Diabetes :-

Diabetes mellitus is a metabolic disease that causes high blood sugar. Your body either doesn’t make enough insulin or can’t effectively use the insulin it makes.

The hormone insulin moves sugar from the blood into your cells to be stored or used for energy. If this malfunctions, you may have diabetes.

Untreated high blood sugar from diabetes can damage your nerves, eyes, kidneys, and other organs. But educating yourself about diabetes and taking steps to prevent or manage it can help you protect your health.

Types of diabetes

There are a few different types of diabetes:

• Type 1:  Type 1 diabetes  is an  autoimmune . The immune system attacks and destroys cells in the  pancreas, where insulin is made. It’s unclear what causes this attack.
• Type 2:  Type 1 diabetes occurs when your body becomes resistant to  insulin , and sugar builds up in your blood. It’s the most common type—about  90% to 95 % Trusted Source  of people living with diabetes have type 2.
• Type 1.5:Type 15 diabetes  is also known as latent autoimmune diabetes in adults (LADA). It occurs during adulthood and sets in gradually like type 2 diabetes. LADA is an autoimmune disease that cannot be treated by diet or lifestyle.
• Gestational:  Gestational diabetes is high blood sugar during pregnancy. Insulin-blocking hormones produced by the placenta cause this type of diabetes.

A rare condition called  diabetes insipidus is not related to diabetes mellitus, although it has a similar name. It’s a different condition in which your kidneys remove too much fluid from your body.

Each type of diabetes has unique symptoms, causes, and treatments.

Prediabetes

Prediabetes  is the term that’s used when your blood sugar is higher than expected, but it’s not high enough for a diagnosis of type 2 diabetes. It occurs when the cells in your body don’t respond to insulin the way they should. This can lead to type 2 diabetes down the road.

Symptoms of diabetes

Diabetes symptoms are caused by rising blood sugar.

General symptoms

The symptoms of type 1, type 2, and type 1.5 (LADA) are the same, but they occur in a shorter period than types 2 and 1.5. In type 2, the onset tends to be slower. Tingling nerves and slow-healing sores are more common in type 2.

Left untreated, type 1, in particular, can lead to  diabetic ketoacidosis. This is when there is a dangerous level of ketones in the body. It’s less common in other types of diabetes, but still possible.

The general symptoms of diabetes include:

• increased hunger
• increased thirst
• weight loss
• frequent urination
• blurry vision
• extreme fatigue
• sore that don’t sore

Symptoms in men

In addition to the general symptoms of diabetes, men with diabetes may have:

• a decreased sex drive
• erectile dysfunction
• poor muscle strength

Symptoms in women

women with diabetes can have symptoms such as:

• vaginal dryness
• urinary tract infections
• yeast infections
• dry, itchy skin

Gestational diabetes

Most people who develop gestational diabetes don’t have any symptoms. Healthcare professionals often detect the condition during a routine blood sugar test or oral glucose tolerance test, which is usually performed between the 24th and 28th weeks of pregnancy.

In rare cases, a person with gestational diabetes will also experience increased thirst or urination.

Causes of diabetes

Different causes are associated with each type of diabetes.

Type 1 diabetes

Doctors don’t know exactly what causes type 1 diabetes. For some reason, the immune system mistakenly attacks and destroys insulin-producing beta cells in the  pancreas.

Genes may play a role in some people. It’s also possible that a virus sets off an immune system attack.

Type 2 diabetes

Type 2 diabetes stems from a combination of  genetics and lifestyle factors. Having overweight or  obesity increases your risk, too. Carrying extra weight, especially  in your belly , makes your cells more resistant to the effects of insulin on your blood sugar.

This condition runs in families. Family members share genes that make them more likely to get type 2 diabetes and to be overweight.

Type 1.5 diabetes

Type 1.5 is an autoimmune condition that occurs when the pancreas is attacked by your own antibodies. as in type 1. It may be genetic, but more research is needed.

Gestational diabetes

Gestational diabetes occurs as the result of hormonal changes during pregnancy. The placenta produces hormones that make a pregnant person’s cells less sensitive to the effects of insulin. This can cause high blood sugar during pregnancy.

People who are overweight when they get pregnant  or who  gain too much weight during pregnancy are more likely to get gestational diabetes.

Diabetes risk factors

Certain factors increase your risk for diabetes.

Type 1 diabetes

You’re more likely to get type 1 diabetes if you’re a child or teenager, you have  a parent or sibling with the condition, or you carry certain genes that are linked to the disease.

Type 2 diabetes

Your risk for type 2 diabetes increases if you:

• are overweight
• are age 45 or older
• have a parent or sibling with the condition
• aren’t physically active
• have had gestational diabetes
• have prediabetes
• have h high blood pressure , high cholesterol high cholesterol, or  triglycerides

Type 2 diabetes also disproportionately affects certain racial and ethnic populations.

Adults who have African American, Hispanic or Latino American, or Asian American ancestry are more likely to be diagnosed with type 2 diabetes than white adults, according to 2016 research. They’re also more likely to experience decreased quality of care and increased barriers to self-management.

Type 1.5 diabetes

Type 1.5 diabetes is found in adults over 30 and is often mistaken for type 2, but people with this condition are not necessarily overweight, and oral medications and lifestyle changes have no effect.

Gestational diabetes

Your risk for gestational diabetes increases if you:

• are overweight
• are over age 25
• had gestational diabetes during a past pregnancy
• have given birth to a baby weighing more then 9 pounds
• have a family history of type 2 diabetes
• have polycystic ovary syndrome (PCOS)

Diabetes complications

High blood sugar damages organs and tissues throughout your body. The higher your blood sugar is and the longer you live with it, the greater your risk for complications.

Complications associated with diabetes include:

• heart disease , heart attack and stroke
• neuropathy
• nephropathy
• retinopathy and vision loss
• hearing loss
• foot damage , such as infections and sores that don’t heal
• skin conditions, such as bacteria and  fungal infections
• depression
• dementia

Gestational diabetes

Unmanaged gestational diabetes can lead to problems that affect both the mother and baby. Complications affecting the baby can include:

• premature birth
• higher than typica; weight at birth
• increased risk for type 2 diabetes later in life
• low blood sugar
• jaundice
• stillbirth

A pregnant person with gestational diabetes can develop complications such as high blood pressure ( preeclampsia) or type 2 diabetes. You may also require  cesarean delivery, commonly referred to as a C-section.

The risk of gestational diabetes in future pregnancies also increases.

Treatment of diabetes

Doctors treat diabetes with a few different medications. Some are taken by mouth, while others are available as injections.

Type 1 and 1.5 diabetes

Insulin is the main treatment for type 1 and 1.5 diabetes. It replaces the hormone your body isn’t able to produce.

Various types of insulin are commonly used by people with type 1 and 1.5 diabetes. They differ in how quickly they start to work and how long their effects last:

• Rapid-acting insulin: starts to work within 15 minutes and its effects last for 2 to 4 hours
• Short-acting insulin: starts to work within 30 minutes and lasts 3 to 6 hours
• Intermediate-acting insulin: starts to work within 2 to 4 hours and lasts 12 to 18 hours
• Long-acting insulin: starts to work 2 hours after injection and lasts up to 24 hours
• Ultra-long acting insulin: starts to work 6 hours after injection and lasts 36 hours or more
• Premixed insulin: starts working within 15 to 30 minutes (depending on whether a rapid-acting or short-acting insulin is part of the mix) and lasts 10 to 16 hours

Type 2 diabetes

Diet and exercise can help some people manage type 2 diabetes. If lifestyle changes aren’t enough to lower your blood sugar, you’ll need to take medication.

These drugs lower your blood sugar in a variety of ways:

Drug	How it works	Examples
alpha-glucosidas inhabitors	slow your body’s breakdown of sugars and starchy foods	acarbose (Precose) and miglitol
biguanides	reduce the amount of  glucose your liver makes	metformin (Glucophage, Riomet)
DPP-4 inhibitors	improve your blood sugar without making it drop too low	alogliptin (Nesina), linagliptin (Tradjenta), saxagliptin (Onglyza), and sitagliptin (Januvia)
glucagon-like peptides	stimulate your pancreas to produce more insulin; slow stomach emptying	semaglutide (Ozempic), dulaglutide (Trulicity), exenatide (Byetta), and liraglutide (Victoza)
meglitinides	stimulate your pancreas to release more insulin	nateglinide and repaglinide
SGLT2 inhibitors	release more glucose into the urine	canagliflozin (Invokana), dapagliflozin (Farxiga), and empagliflozin (Jardiance)
sulfonylureas	stimulate your pancreas to release more insulin	glyburide (Glynase),  glipizide (Glucotrol), and (Amaryl)
thiazolidinediones	help insulin work better	pioglitazone (Actos) and rosiglitazone

You may need to take more than one of these medications. Some people with type 2 diabetes also take insulin.

Gestational diabetes

If you receive a diagnosis of gestational diabetes, you’ll need to  monitor your blood sugar several times per day during pregnancy. If it’s high, dietary changes and exercise may be enough to bring it down.

Research has found that about 15% to 30 % Trusted Source of women who develop gestational diabetes will need insulin to lower their blood sugar. Insulin is safe for the developing baby.

Diabetes and diet

Healthy eating is a central part of managing diabetes. In some cases, changing your diet may be enough to manage the disease.

Types 1 and 1.5 diabetes

Your blood sugar level rises or falls based on the types of foods you eat. Starchy or sugary foods make blood sugar levels rise rapidly. Protein and fat cause more gradual increases.

Your medical team may recommend that you limit the amount of carbohydrates you eat each day. You’ll also need to balance your carb intake with your insulin doses. Counting carbs helps to balance the carb intake with the insulin doses.

Type 2 diabetes

Eating the right types of foods can both manage your blood sugar and help you lose any excess weight.

Carb counting is an important part of eating for type 2 diabetes. A dietitian can help you figure out how many grams of carbohydrates to eat at each meal.

In order to keep your blood sugar levels steady, try to eat small meals throughout the day. Emphasize healthy foods such as:

• fruits
• vegetables
• whole grains
• lean protein such as poultry and fish
• healthy fats such as  oil and nuts olive

Certain other foods can hurt efforts to manage your blood sugar.

Gestational diabetes

Eating a well-balanced diet is important for both you and your baby during these 9 months. Making the right food choices can also help you avoid diabetes medications.

Watch your portion sizes, and limit sugary or salty foods. Although you need some sugar to feed your growing baby, you should avoid eating too much. Check out  others do’s and dont’s for healthy eating with gestational diabetes.

Diabetes and exercise

Along with diet and treatment, exercise plays an essential role in diabetes management. This is true for all types of diabetes.

Staying active helps your cells react to insulin more effectively and lower your blood sugar levels. Exercising regularly can also help you:

• reach and maintain a healthy weight
• reduce your risk of diabetes-related health complications
• boost mood
• get better sleep
• improve memory

If you have type 1 or type 2 diabetes, general guidance is to aim for at least 150 minutes of moderate-intensity exercise each week. There are currently no separate exercise guidelines for people who have gestational diabetes. But if you’re pregnant, start out slowly and gradually increase your activity level over time to avoid overdoing it.

Diabetes friendly exercise include:

• walking
• swimming
• dancing
• cycling

Talk with your doctor about safe ways to incorporate activity into your diabetes management plan. You may need to follow special precautions, like checking your blood sugar before and after working out and making sure to stay hydrated.

Consider working with a personal trainer or exercise physiologist who has experience working with people who have diabetes. They can help you develop a personalized workout plan tailored to your needs.

Diabetes diagnosis

Anyone who has symptoms of diabetes or is at risk for the condition should be tested. People are routinely tested for gestational diabetes during their   second trimester or  third trimester of pregnancy.

Doctors use these  blood tests to diagnose prediabetes and diabetes:

• The fasting plasma glucose (FPG) test measures your blood sugar after you’ve fasted for 8 hours.
• The   A1C test provides a snapshot of your blood sugar levels over the previous 3 months.
• A 75-gram oral glucose tolerance test is also used. This checks the BG 2 hours after ingesting a sugary drink containing 75 grams of carbs.

How to diagnose gestational diabetes

To  diagnose gestational diabetes , your doctor will test your blood sugar levels between the 24th week and 28 week of pregnancy. There are two types of tests:

• Glucose challenge test: During a glucose challenge test, your blood sugar is checked an hour after you drink a sugary liquid. If your results are standard, no more testing is done. If blood sugar levels are high, you’ll need to undergo a glucose tolerance test.
• Glucose tolerance test: During a glucose tolerance test, your blood sugar is checked after you fast overnight. Then you’re given a sugary drink and your blood sugar is re-tested after 1 hour and again after 2 hours. Gestational diabetes is diagnosed if any of these three readings come back noting high blood sugar.

The earlier you are diagnosed with diabetes, the sooner you can start treatment.

Diabetes prevention

Type 1 and type 1.5 diabetes are not preventable because they are caused by an issue with the immune system. Some causes of type 2 diabetes, such as your genes or age, aren’t under your control either.

Yet many other diabetes risk factors are manageable. Most diabetes prevention strategies involve making simple adjustments to your diet and fitness routine.

If you’ve received a diagnosis of prediabetes, here are a few things you can do to delay or prevent type 2 diabetes:

• Get at least 150 minutes per week of  aerobic exercises like walking or  cycling
• Cut  saturated  and  trans fats, along with  refined carbohydrates , out of your diet.
• Eat more  fruits, vegetables, and whole grains.
• Eat smaller portions.
• Try to lose 5% to 7% of your body weight if you have overweight or obesity.

Diabetes in pregnancy

People who’ve never had diabetes can suddenly develop gestational diabetes during pregnancy. Hormones produced by the placenta can make your body more resistant to the effects of insulin

Pre-gestational diabetes

People can have diabetes before they conceive and carry it with them into pregnancy. This is called  pre-gestational diabetes.

Risks to your newborn

Diabetes during pregnancy can lead to complications for your newborn, such as jaundice or  breathing problems

If you’re diagnosed with pre-gestational or gestational diabetes, you’ll need special monitoring to prevent complications.

Does gestational diabetes disappear on its own?

Gestational diabetes should go away after you deliver, but it does significantly increase your risk of getting diabetes later. about half of people with gestational diabetes will go on to develop type 2 diabetes.

Diabetes in children

Children can get both type 1 and type 2 diabetes. Managing blood sugar is especially important in young people because diabetes can damage important organs such as the heart and kidneys.

Type 1 diabetes

The autoimmune form of diabetes often starts in childhood. One of the main symptoms is  increased urination . Kids with type 1 diabetes may start wetting the bed after they’ve been toilet trained.

Extreme thirst, fatigue, and hunger are also signs of the condition. It’s important that children with type 1 diabetes get treatment right away. The condition can cause high blood sugar,  dehydration, and diabetic ketoacidosis (DKA), which can be medical emergencies

Type 2 diabetes

Type 1 diabetes used to be called juvenile diabetes because type 2 was so rare in children. Now that more children have overweight or  obesity , type 2 diabetes is  becoming more common in this age group.

Some children living with type 2 diabetes don’t experience symptoms. Others may experience:

• increased thirst
• frequent urination
• extreme fatigue
• blurry vision