Who Let The Doc Out?! #009: What you need to know about diabetes

Diabetes mellitus, commonly known as diabetes, is a chronic metabolic disease in which the body’s ability to process blood glucose is impaired, resulting in high blood sugar. Diabetes is one of several dangerous non-communicable diseases (NCDs) that have become leading causes of morbidity and mortality across the world.

According to the World Health Organization, the number of people with diabetes rose from 108 million in 1980 to a staggering 422 million in 2014, with cases rising more rapidly in low- and middle-income countries. In 2019, diabetes was the direct cause of 1.5 million deaths globally. This figure went even higher when indirect causes involving organ damage and immunosuppression were included.

With the knowledge that the prevalence of diabetes is increasing worldwide, it is important for every person to know what diabetes is, how it presents, and how you can prevent it.

Types of diabetes

Diabetes occurs as a result of either impaired insulin production or reduced insulin sensitivity. Insulin is a naturally produced hormone in the body that moves glucose from your blood into your cells for either storage or breakdown. The categorization of diabetes into two major types depends on the way insulin function is impaired in the body.

  • Type 1 diabetes (T1DM): In T1DM, your blood sugar is high because your body cannot produce insulin. This happens because your body attacks and destroys your insulin-producing cells in what is termed as an autoimmune response. This condition is commonly seen in children, younger adults, and people with autoimmune conditions like thyroid disease.
  • Type 2 diabetes (T2DM): In T2DM, there are two primary issues. First, your pancreas is not producing enough insulin. Second, your cells are losing sensitivity to insulin and are unable to take in sugar effectively. This occurs more commonly in older adults, although its prevalence is increasing in children in recent years.

Type 2 diabetes accounts for an overwhelming percentage of diabetes cases – over 90% according to this US study – with most cases occurring in older adults with obesity. It used to be known as adult-onset diabetes because of the common age of onset, but with cases among children increasing and the understanding that type 1 diabetes also occurs in adults, the terminology was changed.

Risk factors for diabetes

Type 1 and type 2 diabetes have different causes, but both are associated with a genetic predisposition and environmental triggers collaborating to cause disease. In type 1 diabetes, the primary cause is an autoimmune response.

In type 2 diabetes, the risk factor most associated with developing disease is a diabetogenic lifestyle: ingesting more calories than you can expend and obesity. Other risk factors include:

  • Age > 45 years
  • Family history of type 2 diabetes in a first-degree relative
  • Hypertension
  • Dyslipidemia
  • History of gestational diabetes
  • Polycystic ovarian syndrome

Signs and symptoms of diabetes

Some of the common signs and symptoms of diabetes include:

  • Excessive urination, especially at night
  • Increased thirst
  • Increased hunger
  • Unplanned weight loss
  • Blurry vision
  • Sores and wounds that take long to heal
  • Burning sensation in limbs
  • Extreme fatigue

In men, there may also be symptoms of erectile dysfunction and muscle weakness. In women, there may be genital itching due to fungal infections.

These symptoms usually occur as a result of high blood sugars and the consequent damage they cause in the different systems of the body like the blood vessels, nerves, and brain.

Complications of diabetes

When blood sugar levels are chronically high, a harmful microenvironment is created in the body. As a result of this, there is damage to organs all over the body. In the long term, diabetes can cause complications like:

  • Stroke
  • Eye problems
  • Dental problems
  • Heart disease
  • Kidney disease
  • Nerve damage
  • Foot problems
  • Impaired immunity

COVID-19 and diabetes

In the wake of the COVID-19 pandemic, data has arisen to show that patients with diabetes are more likely to develop severe disease when they are infected with COVID-19. This is worsened by pathological processes that cause elevations in blood sugar levels.

However, as a patient with diabetes, you are not more likely to contract COVID-19 than a non-diabetic person. Therefore, it is important to take greater precautions to avoid contracting the disease, for example getting vaccinated, wearing masks, social distancing, and hand-washing.

How to prevent diabetes

While type 1 diabetes does not follow an easily predictable course, there are precautions you can take through the course of your life to prevent type 2 diabetes, and they include:

  • Regular exercise
  • Healthy diet including fruits and vegetables, and less fats
  • Maintaining a healthy weight

Innocent Immaculate Acan is a medical doctor and writer currently working at Adjumani Hospital. She won the Writivism Short Story Prize in 2016 and has published an illustrated children’s book titled The Pearl Trotters in Black, Yellow, Red. She was part of the 2018 class of the Young and Emerging Leaders Project.

Innocent Immaculate Acan