DR.V. MOHAN, M.D., FRCP (London, Edinburgh, Glasgow & Ireland), Ph.D., D.Sc.
D.Sc (Hon. Causa), FNASc, FASc, FNA, FACE, FACP, FTWAS, MACP
(Awarded Padma Shri by Govt. of India)
Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood sugar levels either due to defective insulin secretion or action or both. There are two major types of diabetes, type 1 and type 2 diabetes. Type 1 diabetes usually develops in children or young adults and in this type the body completely stops producing insulin, the hormone that enables the body to use glucose found in food into energy. In Type 2 diabetes the main deficiency is insulin resistance, which means that the available insulin does not work properly.
Symptoms of diabetes
Being very thirsty
Having to go to the bathroom very frequently to urinate
Tingling or numbness in the hands or feet
Frequent skin, bladder or gum infections
Wounds that don't heal
Itching in the genital areas
Extreme unexplained fatigue
Remember that up to 50% of patients with diabetes may not have any symptoms at all !. Hence it is important for everyone above 30 years to be checked up to rule out diabetes at least once a year.
Diagnosis of diabetes
Diabetes should be ideally diagnosed after an oral glucose tolerance test (GTT) as this helps to pick up early stages of the disease. This test involves testing of fasting plasma glucose (FPG) and two-hour plasma glucose (2hr PG) after intake of 75 gms of glucose dissolved in water. The diagnostic cut off for diabetes and the two “pre-diabetic stages” namely Impaired Fasting Glucose (IFG) or Impaired Glucose Tolerance (IGT) are given in the table below.
Those who have pre-diabetes ie., IFG or IGT are at increased risk of developing diabetes. Such individuals must undergo a GTT at least once a year and should follow a proper diet and exercise program and if overweight, reduce weight in order to prevent diabetes. Our studies have shown that it is possible to prevent diabetes in 35% of those with prediabetes by lifestyle modification.
Diabetes can also be diagnosed, if a random or casual plasma glucose is greater than 200 mg/dl or more on more than two occasions in the presence of symptoms of diabetes, or if the glycosylated hemoglobin (HbA1c) is > 6.5%.
Early detection is the key for prevention and effective control of diabetes. As diabetes is largely asymptomatic, regular screening for diabetes is of utmost importance. One should not wait for symptoms like thirst, excess urination and weight loss as they are late symptoms. All those who have a family history of diabetes or an overweight or obese should undergo a preventive diabetic checkup at least after 30 years of age.
(Dr.V. Mohan is the Chairman & Chief of Diabetology, of Dr. Mohan’s Diabetes Specialities Centre & Madras Diabetes Research Foundation, Chennai, India Email : , Websites : & Youtube:)