What is diabetes?

Diabetes is a chronic disease that occurs as a result of the body’s difficulty in properly using carbohydrates, which results in an increase in blood glucose. The cause is the lack of insulin production in the pancreas or failure in its use.

Types of Diabetes:

Type 1.- When the pancreas of the person suffering from it does not produce the insulin that is needed.

Type 2.- When the insulin produced by the pancreas of the sick person is not effective and does not function.

Type 1 Diabetes is more common in children and young adults although it can occur at any age. People with Diabetes 1 need to administer insulin to control blood glucose levels. Diabetes 1 represents 5-10% of the entire population with Diabetes.

Type 2 Diabetes is more common in older people, particularly those who are overweight. Currently, as a result of a sedentary lifestyle and the increase in obesity of the population, it also occurs in younger people. Often, Diabetes 2 can be controlled with diet, weight loss and exercise and also with pills. Diabetes 2 represents 90-95% of the entire population with Diabetes.

What complications can Diabetes give?

When glucose circulates in the blood instead of being used as energy, its concentration increases, hyperglycemia. This entails short and medium-term complications that, if not prevented, can affect the majority of blood vessels in our body. The most significant long-term complications are at the level of small vessels such as those of the kidney (nephropathy) and retina (retinopathy) and large vessels, causing the so-called generalized vascular disease, which affects the heart, brain, and lower extremities. It also affects nerve conduction leading to the so-called diabetic neuropathy, explains nephrologist in Delhi.

What symptoms guide us to the presence of Diabetes?

The onset of Type 1 Diabetes is often sudden and may include symptoms such as increased urinary frequency, abnormal thirst, extreme tiredness, irritability, weight loss, frequent infections.

Diabetes 2 starts gradually and is generally not detected. Sometimes symptoms similar to those of type 1 diabetes may appear, but much more attenuated. Often the initial symptoms are not detected and the diagnosis of the disease is made late, years after the onset of the disease. At that time in half of the patients, complications are already present.

Who is at risk for diabetes?

Some people may be more predisposed to present the disease. The most relevant factors are:

• Diabetes family history
• Excess weight, particularly abdominal obesity
• Age over 45 years
• Sedentary life
• Diabetes during pregnancy
• Abnormalities in glucose tolerance

Which is the treatment?

Diet, exercise, drugs called oral antidiabetics and finally insulin.

Can you prevent the onset of diabetes or its complications?

Overweight and sedentary life are modifiable factors that can clearly influence the onset of Diabetes in predisposed people. Therefore, there are two clear factors that can be prevented.

Why does the kidney get sick? It is quite frequent? What can be done to prevent kidney disease?

Kidney disease caused by diabetes occurs in a third of the population with diabetes.

The first specific fact that alterations in the kidney are occurring is the presence of a protein called albumin in small amounts in the urine. This alerts you to the possibility that the small blood vessels that feed the kidneys may suffer damage if we do not act. There are interventions and drugs that can prevent and reverse kidney damage in the early stages, the best nephrologist in Delhi says.

Diabetic kidney disease “Diabetic nephropathy”:

Kidney disease caused by Diabetes is called Diabetic Nephropathy. It is a chronic and progressive disease that develops in a third of people with diabetes. High blood glucose levels affect the small vessels throughout the body and also those that are part of the kidneys. When these small vessels or capillaries are damaged, they do not work properly affecting their function, filtration. Toxic products can then accumulate in the blood, while other necessary substances such as proteins are eliminated in the urine improperly. If this progresses, we can reach the complete loss of kidney function that stops its filtration process.

Risk factors for kidney disease in Diabetes:

• Tobacco
• High blood pressure
• Uncontrolled blood glucose figures
• Family history of kidney disease

Signs and symptoms of kidney disease in Diabetes:

Symptoms of kidney involvement may appear late, when the organ is already severely damaged. It is important to know the early signs that can alert us to the onset of kidney damage:

• Proteins in the urine
• Hypertension
• Swelling of legs and cramps
• Impaired renal function
• Increased frequency and amount of urine
• Less need for insulin
• Nausea and vomiting
• Weakness, paleness, and anemia

Without treatment, diabetes can cause serious long-term complications:

Nephropathy. Diabetes is the leading cause of kidney failure in the developed world and accounts for approximately 35-40% of new cases of kidney failure each year.

Retinopathy. Diabetes is the leading cause of blindness and visual impairment in adults in developed countries. The incidence of blindness is 25 times higher in people with diabetes, compared to the general population.

Neuropathy. Nerve injuries, along with peripheral vascular disease make diabetes the most common cause of amputation not resulting from an accident or trauma. People with diabetes are 15 to 40 times more likely to need an amputation of the lower limbs compared to the general population.

Cardiovascular diseases. People with diabetes are 2 to 4 times more likely to develop cardiovascular disease than people without diabetes – people with type 2 diabetes have the same risk of having a myocardial infarction as people without diabetes who have already suffered a first heart attack. The risk of mortality from cardiovascular disease is 40 times higher than in people without diabetes.

The development of the initial phases of diabetic nephropathy is frequent.

Throughout life, about 50% of people with type 1 diabetes develop microalbuminuria – the presence of albumin protein in the urine, which is an indicator of impaired renal function.

Approximately 20% of people with type 1 diabetes develop renal insufficiency

In Caucasian people with type 2 diabetes, between 5 and 10% develop chronic end-stage renal insufficiency (IRCT), while among those not Caucasians the proportion is even higher.

Diabetic renal failure is the most common cause of admission to a renal replacement, dialysis or kidney transplant, in most countries of the world.

In India, about one-third of people with end-stage chronic renal failure suffer from diabetes. It is estimated that this population will grow at an annual rate of 8%.

Up to 40% of new cases of IRCT can be attributed to diabetes.

The risk of IRCT is 12 times higher in people with type 1 diabetes compared to those with type 2 diabetes.

There are two treatment options when the kidneys fail:

Dialysis (peritoneal dialysis or hemodialysis) and kidney transplant. The costs of both treatments are high. It is estimated that diabetes represents between 5 and 10% of the national health budget in developed western countries.

Diabetic renal failure develops so slowly that it may not show symptoms for many years.

The best way to detect the problem is the analysis of urine for proteins, which normally should not be present, such as albumin. It is recommended that every person with diabetes undergo a urinalysis every year for albuminuria.

There is conclusive evidence that good blood glucose levels can significantly reduce the risk of developing complications and slowing their progression in all types of diabetes.

The control of high blood pressure and high levels of blood fats (hyperlipidemia) is also very important.