When you have diabetes, your body can’t use the food you eat in a proper way. When you eat, food is digested and much of it is changed into glucose, a sugar the body uses for fuel. The glucose is carried by the bloodstream to the individual cells of the body. The body produces a hormone called insulin that helps the glucose to enter the cells. Normally, enough insulin is produced to allow the amount of glucose in the blood to be absorbed by the cells, where it is used for energy. Insulin also helps the body to store extra glucose and fat for later use.
When you have diabetes, your body does not make enough insulin or does not use it properly. Without insulin, your body cannot use the food you eat. The digested food, in the form of glucose, builds up in your blood. The cells can’t get the energy they need, because insulin isn’t available to move the glucose into the cells. The symptoms of diabetes are caused by high blood glucose.
Permissible Sugar in Blood
The range of blood sugar in normal, borderline and extreme levels:
Degree of Control -mg/lOOml
Normal – Borderline – Extreme
Fasting Below 100 – 110-120 – above 120
2 hours after meals Below 120 – 130-179 – above 180
Blood sugar level below 100 mg and 120 mg/100 ml for fasting and two hours after meals respectively, is considered normal. When the figure obtained is within limits, there is nothing to worry. Once it is detected and established that one is a diabetic, it is prudent to follow the diabetologist’s advice and have regular urine test and periodical blood sugar tests.
There are three major types of Diabetes Mellitus:-
• Insulin-Dependent (IDDM, Type I, juvenile-onset).
• Non-Insulin-Dependent (NIDDM, Type II, adult-onset).
• Gestational Diabetes Mellitus (GDM, Type III).
In people with Insulin-Dependent Diabetes Mellitus the body is unable to make insulin. When the body has no insulin and cannot use glucose for energy, it begins to burn fat. When fat is burnt for energy, acid wastes called ketones are formed. The ketones build up in the blood and cause a serious condition called ketoacidosis. People with insulin-dependent diabetes must take insulin injections to avoid this life-threatening condition.
In people with Non-Insulin-Dependent Diabetes Mellitus, the body produces some insulin, but either there is not enough insulin, or it does not function properly. People can often control this type of diabetes by limiting the amount of food they eat and by increasing their exercise. Oral hypoglycaemic agents (diabetes pills) help some people to make more insulin or to use their own insulin better. Some people with Non-Insulin-Dependent Diabetes Mellitus, may need insulin injections to regulate their blood-sugar levels.
The third type of diabetes called Gestational Diabetes Mellitus refers to abnormal carbohydrate metabolism that appears during pregnancy and which reverts to normal with the termination of gestation.
In gestational diabetes, the treatment is to maintain the blood sugar levels within normal range by first adjusting the diet alone and keeping in mind the patient’s increased requirement during pregnancy. If dietary measures fail, insulin dose should be added to maintain normal blood sugar level.
The goal in the management of GDM is to achieve normal glucose level throughout pregnancy, to obviate maternal complications and to have successful deliveries.
Another type of diabetes called Malnutrition Related Diabetes Mellitus (MRDM), which is common in some third world countries is being investigated further to know the exact cause.