Live well with Diabetes
■ What is diabetes?
Diabetes is a chronic condition in which a person has high blood glucose (blood sugar), either because insulin production is inadequate (insulin deficiency), or because the body's cells do not respond properly to insulin (insulin resistance), or both. Insulin is a hormone secreted from the pancreas and helps the body's cells to utilise glucose for energy. If there is deficiency of insulin or resistance to insulin action, glucose stays in the blood and doesn't enter the cells. Thus blood glucose level becomes high and diabetes results.
■ What are the different types of diabetes?
There are two major types of diabetes:
• Type 1 Diabetes - In Type 1 Diabetes the pancreas does not produce insulin. This is because the body's immune system attacks and destroys pancreatic beta cells that make insulin. This form of diabetes usually develops in children or young adults, but can occur at any age. About 5% of people with diabetes have this form of diabetes. People with Type 1 Diabetes usually need to take life - long multiple daily insulin injections.
• Type 2 Diabetes — Typically, insulin resistance is the initial defect in this condition. At first, the pancreas makes extra Insulin to make up for it. Over time the pancreas gets fatigued and is unable to make enough insulin to keep blood glucose levels normal. Type 2 Diabetes accounts for more than 90 - 95% of all cases of diabetes worldwide. Type 2 Diabetes usually occurs in overweight people over 30 who have a family history of diabetes and lead a sedentary lifestyle. It is treated with lifestyle changes, oral medications, and sometimes with insulin.
■ What are the chances of developing diabetes during pregnancy?
What are the probable causes? Diabetes diagnosed during pregnancy is called Gestational Diabetes Mellitus (GDM). In India, GDM is increasing in parallel with the rise in diabetes and obesity. Figures suggest that more than 10% of pregnant Indian women are affected by GDM. Hormonal changes in pregnancy produce insulin resistance, which makes it difficult for the mother's body to utilise insulin and this results in high blood sugar level.
■ Will the presence of diabetes affect the baby in the womb?
Will the new born baby be diabetic by birth? Having diabetes during pregnancy does not mean that the baby will be born with diabetes. Later in life, however. babies born to mothers with GDM are at risk for developing obesity and Type 2 Diabetes. Most women who have gestational diabetes deliver healthy babies. However. uncontrolled diabetes during pregnancy can cause problems for the new - born, including large size, difficult delivery and complications like breathing problems, low blood sugar, low calcium level and jaundice. Good control during pregnancy and a healthy lifestyle during childhood can avoid these short and long term consequences.
■ What Is the difference between diabetes in children and adults?
Children typically tend to get Type 1 Diabetes - overall that is much less common than the common variety of Type 2 which affects adults. Unlike adult onset diabetes, which is often silent in the early stages, childhood Type 1 Diabetes presents with rapid onset of symptoms such as weight loss, excessive thirst and urination. If undiagnosed and untreated, children can lapse into a serious condition. Lifestyle and heredity play little role in risk for Type 1 Diabetes. Childhood diabetes is typically managed by daily insulin injections, given nowadays through easy to use pens. The use of new generation insulin pumps -small devices attached on the skin which deliver insulin continuously has helped improve management of some of these cases. Positive attitude, along with good medical guidance helps children with diabetes lead long and healthy lives.
With increasing obesity and the Type 2 Diabetes epidemic threatening to engulf countries like India, there is an earlier onset of Type 2 Diabetes too. Nowadays it is not unusual to diagnose Type 2 - the usual adult type diabetes - in obese children and teenagers with a lamily history of diabetes. Almost one fourth of Indian youth with onset of diabetes between the ages of 18 and 25 may actually be affected with Type 2 rather than Type 1 Diabetes. On the other hand, some people in their midlife are now recognised to be having Type 1 rather than typical Type 2 Diabetes, the most famous example being British PM Theresa May. So while the broad differences remain, there in increasing blurring of the boundaries between childhood and adult diabetes as we traditionally understand them.