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Types of diabetes

Type I diabetes

What is Type I diabetes?

In Type 1, or insulin dependent diabetes, the cells in the pancreas that normally produce insulin have been destroyed. When little or no insulin comes from the pancreas, the body cannot absorb sugar from the blood and the cells begin to "starve" while the blood sugar level remains high.


What are the symptoms?

Any or all of the following are possible:

Who is at risk?

Type I diabetes is also called juvenile onset diabetes. This occurs in children or young adults. But it is not unusual in older people as well.

It is still not known what causes the destruction of the insulin-producing cells in the pancreas, or why it happens in some people and not in others. Hereditary factors appear to play a role, but the disorder is practically never directly inherited. Diabetics, or people with diabetes in their family, are therefore not advised against having children.

What are the treatment options available?

Once the disorder has developed, there is no way to "revive" the insulin-producing cells in the pancreas. Transplanting a healthy pancreas - or just the insulin producing cells from a pancreas - has been tried, but is still in the experimental stage. Diet and treatment with insulin are therefore necessary throughout a diabetic's life (Read more in Lifestyle changes and Medication).

The remedy is to inject insulin under the skin so that it can be absorbed into the blood. It has not yet been possible to produce a form of insulin that can be taken by mouth, since insulin is broken down to an inactive form in the stomach.

Type II diabetes


What is Type II diabetes?

In type II diabetes there may be three areas of trouble.

The pancreas - In Type II diabetes, the cells in the pancreas still produce insulin, but they may have lost their ability to replenish the insulin supply quickly when needed.

Cell surfaces - If the number of insulin receptors on the surface of various cells is too small or if they don't function properly, blood sugar can't enter cells freely. In other words the insulin "keys" may not fit the cell's "locks" so sugar cannot enter. This condition is called "insulin resistance" or "insulin insensitivity."

Inside the cells- When sugar enters a cell, it is escorted to the place where it is needed by a system of transporters. A defect in this system is another possible cause of insulin resistance. All Type II diabetics still produce insulin at the onset of the disease. Most will continue to do so for the rest of their lives, although the amount of insulin produced may decline over the years.

What are the symptoms?

The trouble with Type II diabetes is that the affected may live for months or years without any significant symptom. This makes it a serious health risk. Some may feel some of these symptoms to a lesser or greater extent:

  • Constant thirst
  • Frequent need to urinate
  • Increased hunger
  • Fatigue
  • Weight loss
  • Blurry vision
  • Skin infections
  • Wounds that don't heal

Who is at risk?

Type II diabetes is also known as adult onset diabetes. The 40 plus age group is the most affected. While it is not known what causes Type II diabetes, heredity seems to play a larger role here than in Type I diabetes. There is also a connection between obesity and Type II diabetes, although obesity does not necessarily lead to diabetes.


What are the Treatment options available?

Type II diabetes is often considered "milder" than Type I. It must be taken seriously, however, precisely because its symptoms may go undetected for a long time, thereby creating a serious health risk. Type II diabetes can be managed with a multipronged approach of exercise,diet plan and medication.


Gestational Diabetes

What is gestational Diabetes?

When a woman develops high blood sugar levels during pregnancy, she is said to have gestational diabetes. During the second trimester (about 24 to 26 weeks of pregnancy), the placenta begins to produce many hormones. One of these hormones may block the action of insulin in the mother. This is called insulin resistance. The mother may experience difficulty moving sugar out of her blood and into cells. If the mother cannot produce enough extra insulin to overcome the resistance, her blood sugar will rise. The high blood sugar stimulates the baby to make more insulin causing him or her to gain extra weight. If unregulated, these changes can have serious and harmful effects on both mother and child.

Who is at risk?

Gestational diabetes is noticed more often in women who fall under the following categories:

  • Those who are obese
  • Those who have a family history of diabetes
  • Those who have had problems with pregnancies earlier
  • Those who are under severe stress.

How does gestational diabetes affect the baby?

The foetus gets more sugar from the mother and may grow large in size. Because of the increased size of the foetus childbirth may become difficult.

  • Untreated diabetes in the mother can lead to the baby being delivered with jaundice.
  • The baby may have respiratory problems.
  • There may be a drop in the sugar levels of the baby as soon as it is delivered.

Because of the above reasons both the mother and the newborn should be monitored closely in case of gestational diabetes.

What are the treatment options available?

Regular monitoring of blood glucose is required.

The doctor usually suggests a diet plan. If this is not adequate to control the blood glucose, the doctor may also suggest an insulin dosage.

Pregnancy in women with diabetes

 

This is different from gestational diabetes. In gestational diabetes, diabetes is set off by hormonal action, usually in the second trimester of pregnancy. Here the mother is diabetic at the time of conception.

Women with diabetes can have a normal pregnancy and give birth to healthy children provided they take certain precautions. The more the diabetic mother's metabolism deviates from normal during pregnancy, the greater the risk to the developing baby. Because they share the same blood supply, blood glucose levels in mother and baby will be identical. While an adult can tolerate periodic high levels of blood glucose, the same levels would constitute a threat to the normal development of a baby. Because of these risks, planned pregnancies are recommended to provide optimal control from the start. The first 7-8 weeks after conception are particularly important because this is the period when various organs are formed in the baby. Tablet treated diabetics are usually advised to switch to insulin during pregnancy. The insulin treated diabetic should expect her need for insulin to change during pregnancy - possibly a little less insulin in the beginning and more insulin later on. Insulin requirements will drop back to the usual amount after delivery. Pregnancy also increases the need for certain other substances such as calcium, iron and vitamins. Women with diabetes can breast-feed provided they take precautions against hypoglycaemia - either by reducing the amount of insulin taken or by eating more food, especially carbohydrates.

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