Diabetes: Types, Causes and Symptoms

A chronic metabolic disorder that stops the body’s ability to utilize glucose partially or completely, known as Diabetes mellitus. This health condition can be due to failure with in the formation of insulin or release or action. It is characterized by high glucose levels, in medical term called as hyperglycemia for a prolonged period of time. As explained by WHO (world health organization), criteria to diagnose diabetes is capillary fasting blood sugar levels >126 mg/dl or 2 hours post prandial that is capillary post glucose value > 220 mg/dl.
According to India Diabetes (INDIAB,2017) 7.3% of India’s adult population has diabetes. In Ayurveda, it is known as “Madhu Meha,” that is passing honey-like urine.
Nutrition is the process of consumption, absorption and utilization id nutrients needed by the body for normal functioning of the body – growth, development and maintenance of life.
The food we eat, it contains carbohydrate, proteins and fats. carbohydrates in our digestive system gets break down into the simple sugar or glucose, which then enters into the blood it gets transported to tissues of the body, which afterwards utilizes for energy purpose.
Diabetes is due to either the pancreas, which is not producing enough INSULIN, or the cells of the body not responding properly to the insulin produced.
Insulin is a hormone produced by beta cells of pancreas it regulates the metabolism of carbohydrates. It helps glucose to enter into the cell, it functions like a lock and key, for example, we need a key to unlock the door, like wise glucose needs insulin as a key to unlock the door to enter into the cell.
 There are 4 types of diabetes mellitus
1. Insulin dependent diabetes/ Type 1 Diabetes:  It is an autoimmune disease, also known as juvenile onset diabetes. when the pancreas produces no insulin. This usually sudden onset and develops in the early teens/younger age group though it can appear later also.
2. Non-insulin dependent diabetes/Type 2 Diabetes: It is a milder and most common form of diabetes, resulting when insulin may be produced by pancreas but action- utilization is impaired. When the cells of the body are not responding to insulin, known as insulin resistance. Most people in this group are over 40 years and overweight. Acidosis is infrequent.
3. Gestational diabetes: It occurs when pregnant women, without previous history of diabetes develop high blood sugar levels. Diabetes in pregnancy increases the chance of adverse effect on health of mother as well as infant (neonatal health)
4. Monogenic diabetes: Some rare forms of diabetes result from mutations or changes in a single gene and are called monogenic.
Neonatal diabetes mellitus (NDM), Neonatal diabetes mellitus is hereditary disease. It occurs mainly before 6 months of age, NDM can be defined as extreme hyperglycemia along with insufficient or no circulating insulin and
Maturity-onset diabetes of the young (MODY) is a group of conditions mark by high sugar levels.it occurs mostly at young age before 30 or may occur later in life. Monogenic defects of beta cells function lead to MODY.
Causes:
TYPE 1 DIABETES MELLITUS: 
• Genetics: Type 1 diabetes caused by genes and factors in the environment, such as viruses that might trigger the disease.
• Environmental factors:
• Infections cause a non-specific outpouring of catabolic hormones which antagonize insulin action and then may trigger the onset of disease.
• Acute stress, when body is in stress it releases stress hormones like cortisol, adrenaline, noradrenaline that raise blood sugar levels to provide instant energy for coping with stress. In acute stress condition, it rise quite extremely and which results in ketosis.
• Immunological factor
TYPE 2 DIABETES MELLITUS:
• Genetics: it is commonly associated with obesity, hypertension and hyperlipidemia insulin resistance being the primary defects known to be on syndrome X or metabolic syndrome.
• Environmental factors:
• Lifestyle: obese people who don’t exercise and overeats. Obesity probably acts as a diabetogenic factor through increasing insulin resistance. Higher intake of refined grains which have high GI such as white rice, combined with sedentary activity could be major reason for the incidence of obesity and cardiovascular disease.
• Alcoholic stress
• Low fiber diet
• Insufficient intake of micronutrients and anti-oxidants.
GESTATIONAL DIABETES:
• Gestational diabetes is sometimes related to the hormonal changes of pregnancy that make your body less able to use insulin. There is as such no symptoms of gestational diabetes, although mild symptoms like polydipsia (being thirstier) or urge to urinate can be seen.
Sign and symptoms
1. Hyperglycaemia: high sugar levels in blood then normal.
2. Polydipsia -increased thirst
3. Polyphagia –excess/increased hunger, as cells are deprived of glucose.
4. Glycosuria- increased urination (blood glucose levels exceeds the renal threshold of 160 to 180 mg per 100ml). glucose can be seen in urine.
5. Blurred vision.
6. Fatigue.
7. Fluid and electrolyte imbalance.
8. Numbness or tingling in the feet or hands (diabetic neuropathy)
9. Sores that do not heal.
10. Unexplained weight loss.
11. A life-threatening condition, DKA (diabetic ketoacidosis) which leads to symptoms like vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion and occasionally loss of consciousness.
12. Acidosis which leads to ketonuria (ketone bodies are present in urine. (acetone is excreted by lungs and gives the characteristic fruity odour to breath).
13. Polyuria and Nocturia.

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