What Is Diabetes?

Diabetes is a long standing or chronic disease and is characterized by blood sugar ( glucose ) levels that are high or above normal values. Glucose that accumulates in the blood due to not being absorbed by the body's cells properly can cause various organ disorders. If diabetes is not properly controlled, various complications can occur that endanger the lives of sufferers.

Glucose is the main energy source for cells of the human body. Blood sugar levels are controlled by the hormone insulin which is produced by the pancreas, which is an organ that is located behind the stomach. In diabetics, the pancreas is unable to produce insulin according to the body's needs. Without insulin, the body's cells cannot absorb and process glucose into energy.

Types of Diabetes
In general, diabetes is divided into two types, namely type 1 and type 2 diabetes. Type 1 diabetes occurs because the patient's immune system attacks and destroys pancreatic cells that produce insulin. This results in an increase in blood glucose levels, resulting in damage to body organs. Type 1 diabetes is also known as autoimmune diabetes. The trigger for the onset of this autoimmune state is still unknown. The strongest guess is caused by genetic factors of patients who are also influenced by environmental factors.

Type 2 diabetes is a type of diabetes that is more common. This type of diabetes is caused by body cells that become less sensitive to insulin, so that the insulin produced cannot be used properly (body cell resistance to insulin). About 90-95% of people with diabetes in the world suffer from this type of diabetes.

Apart from these two types of diabetes, there is a special type of diabetes in pregnant women called gestational diabetes . Diabetes in pregnancy is caused by hormonal changes, and blood sugar will return to normal after the mother is pregnant.

Symptoms of Diabetes
Type 1 diabetes can develop rapidly in a few weeks, even a few days. Whereas in type 2 diabetes, many sufferers do not realize that they have suffered from diabetes for years, because the symptoms tend to be non-specific. Some of the symptoms of type 1 and type 2 diabetes include:
  • Often feel thirsty.
  • Frequent urination, especially at night.
  • Often feeling very hungry.
  • Weight loss without obvious reasons.
  • Reduced muscle mass.
  • There is ketone in the urine. Ketones are waste products from muscle breakdown and fat because the body cannot use sugar as an energy source.
  • Limp.
  • Blurred vision.
  • Wounds that are difficult to heal.
Frequent infections, for example in the gums, skin, vagina, or urinary tract .

Some symptoms can also be a sign that someone has diabetes, including:
  • Dry mouth.
  • Burning, stiffness, and pain in the legs.
  • Itchy.
  • Erectile dysfunction or impotence .
  • Easily offended.
  • Reactive hypoglycemia, which is hypoglycemia that occurs several hours after eating due to excessive insulin production.
  • The appearance of black patches around the neck, armpits, and groin, ( akantosis nigrikans ) as a sign of insulin resistance.
Some people can experience prediabetes, a condition when glucose in the blood is above normal, but not high enough to be diagnosed as diabetes. Someone who suffers from prediabetes can suffer from type 2 diabetes if not treated properly.

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Diabetes Risk Factors
A person will be easier to experience type 1 diabetes if they have risk factors, such as:
  • Have a family with a history of type 1 diabetes.
  • Have a viral infection.
  • White people are suspected to be easier to experience type 1 diabetes than other races.
  • Travel to areas far from the equator (equator).
  • Type 1 diabetes occurs a lot at the age of 4-7 years and 10-14 years, although type 1 diabetes can appear at any age.
Whereas in the case of type 2 diabetes, a person will find it easier to experience this condition if they have risk factors, such as:
  • Overweight.
  • Have a family with a history of type 2 diabetes.
  • Less active. Physical activity helps control weight, burn glucose as energy, and make the cells of the body more sensitive to insulin. Less active physical activity causes a person more susceptible to type 2 diabetes.
  • Age. The risk of developing type 2 diabetes will increase with age.
  • Suffering from high blood pressure ( hypertension ).
  • Have abnormal cholesterol and triglyceride levels. Someone who has good cholesterol or high HDL ( high-density lipoportein ) and high triglyceride levels are more at risk of developing type 2 diabetes.
Especially for women, pregnant women who suffer from gestational diabetes can more easily experience type 2 diabetes. In addition, women who have a history of polycystic ovarian syndrome (PCOS) are also more prone to type 2 diabetes.

Diabetes diagnosis
Symptoms of diabetes usually develop gradually, except for type 1 diabetes whose symptoms can appear suddenly. Because diabetes is often undiagnosed at the onset of its appearance, people who are at risk of developing this disease are encouraged to undergo regular examinations. Among others are:
  • People over 45 years old.
  • Women who have had gestational diabetes while pregnant.
  • People who have a body mass index (BMI) above 25.
  • People who have been diagnosed with prediabetes.
A blood sugar test is an absolute test to diagnose type 1 or type 2 diabetes. The results of blood sugar measurements will indicate whether a person has diabetes or not. The doctor will recommend the patient to undergo a blood sugar test at a certain time and method. The blood sugar test method that can be undertaken by patients, including:
  • When blood sugar testing . This test aims to measure blood glucose levels at certain hours randomly. This test does not require the patient to fast first. If the results of a blood sugar test when showing sugar levels of 200 mg / dL or more, patients can be diagnosed with diabetes.
  • Fasting blood sugar test. This test aims to measure blood glucose levels when the patient is fasting. Patients will be asked to fast for 8 hours, then undergo blood sampling to measure their blood sugar levels. The results of the fasting blood sugar test which showed a blood sugar level of less than 100 mg / dL showed normal blood sugar levels. The results of fasting blood sugar tests between 100-125 mg / dL showed patients suffering from prediabetes. While the results of fasting blood sugar tests 126 mg / dL or more showed patients suffering from diabetes.
  • Glucose tolerance test. This test is done by asking the patient to fast overnight overnight. The patient will then undergo a fasting blood sugar test. After the test is done, the patient will be asked to drink a special sugar solution. Then the blood sugar sample will be taken back after 2 hours of drinking sugar solution. The glucose tolerance test results below 140 mg / dL show normal blood sugar levels. The results of the glucose tolerance test with sugar levels between 140-199 mg / dL showed the condition of prediabetes. The glucose tolerance test results with sugar levels of 200 mg / dL or more indicate the patient has diabetes.
  • Hb A1C test ( glycated hemoglobin test ). This test aims to measure the average glucose level of patients for the past 2-3 months. This test will measure blood sugar levels that are bound to hemoglobin, which is a protein that functions to carry oxygen in the blood. In the HbA1C test, patients do not need to undergo fasting first. HbA1C test results below 5.7% are normal. The HbA1C test results between 5.7-6.4% showed patients experiencing prediabetes. The HbA1C test results above 6.5% showed the patient had diabetes.

The results of the blood sugar test will be examined by a doctor and informed to the patient. If the patient is diagnosed with diabetes, the doctor will plan the treatment steps to be taken. Especially for patients suspected of having type 1 diabetes, doctors will recommend an autoantibody test to ascertain whether the patient has antibodies that damage body tissues, including the pancreas.

Treatment of Diabetes
Diabetic patients are required to regulate their diet by increasing consumption of fruits, vegetables, protein from whole grains, and foods low in calories and fat. Diabetic patients and their families can consult a doctor or nutrition doctor to manage their daily diet.

To help convert blood sugar into energy and increase cell sensitivity to insulin, diabetic patients are encouraged to exercise regularly, at least 10-30 minutes every day. Patients can consult with a doctor to choose appropriate exercise and physical activity.

In type 1 diabetes, patients will need insulin therapy to regulate blood sugar daily. In addition, some type 2 diabetes patients are also advised to undergo insulin therapy to regulate blood sugar. This added insulin will be given by injection, not in the form of a drinking drug. The doctor will set the type and dosage of insulin used, and tell how to inject it.

In the case of severe type 1 diabetes, doctors can recommend a pancreatic transplant to replace a damaged pancreas. Type 1 diabetes patients who have successfully undergone such surgery no longer need insulin therapy, but must take immunosuppressive drugs regularly.

In type 2 diabetes patients, doctors will prescribe drugs, one of which is metformin , a drinking drug that serves to reduce glucose production from the liver. In addition, other diabetes drugs that work by keeping glucose levels in the blood from being too high after the patient eats, can also be given.

Diabetic patients must control their blood sugar in a disciplined manner through a healthy diet so that blood sugar does not increase until above normal. In addition to controlling glucose levels, patients with this condition will also be scheduled to undergo an HbA1C test to monitor blood sugar levels over the past 2-3 months.

Complications of Diabetes
A number of complications that can arise due to type 1 and 2 diabetes are:
  • Heart disease
  • Stroke
  • Chronic kidney failure
  • Diabetic neuropathy
  • Visual impairment
  • Depression
  • Dementia
  • Hearing disorders
  • Wounds and infections in the feet that are difficult to heal
  • Skin damage due to bacterial and fungal infections
Pregnancy-related diabetes can cause complications in pregnant women and infants. An example of a complication in pregnant women is preeclampsia . While examples of complications that can arise in infants are:
  • Overweight at birth.
  • Premature birth .
  • Low blood sugar (hypoglycemia).
  • Miscarriage.
  • Jaundice .
  • Increased risk of developing type 2 diabetes when the baby is an adult.

Prevention of Diabetes
Type 1 diabetes cannot be prevented because the trigger is unknown. Whereas, type 2 diabetes and gestational diabetes can be prevented, namely with a healthy lifestyle. Some things that can be done to prevent diabetes, including:
  • Adjust the frequency and health menu.
  • Maintain ideal body weight .
  • Exercise regularly.
  • Routinely undergo blood sugar checks, at least once a year.

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