to lifestyle factors.

How to prevent Diabetes?

Preventing diabetes, especially Type 2 and gestational diabetes, involves taking proactive steps toward a healthier lifestyle. While Type 1 diabetes is not preventable due to its autoimmune nature, the risk of developing Type 2 diabetes can be significantly reduced with certain changes. These changes are especially crucial if you’re at an increased risk due to factors like being overweight, having a family history of diabetes, or having been diagnosed with prediabetes.

Making lifestyle changes now can help you avoid the severe complications associated with diabetes, including nerve damage, kidney disease, and heart problems. It’s never too late to start taking control of your health.

1. Achieve and Maintain a Healthy Weight

Carrying extra weight, particularly around the abdomen, is one of the biggest risk factors for developing Type 2 diabetes. Studies show that losing as little as 5-7% of your body weight can reduce the risk of diabetes by nearly 60%. For instance, if you weigh 200 pounds, losing 10-14 pounds could have a significant impact on your health and reduce your risk of diabetes.

• Set Realistic Goals: Work with your doctor or nutritionist to set achievable weight-loss goals, aiming to lose 1 to 2 pounds per week through a balanced diet and regular physical activity.
• Focus on Long-Term Success: Rather than crash diets, aim for sustainable weight loss through consistent lifestyle changes that you can maintain over time.

2. Engage in Regular Physical Activity

Exercise not only helps in weight management but also improves your body’s ability to use insulin effectively. Physical activity can help lower blood sugar and prevent insulin resistance, which is a major cause of Type 2 diabetes.

• Aerobic Exercise: Aim for at least 150 minutes of moderate exercise per week, such as brisk walking, cycling, swimming, or dancing. These activities help burn calories, reduce body fat, and improve cardiovascular health.
• Resistance Training: Strength training exercises, such as weightlifting, yoga, or resistance bands, should be done two to three times a week. Building muscle mass improves insulin sensitivity and helps regulate blood sugar levels.
• Break Up Long Periods of Inactivity: If you have a sedentary job or lifestyle, try to stand, stretch, or take short walks every 30 minutes. Prolonged sitting can lead to increased blood sugar levels, so staying active throughout the day is important.

3. Follow a Nutrient-Rich, Balanced Diet

A healthy diet plays a vital role in preventing diabetes. Choosing the right foods helps keep your blood sugar levels stable and supports weight loss.

• Increase Fiber Intake: Fiber-rich foods, such as fruits, vegetables, legumes (beans, chickpeas, lentils), and whole grains (brown rice, oats, whole-wheat pasta), help slow the absorption of sugars and improve blood sugar control. They also keep you feeling full for longer, making it easier to avoid overeating.
• Healthy Carbohydrates: Focus on whole, unprocessed carbs that are high in nutrients and low on the glycemic index. Foods like whole grains and non-starchy vegetables help regulate blood sugar.
• Limit Processed Sugars and Refined Carbs: Avoid foods high in added sugars, such as sugary drinks, pastries, and white bread, as these can cause spikes in blood sugar levels and lead to insulin resistance.

4. Include Healthy Fats in Your Diet

Incorporating the right fats into your diet can help manage cholesterol levels and reduce the risk of heart disease, a common complication of diabetes. Focus on unsaturated fats, which are heart-healthy and can help reduce inflammation.

• Good Fats: Include sources of monounsaturated and polyunsaturated fats in your diet, such as olive oil, avocados, nuts, seeds, and fatty fish (like salmon, sardines, and tuna). These fats improve heart health and help regulate cholesterol levels.
• Limit Saturated and Trans Fats: Found in processed foods, red meat, and full-fat dairy products, saturated fats can increase cholesterol levels and contribute to insulin resistance. Opt for lean protein sources like poultry, fish, and plant-based proteins (e.g., legumes).

5. Preventing Gestational Diabetes

Gestational diabetes occurs during pregnancy, and while it usually resolves after delivery, it increases the risk of Type 2 diabetes later in life. Women who have gestational diabetes need to take extra care to prevent future complications.

• Maintain a Healthy Weight Before Pregnancy: If you are planning to become pregnant, try to achieve a healthy weight beforehand to reduce the risk of gestational diabetes.
• Monitor Diet During Pregnancy: Focus on balanced meals with plenty of fruits, vegetables, and whole grains, while limiting processed foods and sugary snacks. Smaller, frequent meals can help regulate blood sugar levels during pregnancy.
• Stay Active During Pregnancy: Engage in regular, moderate physical activity during pregnancy, such as walking or prenatal yoga, to help manage blood sugar levels. Always consult your healthcare provider before starting or continuing an exercise regimen during pregnancy.

6. Skip Fad Diets and Focus on Sustainable Habits

Fad diets, like keto or paleo, may promise quick results, but they are often hard to maintain long-term. While these diets can lead to short-term weight loss, there is limited evidence about their benefits for diabetes prevention.

• Balanced, Sustainable Diet: Your goal should be to establish a healthy eating plan that you can stick to for life. Focus on moderation and portion control, and create a balanced plate: fill half your plate with fruits and vegetables, one-quarter with whole grains, and one-quarter with lean protein.
• Find What Works for You: Make choices that reflect your personal preferences and cultural traditions. Tailor your diet to include the healthy foods you enjoy, making it easier to stick with your plan long-term.

7. Regular Screenings and Medical Check-Ups

Early detection of diabetes or prediabetes is crucial for prevention. The American Diabetes Association recommends regular screenings for anyone over 45 years of age, especially if you’re overweight or have risk factors like a family history of diabetes or gestational diabetes.

• Talk to Your Doctor: If you have concerns about your risk for diabetes, your doctor can recommend regular blood sugar tests and guide you on preventive measures based on your health history. For individuals with prediabetes, medication such as metformin may be prescribed to help lower the risk of developing diabetes.

Diabetes Treatment in India

Cost of Diabetes Treatment

Managing diabetes involves significant financial burdens, impacting individuals and families. For many low-income families in India, up to 20-35% of their income may be spent on diabetes care, with costs increasing over time as complications arise. Over a span of five years, diabetes treatment costs can total ₹1.5 lakh, escalating to ₹4 lakh after ten years and reaching ₹15 lakh after twenty years, primarily due to the need for more advanced care and management of complications like heart disease, kidney issues, and foot problems. Direct costs include consultations, lab tests, medication, and insulin, which can add up to ₹35,000 to ₹75,000 annually for routine care, depending on whether the patient is on oral medications or insulin therapy.

In addition to these direct costs, there are significant indirect costs due to lost productivity caused by frequent absenteeism, disability, and early retirement. The intangible costs—such as stress, anxiety, and reduced quality of life—are difficult to quantify but can further exacerbate the financial strain on families. Preventive measures, including lifestyle changes and early intervention, can reduce long-term complications and help manage costs more effectively. Insurance schemes targeted at vulnerable households may also provide crucial financial protection as diabetes cases continue to rise in India.

Cost Breakdown of Diabetes Care in India

Expense Type	Estimated Cost (₹)
Monthly Routine Care	₹3,000 – ₹8,000
– Consultations	₹700 per consultation
– Lab Tests	₹500 per test
– Medications & Insulin	₹6,000 per month
Annual Routine Care	₹35,000 – ₹75,000
Complications (Monthly Costs)
– Foot Complications	₹19,020 per month
– End-Stage Renal Disease	₹12,690 per month
– Cardiovascular Complications	₹13,135 per month
– Retinal Complications	₹13,922 per month
Lost Income Due to Absenteeism	₹50,000 per year

FAQs

Can a diabetic live a long life?

Yes, individuals with diabetes can live long and fulfilling lives, especially with proper management. Maintaining healthy blood sugar levels, following a balanced diet, regular physical activity, and keeping up with medical appointments all contribute to reducing the risk of complications. With advances in treatment and technology, people with diabetes can manage their condition effectively and lead a quality life.

How does diabetes affect life?

Diabetes can affect daily life in various ways, from dietary considerations and medication schedules to frequent monitoring of blood sugar levels. However, with proper management, people with diabetes can minimize its impact on their lifestyle. Without effective control, diabetes may lead to long-term complications like heart disease, kidney damage, vision issues, and nerve damage, making proactive care crucial for a healthier life.

How to live to 100 with diabetes?

Living a long life with diabetes is possible with consistent care and healthy habits. Key factors include maintaining stable blood sugar levels, eating a well-balanced diet rich in whole grains, fruits, and vegetables, and staying active with regular exercise. It’s also important to manage stress, avoid smoking, limit alcohol intake, and attend regular medical check-ups. By sticking to these practices, people with diabetes can significantly reduce the risk of complications and live a long, healthy life.

What is the normal range for blood sugar?

For a fasting blood glucose test, a normal range is between 70 to 99 mg/dL (3.9 to 5.5 mmol/L). In the case of a random blood glucose test, normal levels typically fall below 125 mg/dL (6.9 mmol/L), though this can vary depending on when you last ate. Maintaining blood sugar levels within these ranges is important for avoiding complications related to diabetes.

Can diabetes be cured permanently?

Currently, there is no permanent cure for diabetes. Type 1 diabetes is managed with insulin, while Type 2 diabetes can be controlled through lifestyle changes, medications, and in some cases, surgical interventions. However, even though Type 2 diabetes can go into remission with significant lifestyle changes, it is not considered cured, as blood sugar levels may rise again if proper management is not maintained.

What is the last stage of diabetes?

The last stage of diabetes is often referred to as end-stage complications, where long-term, poorly managed diabetes leads to serious health problems. These complications may include kidney failure (requiring dialysis), severe cardiovascular disease, vision loss, amputations due to poor circulation and infections, and advanced neuropathy. Proper management can prevent or delay reaching this stage.

How serious is diabetes?

Diabetes is a serious chronic condition that requires lifelong management. If left untreated or poorly managed, it can lead to severe complications such as heart disease, stroke, kidney failure, blindness, and nerve damage. However, with early diagnosis and effective control of blood sugar, many of these complications can be prevented, allowing individuals to lead healthy lives.

What are 5 signs your blood sugar is too high?

Five common signs that your blood sugar may be too high include:

1. Frequent urination (especially during the night).
2. Increased thirst, even after drinking fluids.
3. Fatigue or feeling unusually tired.
4. Blurred vision or difficulty focusing.
5. Unintended weight loss, despite eating normally.

If you experience these symptoms, it’s important to monitor your blood sugar and consult a healthcare provider for guidance on managing your levels.