What is diabetes?
Diabetes is a disease in which the body is unable to properly use and store glucose. This results into causing one’s blood glucose / blood sugar to rise too high which is called as hyperglycemia. The reason behind this is that people with diabetes either don’t have enough insulin, or the insulin they have doesn’t work as it should to get sugar into the body’s cells for energy.

What is type 1 and type 2diabetes?
There are two major types of diabetes. Type 1 diabetes occurs because the insulin producing cells of the pancreas are damaged. People with type 1 diabetes must take daily insulin injections to survive. This type of diabetes usually develops in children or young adults, but can occur at any age. People with type 2 diabetes produce insulin, but it’s either too little or doesn’t work properly. Type 2 diabetes is most common in those over 30 years of age, who are overweight, have a family history of diabetes among any of the parents. Today it is increasingly found in younger people and particularly adolescents. Controlling blood sugar (glucose) levels is the best way to reduce risks for long-term complications like eye disease, kidney disease, and damage to nerves and blood vessels.

What is Type 2 Diabetes?
Type 2 diabetes is a lifelong disease that happens when your body either can't use insulin or make enough insulin. It often affects people who are overweight and not physically active. Insulin helps sugar (glucose) move from the blood into the body's cells, where it can be used for energy or stored. Without insulin, sugar cannot enter into the cells, and your blood sugar gets too high. If not controlled, high blood sugar can lead to problems with your eyes, heart, blood vessels, nerves, and kidneys. You may be able to manage diabetes by eating a diabetic diet and getting regular exercise in early stages. But some people need medicines to help control their blood sugar levels.

Who Develops Type 2 Diabetes?
Age, sex, obesity, physical inactivity, diet, lifestyle, and family health history all affect someone's chances of developing type 2 diabetes. The chances that someone will develop diabetes increase if the person's parents or siblings have the disease. Experts now know that diabetes is increasing in India and commonly occurring in Young adults. A doctor can decide if someone is at risk for developing diabetes and offer advice on reducing that risk.

What are the symptoms of diabetes? Or How do people know if they have diabetes?
People with diabetes frequently experience certain symptoms. These include:
• being very thirsty
• frequent urination
• weight loss
• increased hunger
• blurry vision
• irritability
• tingling or numbness in the hands or feet
• frequent skin, bladder or gum infections
• wounds that don't heal
• extreme unexplained fatigue

How would I know if I should get a checkup?
If you are concerned, ask your physician or visit Diabelife Clinic for a baseline screening for diabetes mellitus.

Can I get diabetes?
Diabetes can occur in anyone. The risk of developing diabetes also increases in people who are over 30 years of age. Physically inactive and overweight people are more likely to develop diabetes. Diabetes is more common among Asians, Native Americans, African Americans, Hispanic Americans and Asian Americans/Pacific Islanders. Women who develop diabetes during pregnancy (a condition called gestational diabetes) have a higher risk of developing diabetes later in life.

What tests are done to diagnose diabetes?
Diabetes is diagnosed with a simple blood test to know the levels of your sugar in blood. If you fall in high risk category, you should have a blood test for diabetes every year. Risk factors include a family history of diabetes, being Overweight, physically inactive and have a history of gestational diabetes.

What is HbA1c test? Should I take HbA1c test as suggested by my doctor?
HbA1c is a blood test that tells your average blood sugar over the last three months. It is reported as a percent. The ideal HbA1c for a diabetic person is 6.5 to 7 percent. HbA1c of 7 percent suggests a person’s blood sugar has been running on average in the 100 to 150 range. The test is to be taken once every three months for diabetics on treatment, and also if any active changes are being made to the regimen. For a well-controlled patient with no active medication changes, once every six months is adequate.

How is diabetes treated?
Everyone who has diabetes should visit regularly once every 3 monthly to a diabetes specialist (an endocrinologist or a diabetologist). He or she should also be seen periodically by other members of a diabetes treatment team, including a diabetes educator for diabetes education and a dietitian who will help develop a meal plan for the individual. Diabetes is managed through proper meal planning, exercise and, if needed, medication. Your doctor will monitor your blood sugar levels, cholesterol, HbA1c and triglycerides. It is important to keep these values within normal range.

I was told by my doctor that I am a prediabetic. Will this turn into diabetes, or are there ways you can stop it from progressing to diabetes later?
The rate of progression from prediabetes to diabetes is approximately 20 percent at five years, i.e., 20 out of 100 patients with prediabetes would convert to diabetes in the next five years. Aggressive lifestyle modification with proper diet, exercise, weight loss and medications, like metformin, can delay or even prevent diabetes later.

How can I avoid long-term problems associated with diabetes?
The best ways to reduce your risk for long-term problems related to diabetes are to control your blood sugar and to take good care of yourself.

Why do I have to monitor glucose?
Monitoring your blood glucose is helpful in preventing the complications of diabetes. Monitoring blood glucose is essential if you are on insulin injections to help you achieve good control while reducing your risk of low blood sugar (hypoglycemia). If you are treated by tablets, monitoring blood glucose is still helpful. The frequency and intensity of monitoring will be advised by your diabetologist based on your sugar levels and other associated conditions.

What can I do to take control of my diabetes?
• Be on a diabetic diet. Make healthy food choices; eat smaller portions and less fat.
• If you are overweight, try to lose some weight so you can better use insulin.
• See a dietitian in diabetes clinic for a meal plan that works for you.
• Increase physical activity. Aim for 30 minutes every day for atleast 5 days per week.
• Take medications of diabetes as prescribed. Most people with type 2 diabetes need several medicines to control blood glucose; those with type 1 diabetes must take insulin.
• Check blood glucose regularly and visit your diabetologist regularly.

What other problems can diabetes cause?
Poorly managed/controlled diabetes can lead to a host of long-term complications like heart attacks, strokes, blindness, kidney failure, blood vessel disease (leading to amputation) peripheral nerve damage and impotence in men.

If people keep their blood glucose as close to normal levels as possible, they can reduce their risk of developing some of these complications by 50 percent or more.

Foot complication/Foot care in diabetes:
Why should I see a diabetologist or a podiatrist (foot care expert) to screen for foot complications?

About 30-50 % of people with diabetes have mild to severe forms of diabetic nerve damage. The feet can reveal diabetes warning signs such as numbness, redness, swelling, or non-healing wounds. Making at least one visit per year to have your feet examined is a critical step in avoiding diabetic foot complications and amputation.

I have been diagnosed with diabetes. What foot complications could I experience?
1. A loss of feeling in your feet
2. Foot ulcers or sores that do not heal
3. Amputation

What are diabetic ulcers, and how can I prevent them?
Diabetic ulcerations are often one of the first signs of complications from diabetes in the lower leg. These ulcers arise from a small wound or cut on the foot that is slow to heal. If left untreated, ulcers can become harder to treat and could lead to amputation. If discovered early and treated by a diabetologist or podiatrist, ulcers may not lead to amputation.

Is there a special kind of footwear available for those with diabetes?
Yes! Certain types of shoes, socks, and customized footwear are all created especially for those with diabetes. People with diabetes should never walk barefoot which can lead to complications.