Diabetes is a chronic disease which marked by characteristics such as height sugar level (glucose) blood.Glucose is the main energy source for the cells of the human body.
Glucose that accumulates in the blood due to not being absorbed by the body's cells properly can cause various disorders of the body's organs. If diabetes is not controlled properly, various complications can arise that endanger the patient's life.
Blood sugar levels are controlled by the hormone insulin, which is produced by the pancreas, which is an organ located behind the stomach. In people with diabetes, the pancreas is unable to produce insulin according to the body's needs. Without insulin, the body's cells cannot absorb and process glucose into energy.
Types of Diabetes
In general, diabetes is divided into two types, namely type 1 and type 2 diabetes. Type 1 diabetes occurs when the patient's immune system attacks and destroys the pancreatic cells that produce insulin. This results in an increase in blood glucose levels, resulting in damage to the body's organs. Type 1 diabetes is also known as autoimmune diabetes. The trigger for this autoimmune condition is still not known with certainty. The strongest suspicion is that it is caused by genetic factors of the patient which are also influenced by environmental factors.
Type 2 diabetes is the most common type of diabetes. This type of diabetes is caused by the body's cells becoming less sensitive to insulin, so that the insulin produced cannot be used properly (body cell resistance to insulin). About 90-95% percent of diabetics in the world suffer from this type of diabetes.
In addition to these two types of diabetes, there is a special type of diabetes in pregnant women called gestational diabetes. Diabetes in pregnancy is caused by hormonal changes, and blood sugar will return to normal after the pregnant woman has given birth.
Symptoms of Diabetes
Type 1 diabetes can develop rapidly within a few weeks, even days. Whereas in type 2 diabetes, many sufferers do not realize that they have had diabetes for years, because the symptoms tend to be non-specific. Some of the characteristics of type 1 and type 2 diabetes include:
- Often feel thirsty.
- Frequent urination, especially at night.
- Often feel very hungry.
- Weight loss for no apparent reason.
- Reduced muscle mass.
- There are ketones in the urine. Ketones are a by-product of the breakdown of muscle and fat as the body cannot use sugar as an energy source.
- Weak.
- Blurred vision.
- Wounds that are difficult to heal.
- Frequent infections, such as the gums, skin, vagina, or urinary tract.
Several other symptoms can also be signs that a person has diabetes, including:
- Dry mouth.
- Burning, stiffness, and pain in the legs.
- Itchy rash.
- Erectile dysfunction or impotence.
- Easily offended.
- Experiencing reactive hypoglycemia, which is hypoglycemia that occurs several hours after eating due to excessive insulin production.
- The appearance of black spots around the neck, armpits, and groin, (acanthosis nigricans) as a sign of insulin resistance.
Some people can develop prediabetes, which is a condition when the glucose in the blood is above normal, but not high enough to be diagnosed as diabetes. A person who has prediabetes can develop type 2 diabetes if it is not treated properly.
Diabetes risk factors
A person is more likely to develop type 1 diabetes if they have risk factors, such as:
- Have a family history of type 1 diabetes.
- Suffering from a viral infection.
- White people are thought to be more prone to type 1 diabetes than other races.
- Type 1 diabetes mostly occurs at the ages of 4-7 years and 10-14 years, although type 1 diabetes can appear at any age.
Whereas in the case of type 2 diabetes, a person will more easily experience this condition if he has risk factors, such as:
- Overweight.
- Have a family history of type 2 diabetes.
- Have a black or Asian race.
- Less active. Physical activity helps control weight, burns glucose for energy, and makes cells more sensitive to insulin. Lack of physical activity makes a person more susceptible to type 2 diabetes.
- Age. The risk of developing type 2 diabetes increases with age.
- Suffering from high blood pressure (hypertension).
- Have abnormal cholesterol and triglyceride levels. A person who has good cholesterol or HDL (high-density lipoprotein) low and high triglyceride levels are more at risk of developing type 2 diabetes.
Especially in women, pregnant women who suffer from gestational diabetes can more easily develop type 2 diabetes. polycystic ovarian syndrome (PCOS) are also more likely to develop type 2 diabetes.
Diabetes Diagnosis
Symptoms of diabetes usually develop gradually, except for type 1 diabetes, where symptoms can appear suddenly. Because diabetes is often undiagnosed in its early stages, it is recommended that people who are at risk of developing the disease undergo regular check-ups. Among others are:
- People over 45 years old.
- Women who have had gestational diabetes while pregnant.
- People who have a body mass index (BMI) above 25.
- People who have been diagnosed with prediabetes.
Blood sugar test is an absolute examination that will be done to diagnose type 1 or type 2 diabetes. The results of blood sugar measurements will show whether a person has diabetes or not. The doctor will recommend the patient to undergo a blood sugar test at a certain time and with a certain method. The blood sugar test methods that can be carried out by patients include:
Blood sugar test when
This test aims to measure blood glucose levels at a certain random hour. This test does not require the patient to fast first. If the results of the current blood sugar test show a sugar level of 200 mg/dL or more, the patient can be diagnosed with diabetes.
Fasting blood sugar test
This test aims to measure blood glucose levels when the patient is fasting. Patients will be asked to fast for 8 hours first, then undergo blood sampling to measure their blood sugar levels. Fasting blood sugar test results that show blood sugar levels less than 100 mg/dL indicate normal blood sugar levels. Fasting blood sugar test results between 100-125 mg/dL indicate the patient has prediabetes. While the results of a fasting blood sugar test of 126 mg/dL or more indicate the patient has diabetes.
Glucose tolerance test
This test is done by asking the patient to fast overnight first. The patient will then undergo a fasting blood sugar test measurement. After the test is done, the patient will be asked to drink a special sugar solution. Then the blood sugar sample will be taken back after 2 hours of drinking the sugar solution. A glucose tolerance test result below 140 mg/dL indicates normal blood sugar levels. The results of the glucose tolerance test with sugar levels between 140-199 mg/dL indicate prediabetes. The results of a glucose tolerance test with a sugar level of 200 mg/dL or more indicate the patient has diabetes.
Test HbA1C (glycated hemoglobin test)
This test aims to measure the patient's average glucose level over the past 2-3 months. This test will measure blood sugar levels bound to hemoglobin, the protein that carries oxygen in the blood. In the HbA1C test, the patient does not need to undergo fasting first. HbA1C test results below 5.7% is a normal condition. HbA1C test results between 5.7-6.4% indicate the patient has prediabetes. An HbA1C test result above 6.5% indicates the patient has diabetes. In addition to the HbA1C test, an estimated average glucose (eAG) test can also be done to determine blood sugar levels more accurately.
The results of the blood sugar test will be checked by the doctor and informed to the patient. If the patient is diagnosed with diabetes, the doctor will plan the treatment steps that will be taken. Especially for patients suspected of having type 1 diabetes, the doctor will recommend an autoantibody test to determine whether the patient has antibodies that damage body tissues, including the pancreas.
Diabetes Treatment
Diabetic patients are required to adjust their diet by increasing the consumption of fruits, vegetables, protein from grains, and foods low in calories and fat. Food choices for diabetics should also really be considered.
If necessary, diabetic patients can also replace sugar intake with a sweetener that is safer for diabetics, sorbitol. Diabetic patients and their families can consult nutrition and diet with a doctor or nutritionist to regulate their daily diet.
To help convert blood sugar into energy and increase the sensitivity of cells to insulin, diabetic patients are recommended to exercise regularly, at least 10-30 minutes every day. Patients can consult a doctor to choose the appropriate sport and physical activity.
In type 1 diabetes, the patient will need insulin therapy to regulate daily blood sugar. In addition, some type 2 diabetes patients are also advised to undergo insulin therapy to regulate blood sugar. The additional insulin will be given by injection, not in the form of oral medication. The doctor will set the type and dose of insulin used, as well as tell how to inject it.
In severe cases of type 1 diabetes, your doctor may recommend pancreatic transplant surgery to replace the damaged pancreas. Type 1 diabetes patients who successfully undergo the operation no longer require insulin therapy, but must take immunosuppressive drugs regularly.
In patients with type 2 diabetes, doctors will prescribe drugs, one of which is metformin, an oral medication that works to reduce glucose production from the liver. In addition, other diabetes drugs that work by keeping glucose levels in the blood from getting too high after the patient eats can also be given.
Doctors can also accompany the above drugs with supplements or vitamins to reduce the risk of complications. For example, diabetic patients who often experience tingling symptoms will be given neurotropic vitamins.
Neurotrophic vitamins generally consist of vitamins B1, B6, and B12. These vitamins are useful for maintaining the function and structure of the peripheral nerves. This is very important to maintain in patients with type 2 diabetes to avoid complications of diabetic neuropathy which are quite common.
Diabetic patients must control their blood sugar in a disciplined manner through a healthy diet so that blood sugar does not rise above normal. In addition to controlling glucose levels, patients with this condition will also be scheduled to undergo an HbA1C test to monitor blood sugar levels for the last 2-3 months.
Diabetes Complications
A number of complications that can arise from type 1 and 2 diabetes are:
- Heart disease
- stroke
- Chronic kidney failure
- Diabetic neuropathy
- Visual disturbance
- Cataract
- Depression
- Dementia
- Hearing disorders
- Frozen shoulder
- Wounds and infections on the feet that are difficult to heal
- Skin breakdown or gangrene from bacterial and fungal infections, including flesh-eating bacteria
Diabetes due to pregnancy can cause complications in pregnant women and babies. An example of a complication in pregnant women is preeclampsia. While examples of complications that can arise in infants are:
- Excess weight at birth.
- Premature birth.
- Low blood sugar (hypoglycemia).
- Miscarriage.
- Jaundice.
- Increased risk of developing type 2 diabetes when the baby is an adult.
Diabetes Prevention
Type 1 diabetes cannot be prevented because the trigger is not known. Meanwhile, type 2 diabetes and gestational diabetes can be prevented, namely with a healthy lifestyle. Several things can be done to prevent diabetes, including:
- Regulate the frequency and menu of foods to be healthier
- Maintain ideal body weight
- Exercise regularly
- Regularly check blood sugar, at least once a year