PT Health Life – Diabetes mellitus is a metabolic disease that causes high blood sugar levels. The disease progresses silently and dangerously, causing many serious complications in organs in the body. Pregnant women are also among the groups at risk of the disease.
The rate of people with diabetes is increasing and getting younger, the number of children with diabetes is also increasing, many people aged 25-30 have diabetes without knowing it.
According to a survey of specialized obstetric hospitals nationwide, in the period from 2001-2004, the detection rate of gestational diabetes was about 3%-4%, however, by 2017, this rate had increased to 20% of the total number of pregnant women examined at specialized hospitals/medical facilities.
Diabetes is the third leading cause of death among non-communicable diseases. Untreated high blood sugar from diabetes can damage the nerves, eyes, kidneys and other organs.
Diabetes is a metabolic disease, the main cause is due to complete or partial lack of insulin (pancreatic hormone) in the blood. The World Health Organization (WHO) states that diabetes is manifested by glucose metabolism disorder, increasing blood glucose concentration and glucose in urine. It is for this reason that people use the name of this typical symptom to name the disease.
The hormone insulin moves sugar from your blood into your cells for storage or use as energy . With diabetes , your body either does n’t produce enough insulin or ca n’t effectively use the insulin it produces .
1. Classification of some types of diabetes
Type 1 diabetes ( type 1) is an autoimmune disease. The immune system attacks anddestroys cells in the pancreas that make insulin. It is not clear what causes this attack . About 10% of people with diabetes have thistype . Type 1 diabetes is insulin-dependent diabetes that usually occurs in young people. Type 1 diabetes is a severe form of the disease that often appears suddenly, with an acute course often following an infection or poisoning, and can lead to coma.
Type 2 diabetes ( type 2) occurs when the body becomes resistant to insulin and sugar builds up in the blood. Type 2 diabetes is non – insulin dependent. It is common in older people, more common in women than men , and more common in obese people. This is a common form of the disease, with more than 90% of people with diabetes having type 2.
Prediabetes occurs when blood sugar levels are higher than normal but not high enough to diagnose type 2 diabetes . Prediabetes is a technical term used to describe carbohydrate disorders in the body. Medically, prediabetes is classified as stage 2 – the early stage of type 2 diabetes .
Gestational diabetes is high blood sugar during pregnancy. It occurs when a woman who has never had diabetes develops high blood sugar during pregnancy. Insulin-blocking hormones produced by the placentacause this type of diabetes.
Each type of diabetes has its own symptoms , causes , and treatments .
2. Symptoms of diabetes
Symptoms of diabetes are caused by high blood sugar levels. When you have type 1 or type 2 diabetes, you often have some common symptoms such as: eating a lot, drinking a lot, urinating a lot and losing weight quickly.
Common symptoms of diabetes include :
- Sick people are often hungry.
- Thirst increases
- Weight loss
- Frequent urination
- Blurred vision
- Ulcers , wounds that are difficult to heal
In addition to the common symptoms of diabetes , men with diabetes may experience decreased libido , erectile dysfunction , and poor muscle strength.
Women with diabetes may also have symptoms such as urinary tract infections , yeast infections , and dry , itchy skin .
Children with diabetes also have similar symptoms as adults and they appear in a few weeks: children drink more water than usual and do not feel thirsty. Children often feel tired and lose weight quickly for no apparent reason. Children urinate more, for young children often wet the bed; in infants, diapers may be heavier than usual. Some children have abdominal pain, headaches and unusual behavior. Diabetes in children if blood sugar is not well controlled will be very difficult to treat because complications cannot be screened.
2.1 Type 1 diabetes
Symptoms of type 1 diabetes may include :
- That ‘s extreme .
- Thirst increases
- Unintentional weight loss
- Frequent urination
- Blurred vision
- Tired
- It can also lead to mood swings .
2.2 Type 2 diabetes
Symptoms of type 2 diabetes may include :
- very good
- Always feel thirsty
- Frequent urination
- Blurred vision
- Tired
- Ulcers , slow healing wounds
Diabetes can also cause recurrent infections . This is because high glucose levels make it harder for the body to heal .
2.3 Gestational diabetes
Most women with gestational diabetes do not have any symptoms . The condition is usually detected during a routine blood sugar test or oral glucose tolerance test , which is usually done between 24 and 28 weeks of pregnancy .
In rare cases, women with gestational diabetes will also feel thirsty or urinate more often. Diabetes symptoms can be so mild that they are difficult to detect at first .
3. Causes of diabetes
Different causes are associated with each type of diabetes .
Type 1 diabetes
Doctors do n’t know exactly what causes type 1 diabetes . For some reason , the immune system mistakenly attacks and destroys the insulin – producing beta cells in the pancreas. Genes may play a role in some people . Viruses may also attack the immune system .
Type 2 diabetes
Type 2 diabetes is caused by a combination of genetics and lifestyle . Being overweight or obese also increases your risk . Carrying extra weight , especially around your belly , makes your cells more resistant to the effects of insulin on blood sugar .
This condition runs in families . Family members share genes that make them more likely to develop type 2 diabetes and be overweight .
Gestational diabetes
Gestational diabetes is a result of hormonal changes during pregnancy . The placenta produces hormones that make a pregnant woman’s cells less sensitive to the effects of insulin . This can cause high blood sugar levels during pregnancy .
Women who are overweight when they become pregnant or gain too much weight during pregnancy are at increased risk of gestational diabetes .
Both genes and environmental factors play a role in the development of diabetes .
4. Risk factors for diabetes
Here are some factors that increase your risk of diabetes:
Type 1 diabetes
You are more likely to develop type 1 diabetes if you are a child or teenager , have a parent or sibling with the disease, or carry certain genes linked to the disease .
Type 2 diabetes
The risk of developing type 2 diabetes increases if the following risk factors are present:
- Overweight
- 45 years old and above
- Have a parent or sibling with this condition
- Physical inactivity
- Gestational diabetes
- Prediabetes
- Have high blood pressure, high cholesterol , or high triglycerides
Gestational diabetes
Women are at increased risk of developing gestational diabetes if they:
- Overweight
- Over 25 years old
- Had gestational diabetes in past pregnancies
- Gave birth to a baby weighing more than 4kg
- Have a family history of type 2 diabetes
- Have polycystic ovary syndrome
- Family , environment , and existing medical conditions can all influence the incidence of diabetes .
5. Complications of diabetes
High blood sugar damages organs and tissues throughout the body . The higher your blood sugar and the longer you live with it , the greater your risk of complications .
Complications associated with diabetes include:
- Heart disease , heart attack and stroke
- Neuropathy
- Kidney disease
- Retinal disease and vision loss
- Hearing loss
- Foot injuries such as infections and ulcers are not uncommon .
- Skin conditions such as bacterial and fungal infections
- Depression
- Dementia
Gestational diabetes
Uncontrolled gestational diabetes can lead to problems that affect both mother and baby . Complications that affect the baby can include :
- Premature birth
- Higher than normal birth weight
- Increased risk of developing type 2 diabetes in the future
- Low blood sugar
- Jaundice
- Stillbirth
- Pregnant women may experience complications such as high blood pressure causing preeclampsia or type 2 diabetes .
Diabetes can lead to serious complications , but the condition can be controlled with medication and lifestyle changes .
6. Treatment of diabetes
The goal of treatment in diabetes is to control blood sugar levels well and detect complications early, preventing or slowing down the progression of complications of diabetes. Patients need to have regular check-ups and strictly follow the doctor’s treatment method. Absolutely do not take medicine according to the advice or prescription of another patient because it is very dangerous. Doctors treat diabetes with a number of different types of drugs . Some of these drugs are taken orally and others are given as injections .
6.1 Type 1 diabetes
Insulin is the main treatment for type 1 diabetes. It replaces the hormone that the body cannot produce .
There are 4 types of insulin most commonly used :
- Rapid-acting insulin starts working within 15 minutes and its effects last 3 to 4 hours.
- Short-acting insulin starts working within 30 minutes and lasts 6 to 8 hours.
- Intermediate-acting insulin begins working within 1 to 2 hours and lasts 12 to 18 hours.
- Long – acting insulin begins working a few hours after injection and lasts 24 hours or longer.
Depending on the patient’s condition and disease progression, the treating physician can proactively use insulin from the beginning.
6.2 Type 2 diabetes
Diet and exercise can help some people control type 2 diabetes. If lifestyle changes are not enough to lower blood sugar, blood sugar-lowering medications will be needed. People with diabetes may need to take more than one type of medication. Some people with type 2 diabetes also take insulin.
People with type 2 diabetes should only use insulin in the following cases:
- Acute course of the disease: acute hyperglycemia, acute infection, other acute diseases such as myocardial infarction, cerebrovascular stroke…
- Acute liver and kidney damage; Type 2 diabetics with kidney complications – causing kidney failure (depending on the severity, each drug is contraindicated)
- Taking pills but not lowering blood sugar despite combining many oral medications.
6.3 Gestational diabetes
Women will need to monitor their blood sugar levels several times a day during pregnancy. If they are high, changes in diet and exercise may or may not be enough to lower them . As a result, about 10 to 20 percent of women with gestational diabetes will need insulin to lower their blood sugar . Insulin is safe for the growing baby .
The combination of medications your doctor prescribes will depend on the type of diabetes you have and its cause .
7. Diet in diabetes
Eating healthy is an important part of managing diabetes. In some cases, dietary changes may be enough to control the disease.
Eating healthy is an important part of managing diabetes . In some cases, dietary changes may be enough to control the disease. Tailoring the diet to the individual case can help patients control glucose fluctuations and, for patients with type 2 diabetes, lose weight .
In general, all diabetic patients should be advised to follow a diet low in saturated fat and cholesterol and moderate in carbohydrate, preferably from whole grain sources that are higher in fiber. Although dietary protein and fat contribute to caloric intake, only carbohydrate has a direct impact on blood glucose. Low-carbohydrate, high-fat diets improve glucose control in some patients and may be used for a short period of time, but their long-term safety is uncertain.
Children with diabetes need to pay the same attention to diet and weight control as adults, and to awareness and management of dyslipidemia and hypertension. Most children with type 2 diabetes are obese, so lifestyle changes are also a focus of treatment.
7.1 For type 1 diabetes
Blood sugar levels rise or fall depending on the type of food. Foods high in starch or sugar cause blood sugar levels to rise quickly. Protein and fat cause them to rise gradually.
Your doctor will advise you to limit the amount of carbohydrates you eat each day , but also to balance your sugar, starch, and fiber intake with your insulin dose.
People with diabetes need to consult a nutritionist to have a meal plan . Balancing protein , fat and appropriate amounts of carbohydrates , fiber can help control blood sugar levels .
7.2 Type 2 diabetes
Eating the right foods can help control blood sugar and lose weight . Counting carbs, sugars, and fiber is an important part of eating for type 2 diabetes. A dietitian can advise you on how many grams of carbohydrates you should eat at each meal .
To keep your blood sugar stable , try to eat several small meals throughout the day . Eat healthy foods such as low – sugar fruits, vegetables, whole grains, lean proteins such as poultry and fish , and healthy fats such as olive oil and nuts .
7.3 Gestational diabetes
Eating a balanced diet is important for both the mother and the baby . Choosing the right foods can also help pregnant women avoid diabetes medications .
It is important to watch your food intake and limit sugary or salty foods . Although some sugar is needed to feed the growing baby , too much should be avoided .
Consider planning your meals with the help of a dietitian to ensure your diet has the right mix of macronutrients .
8. Diagnosis of diabetes
Anyone who has symptoms of diabetes or is at risk should be tested . Women are routinely screened for gestational diabetes during the second and third trimesters of pregnancy .
Doctors use these blood tests to diagnose prediabetes and diabetes :
– Fasting blood sugar test , measures blood sugar after fasting for 8 hours .
– The A1c test, also known as the HbA1c test (a blood test that measures average blood sugar levels over the past 2-3 months) provides a snapshot of blood sugar levels over the previous 3 months .
– To diagnose gestational diabetes , your doctor will check your blood sugar levels between the 24th and 28th weeks of pregnancy. During the glucose challenge test , your blood sugar is checked one hour after you drink a sugary liquid . During the 3-hour glucose tolerance test, your blood sugar is checked after you fast overnight and then drink a sugary liquid .
The earlier diabetes is diagnosed , the sooner treatment can be started .
9. Diabetes prevention
Type 1 diabetes cannot be prevented because it is caused by a problem with the immune system . Some causes of type 2 diabetes , such as genes or age , are also beyond your control .
However , many other diabetes risk factors are controllable . Most diabetes prevention strategies involve making simple adjustments to diet and exercise habits .
If you ‘ve been diagnosed with prediabetes , there are a number of things you can do to delay or prevent type 2 diabetes :
- Exercise at least 150 minutes a week, such as walking or cycling .
- Cut saturated fats and trans fats , along with refined carbohydrates, from your diet .
- Eat plenty of fruits , vegetables and whole grains.
- Divide into many small meals.
- Try to lose 7% of your body weight if you are overweight or obese .
Diabetes in pregnancy
Women who have never had diabetes can suddenly develop diabetes during pregnancy . Hormones produced by the placenta can make a pregnant woman ‘s body more resistant to the effects of insulin .
Some women have diabetes before they become pregnant, which is called pre-gestational diabetes . Gestational diabetes goes away after the baby is born, but it significantly increases the risk of developing diabetes later in life.
Having diabetes during pregnancy can also lead to complications for the newborn , such as jaundice or breathing problems .
If you are diagnosed with diabetes before or during pregnancy, you will need special monitoring to prevent complications .
Diabetes in children
All types of childhood diabetes have a familial component, although the rates and mechanisms vary. Children can develop both type 1 and type 2 diabetes. Controlling blood sugar is especially important in children, as the disease can damage vital organs such as the heart and kidneys. It is important that children with diabetes receive prompt treatment.
Children with diabetes need a scientific diet and reasonable exercise. However, children should not be forced to abstain too much but should pay attention to choosing alternative foods for people with diabetes. At the same time, implement a reasonable diet to ensure the physical and mental development needs of children. Note that increasing exercise for children with diabetes is important in helping to reduce blood sugar levels and reduce insulin resistance.
10. Doctor’s advice
Some types of diabetes , such as type 1 , are caused by factors beyond your control . Type 2 diabetes can be prevented by making better food choices, increasing activity , and losing weight .
People who suspect they have diabetes or have diabetes should see their doctor and discuss the potential risks of diabetes with them . If you are at risk , check your blood sugar and follow your doctor ‘s advice for managing your blood sugar .
