Centre for Diabetes & Endocrinology at Fortis Hospitals, Bangalore

Diabetes is a chronic disease that occurs due to the body’s inability in regularizing the production and utilization of insulin. It may occur in one of the 2 ways: insufficient production of insulin or ineffective use of insulin. This generally results into high blood sugar. Ideally, this insulin is used to move sugar from the bloodstream into cells which in turn use it for energy. Since years the team at Fortis Hospitals, Bangalore has been treating mild to severe cases of diabetes among patients of diverse age groups and lifestyle backgrounds. Their unwavered commitment to healthy living for all ensures best in class diagnosis and access to treatment.

Types of Diabetes

There are mainly 2 types of diabetes along with one that is sometimes observed in pregnant women.

Even though science has progressed by leaps and bounds, it has still not been able to find the exact cause of Type 1 diabetes (also known as insulin dependent diabetes) and associated remedial solutions. It has been observed that for Type 1 patients, the immune system mistakenly attacks and destroys islets i.e. insulin-producing cells in the pancreas. Since insulin serves as an entry guard of glucose to the cells, absence of it results into indefinite glucose starvation.  This is detected in children/ teenagers and may be caused due to a poor immune system or passed on via genes.

Although the symptoms for diabetes may be mild to spot initially and may be confused for modern lifestyle hazards, we must keep a look out for the following symptoms:

• Increased thirst and hunger

• Dry mouth

• Sudden weight loss

• Frequent urination

• Blurred vision

• Extreme fatigue and long duration to heal body sores

• Decreased sex drive and erectile dysfunction in men

• Numbness or tingling feeling in feet and arms

• Frequent urine tract infections, fungal genital infections  in both men and women

Type 1 diabetes may also result in mood changes. In children, this can result into medical emergencies such as sudden high blood sugar and dehydration,  loss of consciousness.

On the other hand, Type 2 diabetes is mainly a lifestyle induced disease and stems from a combination of genetics and lifestyle factors. A major cause is obesity since carrying extra weight around the belly area makes the human cells more resistant to the effects of insulin.

Risk factors

Type 1 Diabetes can occur in anyone with defective immune system.
 
Type 2 diabetes involves multiple risk factors such as:

• Being overweight or obese

• > 40 age

• Mental health disorders

• Sedentary lifestyle

• Family history of type 2  diabetes

• Women who have had gestational diabetes  (pregnancy diabetes )

• Patient of high blood pressure, high cholesterol level.

Risk for gestational diabetes increases if the women:

• Is overweight

• > 25 age

• Has had gestational diabetes during a past pregnancy

• Has given birth to a baby weighing more than 9 pounds

• Has a family history of type 2 diabetes

• Has polycystic ovary syndrome (PCOS)

It can thus be safely concluded that the family history, mental health and stress levels, environment and preexisting medical conditions can greatly increase the probability of developing diabetes.

Complications

Living with uncontrolled and untreated diabetes is a risky proposition. Constantly high blood sugar levels are capable of damaging key organs in the human body and adversely impacting the standard of life.
 
Complications associated with diabetes include:

• Heart diseases such as heart attack and stroke

• Neuropathy  (nerve damage )and nephropathy ( kidney damage )

• Retinopathy and vision loss

• Foot damage such as infections and sores that don’t heal

• Skin conditions such as bacterial and fungal infections

• Depression

• Dementia

Diagnosis

Anyone who has experienced one of multiple symptoms for a prolonged period must surely get themselves tested. Women should be routinely tested during their second or third trimesters of pregnancy.

Advancement in technology has allowed for pre-diabetes and diabetes to be diagnosed by a simple blood test. In some cases, a urine test would be suggested as well. Key tests include fasting and random plasma glucose level, oral glucose tolerance tests and A1C testing.

Treatment

Although diabetes is one of the bigger threats to the human body, its treatment is relatively simpler and more dependent on the patient than it is for any other disease. The treatment includes a list of defined medications that are administered via oral intake of intravenous injections.

In type 1 diabetes, insulin intake partnered with a monitored dietary intake is the main treatment. This compensates for the hormones that the human body has not been able to produce.

On the other hand, a controlled diet partnered with a strict exercise regime can help control type 2 diabetes.

Starchy foods increase blood sugar levels rapidly whereas protein and fat intake results into a more gradual rise. It is because of this that the Fortis team extends access to the best dieticians/ nutritionists to help define a customized meal plan basis your diabetes history, lifestyle and age. Getting the right balance of protein, fat, and carbs can significantly help you control your blood sugar.

As commonly suggested as a routine good lifestyle factor, it is strongly recommended to have small meals throughout the day. Although a customized plan for every patient is created at Fortis, it generally includes a mix of:

• Fruits, vegetables and whole grains

• Lean protein such as poultry and fish

• Healthy fats such as olive oil and nuts

However, if these lifestyle changes make little to no impact, they would have to supported with diabetes medication. A side effect of these medications could be low glucose level i.e. hypoglycemia. Doctors at Fortis Hospital coach you on identifying its warning signs to avoid any serious and permanent damage.

In some advanced cases, a pancreas and islet transplant is recommended. However, it is not an ideal solution for all patients.

Prevention

As mentioned above, type 1 diabetes is not preventable. Also, some factors of type 2 diabetes are beyond human control as well. However, with advancements in technology, world class services at Fortis Hospital,  which has a multidisciplinary team ,living a normal lifestyle albeit with some changes cannot have any excuse. Most diabetes prevention strategies involve making simple adjustments to your diet and fitness routine. The patient has to put in genuine efforts and should be able to share all their concerns with their doctor to get real results. Luckily, the bouquet of nurses, doctors with extensive international experience, therapists and dieticians at Fortis Hospital, Bangalore allow for such transparent communication in a comforting environment.

Abiding with the age old adage, prevention is any day better than cure. Irrespective of your genes and blessed immune system, it is crucial that every person:

• Includes at least 30 minutes of exercise in their schedule/ day

• Ensure body weight is in the desired range basis your age, gender and height

• Eats more fruits, vegetables and whole grains and eliminates saturated fats and refined carbs

• Eat smaller and frequent portions instead of large lump sum meals.