On World Health Day 2016, WHO quoted that, as per a survey conducted in 2015, 69.2 million people (8.7% of the total population) were living with diabetes. Of these, more than 36 million people remain undiagnosed and Type 2 diabetes complications are the most prevalent form of the disease.
This indicates that Diabetes mellitus is potentially reaching epidemic proportions in India making public awareness and preventive health initiatives the need of the hour to manage the health of the nation.
Glucose is a key source of energy in our body and its metabolism is highly regulated by hormones like insulin and glucagon. Diabetes is a condition that impairs the body’s ability to process blood sugar leading to persistent high levels of glucose in blood (hyperglycaemia).
There are 4 types of diabetes and a basic understanding of each type can help you in early detection and prevention.
- Diabetes Mellitus (Type 2)or noninsulin – dependent diabetes is caused when the pancreas loses its ability to produce adequate insulin for the body. It also affects the way in which the body metabolises glucose. It is a multi-factorial chronic condition and accounts for 90% of the cases of diabetes in India.
- Diabetes Insipidus (Type 1)or insulin – dependent diabetes, is a chronic condition where the pancreas produces very little or no insulin required for the body. In this type, the cells producing insulin in the pancreas are destroyed by the immune system which usually kills all the harmful bacteria and viruses in the body. It occurs in 8-9 % diabetic patients and can affect children as well. Diabetes in children is commonly called juvenile diabetes.
- Gestational diabetescan develop during pregnancy (gestation) causing high blood sugar that can affect your pregnancy and your baby’s health. The placenta, which connects your baby to your blood supply for nourishment, produces high levels of various other hormones which can impair insulin activity. The blood sugar usually returns to normal soon after the delivery. But the mother is at a high risk of developing type 2 diabetes later.
- MODY (Maturity of Diabetes of the Young) is a rare form of diabetes which is different from both Type 1 and Type 2 diabetes and runs strongly in families.It is commonly known as monogenic diabetes. While diabetes is mostly a multifactorial disease with several factors including lifestyle, diet, autoimmunity and the environment affecting disease development, MODY is caused by a mutation in a single gene with a 50% chance of it being inherited by the next generation. It is widely recognised and suspected in individuals below the age of 25.
Early signs of Diabetes
The three triad or polys’ –
Polydipsia- excessive thirst
Polyuria- urinating at above normal frequency (especially at night)
Polyphagia- increased hunger or appetite with weight loss and fatigue
Others signs include itchy skin, dry mouth, delayed healing of wounds, weight loss and blurred vision.
The purpose of diabetes screening is to identify asymptomatic (before the disease develops) individuals who are likely to have diabetes. It is extremely crucial to prolong or prevent severe diabetes complications.
The best diabetes screening test is the simple measurement of fasting plasma glucose (FPG) and post-prandial glucose (PPG).
Recommendations indicate that screening should begin at the age of 45 years and must be done regularly once in every 3 years for the general population. But, if diabetes risk factors are present like family history and obesity, screening should be done at 30 years.
Classical triad for Diabetes is Polyuria, Polydypsia and weight loss.
|Understanding your results (ADA Criteria)|
|FPG <100 mg/dl||FPG ≥100 and <125 g/dl (IFG)||FPG ≥126 mg/dl|
|2-h PG† <140 mg/dl||2-h PG† ≥140 and <200 mg/dl (IGT)||2-h PG† ≥200 mg/dl|
|Symptoms of diabetes and casual plasma glucose concentration or random glucose values ≥200 mg/dl can indicate diabetes|
Diagnosis of Diabetes:
Diagnostic testing should be performed in any clinical situation in which such testing is warranted.
The diagnosis can be made with an HbA1C (Glycated haemoglobin) level of 6.5% or greater.
However, testing should be repeated on a subsequent day to confirm the diagnosis.
Blood glucose monitoring is mandatory post diagnosis for diabetes management.
Self- monitoring of glucose using a glucometer is easy and convenient, however you need to follow a proper procedure in order to ensure accuracy and effectiveness.
A regular follow up of FPG, PPG and HbA1C with a trusted laboratory partner can ensure quality of results. 1, 5 Anhydroglucitol can be used for intermediate term monitoring of glycaemic control.
Diabetes mellitus is a chronic condition that can lead to long term complications. A careful regulation and monitoring of blood glucose levels is the first step towards preventing them.
|SLNo||Secondary complications identified by WHO||Monitoring program initiated at diagnosis|
|1||Diabetic Nephropathy can lead to end stage renal disease and is a major cause of death in diabetic individuals.||Complete assessment of renal function should be performed periodically including regular Blood pressure, U. Protein, U. microalbumin/ creatinine ratio, S. Urea, S. creatinine, S. Potassium and eGFR.|
|2||Cardio-vascular diseases have a higher incidence in diabetic individuals causing problems in the heart and blood vessels.||Fasting lipid measurements including total cholesterol, triglycerides, HDL, LDL should be done regularly, additional markers like HsCRP and LpA can increase efficiency of monitoring. ECG, TMT/ Echo tests are missing in cardiovascular disease monitoring.|
|3||Diabetic Neuropathy is a common complication of diabetes that can cause pain, gastropathy, diarrhoea or constipation.||The evaluation criteria include family history, testing using 10-g monofilament, Pinprick testing, temperature and vibration sensing.|
|4||Diabetic Retinopathy is a prevalent cause of visual disability.||Dilated and comprehensive annual eye exam|
|5||Diabetic Foot is a case of severe foot lesions requiring amputation is one of the major diabetes complications.||Examination of foot to identify risks that can cause ulcers and amputations.
Identification of foot deformities, inspection of skin, examination of nerves and heart rate.
Provide foot self-care education.
A well-designed program for monitoring various types of diabetes can support early detection and management to ensure a better quality of life. Head out to Neuberg Diagnostics today and get one step closer to a diabetic-free way of life. You can also read our blogs on the common summer diseases and the importance of preventive health checks in a fast-paced world.