Diabetes, or diabetes mellitus, is a long-term disorder of metabolism in which the body's inability to properly control blood sugar (glucose) levels results from inadequate insulin production or an inability to respond to the effects of insulin, or both. Insulin is an essential hormone produced by the pancreas and its main responsibility is to facilitate the absorption of glucose into the body's cells for energy use or storage for future consumption. This process goes awry and results in very high levels of glucose in the blood, called hyperglycemia, which in the long run becomes the major cause of multiple organ system complications.
Broadly, the disease is classified into two major types, namely Type I and Type II diabetes. There are other types such as gestational diabetes and even rarer ones. Type 1 diabetes, also known as insulin-dependent diabetes, is primarily diagnosed in children and adolescents, although it can also occur at any age. The defining features of this condition are symptoms resulting from autoimmune damage to the insulin-producing beta cells of the pancreas, leading to an absolute lack of insulin. Type 2 diabetes is the more common type and most commonly occurs in adulthood with new diagnoses. The increasing incidence of younger diagnoses also includes children. Type 2 diabetes comes from a combination of insulin resistance whereby cells in the body do not respond to insulin as they should. Then eventually, there is a slow decrease in the daily production of insulin in the pancreas.
The defining feature of diabetes is chronic hyperglycemia, which, if left untreated, leads to both acute and chronic complications. Serious complications include diabetic ketoacidosis, a potentially fatal condition found primarily in patients with type 1 diabetes, and hyperosmolar hyperglycemic state, a serious complication most commonly associated with type 2 diabetes. Long-term complications, primarily caused by damage to blood vessels and nerves as a result of continued exposure to hyperglycemia, mostly include ischemic heart disease, nephropathy (diabetic nephropathy), loss of vision (diabetic retinopathy), neuropathy (diabetic neuropathy), and increased susceptibility to infection and possible amputation due to poor healing, especially of the lower limbs.
Diabetes is also associated with a variety of diseases, ranging from an increased risk of stroke and heart attack to mental health problems such as depression and anxiety. It also significantly affects the quality of life due to the need for regular monitoring of blood sugar levels, compliance with dietary restrictions, physical activities and mostly lifelong medication or insulin therapy. Gestational diabetes is also a form of diabetes that occurs during pregnancy, which can predispose the mother to preeclampsia, premature delivery and later type 2 diabetes in the offspring.
Diabetes is diagnosed by blood tests specifically measuring glucose levels: fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), or glycated hemoglobin (HbA1c). They are indicators of blood sugar regulation and normal glucose metabolism, the difference between prediabetes and diabetes. Managing diabetes is always multi-faceted: lifestyle changes in healthy eating and exercise, pharmacological approaches such as oral medications or insulin therapy, and education so that a person can learn to deal with the management aspect of their condition. With the availability of new medical technologies such as continuous glucose monitors (CGM) and insulin pumps, people with diabetes can achieve excellent blood sugar levels with complete simplicity.
Diabetes is spreading rapidly in all corners of the world – it appears to be an epidemic that is generally caused by lifestyle and dietary factors as well as the growing number of overweight people with sedentary lifestyles. Public health campaigns to reduce the impact of diabetes as an epidemic include prevention involving lifestyle changes, early identification of prediabetes and diabetes, followed by access to comprehensive care and education for the population on managing the condition. Still, diabetes ranks highest in terms of morbidity and mortality worldwide, necessitating further research on its causes, treatments, and, hopefully, cures.
Diabetes is a highly complex and multifaceted disorder that is of vital importance to health and well-being. It is a condition that has health consequences as well as socio-cultural and economic consequences, affecting millions of individuals and families worldwide. Improvements through medicine have led to better management and supervision of diabetes, but efforts by health care systems and researchers around the world continue to race to find ways to prevent and cure it.
