Diabetes Treatment in Mumbai, India

Diabetes is a chronic (long-lasting) metabolic medical condition that causes an increase in blood sugar levels. Glucose is the primary source of energy and is vital for survival. However, a pathologic increase in the level of sugar in the bloodstream leads to Diabetes.

Irrespective of the type of Diabetes, there is an increase in the sugar levels in the blood. Either the body is not making enough insulin or is resistant to it. Being a chronic condition, Diabetes makes an individual prone to health conditions such as cardiovascular issues, loss of vision, loss of sensation, and kidney diseases.

Associated Anatomy:

Pancreas

Diabetes Symptoms

• Frequent urination
• Blurry vision or loss of vision
• Fatigue
• Sores and delayed wound healing
• Weight changes
• Increased thirst and hunger
• Urinary tract infections
• Yeast infection
• Decreased sex drive and erectile dysfunction
• Loss of sensation
• Decreased muscle strength
• Ketouria

Signs and symptoms will vary depending on the progression and nature of the disease. Symptoms can be controlled with lifestyle changes. Early detection and control can prevent the long-term consequences of Diabetes.

Diabetes Causes

Diabetes can be caused due to various reasons. Genetic and environmental factors predispose an individual to Diabetes. The causes of Diabetes are as follows;

• Genetic - Hereditary predisposition is believed to have a role in the development of Diabetes. Having a family history of diabetes increases the odds of developing Diabetes.
• Age – For individuals above the age of 40, due to reduced muscle mass, weight gain, and reduced exercise, there is a possibility of developing Type 2 Diabetes. However, Type 1 Diabetes usually is diagnosed below the age of 30.
• Obesity – Increased body fat can cause insulin resistance. However, more research is needed for a conclusive correlation between obesity and diabetes, but it can surely be an additive factor for Diabetes.
• Diet – Dietary habits such as high-caloric food, fats, and cholesterol increase insulin resistance.
• Sedentary lifestyle – Lack of exercise decreases the muscle response to insulin.
• Insulin – Decreases in insulin production or resistance to insulin are the leading causes of Diabetes. As insulin is needed to move blood sugar into cells, it increases blood sugar.
• Pregnancy – Placental hormones increase insulin resistance causing increased sugar levels in the bloodstream.
• Hormonal conditions – Pre-existing hormonal conditions such as Cushing’s syndrome, Acromegaly, and Hyperthyroidism can lead to Diabetes.

Diabetes Types

• Type 1 - Prevalent in 10% of the Diabetic population, it is an autoimmune condition affecting the pancreatic cells which produce insulin. Type 1 Diabetes often appears in childhood or adolescence.
• Type 2 - Insulin resistance causes Type 2 Diabetes. It can develop at any stage. However, it is common in individuals over the age of 40. In the case of uncontrolled Type 2 Diabetes, several symptoms are aggravated and lead to severe complications due to the build-up of sugar in the bloodstream.
• Prediabetes – Blood sugar is higher than normal but not conclusive of Type 2 Diabetes. Controlling the sugar levels through diet and weight management is believed to curb the progression of Type 2 Diabetes.
• Gestational diabetes – Due to placental hormones, cells develop insulin resistance which causes an increase in the blood sugar level during pregnancy.

Prediabetic patients are more prone to the progression of Diabetes. Appropriate measures, including lifestyle changes, diet modification, and exercise, can help curb the symptoms. Type 1 and Type 2 are chronic conditions, while prediabetes and gestational diabetes are potentially reversible conditions. In most cases, gestational diabetes is reversed after delivery.

Additional Type

Diabetes Insipidus differs from Diabetes as it is characterized by increased fluid loss.

Diabetes Treatment

Diabetes treatment and care plan will depend on the type of Diabetes and its severity. While prediabetic cases can be managed through lifestyle changes, Type 1 and Type 2 needs pharmacological intervention. In addition to medication, lifestyle changes are a must. Diabetes Treatments can be employed on a case-to-case basis depending on severity, type, and progression. Some diabetes treatments are as follows:

• Insulin – Insulin before meals through pens, syringes, pumps, and an inhaler for insulin delivery.
• Anti-diabetic medications
• Bariatric surgery
• Artificial pancreas
• Pancreatic islet transplantation

Consulting a Endocrinologists and having a management and care plan can ensure a normal life for Diabetic patients.

Risk factors Associated With Diabetes

• Lack of physical activity
• Obesity
• Unhealthy diet
• Genetic predisposition
• Pre-existing health conditions
• Prediabetes
• Increasing age
• History of gestational diabetes during a past pregnancy
• High blood pressure
• High levels of bad cholesterol

Taking a Diabetes Risk Test is suggested.

Complications Associated With Diabetes

Increased level of blood sugar causes damage to the body. Long-term uncontrolled diabetes can lead to complications such as;

• Neuropathy
• Nephropathy
• Heart attack and stroke
• Retinopathy
• Diabetic foot
• Bacterial and fungal infections
• Dementia
• Depression
• Skin diseases

Increased sugar levels in the blood cause delayed healing. In Diabetic patients, even minor wounds are prone to infection. In the later stages of the condition, neuropathy leads to loss of sensation in the extremities. Diabetic foot ulcers can lead to severe infections and amputations.

Diabetes Prevention

Primary Prevention

Lifestyle modification and regular exercise benefit in the long run and prevent associated complications. In case of genetic predisposition, regular check-ups and tests are recommended.

Secondary Prevention

• Medications and artificial insulin intake are based on the type of diabetes.
• Symptom management and treatment in cases of associated illness such as retinopathy, neuropathy, and diabetic foot.
• Lifestyle modifications include diet and regular exercise.

Differential Diagnosis

Chronic pancreatitis, cystic fibrosis, obesity, non-diabetic glycosuria.

Test for Diagnosing Diabetes

Timely diagnosis and testing are crucial to managing Diabetes. Scheduled visits to healthcare professionals and blood tests are essential to managing Diabetes. One can opt for laboratory testing for an accurate result. Using testing devices over the counter such as blood glucose meters is helpful for diabetes management but not as a conclusive diagnosis. Certain tests used for diagnosing diabetes are:

• Fasting plasma glucose
• HbA1c test (Glycosylated hemoglobin test)
• Random plasma glucose
• Glucose challenge test
• Glucose tolerance test

In case of a definite diagnosis by a healthcare professional, a management plan can include regular testing and lifestyle changes to prevent the condition from worsening.

Epidemiology

• An estimated 422 million people worldwide are diabetic.
• Diabetes-related deaths are estimated to be 1.5 million every year.
• Diabetes is prevalent in low-and-middle-income countries compared to high-income countries. A steep increase in diabetes cases has been observed over the last 10 years.

Prognosis

Expected prognosis

Lifestyle modification and medical supervision, regular check-ups, and testing allow an individual to live a normal life.

Natural prognosis

If left untreated, long-standing diabetes causes many problems, including loss of vision, diabetic ulcers, loss of sensation, cardiovascular issues, and organ failure.

Pathophysiology

Diabetes results from decreased insulin secretion or insulin resistance, which leads to a lack of sugar uptake. Sugar being the fuel for organs, diabetes results in multiple medical conditions in the long run.

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