Diabetes is a chronic disease that arises either when the pancreas does not produce sufficient insulin or when the body cannot efficiently use the insulin it produces. Insulin is a hormone that controls the amount of blood sugar. Hyperglycaemia, or raised blood sugar, is a common consequence of unrestrained diabetes and over time leads to grave damage to many of the body’s structures, especially the nerves and blood vessels.

In 2014, 8.5% of adults aged 18 years and older were diagnosed with diabetes. In 2016, diabetes was the straight cause of 1.6 million deaths and in 2012 high amounts of blood glucose was the source of additional 2.2 million deaths.

Between 2000 and 2016, there was a 5% upsurge in premature mortality from diabetes. In high-income nations the premature mortality rate due to diabetes reduced from 2000 to 2010 but then augmented in 2010-2016. In lower-middle-income countries, the premature mortality frequency due to diabetes amplified across both time periods.

By distinction, the likelihood of dying from any one of the four main non-communicable diseases (cardiovascular diseases, cancer, chronic respiratory diseases or diabetes) between the ages of 30 and 70 declined by 18% worldwide between 2000 and 2016.

Type 2 diabetes

Type 2 diabetes (previously called non-insulin-dependent, or adult-onset) results from the body’s ineffectual use of insulin. The majority of people suffering with diabetes have type 2 diabetes. This type of diabetes is principally the consequence of extra body weight and physical dormancy.

Indicators may be similar to those of type 1 diabetes, but are often less noticeable. As a result, the disease may be identified several years after onset, after difficulties have already arisen.

Lately, this type of diabetes was evident only in adults but it is now also arising progressively repeatedly in children.

Type 1 diabetes

Type 1 diabetes (earlier known as insulin-dependent, juvenile or childhood-onset) is described by deficient insulin production and needs day-to-day administration of insulin. Neither the reason of Type 1 diabetes nor the methods to avert it are known.

Indications include extreme excretion of urine (polyuria), thirst (polydipsia), persistent hunger, weight loss, vision changes, and fatigue. These symptoms may occur unexpectedly.

Gestational diabetes

Gestational diabetes is hyperglycaemia with blood glucose values above standard but below those indicative of diabetes. Gestational diabetes generally occurs during pregnancy.

Women with gestational diabetes are at an augmented peril of difficulties during pregnancy and at delivery. These women and feasibly their children are also at amplified danger of type 2 diabetes in the future.

Gestational diabetes is identified through prenatal screening, rather than through conveyed symptoms.

Impaired glucose tolerance and impaired fasting glycaemia

Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) are transitional circumstances in the shift between normality and diabetes. People with IGT or IFG are at a higher threat of progressing to type 2 diabetes, although this is not unavoidable.

Health impact

Over time, diabetes can harm the heart, blood vessels, eyes, kidneys, and nerves.

  • Adults with diabetes have a two- to three-fold bigger risk of heart attacks and strokes.
  • Pooled with decreased blood flow, neuropathy (nerve damage) in the feet intensifies the probability of foot ulcers, infection and subsequent need for limb amputation.
  • Diabetic retinopathy is a significant root of blindness, and happens as a result of long-term accrued damage to the small blood vessels in the retina. Diabetes is the basis of 2.6% of global blindness.
  • Diabetes is among the foremost sources of kidney failure.

Prevention

Modest routine measures have been shown to be efficient in averting or suspending the onset of type 2 diabetes. To help prevent type 2 diabetes and its difficulties, people should:

  • Accomplish and preserve a healthy body weight;
  • Be substantially active – doing at least 30 minutes of steady, moderate-intensity movement on most days. More movement is required for weight control;
  • Maintain a healthy diet, evading sugar and saturated fats; and
  • Avoid tobacco use – smoking escalates the risk of diabetes and cardiovascular disease.

Diagnosis and treatment

Initial diagnosis can be achieved through comparatively economical testing of blood sugar.

Management of diabetes includes diet and physical activity along with reduction of blood glucose and the intensities of other known hazards that harm blood vessels. Tobacco use termination is also significant to avoid impediments.

Mediations that are both cost-saving and practicable in low- and middle-income countries comprise:

  • Blood glucose control, chiefly in type 1 diabetes. People with type 1 diabetes need insulin, people with type 2 diabetes can be treated with oral medication, but may also require insulin;
  • Blood pressure regulation; and
  • Foot care (patient self-care by upholding foot hygiene; wearing suitable footwear; seeking specialized care for ulcer management; and regular inspection of feet by health experts).

Other cost saving interventions include:

  • Screening and management for retinopathy (which causes blindness);
  • Blood lipid control (to control cholesterol levels);
  • Screening for early signs of diabetes-related kidney disease and management.

Key facts

  • The number of people with diabetes spiked from 108 million in 1980 to 422 million in 2014.
  • The global occurrence of diabetes among adults over 18 years of age rose from 4.7% in 1980 to 8.5% in 2014.
  • Between 2000 and 2016, there was a 5% upsurge in premature mortality from diabetes.
  • Diabetes occurrence has been increasing more quickly in low- and middle-income nations than in high-income countries.
  • Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.
  • In 2016, an appraised 1.6 million deaths were directly caused by diabetes. Another 2.2 million deaths were associated to high blood glucose in 2012.
  • Almost half of all deaths associated to high blood glucose happen before the age of 70 years. WHO evaluates that diabetes was the seventh prominent cause of death in 2016.
  • A healthy diet, steady physical activity, maintaining a normal body weight and evading tobacco use are meant to avert or delay the inception of type 2 diabetes.

Diabetes can be treated and its impacts avoided or hindered with diet, physical activity, medication and regular screening and treatment for complications.