Diabetes: The Basics

Everybody knows that the global epidemic hitting us hard at the moment is diabetes. Diabetes Mellitus is a very common metabolic disorder. This refers to the way our bodies use digested food for energy and growth. Most of what we eat is broken down into finer forms of sugar or otherwise known as glucose. Glucose is one of the principal sources of fuel energy for our physical bodies. But if one is not careful, developing diabetes may turn a regular source of energy into a regular source of misery.

Once formed, the glucose makes its way into our bloodstream. Normally, our cells use this glucose for energy and growth. However, glucose cannot enter our cells without insulin being present – Insulin makes it possible for our cells to take in the glucose.

Insulin is a hormone that is produced by the pancreas, an endocrine organ in the abdomen. Postprandially (i.e., immediately after eating), the pancreas automatically releases an adequate and appropriate amount of insulin to shift the glucose present in our blood into the cells, and lowers the blood sugar level.

Unlike healthy individuals, a person with diabetes has a condition in which the quantity of glucose in the blood is too elevated (hyperglycemia). This is because the body either does not produce enough insulin appropriately, produces no insulin at all, or has cells that not sensitive to the insulin the pancreas produces. Subsequently too much glucose builds up in the blood. This excess blood glucose eventually passes out of the body in urine (hence the use of urine as a detection tool). So, even though the blood has plenty of glucose, this surplus of glucose is useless and in fact harmful to the body as the cells are not getting it for their essential energy and growth requirements.

Generally, there are three main types of diabetes:

• Diabetes Type 1 – The body does not produce insulin
• Diabetes Type 2 – The body does not produce enough insulin, or the insulin is not working properly.
• Gestational Diabetes – Diabetes developing during pregnancy.

According to World Health Organization, Type 2 Diabetes is the commonest type in the world. Types 1 and 2 are generally life-long conditions and will require long-term medications and adjustment of life style. Meanwhile, gestational diabetic recovers after the birth of the child.

At the moment there is no known cure for Type 1 and 2 Diabetes. Diabetic patients, in general, will usually need regular medications and sometimes insulin. The treatment for a patient with Type 1 is mainly injected insulin, plus some dietary and exercise adherence.

Patients with Type 2 are usually treated with tablets, exercise and a special diet, but occasionally insulin injections are also required alone or in combination with oral medications depending on level of glucose control.

If diabetes is not adequately controlled the patient has a significantly higher risk of developing complications, such as hypoglycemia, ketoacidosis, and non-ketotic hyperosmolar coma. Longer term complications could be cardiovascular disease, retinal damage, chronic kidney failure, nerve damage, poor healing of wounds, gangrene on the feet which may lead to amputation, and erectile dysfunction.

We have all heard of stories of diabetic relatives who either had their leg amputated, had a bypass surgery done on the heart, had needed dialysis for renal failure or ended up in ICU for weeks due to a critical infection such as pneumonia or even a stroke. Yes, all these stories are true. In fact it happens every single day in most hospitals! Diabetics do tend to develop such medical complications especially those whose blood glucose are not adequately controlled.

Hence, it is necessary to do a medical check up or screening especially if you have not done so and have risks such as family history of diabetes. Do pay a visit to your family doctor and request for a screening before it is too late.