Tag: diabetes

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“How to Diagnose Diabetes: WHO Diabates guidelines “

Introduction:

Diabetes is a chronic health condition that is caused by inadequate production of insulin or inability of the body to utilize the insulin effectively which primarily turns food into energy. Across the Globe this is one of the most prevalent diseases among all age groups. Early diagnosis benefits and Importance of early medical treatment are the areas where most of the research is done. Benefits for early diagnosis are it allows timely intervention, reducing the risk of severe health issues such as heart disease, kidney failure, and vision loss. Regular checkups should be done for timely diagnosis as symptoms of type 2 diabetes may go unnoticed for years. Effective management through lifestyle changes and medication can significantly reduce the risk of complications. Moreover, early intervention has economic benefits as it reduces the costs treatment of complication of untreated diabetes. In summary early disease detection and timely medical intervention are vital for preventing complications, enhancing quality of life, and reducing healthcare costs.

Early Warning Signs of Diabetes:

Identifying the early warning signs of the diabetes help in early diagnosis and effective management of the diseases. Following are the signs you should look forward

  • Increased thirst and dry mouth which is also known as polydipsia is due to high blood sugar levels pulling water from the cells
  • Frequent Urination (Polyuria) especially during the nighttime is because the kidneys have work to expel excess levels of glucose out of the blood.
  • Unexplained Weight Loss occurs even after eating normal or more because cells are not getting energy, so they burn fat and muscles for energy.
  • Extreme Hunger (Polyphagia) happens because of body’s inability to utilize the glucose for energy or store glucose as glycogen.
  • Fatigue and Weakness persistent tiredness due to low energy levels.
  • Slow-Healing of Wounds due to impaired blood circulation and high glucose levels.
  • Frequent Infections happens such as UTIs due to high glucose levels that support bacterial and fungal growth.

Who Should Undergo Testing for Diabetes?

All individuals with specific risk factors, symptoms, or conditions are recommended to undergo testing for the diabetes. According to World Health Organization (WHO) and the American Diabetes Association (ADA), the following group of people should undergo testing

  • People with Symptoms of Diabetes
  • Adults Aged 45 and Older
  • Individuals with Overweight or Obesity
  • People with a Family History of Diabetes
  • Individuals with a Sedentary Lifestyle
  • Women with a History of Gestational Diabetes or Polycystic Ovary Syndrome (PCOS)
  • Individuals with Cardiovascular Risk Factors
  • Individuals with Pre-diabetes
  • Children and Adolescents
  • Individuals with Certain Ethnic Backgrounds
  • People with Other Medical Conditions

How to diagnose diabetes:

WHO diabetes diagnostic criteria 

World health organization has set a specific criterion for accurate diagnosis management of the diabetes which includes diagnostic tests for diabetes:

Common Diagnostic Tests:

A. Fasting Plasma Glucose (FPG) Test: Fasting is defined as no caloric intake for at least 08 hours prior to the test. And this test measures the blood glucose level after a fast. The diagnostic criteria include

  • Normal: <100 mg/dL (5.6 mmol/L)
  • Prediabetes: 100–125 mg/dL (5.6–6.9 mmol/L)
  • Diabetes: ≥126 mg/dL (7.0 mmol/L)

B. Oral Glucose Tolerance Test (OGTT): This test measures the glucose level in the blood before and 2 hours after consuming a glucose rich drink. The diagnostic criterion for this test includes following after 02 hours of consuming glucose rich drink

  • Normal: <140 mg/dL (7.8 mmol/L)
  • Prediabetes: 140–199 mg/dL (7.8–11.0 mmol/L)
  • Diabetes: ≥200 mg/dL (11.1 mmol/L)

C. Hemoglobin A1c (HbA1c) Test: This test measures the average blood glucose level of previous 2-3 months. The diagnostic criterion for this test is following:

  • Normal: <5.7%
  • Prediabetes: 5.7%–6.4%
  • Diabetes: ≥6.5%

D. Random Plasma Glucose Test: This test measures the blood glucose levels at any time of the day without fasting and the individuals which have symptoms of diabetes along with random plasma glucose of ≥11.1 mmol/L (200 mg/dL) is suggestive of diabetes.

Diagnostic Criteria for Gestational Diabetes Mellitus (GDM):

Gestational diabetes is a type of diabetes that occurs during pregnancy when the body cannot effectively use insulin, leading to high blood sugar levels. The following plasma glucose values are used to diagnose GDM:

  • Fasting Plasma Glucose: 5.1–6.9 mmol/L (92–125 mg/dL)
  • 1-Hour Post-Load Plasma Glucose: ≥10.0 mmol/L (180 mg/dL)
  • 2-Hour Post-Load Plasma Glucose: 8.5–11.0 mmol/L (153–199 mg/dL)

These values are given it the latest WHO’s guidelines on classification of diabetes mellitus. It is important to remember that these values are measured from the venous plasma glucose measurements. Repeated testing on multiple days should be done to diagnose diabetes mellitus as sometimes there is unequivocal hyperglycemia with acute metabolic decompensation.

When to Test for diabetes?

According to World Health Organization (WHO) and the American Diabetes Association (ADA) All these people with risk factors that are mentioned above should be tested every 03 years. And the people who had blood sugar levels in pre-diabetes range may require annual testing.

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Understanding Diabetes: what is diabetes and what causes diabetes?

Introduction

Diabetes is a chronic health condition that is caused by inadequate production of insulin or inability of the body to utilize the insulin effectively which primarily turns food into energy. Across the Globe this is one of the most prevalent diseases among all age groups. According to WHO the number of people living with diabetes rose from 200 million in 1990 to 830 million in 2022. Prevalence has been rising more rapidly in low- and middle-income countries than in high-income countries and more than half of people are not taking medication for their diabetes. In 2021, diabetes and kidney disease due to diabetes caused over 2 million deaths. In addition, around 11% of cardiovascular deaths were caused by high blood glucose.

Insulin, a hormone that is produced by the pancreas in response to the body signals of the high blood sugar levels, signals cells in the body (especially in muscles, fat, and the liver) to absorb glucose for energy or storage. It helps conversion of glucose in glycogen a storage form of energy for later use and glucose as fat for long-term energy reserves. By ensuring the effective uptake of glucose it prevents body from hyperglycemia keeps sugar in normal levels.

Hyperglycemia, raised blood sugar levels or raised blood sugar, is the common effect of the diabetes which if left untreated can cause serious damage to the body especially the nerves and blood vessels which in turn leads to damage to the different systems of the body.

what is diabetes?

Types of Diabetes:

1. Type 1 Diabetes:

Type 1 diabetes is an autoimmune condition where body’s immune system produce antibodies against Beta cells of pancrease which produce insulin, leading to little or no insulin production. The exact cause of type 1 diabetes is unknown, but it is beleived to be combination of genetic and enviornmental factors. This type of diabetes is often diagnosed in young adults and children.

2. Type 2 Diabetes:

Type 2 diabetes is caused by resistance of the body to insulin or when pancreas fails to produce enough insulin that is required for the body to function properly. When body isn’t responding to insulin effectively it leads to increased sugar levels in the body which signals the pancreas to produce more insulin. Overtime pancreas starts producing less insulin which further worsens the balance. Type 2 diabetes accounts for 90-95% of all diabetes globally. It mostly diagnosed in later years of life.

3. Gestational diabetes:

Gestational diabetes is a type of diabetes that occurs during pregnancy when the body cannot effectively use insulin, leading to high blood sugar levels. This condition typically develops in the second or third trimester and often resolves after delivery. However, it can pose health risks for both the mother and baby if not managed properly.

4. Secondary diabetes:

This is the type of diabetes that is caused by some other medical condition or some medications that disrupts body’s ability to regulate blood sugar level. This may include pancreatic diseases, hormonal disorders or certain medications.

What Causes Diabetes?

Causes of Type 1 Diabetes:

The exact cause is not known while several factors contribute to the development of Type 1 diabetes:

1. Autoimmune Response:

The immune system of the body attacks its own Beta cells in the pancreas that produces the insulin the exact cause to this is not fully understood but involves combination of genetic and environmental factors.

2. Genetic Factors:

Positive family history of type 1 diabetes increases the risk. Variations in the HLA (human leukocyte antigen) gene complex which have a role in immune system is associated with higher likelihood of prevalence of type 1 diabetes

3. Environmental Triggers:

There are certain viruses, such as the coxsackievirus, rubella, or enteroviruses, may trigger the autoimmune response in genetically predisposed individuals. A correlation has been found between the cow’s milk or lack of breastfeeding in infancy and type 1 diabetes, yet it is bit controversial. Prevalence is high in colder climates and during winter months for example Northern European countries have a higher incidence of Type 1 diabetes compared to equatorial regions.

4. Toxins:

Certain environmental toxins (e.g., nitrosamines) are found in association with damaging pancreatic Beta cells and triggering autoimmune reactions.

Causes of Type 2 Diabetes:

Unlike Type 1 diabetes, Type 2 diabetes is associated with modifiable lifestyle choices and predisposition. And the factors that contribute to it are

1. Insulin Resistance:

The receptors on the cells in muscles, fat, and the liver fail to respond effectively to insulin, which prevents glucose from entering into the cells which leads to hyperglycemia the pancreas produces more insulin to compensate, but with the time, this leads to beta-cell dysfunction and reduced insulin secretion.

2. Genetic Factors:

There are certain genetic mutations that affects the insulin sensitivity, glucose metabolism, or beta-cell function, which predisposes an individual to diabetes. So, if your parents have type 2 diabetes the risk increases significantly.

3. Lifestyle and Behavioral Factors:

Unhealthy Diet, lack of physical activity and obesity are the leading contributors to type 2 diabetes. A sedentary lifestyle reduces insulin sensitivity and contributes to excess body fat, especially around the abdomen which leads to hormonal imbalance that promote insulin resistance.

4. Age and Demographics:

the risk of type 2 diabetes increases after age 45 due to natural declines in insulin sensitivity and physical activity. Certain groups of people are at higher risk of diseases then others such as African Americans, Hispanics, Native Americans, and South Asians, are at higher risk.

5. Medical and Environmental Factors:

Metabolic syndromes such as high blood pressure, high cholesterol, and excess abdominal fat, increases the risk. Hormonal disorders can contribute to the insulin resistance such as polycystic ovary syndrome (PCOS). Stress, poor sleep, or exposure to toxins may contribute to Type 2 diabetes development.

6. Certain Medications:

Type 2 diabetes can result from long-term use of drugs such as beta-blockers, corticosteroids, or antipsychotics that affect glucose metabolism.