Diabetes, its Causes and Diagnosis
Diabetes is a condition that is characterized by high blood sugar (glucose) in our body.
Under normal conditions the food we eat is broken down into glucose, a simple sugar, that leads to a rise in our blood sugar levels which is also known as blood glucose levels as both terms refer to the same condition. We have referred to it as blood sugar levels throughout this section.
A hormone called insulin secreted by the beta cells of the pancreas decreases the blood sugar levels and aids in producing energy for the cells. Without enough insulin, sugar from the food that is consumed builds up in the blood stream, initiating various health problems.
Lack of insulin or its insufficient production leads to a rise in the blood sugar levels which is commonly known as Diabetes Mellitus.
Causes of Diabetes
How diabetes develops is not really known, but the most common causes are genetics (heredity), obesity, irregular and unhealthy eating habits and stress.
Genetics (heredity) plays an important role in the manifestation of diabetes. Many people are prone to developing diabetes, especially after the age of 30 years. If one has a family history of diabetes, then it is wisest to take all the possible precautionary measures beginning from childhood to lay a strong foundation to delay its onset or to even avoid it.
Have regular meals, indulge in an exercise programme and restrict the consumption of junk foods and alcohol. These can lead to obesity which can accelerate the onset of diabetes.
Obesity. Most obese individuals are prone to developing diabetes as excessive fat stores can interfere with the body’s ability to utilize insulin effectively and in turn lead to high blood sugar (glucose) levels.
People who have high fat deposits on their abdomen (apple shaped obesity) have a higher risk of developing diabetes than those who have more fat deposits on their hips or thighs (pear shaped obesity). Most doctors take into account waist-to-hip ratio (WHR) in determining how prone the person is to being diabetic. Dividing the waist measurements by the hip measurements in inches determines this ratio. Men who have a WHR greater than 0.9 and women who have a WHR greater than 0.85 are more prone to diabetes. If a person’s waist measures 44 inches in circumference and the hips measure 40 inches in circumference the waist-to-hip ratio (WHR) is 1.1
Irregular and unhealthy food habits fluctuate the blood sugar levels erratically. Irregular eating habits (i.e. without any definite timing) or an increased intake of fats and refined and processed carbohydrates (bakery products, mithais, refined noodles, pasta etc.) makes can make a person prone to becoming diabetic.
Stress has become an integral part of urban living. To cope with stress, some people also over eat, or reach for the wrong kind of foods while others may take to alcohol or smoking which can create the perfect setting that may lead to diabetes
Diagnosis Of Diabetes
The most common symptoms of diabetes that are easily detectable in the early stages are increased urination (polyuria), increased thirst (polydypsia) and increased hunger (polyphagia). Some individuals may also lose weight and strength as glucose utilization is impaired. This situation is often referred as ‘poverty in the midst of plenty’. This is because although there is plenty of sugar available in the blood, a diabetic person cannot utilize it, due to the disturbed or faulty utilization of sugar resulting from lack of insulin.
The simplest and most reliable way to diagnose diabetes is to test blood sugar levels and urine for the presence of sugar.
The diagnostic criteria for Diabetes Mellitus are shown in the following table.
|Categories|| Fasting Blood Sugar
| Post Lunch Blood Sugar
|Normal||80 to 110||Less than 140|
|Impaired Glucose Tolerance||111 to 126||126 to 199|
|Diabetes||More than 126||More than 200|
* WHO / ADA Criteria, 1999.(Venous Plasma Glucose)
To explain the table above:
Fasting blood sugar is a test done to check the sugar levels in the morning on an empty stomach.
Post lunch blood sugar is the test done to check the sugar levels 2 hours after a meal. This is done to check how effectively the insulin functions.
A person is considered to be normal when his fasting blood sugar level is between 80 to 110 mg/dl and post lunch blood sugar level is less than 140 mg/dl.
A fasting blood sugar level of 111 to 126 mg/dl and/or a post lunch blood sugar level of 126 to 199 mg/dl are in this range, the sugar levels are higher than normal. This rise in blood sugar levels could be due to some other disease or ailment, not necessarily diabetes. The sugar levels probably rise because of impaired glucose tolerance which is not diagnosed as diabetes. However there is certainly a higher risk of developing diabetes. Consult a diabetologist about appropriate changes in your life style, diet and exercise which can help in preventing the progression of impaired glucose tolerance to diabetes.
A person is diagnosed as diabetic when either the fasting blood sugar levels are more than 126 mg/dl or post lunch blood sugar levels are more than 200 mg/dl. You need to be cautious and consult your diabetologist for tips to control blood sugar levels and prevent further complications.
Another screening test is to check the presence of glucose (sugar) in the urine. In normal circumstances, sugar is never present in urine. Only when the blood sugar goes beyond a certain level, the extra sugar is spilled and is excreted through urine.