What is diabetes?
Across the world, it is estimated that the number of people who had diabetes went up to 422 million in 2014- from 108 million in 1980. It has risen from 108 million in 1980 to 422 million in 2014. For the same period, the incidence of the disease for people over 18 years of age rose from 4.7% to 8.5%. In India, 8.7% of the total population is diabetic, according to the World Health Organization. In the United States of America, 9.4% of the population had diabetes. Diabetes has also shown the maximum growth in prevalence rates among all non-communicable diseases between 1990 and 2016. So how can we keep this disease at bay? And how can we identify its symptoms? Let us take a thorough look at it.

What is Diabetes Mellitus?
Have you got a cut or a wound that is refusing to heal? Are you experiencing drastic weight loss without any explanation? Do you urinate frequently? These can be symptoms of high blood sugar.

Diabetes Mellitus or DM is commonly called diabetes. The term encompasses a group of metabolic disorders which are characterized by high blood sugar levels over an extended period. If left untreated, it can lead to a wide range of complications, including cardiovascular diseases, stroke, kidney diseases, diabetic foot ulcers and retinal damage. According to the International Diabetes Federation, 425 million people worldwide have diabetes of 2017, with type 2 diabetes being the most prevalent form of diabetes (almost 90%). Type 2 constitutes nearly 9% of the total global population, with both men and women being affected similarly. Diabetes comes in three forms- type 1 and type 2 diabetes, and gestational diabetes. However, in day to day life, diabetes type 2 is called “diabetes”.

Types of Diabetes Mellitus
There are four types of diabetes:

1. Type 1 Diabetes
It occurs when the pancreas cannot produce enough insulin, hence failing to regulate blood glucose levels. Patients with type 1 diabetes have to take insulin injections daily to stay healthy. This type of diabetes is not associated with weight gain. Earlier, it used to be called “juvenile diabetes.”

Type 1 diabetes is an autoimmune disease. It means that for some reason, our immunity system attacks the cells in the pancreas, which leads to the destruction of beta cells that produce insulin. Over time, with sustained damage, the pancreas can no longer produce sufficient insulin, and hence, the patient has to depend on insulin injections.

2. Type 2 Diabetes
It is the most common type of diabetes. It is a chronic condition, and people develop type 2 diabetes when their body develops insulin resistance. This means that their cells fail to respond to insulin properly, which in turn adversely affects their blood sugar levels. As the disease progresses, the body may start to produce less insulin with time. There is no cure for type 2 diabetes, but you can manage it by staying healthy, monitoring the foods you eat and exercising regularly. Earlier, it used to be called “adult-onset diabetes”. However, more children have been diagnosed with type 2 diabetes now- possibly due to the rise in childhood obesity and lack of physical activity. Though different reasons cause its onset, it is similar to type 1 diabetes as both results in high blood sugar levels and resultant complications.

3. Pre-Diabetes
The name itself is self-explanatory. It is characterised by high blood sugar levels- but not as high as those observed in diabetic patients. It is also called “borderline diabetes”. Pre-diabetes increases the chances of getting heart disease, but if you lead a healthy and active lifestyle, you can stop or slow down the slide into diabetes. But where do you draw the line between pre-diabetes and diabetes proper? Check with your doctor to know. If your fasting sugar levels are within the 100-125 range, and your post-breakfast sugar levels are in the 140-199 range, you are likely to have pre-diabetes. However, to make sure, the doctor can also prescribe the Hemoglobin A1C test, which checks the blood sugar levels for the last 3 months to rule out temporary irregularities. If your A1C results are in the 5.7%-6.4% range, you are pre-diabetic.

4. Gestational Diabetes Mellitus
This is a condition in which a woman without diabetes shows high blood sugar levels during pregnancy. It does not have many symptoms. However, if left untreated, pregnant women can develop depression, have birth complications and need a caesarean section while giving birth. Babies born to mothers whose gestational diabetes go untreated can be obese and may develop type 2 diabetes. Doctors advice losing weight before pregnancy and staying active before and during pregnancy to prevent gestational diabetes. So how do you know if you have diabetes? It is always good to get checked by your doctor and check your blood sugar levels. However, you should look out for some signs- so that you are not blindsided by it.

Diabetes Symptoms
While you have to talk to your doctor to understand what type of diabetes you have, you must know whether you have high blood sugar levels. The symptoms of high blood sugar are:
Frequent urination
Increased hunger
Increased thirst
Fatigue
Blurred vision
Unexplained weight loss
Recurrent infections
Wounds that refuse to heal

Symptoms In Women
Diabetes affects men and women equally. However, women with diabetes are more likely to develop UTI or yeast infections. Due to high blood sugar levels, some women may not be able to empty their bladder completely- which creates a conducive environment for germs to thrive in.

Menstrual problems are also observed in women with diabetes. While it is difficult to gauge your sugar levels before and during your periods, diabetics may experience longer or heavier periods. Also, periods often result in food cravings, which makes it difficult to control blood sugar levels. Diabetes may also affect your fertility and sex drive. Diabetic women have a low sex drive and may find it difficult to get pregnant.

Symptoms In Men
For men, too, lack of a sexual drive is common when they have diabetes. Similarly, high blood sugar levels may lead to damage in blood vessels which are necessary to achieve or maintain an erection. While erectile dysfunction is common for many men in middle age and afterwards, it is always good to talk to your doctor and see if it is a manifestation of a deeper problem or not.

Diabetic men may also get urinary tract infections frequently. So if you feel that you see an incidence of one or more of these signs, visit your doctor and get checked immediately. Blood sugar can be high periodically- when under some physical or mental stress. Or after ingesting sugary foods or even as a result of some medications. However, to ensure that it is indeed diabetes, you have to check your blood sugar regularly and visit a doctor who will prescribe the appropriate tests for you.

Diabetes Diagnosis and Tests
The doctor may prescribe one or more of the following diabetes test check if you have diabetes:

Hemoglobin A1C Test
For Type 1 and Type 2 diabetes, the doctor may order for a Hemoglobin A1C test. This test does not require fasting, and it identifies the blood sugar levels for three months or so. If you test for 6.5% or higher for two separate tests, you are diabetic. However, it may not be accurate if the person has any abnormalities in their haemoglobin, or is pregnant.

Fasting Blood Sugar Test
This blood test is done after the person has been fasting for at least 8 hours. If your blood sugar levels are below 100 mg/dL, you are not diabetic. Pre-diabetics clock in around 100-125 mg/DL, while diabetics show levels beyond 125mg/dL. If your values are more than 125mg/dL on two separate tests, you are diabetic.

Oral Glucose Tolerance Test
This is done after the fasting test. After checking fasting sugar levels, the person is to drink a sugary liquid and will be tested every 2 hours. If the levels read below 140 mg/dL, it is normal. Pre-diabetics show a blood sugar level of 140-199 mg/dL, while diabetics show a level more than 200 mg/dL.

Random Blood Test
Regardless of when you ate last, a random blood test showing more than 200 mg/dL blood sugar levels usually indicates diabetes.

Even if you keep track of your blood sugar levels at home with over-the-counter devices, definitely visit a doctor to know for sure whether you have diabetes or not. If you are diabetic, follow the guidance of the doctor to monitor your blood sugar levels.

What Causes Diabetes?
The exact causes of diabetes mellitus are not known, however, we know some probable risk factors.

Type 1 Diabetes Causes
It is not known what causes type 1 diabetes. As explained earlier, this happens when the pancreas cannot produce sufficient insulin. This happens when our own immunity system attacks and destroys the beta cells in the pancreas which produce insulin. Scientists are still not clear as to why this happens, but they suspect that a number of genetic and environmental factors are at play here.

Type 2 Diabetes Causes
Type 2 diabetes is called a “lifestyle disease” which is usually the result of a lack of sufficient physical activity and is caused by a sedentary and unhealthy lifestyle.

When you develop type 2 diabetes, your body is also at the risk of developing a host of other complications- especially heart diseases, high blood pressure and diseases related to blood vessels. Type 2 diabetes begins with insulin resistance. This means that the cells in the liver, muscle and fat do not respond to the insulin the body produces. As a result, your body cannot absorb blood sugar effectively. This leads to high blood glucose levels. However, the body produces more insulin to help the organs absorb blood sugar, but over time, it falls behind the amount required, and the blood sugar levels stay high.

Causes Of Gestational Diabetes Mellitus
During pregnancy, the body releases a number of hormones. Some hormones may lead to the buildup of blood sugar levels. Usually, the pancreas produces enough insulin to manage that, but in many women, it is the other case.

When the pancreas cannot produce enough insulin to control the blood sugar buildup in the body of a pregnant woman, they develop gestational diabetes.

While type 1 diabetes is autoimmune diabetes, you can keep type 2 diabetes (and to some extent, gestational diabetes) at bay if you lead an active and healthy lifestyle and follow a healthy diet. So let us take a look at ways to prevent diabetes.

Conclusion
At the end of the day, we should all follow a healthy lifestyle, monitor our health care and go for regular checkups with the doctor. This is doubly important for those who have a family history of diabetes. Living with diabetes in so not easy, but if you make some simple changes to your lifestyle, you can stay fit and happy.