When it is poorly taken up by the cells, glucose accumulates in the blood. An overly high blood sugar level, characteristic of diabetes, is detrimental to the functioning of various organs and blood vessels, the diameter of which shrinks with the formation of fatty deposits inside the arterial walls.
While type 1 diabetes is an autoimmune disease, type 2 diabetes is known as adult-onset, in other words, it sets in progressively over time. At the start of the disease, the pancreas will adapt by producing more insulin and diabetes may go unnoticed for years. Type 2 diabetes is the most common form of diabetes (95% of cases). Lastly, there is a form of diabetes specific to pregnant women; it is called gestational diabetes*Gestational diabetes occurs only during pregnancy and is characterized by a high blood sugar level. It appears in the third trimester of pregnancy and often disappears after giving birth., which appears in the third trimester of pregnancy and often disappears after giving birth.
Symptoms of Diabetes
When they appear, the main symptoms of diabetes are:
- physical tiredness,
- an intense thirst due to a frequent need to urinate,
- difficulty concentrating with a reduction in performance,
- vision issues and in particular blurred vision,
- weight loss (without a feeling of hunger),
- an increased risk of infections.
The symptoms are the same for the different types of the disease, but as the onset of type 2 diabetes is delayed and gradual, diagnosis often takes a while. In the case of gestation diabetes, the clinical picture is often much less obvious, and it is symptoms such as more urine infections than normal and raised blood pressure that point to diabetes.
Causes of Diabetes
While type 1 diabetes is related to a lack of insulin due to the cells that produce it, type 2 diabetes is caused by the body being resistant to the action of insulin leading to issues absorbing sugar and increased sugar levels in the blood. Family history, age, and above all lifestyle (an unbalanced diet, eating too much which leads to significant weight gain, and insufficient exercise) are clearly linked to an increased risk of developing type 2 diabetes.
Environmental factors (for example toxic chemicals) can also contribute to certain rarer forms of diabetes. In the case of gestation diabetes, age, being overweight, and a genetic component can all contribute.
There is a clear link between eating a diet that is too calorific and high in sugar, being overweight, and not doing enough exercise and the risk of developing type 2 diabetes. Four out of every five patients with type II diabetes are estimated to be overweight. Heredity can also play a role however (presence of a family history of diabetes), which means that a healthy lifestyle is not an absolute guarantee of protection.
Tests to detect high fasting blood glucose levels and an abnormal level of glycated hemoglobin**Glycated hemoglobin is the glycated form of the hemoglobin molecule. A glycated hemoglobin test measures the concentration of glucose in the blood, glycaemia, over several months. are the most commonly used to diagnose diabetes.
Everyone with diabetes should receive long-term medical support and nutritional advice to work out the diet that is best suited to their condition.
However, it is not always enough to correct an unhealthy lifestyle by trying to eat more fruit and vegetables, move more, and lose weight to slow the progression of the disease and reduce the risk of diabetes-related complications. When these measures are not enough to obtain a good glycemic balance in cases of type 2 diabetes, antidiabetic medication should be prescribed. Some people require insulin injections (in the form of a pen or pump).
In cases of type 1 diabetes, which is currently incurable, regular insulin injections must be administered for life (using a pen or pump). Insulin cannot be taken in tablet form, as it would be destroyed by the digestive enzymes.
Most cases of gestational diabetes can be controlled through dietary measures.
Progression and Possible Complications
In the long term, untreated diabetes can damage the blood vessels, including large vessels like the aorta or small capillaries that all our organs require to function. This can lead to cardiovascular, eye, kidney, and nervous system disorders. Vascular conditions can cause organ disorders and patients can suffer, for example, from loss of vision, kidney failure*A disease characterized by a reduction in kidney function that leads to a buildup of urea and creatinine in the blood., foot ulcers*A foot ulcer can occur after an injury that is not treated immediately and/or that doesn’t heal well. As diabetics often suffer from a loss of sensitivity in their extremities, these injuries might not be detected straightaway and can lead to significant complications, or even amputation. that can lead to amputation, (strokes*Strokes occur when the blood supply to the brain is interrupted. They can be caused by an obstruction in the blood vessel supplying blood to the brain or by such a vessel rupturing., and other cardiovascular problems (heart attack*A heart attack occurs when there is a partial or complete obstruction of a coronary artery. The part of the heart connected to this artery stops receiving oxygen, and so can necrotize and die. Heart attacks are also known as myocardial infarctions.).
When hyperglycemia is combined with being overweight, elevated blood lipid levels, and high blood pressure, this is referred to as a metabolic syndrome. This again increases the risk of complications related to diabetes.
Gestation diabetes potentially puts the health of the mother and child at risk if not treated.
Many patients are able to keep their diabetes under control once they have made certain lifestyle changes and started suitable medical treatment. Doing an appropriate form of exercise helps to regulate the metabolism of glucides and therefore reduce the risk of diabetes-related complications (kidney failure, stroke, heart attack, etc.). Diabetic patients are advised to undertake around 150 minutes of physical activity per week alternating if possible between endurance activities (walking, Nordic walking, cycling, etc.) and exercises to strengthen the muscles.
When Should You Contact the Doctor?
Given that half of all people with type 2 diabetes do not know that they have it, it is advised that people over the age of 45 should get their blood sugar levels checked once a year.
Early screening is particularly important because once a diabetes diagnosis is finally received, one third of patients already have complications.
Pregnant women at risk of developing diabetes (who are overweight and/or have a family history of the disease) should be screened from their very first pregnancy appointments. As gestation diabetes can occur in a large number of pregnant women without any known risk factors, screening should be performed between the 24th and 28th week of pregnancy in any case.
Care at Hôpital de La Tour
Due to its complexity, diversity, and chronic nature, diabetes requires comprehensive and interdisciplinary medical care with long-term monitoring and involvement of the patient in their care plan. The first step is to measure blood sugar levels (glycemia) and potentially perform urine tests. The results will be used to make a diagnosis and therefore determine whether insulin therapy is required. Insulin therapy in the form of injections is prescribed for most patients for whom antidiabetic medication is not the optimum form of treatment.