What is Diabetes
In order to treat diabetes, we need first to understand what diabetes is.
Diabetes mellitus, or simply diabetes, is a chronic metabolic disease that is manifested by high glucose levels in the blood. This condition usually occurs when the pancreas is no longer able to make insulin, or when the body cannot make good use of the insulin it produces. Insulin is a hormone made by the pancreas, that acts like a key to let glucosefrom the food we eat pass from the blood stream into the cells in the body to produce energy. All carbohydrate foods are broken down into glucose in the blood. Insulin helps glucose get into the cells.Not being able to produce insulin or use it effectively leads to raised glucose levels in the blood (known as hyperglycemia). Over the long-term high glucose levels are associated with damage to the body and failure of various organs and tissues.
Insulin exerts its anabolic actions in the liver, the adipose tissue and muscle tissue. At the cellular level, such target cells possess specific insulin receptors. In the liver, insulin promotes glycogen synthesis by stimulating the enzyme glycogen synthetase and inhibiting glycogen phosphorylase although it has no direct effect on the GLUT 2 transporters and, hence, the uptake of glucose into hepatocytes. In contrast, insulin induces a rapid uptake of glucose in muscle and fat tissue by recruiting intracellular GLUT 4 transporters and, thus, increasing their cell-surface expression.
As a consequence, muscle converts glucose to glycogen. In adipose tissue, glucose is converted to fatty acids for storage as triglycerides. Insulin also stimulates the uptake of amino acids into muscle. At the same time, insulin suppresses the glucose supply from the liver by inhibiting the breakdown of glycogen in the liver, as well as the release of amino acids from muscle and the release of free fatty acids from adipose tissue.
Carbohydrates exist as polysaccharides (such as starch), disaccharides (such as sucrose, maltose and lactose) and monosaccharides (such as galactose, glucose and fructose). Glucose absorbed from the gut is mainly derived from starch that, in Western societies, constitutes about 60% of the daily carbohydrate intake. The rest is in the form of sucrose (30%) and lactose (10%). In starch, straight chains of glucose molecules are held in amylose (approximately 20% of the total starch) whilst branched chains of glucose molecules are held in amylopectin (80% of the total starch).
In the gut, these large molecules are broken down by digestion but the polarity of the hexoses sugars requires specialized transport proteins that will facilitate absorption across the hydrophobic cell membrane of the gut. There are five of these glucose transporters (GLUTs) for the absorption and uptake of glucose into cells. These have distinct tissue distributions and features.
Individuals can experience Different signs and symptoms of diabetes, and sometimes there may be no signs. Some of the signs commonly experienced include:
Weight loss§ Tiredness
Lack of interest and concentration
A tingling sensation or numbness in the hands or fee
Vomiting and stomach pain (often mistaken as the flu)
People with diabetes have an increased risk of developing a number of serious health problems. Consistently high blood glucose levels can lead to serious diseases affecting the heart and blood vessels, eyes, kidneys, nerves and teeth. In addition, people with diabetes also have a higher risk of developing infections. In almost all high-income countries, diabetes is a leading cause of cardiovascular disease, blindness, kidney failure, and lower limb amputation. Maintaining blood glucose levels, blood pressure, and cholesterol at or close to normal can help delay or prevent diabetes complications. Therefore people with diabetes need regular monitoring.
Cardiovascular disease: affects the heart and blood vessels and may cause fatal complications such as coronary artery disease (leading to heart attack) and stroke. Cardiovascular disease is the most common cause of death in people with diabetes. High blood pressure, high cholesterol, high blood glucose and other risk factors contribute to increasing the risk of cardiovascular complications.
Kidney disease (diabetic nephropathy): caused by damage to small blood vessels in the kidneys leading to the kidneys becoming less efficient or to fail altogether. Kidney disease is much more common in people with diabetes than in those without diabetes. Maintaining near normal levels of blood glucose and blood pressure can greatly reduce the risk of kidney disease.
Ddiabetes can cause damage to the nerves throughout the body when blood glucose and blood pressure are too high. This can lead to problems with digestion, erectile dysfunction, and many other functions. Among the most commonly affected areas are the extremities, in particular the feet. Nerve damage in these areas is called peripheral neuropathy, and can lead to pain, tingling, and loss of feeling.
Loss of feeling is particularly important because it can allow injuries to go unnoticed, leading to serious infections and possible amputations. People with diabetes carry a risk of amputation that may be more than 25 times greater than that of people without diabetes. However, with comprehensive management, a large proportion of amputations related to diabetes can be prevented. Even when amputation takes place, the remaining leg and the person’s life can be saved by good follow-up care from a multidisciplinary foot team. People with diabetes should regularly examine their feet.
Eye disease (diabetic retinopathy): most people with diabetes will develop some form of eye disease (retinopathy) causing reduced vision or blindness. Consistently high levels of blood glucose, together with high blood pressure and high cholesterol, are the main causes of retinopathy. It can be managed through regular eye checks and keeping glucose and lipid levels at or close to normal.
Pregnancy complications: Women with any type of diabetes during pregnancy risk a number of complications if they do not carefully monitor and manage their condition. To prevent possible organ damage to the fetus, women with type 1 diabetes or type 2 diabetes should achieve target glucose levels before conception. All women with diabetes during pregnancy, type 1, type 2 or gestational should strive for target blood glucose levels throughout to minimize complications.
High blood glucose during pregnancy can lead to the fetus putting on excess weight. This can lead to problems in delivery, trauma to the child and mother, and a sudden drop in blood glucose for the child after birth. Children who are exposed for a long time to high blood glucose in the womb are at higher risk of developing diabetes in the future.