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ID: 143
Category: Metabolism
CreatedBy: 1
UpdatedBy: 1
createdon: 08 Feb 2023
updatedon: 03 Apr 2023

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Author: Khoa Tran
Published Feb 08, 2023
Updated Apr 03, 2023

Table of contents

Diabetes

Etymology and Pronunciation

Diabetes  (dye-uh-BEE-teez)
diabainein - Greek for "to pass through". Word references increased frequency of urination.

History of Diabetes

The history of diabetes can be traced back to ancient times. The first recorded description of the disease was found in an Egyptian manuscript from around 1500 BCE, which described a condition that caused frequent urination and increased thirst.

In ancient India, the term "madhumeha" (meaning "honey urine") was used to describe a similar condition, which was treated with various remedies such as astringents, tonics, and dietary changes.

Over the centuries, various physicians and researchers continued to study the disease, but it wasn't until the 19th century that significant progress was made in understanding diabetes. In the early 1800s, French physiologist Claude Bernard discovered that the liver played a crucial role in regulating blood sugar levels.

Later, in 1889, Oskar Minkowski and Joseph von Mering demonstrated that removing the pancreas from dogs resulted in the development of diabetes, which led to the discovery of insulin as a treatment for the disease.

In 1921, Frederick Banting and Charles Best successfully isolated insulin from the pancreas of dogs and used it to treat a young boy with type 1 diabetes. This discovery revolutionized the treatment of diabetes and saved countless lives.

Since then, researchers have continued to study diabetes and its underlying causes, as well as develop new treatments and management strategies for the disease. Today, diabetes is a global epidemic, affecting millions of people worldwide, but thanks to ongoing research and advances in medical technology, people with diabetes are able to manage their condition and live longer, healthier lives.

Modern Understanding of Diabetes

Diabetes is a condition in which the body has too much glucose, a type of sugar, in the blood. Glucose is the main source of energy for the body and it comes from the food we eat, mainly from carbohydrates.

Insulin, a hormone produced by the pancreas, is a hormone that regulates blood sugar levels by allowing glucose to enter cells and be used for energy.

High blood sugar levels, also known as hyperglycemia, can cause several health problems, such as diabetic ketoacidosis, diabetic coma, and damage to the eyes, kidneys, nerves, heart, and blood vessels. Low blood sugar levels, known as hypoglycemia, can also occur, especially in people taking insulin.

Warning signs of diabetes is obesity, sweet/fruity smelling urine (due to glucose in the urine), and acetone (nail polish) smell in breath (due to ketosis).

There are three main types of diabetes: type 1, type 2, and Gestational diabetes. 

Type 1 diabetes

Type 1 diabetes, also known as insulin-dependent diabetes, is a chronic autoimmune disorder that occurs when the body's immune system mistakenly attacks and destroys the beta cells in the pancreas that produce insulin.  As a result, the person must take insulin injections or use an insulin pump to replace the missing hormone.

Without insulin, glucose builds up in the bloodstream, leading to high blood sugar levels, which can cause serious health complications. Type 1 diabetes is typically diagnosed in children and young adults, although it can occur at any age.

The exact causes of type 1 diabetes are not yet fully understood, although it is thought to be a combination of genetic and environmental factors. Researchers believe that certain genes may make some people more susceptible to developing type 1 diabetes, but environmental triggers such as viruses or toxins may also play a role in triggering the disease.

If left untreated, type 1 diabetes can lead to serious health complications, including damage to the eyes, kidneys, nerves, and cardiovascular system.

Type 1 diabetes is usually diagnosed through a combination of blood tests and symptom assessment. The most common test for diabetes is a fasting plasma glucose test, which measures the amount of glucose in the blood after an overnight fast. Another test is the hemoglobin A1c test, which provides an average of blood sugar levels over the past 2-3 months.

Type 2 diabetes

Type 2 diabetes, on the other hand, occurs when the body becomes resistant to the effects of insulin and is unable to produce enough of it to regulate blood sugar levels effectively. 

This type of diabetes is caused by a combination of genetic and lifestyle factors, including:

- Obesity: Being overweight or obese is one of the biggest risk factors for type 2 diabetes, as excess body fat can interfere with the body’s ability to properly use insulin.
- Inactivity: Lack of physical activity can contribute to the development of type 2 diabetes by reducing the body’s ability to regulate blood sugar levels.
- Poor diet: A diet high in processed foods, refined carbohydrates, and sugar can increase the risk of type 2 diabetes by causing insulin resistance and inflammation.
- Genetics: Some people may have a genetic predisposition to developing type 2 diabetes, although lifestyle factors also play a significant role.

The goal of treatment for type 2 diabetes is to maintain blood sugar levels within a normal range through a combination of lifestyle modifications, medication, and insulin therapy.

Lifestyle Modifications: Lifestyle modifications are an essential part of managing type 2 diabetes and may include:

- Healthy eating: A diet rich in whole foods, fruits, vegetables, lean protein, and healthy fats can help regulate blood sugar levels and prevent complications.
- Regular physical activity: Exercise can help improve insulin sensitivity, lower blood sugar levels, and improve overall health.
- Weight management: Losing weight can improve insulin sensitivity and reduce the risk of complications associated with type 2 diabetes.

Medication: Several types of medication may be used to manage type 2 diabetes, including:

- Metformin: A medication that helps reduce glucose production in the liver and improves insulin sensitivity.
- Sulfonylureas: Medications that stimulate the pancreas to produce more insulin.
- DPP-4 inhibitors: Medications that help regulate blood sugar levels by increasing the levels of incretin hormones in the body.
- GLP-1 receptor agonists: Medications that help regulate blood sugar levels by increasing insulin production and decreasing glucagon secretion.
- SGLT2 inhibitors: Medications that help lower blood sugar levels by blocking the reabsorption of glucose by the kidneys.
- Insulin Therapy: In some cases, insulin therapy may be necessary to manage type 2 diabetes. This may involve injecting insulin into the body through multiple daily injections or an insulin pump.

Gestational diabetes

Gestational diabetes: Gestational diabetes is a type of diabetes that develops during pregnancy. It occurs when hormones produced by the placenta interfere with the body's ability to use insulin effectively. Gestational diabetes usually develops in the second or third trimester of pregnancy and typically goes away after the baby is born. However, women who develop gestational diabetes are at an increased risk of developing type 2 diabetes later in life.

Risk factors for gestational diabetes include:

- Being overweight or obese
- Having a family history of diabetes
- Having previously given birth to a baby weighing more than 9 pounds
- Having gestational diabetes in a previous pregnancy
- Being older than 25 years of age
- Diagnosis of Gestational Diabetes

Gestational diabetes is typically diagnosed between 24 and 28 weeks of pregnancy through a glucose screening test. During this test, the woman is given a sugary drink and her blood sugar levels are measured one hour later. If the results are abnormal, a follow-up glucose tolerance test may be performed to confirm the diagnosis.

Treatment of Gestational Diabetes

The goal of treatment for gestational diabetes is to keep blood sugar levels within a normal range to prevent complications for both the mother and the baby. Treatment may include:

- Healthy eating: A diet rich in whole foods, fruits, vegetables, lean protein, and healthy fats can help regulate blood sugar levels and prevent complications.
- Regular physical activity: Exercise can help improve insulin sensitivity, lower blood sugar levels, and improve overall health.
- Blood sugar monitoring: Women with gestational diabetes may need to monitor their blood sugar levels regularly to ensure they are within a normal range.
- Medication: In some cases, medication may be necessary to manage gestational diabetes. This may include insulin injections or oral medications.

Complications of Gestational Diabetes

Gestational diabetes can increase the risk of complications for both the mother and the baby, including:

- Pre-eclampsia: A serious condition that can cause high blood pressure and damage to organs.
- Macrosomia: A condition in which the baby grows too large, which can increase the risk of complications during delivery.
- Birth injuries: Large babies may be more likely to experience birth injuries such as shoulder dystocia or nerve damage.
- Low blood sugar: Babies born to mothers with gestational diabetes may have low blood sugar levels at birth.
- Respiratory distress syndrome: Babies born to mothers with gestational diabetes may be at an increased risk of developing respiratory distress syndrome, a condition that can make it difficult for the baby to breathe.

Prevention of Gestational Diabetes

While not all cases of gestational diabetes can be prevented, there are steps that pregnant women can take to reduce their risk, including:

- Maintaining a healthy weight before and during pregnancy
- Eating a healthy diet rich in whole foods, fruits, vegetables, lean protein, and healthy fats
- Regular physical activity
- Getting screened for gestational diabetes between 24 and 28 weeks of pregnancy

If left untreated Diabetes can lead to serious health complications, including:

- Diabetic ketoacidosis: A potentially life-threatening condition that occurs when the body produces high levels of ketones in response to a lack of insulin.
- Hypoglycemia: Low blood sugar levels that can cause confusion, dizziness, and loss of consciousness.
- Cardiovascular disease: Diabetes is a major risk factor for cardiovascular disease, including heart attacks and strokes.
- Kidney damage: High blood sugar levels can damage the kidneys over time, leading to chronic kidney disease.
- Nerve damage: High blood sugar levels can damage nerves throughout the body, leading to numbness, tingling, and pain in the hands and feet.
- Eye damage: High blood sugar levels can damage the blood vessels in the eyes, leading to diabetic retinopathy, a leading cause of blindness.

Causes of Diabetes

Type 1 diabetes
The causes of type 1 diabetes are not entirely understood, but it is believed to be an autoimmune disorder in which the body's immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. Type 1 diabetes is thought to be caused by a combination of genetic and environmental factors, such as exposure to certain viruses or toxins.

Type 2 diabetes
The causes of type 2 diabetes are also complex and can be influenced by a range of genetic and lifestyle factors. Some of the risk factors for type 2 diabetes include:

Gestational diabetes
Gestational diabetes is thought to be caused by hormonal changes during pregnancy that interfere with the body's ability to use insulin effectively. Women who are overweight or have a family history of diabetes are at higher risk for developing gestational diabetes.

Treatments for Diabetes

Managing diabetes involves a combination of diet, physical activity, and medication. A healthy diet is one that is low in sugar and fat and high in fiber, whole grains, and vegetables. Physical activity helps to lower blood sugar levels and maintain a healthy weight.

Medications for diabetes include insulin therapy, oral medications, and combinations of both. Some of the oral medications include thiazolidinediones (TZDs), DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT2 inhibitors.

It is also important for people with diabetes to take care of their feet, as neuropathy, or damage to the nerves, is a common complication of diabetes. They should also have regular eye exams to check for retinopathy, a condition that can lead to vision loss, and kidney function tests to check for nephropathy.

In addition to taking medication and making lifestyle changes, people with diabetes should also stop smoking, limit alcohol consumption, manage stress, get regular sleep, and attend regular check-ups and support groups for education and support.

Diabetes is a chronic condition, but with proper management and treatment, people with diabetes can live healthy and active lives.

Symptoms

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Urine/Pee smells like fruits (smells sweet)
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Excessive thirst
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Increased hunger
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Slow-healing sores or cuts
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Tingling or numbness in the hands or feet
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Need to urinate/pee frequently
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Bad breath
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Fatigue
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542
Blurred vision
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543
Dry mouth
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544
Weight loss

Confirmation Tests

- Blood test

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