Diabetology is a field of medicine that is dedicated towards the study, diagnosis, treatment, follow up and management of diabetes in patients. India has almost 77 million diabetic people in total, which gives it the second rank in world diabetes profile. It is estimated that every one in six people in India are currently suffering from diabetes.
Diabetes is a disease in which the blood glucose (or sugar) levels spike too high and can not be controlled by the body due to malfunctioning in either the insulin production or function. The three biggest symptoms associated with diabetes are polydipsia, polyuria and polyphagia, i.e. the patient is always feeling thirsty and pees and eats a lot in diabetes. Some of the most common symptoms of diabetes are Increased thirst, Frequent urination, Extreme hunger, Unexplained weight loss, Presence of ketones or sugar in the urine, Fatigue, Irritability, Blurred vision, Slow-healing sores and Frequent infections, especially gums or skin infections and vaginal infections.
There are two main types of diabetes- Type 2 diabetes occurs due to the inability of the body to process blood glucose due to an inability to form insulin, while Type 1 diabetes occurs when the insulin produced has little to no effect on the blood glucose.
Diabetes diagnosis can be done by the following tests:
- Fasting Plasma Glucose Test (FPGT): the test is done early in the morning before the patient has eaten anything to measure the patient’s blood glucose naturally. If the value on the test is more than 126 mg/dL then the patient is reported to be diabetic.
- Oral Glucose Tolerance Test (OGTT): this test is more difficult to administer but is much more sensitive to blood glucose than FPGT. The patient is required to fast for 8 hours, after which he is made to drink 75g glucose in water. 2 hours after this, his blood glucose level is measured. If the blood glucose level is more than 200mg/dL then the patient is considered to be diabetic.
- Random Plasma Glucose Test (RPGT): RPGT is done as a primary test when the patient is exhibiting signs of diabetes such as increased urination, increased thirst and unexplained weight loss. A value of over 200mg/dL is considered to be diabetic on RPGT.
- Hemoglobin A1C Test: this is a detailed test which tells the average blood hemoglobin levels over the past 2-3 months. This test tells the patient if they are taking the right insulin dose.
- Monitoring the Blood Sugar- Blood glucose levels have to be monitored regularly using daily blood glucose meters and HbA1C tests every few months. This helps the diabetologist to adjust the patient’s insulin dose according to their needs. Any fluctuation in the blood glucose should be recorded and mapped to find out the exact cause of diabetes and the best way to manage it.
- Insulin Dosage- Insulin therapy is a must for all type 2 patients and most type 1 patients. Depending on their needs, a doctor can prescribe different kinds of insulin such as short-acting (regular insulin), rapid-acting insulin, long-acting insulin and intermediate acting insulin to the patients.Insulin delivery can be done via insulin pen, insulin pump or an artificial implant in the pancreas.
- Oral or other medications- Sometimes other medicines can be prescribed to either stimulate the insulin production in the pancreas or inhibit the production and release of glucose from the liver. Medicines such as Metformin block the digestive enzymes and make the stomach glucose more sensitive to insulin while SGLT2 inhibitors prevent kidneys from reabsorbing sugars from the blood.
- Transplantation- Although very risky, in patients with extreme diabetes, a pancreas transplant is considered to be the last option of treatment. There are very low chances of success but in patients allergic to artificial insulin or where insulin is not effective, pancreas transplant is the last viable treatment option left.
- Bariatric Surgery- Type 2 Diabetic people who are obese and have a BMI higher than 35 can benefit from having gastric bypass surgery.
- Follow up and Management
Follow up of patients with diabetes is very important as the level of insulin dosage has to be altered every time the blood glucose level alters. Management of diabetes is a lifelong endeavour as it never completely goes away but can only be managed.
Risks factors for Diabetes
Some of the most common health risks factors for diabetes are:-
- Family history, environmental factors and presence of autoantibodies for Type 1 Diabetes
- Weight, inactivity, family history, race or ethnicity, age, gestational diabetes, polycystic ovary syndrome, high blood pressure, abnormal cholesterol and triglyceride levels for Type 2 Diabetes.
Complications associated with Diabetes
Some of the common complications associated with Diabetes are:-
- Cardiovascular disease- Diabetes can cause cardiovascular diseases such as chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis).
- Nerve damage (or neuropathy)- Diabetes thins the walls of blood vessels, especially in the legs, leading to tingling, numbness, burning and pain. If the condition is left untreated, it can lead to serious conditions such as erectile dysfunction.
- Kidney damage (nephropathy)- Diabetes can damage glomeruli in the kidneys which can ultimately lead to kidney failure or irreversible end-stage kidney disease.
- Eye damage (retinopathy)- Diabetes can damage blood vessels in the eyes, which can potentially lead to blindness, cataracts and glaucoma.
- Foot damage- Nerve damage in the lower limbs can cause serious infections which can ultimately require the amputation of the whole or part of a leg.
- Skin infections, hearing impairment, Alzheimer’s disease and Depression
Why come to Neelkanth?
Neelkanth Hospital has, in its employ, several highly expert and experienced diabetologists in order to help patients deal with diabetes or a complication of the disease. Recognizing the fact that diabetes can affect so many other organs of the body, Neelkanth Hospital has decided to approach the disease in a bi-pronged manner.
On the one hand, the hospital has been intent on providing world class treatment to all diabetic patients coming to the hospital. They expertly manage all its symptoms and the various complications associated with it.
On the other hand, the hospital has organized several diabetes awareness programs to spread awareness regarding the disease, especially in rural areas, where people can have stigma towards the disease and are apprehensive to come forward with it.
Treatment done: Orthopedics
My experience was very good in every service offered by the hospital, specially services in comparison of other hospitals. Very good Infrastructure & Staff is very cooperative with patients & their family members.
Treatment done: Gynaecology
We are grateful for all you did to make our dream become a reality! We thank you for going the extra mile to coordinate everything.
Treatment done: Urology
We want to thank you again for everything you did for us through this journey - your caring and kindness, your professionalism and support.
Neha Singh Bhati
Treatment done: Gynaecology
I would like to express my deepest appreciation to Dr. Bindu Garg and his team for creating a pleasant and friendly atmosphere for their patients. And, I would like to encourage those women who are stressed by their inabililty to have a baby.