How is Diabetes Diagnosed and Treated

In India, around 8.7% of the population is diabetic. The recent rise in the prevalence of diabetes is due to a sedentary lifestyle, tobacco usage, poor diet, and other unhealthy lifestyle choices. Obesity and physical inactivity are the most common precipitating factors for diabetes. 

Diabetes is a condition where a person’s blood sugar level is higher than the average level. Medically, it’s a chronic condition where the pancreas fails to produce the required amount of insulin. This condition leads to an increased level of glucose in the blood which is called hyperglycaemia. 

There are different types of diabetes, Type 1 diabetes, which is known as insulin-dependent diabetes is caused due to a lack of insulin production. Type 2 diabetes, which is known as non-insulin-dependent diabetes is caused by the body’s ineffective usage of insulin. 

Gestational diabetes can occur during pregnancy if the mother is less sensitive to insulin. This condition doesn’t affect all expectant women and usually resolves after delivery. 

What causes type 1 diabetes?

In type 1 diabetes or juvenile diabetes, the immune system attacks and destroys the cells that are responsible for producing insulin. It’s called insulin-dependent diabetes or early on-set diabetes which develops before the age of 40. This type of diabetes is less common. 

What causes type 2 diabetes?

In type 2 diabetes, when the body cells fail to respond to the produced insulin or don’t produce the required quantity of insulin. It’s called insulin resistance or adult-onset diabetes, which is associated with obesity, inactivity, and other lifestyle causes. 

What are the signs and symptoms of type 1 and type 2 diabetes?

The diabetes symptoms are frequent thirst, urinating more frequently than usual especially during the night, feeling tired, unexplained weight loss, and blurred vision. 
Type 1 diabetes might develop quickly over a few days or weeks. However many people with type 2 diabetes might fail to realise because there are no early symptoms. 

How is diabetes diagnosed?

Type 1 diabetes symptoms are easy to identify with the blood sugar levels. The other types of diabetes symptoms are hard to identify as some of the symptoms might not be evident. 

Here are some diabetes screening guidelines, such as:

1. A person with a BMI more than 23 or 25 with additional risk factors, like sedentary lifestyle, high blood pressure, abnormal cholesterol levels, history of heart disease and diabetes in the family should get regular screenings. 
2. A person aged above 45-50 should have an initial blood sugar test. If the test result is normal, then screening should be done every three years. 
3. A person with gestational diabetes is advised for a blood sugar test every three years. 

Tests advised for type 1 and type 2 diabetes 

A1C test (Glycated Hemoglobin) - This blood test doesn’t require any fasting. It indicates the average sugar level in the body over 2-3 months. The blood sugar level shows the percentage of oxygen-carrying protein in RBCs. 

If the A1C level is 6.5% or higher, it indicates diabetes, and levels between 5.7 and 6.4% indicate prediabetes. A1C level below 5.7 is normal. 

Random blood sugar test - Blood will be drawn at a random time. If the random blood sugar level is 11.1 millimoles per litre (mmol/L) or higher, it indicates diabetes. 

Fasting blood sugar test - Blood is drawn after an overnight fast. If the fasting blood sugar level is less than 100 mg/dL or 5.6 mmol/L, it’s normal. If the blood sugar level is between 100 to 125 mg/dL or 5.6 to 6.9 mmol/L, it’s prediabetes. If the blood sugar level is 126 mg/dL or 7 mmol/L or more, it’s diabetes. 

Oral glucose test - Blood is drawn after overnight fasting to measure the blood sugar level. The person is asked to drink a sugar liquid, and after two hours the blood sugar levels are tested again. 
The normal blood sugar level is less than 140 mg/dL or 7.8 mmol/L. If the blood sugar level is between 140 and 199 mg/dL or 7.8 to 11.0 mmol/L, it may show prediabetes. 

If a person is diagnosed with type 1 diabetes, a urine test will be done to detect the presence of a byproduct called ketones. This byproduct is produced when the fat tissue or muscles are used for energy when the body fails to produce enough insulin. 

What are the treatment options for diabetes?

The treatment depends upon the type of diabetes. Initial treatment would be blood sugar monitoring, oral medications, and insulin. A healthy diet and a healthy weight with regular physical activity are beneficial to manage diabetes. 

Treatments recommended for type 1 and type 2 diabetes

Type 1 diabetes is insulin-dependent that need insulin injections to control blood sugar levels. Type 2 diabetes treatment involves lifestyle modification, blood sugar monitoring, diabetes medications, and insulin. 

A. Monitor the blood sugar

If a person is taking insulin then make sure to check the blood sugar level at least 4 times a day. Remember, monitoring will help to reduce the health risks associated with diabetes. Blood sugar levels can change unknowingly; talk to your healthcare provider about any fluctuations. 
In case of daily blood sugar monitoring, doctors recommend measuring the average blood sugar level for the past 2-3 months. A1C testing indicates the diabetes treatment function and an elevated A1C level may be an indication to change the oral medications, meal plan, and insulin regimen. The target for A1C might vary depending on the age factor and other medical conditions. 

B. Insulin

Type 1 diabetes is insulin-dependent and many people with type 2 diabetes are also in need of insulin. There are many options available for insulin, such as long-acting insulin and rapid-acting insulin. A physician will prescribe insulin mixture depending upon the health conditions. 

Insulin is injected using a sterilised syringe or insulin pen. An insulin pump is also an option where the device is of cellphone size and worn outside the body. It’s a tube that connects with a reservoir of insulin to a catheter which is inserted under the abdominal skin. 

C. Oral medications

Some Diabetologists will prescribe oral medications to stimulate the pancreas to produce more insulin. The release of glucose from the liver needs less insulin to transport the sugar into your cells. General medication prescribed for type 2 diabetes are Metformin, Glumetza, and Glucophage to break down the carbohydrates from the intestinal enzymes. 

Conclusion

If diabetes is left untreated, it could be a serious health condition. Make sure you don’t skip any followup sessions or treatment plans to reduce the risk associated with diabetes. Call Sakra World Hospital at 080 4969 4969 for an appointment and expert opinion about diabetes. Visit our hospital in Devarabeesanahalli, Bangalore.

Ref Link:

https://www.mayoclinic.org
https://www.medicinenet.com
https://www.medicalnewstoday.com
https://www.who.int
https://www.nhsinform.scot/