Diabetes is a chronic disease which is marked by high blood sugar levels. Glucose is the main source of energy for human body cells. However, in diabetics, the glucose cannot be used by the body. The level of sugar (glucose) in the blood is controlled by the hormone insulin, which is produced by the pancreas. However, in diabetics, 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.
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| Diabetes, Causes, Diagnosis, Treatment, Prevention, Complications |
Glucose that is not properly absorbed by body cells will accumulate in the blood. This condition can cause various disorders in the organs of the body. If not properly controlled, diabetes can cause life-threatening complications.
Causes of Diabetes
In general, diabetes is divided into two, namely type 1 diabetes and type 2. The following is an explanation:
Type 1 diabetes
Type 1 diabetes occurs when the body's immune system mistakenly attacks and destroys the insulin-producing cells of the pancreas. This causes blood glucose levels to increase thereby triggering damage to the organs of the body.
Type 1 diabetes is also known as autoimmune diabetes. The cause of type 1 diabetes is still not known with certainty. However, there are suspicions that this disease is related to genetic factors and environmental factors.
Type 2 diabetes
Type 2 diabetes is the most common type of diabetes, which is around 90–95%. Type 2 diabetes occurs when the body's cells become less sensitive to insulin so that the insulin they produce cannot be used properly. This condition is also known as insulin resistance.
Apart from these two types of diabetes, there is a type of diabetes that usually occurs in pregnant women, namely gestational diabetes. This type of diabetes is caused by hormonal changes during pregnancy, but usually the patient's blood sugar will return to normal after delivery.
Diabetes risk factors
A person will be more at risk of developing type 1 diabetes if they have the following risk factors:
- 4–7 years old or 10–14 years old
- Have a family history of type 1 diabetes
- Suffer from a disease caused by a viral infection
- Suffering from an autoimmune disease, such as Grave's disease, Hashimoto's disease, and Addison's disease
- Experiencing injury to the pancreas from an infection, tumor, injury, accident, or side effects after major surgery
Meanwhile, type 2 diabetes is more at risk for someone with the following factors:
- Over 45 years old
- Have a family history of type 2 diabetes
- Rarely do physical activity or exercise
- Are overweight or obese
- Suffer from prediabetes
- Suffering from high cholesterol
- Suffer from high blood pressure (hypertension)
Especially for women, pregnant women who suffer from gestational diabetes can more easily develop type 2 diabetes. In addition, women who have a history of polycystic ovarian syndrome (PCOS) are also more prone to developing type 2 diabetes.
Diabetic Symptoms
Type 1 diabetes can develop rapidly within weeks or 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 diabetes or type 1 and type 2 diabetes include:
- Often feeling thirsty or very hungry
- Frequent urination, especially at night
- Weight loss for no apparent reason
- Decreased muscle mass
- Blurred vision
- Urine contains ketones
- The body gets tired and weak
- Wounds become more difficult to heal
- Easy to get an infection, such as in the gums, skin, vagina, or urinary tract
In addition, there are several other symptoms that diabetics can also experience, including:
- Dry mouth
- Itching of the skin or prurigo occurs
- Erectile dysfunction or impotence
- Burning, stiffness and pain in the legs
- Reactive hypoglycemia, namely hypoglycemia which occurs a few hours after eating due to excessive insulin production
- Black patches around the neck, armpits, and groin (akantosis nigricans) which can be a sign of insulin resistance
Meanwhile, there are also some people who experience prediabetes, which is a condition when glucose in the blood is above the normal range but not high enough to be diagnosed as diabetes. However, a person with prediabetes can also suffer from type 2 diabetes if not handled properly.
When to see a doctor
Check with your doctor if you experience the main symptoms of diabetes, namely:
- Often feel thirsty
- Easily tired
- Urinating more often than usual, especially at night
- Weight loss and loss of muscle mass
- Itching around the penis or vagina
- Wound healing is slow
- Often experience canker sores
- Blurred vision
If you have factors that can increase your risk of developing diabetes, it is recommended to have regular blood sugar checks. The goal is that this disease can be detected and treated early.
Diabetes Diagnosis
The symptoms of diabetes usually develop gradually, except for type 1 diabetes where the symptoms can appear suddenly. However, because diabetes is generally not diagnosed at its onset, it is recommended that people who are at risk of developing the disease undergo regular check-ups, especially in the following groups:
- People over 45 years of age
- 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
A blood sugar test is an absolute test to diagnose type 1 or type 2 diabetes. The results of a blood sugar measurement will show whether a person has diabetes or not. The doctor will recommend that the patient undergo a blood sugar test at a certain time and with a certain method.
Several blood sugar test methods that patients can undergo include:
1. Blood sugar test at any time
This test aims to measure blood glucose levels at certain hours randomly. This test does not require the patient to fast beforehand.
If the blood sugar test results show a sugar level of 200 mg/dL or more, the patient can be diagnosed with diabetes.
2. 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 before undergoing the test.
The results of the fasting blood sugar test can be said to be normal if the patient's blood sugar level is less than 100 mg/dL. Meanwhile, fasting blood sugar test results between 100–125 mg/dL indicate that the patient has prediabetes.
Meanwhile, a fasting blood sugar test result of 126 mg/dL or more indicates that the patient has diabetes.
3. Glucose tolerance test
The patient will first be asked to fast overnight, then undergo a fasting blood sugar test. Next, the patient will be asked to drink a special sugar solution. The patient's blood sugar sample will be taken again 2 hours after drinking the sugar solution.
A glucose tolerance test result below 140 mg/dL indicates normal blood sugar levels. Meanwhile, test results with a sugar level of 140–199 mg/dL indicate prediabetes.
Patients can be said to have diabetes if the glucose tolerance test shows a sugar level of 200 mg/dL or more.
4. Test HbA1C (glycated hemoglobin test)
This test aims to measure the patient's average glucose level over the past 2–3 months. This test measures blood sugar levels bound to hemoglobin, the protein that carries oxygen in the blood. In the HbA1C test, the patient does not need to fast beforehand.
An HbA1C test result below 5.7% is a normal condition, while a test result of 5.7–6.4% indicates prediabetes. Meanwhile, HbA1C test results above 6.5% indicate that the patient has diabetes.
Besides the HbA1C test, an estimation of average glucose (eAG) can also be done to determine blood sugar levels more accurately. If the patient is diagnosed with diabetes, the doctor will plan the treatment method to be followed.
Specifically for patients suspected of having type 1 diabetes, the doctor will suggest an autoantibody test to detect antibodies that damage organs and tissues of the body, including the pancreas.
Diabetes Treatment
Diabetes treatment depends on the type of diabetes experienced by the patient. The following are some methods of diabetes treatment that can be done:
Drugs
In type 1 diabetes, the patient will need insulin therapy to regulate daily blood sugar. Some type 2 diabetes patients are also advised to undergo insulin therapy to regulate blood sugar.
Supplemental insulin will usually be given by injection, not as an oral medication. The doctor will regulate the type and dosage of insulin used, and tell you how to inject it.
In severe cases of type 1 diabetes, the doctor will recommend a pancreas transplant procedure to replace the damaged pancreas. Type 1 diabetes patients who successfully undergo the transplant do not need insulin therapy anymore, but must take immunosuppressive drugs regularly.
In type 2 diabetes patients, doctors will prescribe drugs, one of which is metformin. Metformin reduces the production of glucose from the liver and helps the body process insulin effectively.
Doctors can also provide supplements or vitamins to reduce the risk of complications. For example, diabetic patients who often experience pins and needles will be given neurotropic vitamins.
Neurotropic 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 for type 2 diabetes patients to avoid the complications of diabetic neuropathy which are quite common.
Lifestyle changes
Patients are advised to manage their diet by increasing consumption of fruits, vegetables, protein from whole grains, as well as foods low in calories and fat. Food choices for diabetics should also pay close attention.
If necessary, patients can also replace sugar intake with safer sweeteners, such as sorbitol. Patients and their families can also carry out nutrition and diet consultations with doctors to regulate their daily diet.
To help convert blood sugar into energy and increase cell sensitivity to insulin, patients are advised to exercise regularly, at least 150 minutes a week. Patients can also consult with their doctor regarding appropriate sports and physical activity options.
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, patients will also be given a schedule to undergo an HbA1C test independently to monitor blood sugar levels for the last 2-3 months.
Self blood sugar test
An independent blood sugar test is carried out at least 4 times a day, namely before each meal and before going to bed, especially for those undergoing insulin therapy. The frequency of tests performed depends on the doctor's advice. After that, the test results will be recorded and these records need to be taken when checking with the doctor.
Diabetic complications
Diabetes causes various complications, both of which occur suddenly (acute) or in the long term (chronic). Acute complications that can occur in diabetics are diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome (HHS).
A number of complications that can arise due to type 1 diabetes and 2 is:
- Strokes
- Heart disease
- Chronic kidney failure
- Diabetic neuropathy
- Impaired vision
- Cataract
- Depression
- dementia
- Hearing disorders
- Frozen shoulder
- Wounds and infections on the feet that are difficult to heal
- Skin damage or gangrene due to bacterial and fungal infections, including flesh-eating bacteria
Diabetes due to pregnancy can also cause complications for pregnant women and babies, for example is preeclampsia. Meanwhile, some of the complications that can arise in babies are:
- Miscarriage
- Premature birth
- Excess weight at birth
- Low blood sugar (hypoglycemia)
- Jaundice
- Increased risk of developing type 2 diabetes as an adult
Diabetes Prevention
Type 1 diabetes cannot be prevented because the trigger is unknown. Meanwhile, type 2 diabetes and gestational diabetes can be prevented, namely by living a healthy lifestyle. Some efforts that can be done to prevent diabetes include:
- Set the frequency and diet to be healthier
- Regular exercise and physical activity
- Maintain ideal body weight
- Get enough rest and sleep
- Quit smoking
- Avoid consuming alcoholic beverages
- Manage stress well
- Routinely undergo blood sugar checks, at least once in 1 year
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