Milad Hospital of Isfahan

What is diabetes? (Methods of diagnosis and treatment of diabetes)

How does diabetes begin?

When a person's body cannot produce enough insulin or use the produced insulin correctly, that person will get diabetes.

The question may be raised, what is insulin?

Insulin is a hormone that the pancreas produces in the body. This hormone takes sugar from the blood and transports it into the body's cells so that the body can use that sugar as energy.  In people with diabetes, either the amount of insulin is low or the insulin does not have enough effect for various reasons and the cells cannot absorb the sugar in the blood properly. As a result, the amount of sugar or glucose in the blood increases and over time this issue causes damage to some organs of the body. Now that we know what diabetes is, it is better to know its types:

 

Types of diabetes

There are generally two types of diabetes:

Type 1 and Type 2

In type 1 diabetes, which is also called insulin-dependent diabetes and is less common, genetic and environmental reasons are the cause of the disease, which have not yet been fully identified.

People of any age can develop type 1 diabetes, although this type of diabetes is more common in children and young adults.

Type 2 diabetes, also known as non-insulin-dependent diabetes, is the most common type of diabetes in the world, usually caused by the resistance of the body cells to insulin. Type 2 diabetes is more common in adults, but due to excess weight, reduced mobility and improper nutrition, its prevalence is increasing in young people.

Sometimes, diabetes may occur in a special group such as women, which is called gestational diabetes. In gestational diabetes, a pregnant person first experiences an increase in blood sugar. Although the signs and symptoms of gestational diabetes usually disappear after delivery, these women are prone to developing type 2 diabetes in the future.

What is prediabetes?

Before the onset of diabetes, many people have prediabetes. The blood sugar level of these people is higher than normal, but not so much that it is included in the definition of diabetes. Prediabetes is very common, but the good news is that it can be reversed.

The following points are the key points that help us control diabetes and prevent it from turning into diabetes.

Weight loss: even a small weight loss of five to seven percent can have a significant effect.

Regular exercise: One hundred and fifty minutes of exercise per week, such as brisk walking or thirty minutes per day, five days per week

Proper and healthy nutrition

 Stress control

How to recognize diabetes

Drinking a lot of fluids and excessive thirst

Gluttony

Frequent urination

Excessive fatigue

Vision problems

Weight Loss

Failure to heal wounds and recurrent infections

It is good to see a doctor if you see these symptoms

But unfortunately, it is not possible to diagnose diabetes based on its symptoms, so the advice of experts is to visit a doctor in the following conditions to diagnose diabetes or pre-diabetes:

If you have the symptoms of diabetes mentioned above.

If you do not have the mentioned symptoms, but you are overweight (at any age)

If you don't have the symptoms listed above, but you have one or more of the diabetes risk criteria described above.

Who gets diabetes?

The presence of one or more of the following symptoms, which are known as risk symptoms in diabetes, increases the probability of developing diabetes in a person:

Sedentary people

History of diabetes in first degree relatives

History of gestational diabetes or high birth weight baby

People who are being treated for high blood pressure

Women with polycystic ovary syndrome

The presence of hemoglobin a/c equal to or greater than 5.7% or impaired glucose tolerance in blood tests or impaired fasting glucose in previous tests

Disruption to diseases associated with insulin resistance such as severe obesity

History of cardiovascular diseases

High blood fat

What foods cause high blood sugar and

Starches: refined grains such as white rice, white flour and white bread, fried potatoes

Vegetables Canned vegetables with a lot of added salt cooked vegetables with a lot of butter, cheese and pickles and salt sauce (if you have a salt restriction)

Fruits: Fruit compote or other canned fruits with sugar, types of pastilles, dried fruits, jams and jellies, types of juices

Proteins: fried meat, fatty parts of meat such as ribs and giblets, sausages, bacon, high-fat cheese, poultry meat with fried fish skin.

Dairy products: full-fat milk, full-fat yogurt, cream, full-fat cheese, full-fat ice cream

Fats and sweets: any food that contains trans fat is high in saturated fat, which is primarily derived from animal products (It is necessary to check the label on food from this point of view). If you have heart problems along with diabetes, you should consult your doctor about this.

Drinks: carbonated drinks, fresh fruit juice or mixed juice drinks, sweet tea, coffee with sugar and coffee mate, energy drinks

Nutrition and diet of diabetics

There is no fixed diet for all people with diabetes, but the food we eat not only plays a role in controlling our diabetes, but also determines how much energy and how we feel during the day.

Here we will introduce some of the main food groups that make up a healthy and balanced diet. Include the main food groups in your diet

The amount of energy we need to eat and drink depends on our age, gender, activity level, and our daily caloric needs.

No single food contains all the essential nutrients for our body, and for this reason, a healthy diet basically means choosing a variety of foods from the main food groups in a day.  These groups include proteins such as meat, fish, eggs, legumes and nuts, starchy materials such as bread, pasta and rice, fruits and vegetables, dairy products and fats.

The best foods and edibles for diabetic patients

Starches

Our body needs carbohydrates, but it is better to choose them carefully.

Whole grains such as whole grain rice, oats, quinoa

Grilled sweet potatoes

Foods made of whole grains and no added sugar

Vegetables: fresh vegetables such as spinach, kale, raw or lightly steamed or grilled, frozen steamed vegetables, canned vegetables if they do not have added salt,

Fruits:

Fruits are best consumed fresh, frozen or canned fruits that do not have added sugar, jam without sugar

Protein: plant proteins such as raw dried beans and tofu

Fish and seafood

 Chicken or other birds with soft texture like the breast and with less fat and without skin

Egg

Dairy products:

Use low-fat dairy products (If you want to consume high-fat dairy products, it should be very small).

One and a half percent fat milk

Low fat yogurt

Low fat cheese

Fats and sweets:

It is very difficult to resist the consumption of this food category, keep in mind that eating a large amount of it will lead to weight gain and this will make it difficult to control diabetes.

Natural sources of vegetable oils such as sunflower oil seeds

Foods that contain omega-3 fats, such as fish

Grape seed oil, olive oil and canola oil

Beverages: when you drink your favorite beverage, you're probably consuming more calories, sugar, salt, and fat than you think.  Be sure to pay attention to the food table on the drink can before consuming it.

Plain unflavored water or sparkling water

Bitter tea maybe with a slice of lemon

Coffee without milk, sugar and sweetener

 

Treatment of diabetes without drugs: (spices and anti-diabetic herbs)

As we said, the first step in the treatment of type 2 diabetes is to modify the lifestyle by observing some points such as the following

Proper diet and proper nutrition with the doctor's advice

Regular physical activity 150 minutes of moderate intensity exercise per week such as brisk walking

Lose weight

 Get enough sleep

Stop smoking

Reduce stress

Diabetes drug treatment (drugs for diabetic patients)

Type 1 diabetes is treated with insulin by injection

In type 2 diabetes, there are different categories of oral or injectable drugs against type 2 diabetes, and each of these categories lowers blood sugar with a different mechanism. The mechanisms of blood sugar reduction by these drugs include

Pancreas stimulation to produce and release more insulin

The ability to produce and release Glucose by the liver

Inhibition of stomach enzymes that are responsible for breaking down carbohydrates in the stomach

Improving the sensitivity of cells to insulin

Inhibition of glucose reabsorption in the kidneys

Adjusting the speed of food passage through the stomach

Each drug class contains one or two drugs, metformin, sitagliptin, and empagliflozin

Please note that the choice of the type of medicine and how to take it must be done by a specialized doctor

It should be noted that the right blood sugar is not the same for all people at all ages and the doctor determines the right blood sugar for the patient based on the patient's condition

Complications of Diabetes

As we mentioned at the beginning, more than half of the people with diabetes are not aware of their disease. Lack of awareness of diabetes and high blood sugar can lead to dangerous complications for patients in the long term due to lack of timely diagnosis and control of blood sugar.

The dangerous complications of diabetes include the following

Kidney disease: the most common cause of kidney disease leading to dialysis or kidney transplant

Vision problems: diabetes can lead to serious vision problems and even blindness

Cardiovascular disease: The most important cause of death in diabetic patients is cardiovascular problems

Peripheral nerve disease:  by affecting the peripheral nerves, diabetes causes sensory disturbances and, as a result, causes chronic wounds in the organs. The infection caused by these wounds can lead to amputation