What is Diabetes?

First of all, diabetes mellitus, often just called ‘diabetes’, is a chronic, metabolic disease, which means that it is a long-lasting disease that affects the way food is digested inside the body. As food is processed into small molecules that can be used as a source of energy by the body’s cells, carbohydrates mainly turn into glucose, which is released into the bloodstream.

The amount of sugar in the blood, called the glycemia, is regulated by insulin, a hormone produced by the pancreas, an abdominal organ. To put it simply, insulin acts like a key that makes blood sugar enter the body’s cells, hence lowering blood sugar. This effect is said to be hypoglycemic.

In case of diabetes, either insulin production is insufficient, or your body is unable to use the insulin it makes as well as it should, a phenomenon called insulin resistance. In either case, there is an excess of sugar in your bloodstream that can cause serious harm.¹

How is diabetes diagnosed?

Diagnosis relies on blood sugar tests, sometimes in different situations: when fasting, before and after drinking a glucose-containing liquid, the HbA1c test measuring your average blood sugar over the past 2 to 3 months, or a random blood sugar test. In case of diabetes types other than type 2, other tests are required.²

How can type 2 diabetes be diagnosed?

There are several ways to diagnose diabetes. Each way usually needs to be repeated on a second day to diagnose diabetes. Testing should be carried out in a health care setting (such as your doctor’s office or a lab). If your doctor determines that your blood glucose level is very high or if you have classic symptoms of high blood glucose in addition to one positive test, your doctor may not require a second test to diagnose diabetes. Here are the three common ways of diagnosing diabetes:

• HbA1C : The HbA1C test measures your average blood glucose for the past 2 to 3 months. The advantages of being diagnosed this way are that you don’t have to fast or drink anything. Diabetes is diagnosed at an HbA1C ≥6.5%
• Fasting plasma glucose (FPG) : This test checks your fasting blood glucose levels. Fasting means after not having anything to eat or drink (except water) for at least 8 hours before the test. This test is usually done first thing in the morning, before breakfast. Diabetes is diagnosed at a fasting blood glucose ≥126 mg/dL
• Oral glucose tolerance test (OGTT) : The OGTT is a 2-hour test that checks your blood glucose levels before and 2 hours after you drink a special sweet drink. It tells the doctor how your body processes glucose. Diabetes is diagnosed at a 2-hour blood glucose ≥200 mg/dL

I have heard that there are different kinds of diabetes. Is this true?

Indeed, though we should rather say that there are different types of diabetes. The most common form is known as type 2 diabetes: about 90% of diabetes cases belong to type 2. It usually occurs in adults, when resistance to insulin develops, or when the production of insulin becomes insufficient. For years, symptoms can go unnoticed, hence the necessity of blood sugar tests in at-risk people, especially when considering that type 2 diabetes can be delayed, or even prevented thanks to healthy lifestyle measures.^3,4

Type 1 diabetes, once called juvenile diabetes (or insulin-dependent diabetes) occurs when the pancreas produces no insulin, or very little. It is thought to be due to an autoimmune reaction (the immune system attacks the body by mistake), and it roughly affects 5% of diabetes patients. Unlike type 2 diabetes, most cases develop quickly and are diagnosed in children, teenagers or young adults, but it can develop at any age. Type 1 diabetes cannot be prevented, and it requires taking insulin every day to survive.^3,5

Other types of diabetes exist, but on this website, the main focus is on type 2 diabetes. For any further questions about diabetes and its other forms, please check with your physician.

Why get checked ?

Diabetes and cardiovascular disease

A close link exists between diabetes and cardiovascular disease (CVD), which is the most prevalent cause of morbidity and mortality in diabetic patients. Cardiovascular (CV) risk factors such as obesity, hypertension and dyslipidemia are common in patients with diabetes, placing them at increased risk for cardiac events. Therefore, targeting CV risk factors in patients with diabetes is critical to minimize the long-term CV complications of the disease.¹²

Are there any risk factors for type 2 diabetes, and am I at risk?

In type 2 diabetes, risk factors are rather well-known. The strongest ones are excess body fat, and overweight and obesity. A higher waist circumference and body mass index have been identified as risk factors too, while dietary habits are also involved (high intake of saturated fats, sweetened beverages, lack of fiber, bad dietary habits during childhood…).

Smoking is also an important risk factor, even 10 years after smoking cessation, but a lot of other criteria can play a role: ethnicity, a family history of diabetes, previous gestational diabetes in women, or older age for men and women alike…¹¹

Are there any complications to diabetes?

Yes, and they are quite serious. When diabetes is poorly managed, health-threatening complications can develop. Acute complications such as a coma can occur when blood glucose gets abnormally high, or seizures or loss of consciousness when it gets abnormally low (after too high a dose of anti-diabetic medication, for instance).

Meanwhile, over time diabetes can harm the heart, blood vessels, eyes, kidneys, and nerves. It can also increase the risk of stroke and heart disease. The combination of a reduced blood flow and nerve damage can result in foot ulcers and infection, finally leading to amputation. In the eye, damage to the retina can cause blindness. It is also one of the leading causes of kidney failure.¹¹

“Symptoms of diabetes”

I have heard that there are a variety of different symptoms of diabetes. Is this true?

Yes, there are a multitude of symptoms that can alert you.

Symptoms include :

• Excessive urination both in terms of quantity and frequency, a condition known as polyuria
• Excessive and constant thirst, known as polydipsia
• Constant hunger (or polyphagia)
• Weight loss
• Blurry vision
• Fatigue

Patients might also have numbness or tingling hands or feet, have dry skin, sores that heal slowly, and they might become prone to infections.^11,13,14

Between type 2 and type 1 diabetes, symptoms may be similar, but they are often more subdued, or even absent, in type 2 patients. As a consequence, type 2 diabetes may go unnoticed for years, with its diagnosis occurring once complications have arisen.^11,13

• Pair it up : You always remember to brush your teeth! Get into the habit of taking your pills straight after and you’ll rarely forget them again.*
• Set an alarm on your phone to remind you when to take your medication.
• Use a pill box, It’s a great way to make sure you take the right medication on the right day.