Diabetes is a chronic metabolic disorder characterised by hyperglycaemia (high blood sugar levels) due to defects in insulin secretion, insulin action, or both.
Insulin, a hormone produced by the pancreas, is crucial for regulating blood sugar levels by allowing glucose to enter cells for energy.
Unmanaged diabetes can lead to severe long-term complications affecting various organs.
Major Types of Diabetes
Type 1 Diabetes
Autoimmune disease where the immune system destroys insulin-producing cells in the pancreas, resulting in little or no insulin production.
Usually diagnosed in children and young adults, but it can occur at any age.
Requires lifelong insulin therapy to manage blood sugar levels.
Symptoms develop rapidly, and individuals often present with diabetic ketoacidosis (DKA), a life-threatening condition.
Key Features:
Cause: Autoimmune destruction of pancreatic beta cells.
Insulin Production: Little to none.
Treatment: Lifelong insulin therapy.
Typical Onset: Childhood and young adulthood.
Type 2 Diabetes
The most common type of diabetes, accounting for 90-95% of cases.
Characterised by insulin resistance (body cells don’t respond properly to insulin) and/or insufficient insulin production by the pancreas.
Develops gradually, often without noticeable symptoms in the initial stages.
Risk factors include obesity, physical inactivity, family history, and certain ethnicities.
Management involves lifestyle modifications (diet, exercise), oral medications, and sometimes insulin therapy.
Treatment: Lifestyle changes, oral medications, and potentially insulin.
Typical Onset: Adulthood, but increasingly seen in younger populations.
Gestational Diabetes
Develops during pregnancy in women without pre-existing diabetes.
Caused by hormonal changes during pregnancy leading to insulin resistance.
Usually resolves after delivery, but increases the risk of developing type 2 diabetes later in life.
Management focuses on blood sugar control through diet, exercise, and sometimes medication.
Key Features:
Cause: Hormonal changes during pregnancy leading to insulin resistance.
Onset: During pregnancy.
Resolution: Typically resolves after delivery.
Future Risk: Increased risk of developing type 2 diabetes.
Other Types of Diabetes
Prediabetes: A condition where blood sugar levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes. It increases the risk of developing type 2 diabetes and cardiovascular disease.
Monogenic Diabetes (MODY & Neonatal Diabetes): Caused by genetic mutations affecting insulin production or action. MODY is inherited and often diagnosed before age 25, while neonatal diabetes presents within the first six months of life.
Type 3c Diabetes: Results from damage to the pancreas due to conditions like pancreatitis, pancreatic cancer, or surgery.
Latent Autoimmune Diabetes in Adults (LADA): A slower-progressing form of autoimmune diabetes, often initially misdiagnosed as type 2.
Diabetes Induced by Medications or Conditions: Some medications (e.g., steroids, antipsychotics) and conditions (e.g., Cushing syndrome) can cause diabetes.
Complications of Diabetes
Chronic hyperglycaemia can damage blood vessels and nerves, leading to various complications.
Managing Other Risk Factors: Controlling blood pressure, cholesterol levels, and maintaining a healthy weight are essential to reduce cardiovascular risks.
Prevention
While some types of diabetes (type 1, monogenic) are not preventable, lifestyle modifications can help reduce the risk of developing type 2 and gestational diabetes.
Preventive measures include:
Maintaining a healthy weight
Regular physical activity
Healthy diet
Stress management
Limiting alcohol intake
Adequate sleep
Smoking cessation
Prognosis
The outlook for individuals with diabetes depends on various factors, including diabetes type, management effectiveness, age of diagnosis, and the presence of complications.
Early diagnosis, effective management, and lifestyle modifications can significantly improve the quality of life and reduce the risk of complications.
Consistent blood sugar control is crucial for a better prognosis.
Conclusion
Diabetes is a complex metabolic disorder with various types and potential complications.
Understanding the different types, their causes, and management strategies is crucial for healthcare professionals, especially pharmacists, who play a vital role in patient education and medication management.
Effective management and lifestyle modifications can significantly improve the quality of life and long-term health outcomes for individuals with diabetes.
