Diabeti

Diabeti refers to a family of chronic conditions characterized by elevated blood glucose (sugar). The most common forms are type 1 diabetes, type 2 diabetes, and gestational diabetes that occurs during pregnancy. Other specific types arise from rare diseases, medications, or genetic disorders.

Pathophysiology: Type 1 is an autoimmune destruction of insulin-producing beta cells, leading to insulin deficiency. Type 2 involves insulin resistance and progressive beta-cell dysfunction. Gestational diabetes is due to increased insulin resistance during pregnancy.

Signs and symptoms: Polyuria, polydipsia, unexplained weight loss, fatigue, blurred vision, and slow-healing wounds. Some people, especially with type 2 or gestational diabetes, may not have noticeable symptoms initially.

Diagnosis: Diagnosis uses blood tests, including fasting plasma glucose, HbA1c, oral glucose tolerance test, or random plasma glucose with symptoms. Typical thresholds include fasting glucose ≥126 mg/dL, HbA1c ≥6.5%, 2-hour plasma glucose ≥200 mg/dL, or random glucose ≥200 mg/dL with symptoms.

Management: Management aims to keep blood glucose as close to normal as possible while preventing complications. It includes lifestyle changes (diet and physical activity), self-monitoring of glucose, and medications. Type 1 requires insulin therapy. Type 2 may involve metformin and other oral agents, non-insulin injectables, and sometimes insulin. Gestational diabetes is managed to maintain maternal and fetal safety.

Complications: Chronic hyperglycemia can damage the eyes, kidneys, nerves, heart, and blood vessels. Acute conditions include diabetic ketoacidosis and hyperosmolar hyperglycemic state, requiring urgent care.

Prevention and public health: Prevention focuses on reducing risk factors for type 2 through weight management, activity, and a healthy diet. Type 1 cannot currently be prevented. Early detection and regular screening help minimize complications.