Diabetology

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dia - Diabetology

Diabetes is a chronic metabolic disorder characterised by hyperglycaemia, the presence of high sugar (glucose) levels in the blood. The level of glucose in the blood is regulated by insulin hormone. The normal level of glucose in the blood should be between 70 and 100 mg/dL (fasting) and <140 mg/dL (random). (There are different views about the normal range of blood glucose. Please discuss the same with your healthcare team.) Impaired production or function of insulin increases glucose levels in the blood. There are 3 types of diabetes:

  • iabetes is an autoimmune disease, in which the insulin producing cells are mistakenly killed by the body’s defence system; hence, decreasing the production of insulin and increasing the accumulation of blood sugar
  • diabetes occurs either due to the reduced production of insulin or the inadequate use of the hormone produced by the various cells of the body. This is termed as insulin insensitivity and is the most common type of diabetes.
  • Gestational diabetes is a temporary condition, which occurs during pregnancy. Gestational diabetes resolves after child birth, but poses a future risk for the development of type 2 diabetes in the mother

Anatomy

The pancreas is situated just below the stomach and produces enzymes for the digestion of food, and the hormones insulin and glucagon for the regulation of blood glucose. The pancreas consists of a group of cells called the islets of Langerhans, which produce and store the hormone. Carbohydrates in the food we eat are broken down to form glucose, which is either used immediately by the muscles and liver as energy or stored for later use. When levels of blood sugar start rising after a meal, the islets of Langerhans secrete insulin, which transports sugar to the cells. If the pancreas fails to produce sufficient amounts of insulin or the body’s cells are insensitive to the hormone, glucose starts accumulating in the blood stream, leading to diabetes.

Causes

  • Obesity
  • Sedentary lifestyle
  • Viral infection or nutritional factor in childhood
  • Heredity
  • Old age
  • High blood triglyceride levels
  • Pregnancy
  • Autoimmunity, when the body’s defence system attacks and destroys pancreatic cells

Impact

Diabetes causes damage to the cardiovascular system, vision, kidneys, nerves, feet, hearing, skin and blood vessels. Gestational diabetes can lead to complications such as high birth weight, requiring C-section delivery, and preeclampsia or high blood pressure that could be life-threatening for both mother and child.

Symptoms

The common symptoms of diabetes mellitus are increased thirst, frequent urination, extreme hunger, unexplained weight loss, fatigue, blurred vision, delayed wound healing, dehydration, altered mental status and frequent infections.

Stages

Stages of diabetes are decided based on blood glucose levels. If your blood glucose levels are between 108 and 126 mg/dL (fasting) and 141 to 200 mg/dL (random) then you are considered to be in the pre-diabetic stage. At this stage, although the blood sugar level is high it cannot be classified as diabetes and the sugar levels can be controlled by weight loss and exercise. Blood glucose levels >126 mg/dL (fasting) and ≥200 mg/dL (random) is considered a diabetic stage and will require medication to keep your blood sugar levels under control. The development of type 2 diabetes at a young age increases the risk of diabetes progressing into complications such as neuropathy.