Diabetes is actually a disorder of metabolism. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Insulin is a hormone produced by the pancreas, a large gland behind the stomach. Insulin is needed for glucose to get into cells. The pancreas of people with diabetes type 1 produces little or no insulin. In the case of diabetes type 2, the cells are resistant to insulin produced in the body. Even though the blood contains large amounts of glucose (condition called chronic hyperglycemia), the body cannot use it for energy production. The chronic hyperglycemia is associated with long term tissue damage, especially the blood vessels, nerves, heart, kidneys and eyes.

Diabetes type 1 is autoimmune disease, where pancreatic beta cells responsible for insulin production are selectively destructed by an autoimmune process. It could be in children with a more rapid onset (classic) or adults with a slower onset – LADA, ‘late autoimmune diabetes of adults’.

Type 2 diabetes is more common in older people, especially in people who are overweight. This form of diabetes is also associated with older age, family history of diabetes, previous history of gestational diabetes, physical inactivity, and certain ethnicities.

Symptoms of type 1 diabetes usually develop over a short period. Symptoms may include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue.

The symptoms of type 2 diabetes develop gradually and not sudden as in type 1 diabetes. Symptoms may include fatigue, frequent urination, increased thirst and hunger, weight loss, blurred vision, and slow healing of wounds or sores. Some people have no symptoms.

A diagnosis of diabetes can be made based on any of the following test results, confirmed by retesting on a different day:

• A blood glucose level of 126 milligrams per deciliter (mg/dL) or more after an 8-hour fast. This test is called the fasting blood glucose test.
• A blood glucose level of 200 mg/dL or more 2 hours after drinking a beverage containing 75 grams of glucose dissolved in water. This test is called the oral glucose tolerance test (OGTT).
• A random (taken at any time of day) blood glucose level of 200 mg/dL or more, along with the presence of diabetes symptoms.

A person who has type 1 diabetes must take insulin daily to live. Patients with type 2 diabetes are treated with oral hypoglycemic agents.

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