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Is diabetes a chronic disease?

susantaylor

August 19, 2024

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New Scientific Breakthrough Offers Hope for Better Diabetes Control

Introduction

Chronic disorders, characterized as enduring health conditions resistant to a complete cure and possibly worsening over time, often stem from prolonged exposure to unhealthy behaviors and adverse environmental conditions. Contributory lifestyle factors such as poor dietary habits, obesity, and smoking further exacerbate the onset of chronic disorders. Notable examples encompass cancer, heart disease, stroke, diabetes, arthritis, Alzheimer’s disease, asthma, and COPD. Chronic diseases rank as the principal causes of mortality and disability in the United States, affecting an estimated 129 million individuals.

Diabetes is a chronic ailment stemming from insufficient insulin production by the pancreas or ineffective utilization of the insulin produced within the body. Insulin regulates blood glucose levels. Prolonged elevation of blood glucose, also termed hyperglycemia, associated with uncontrolled diabetes has severe detrimental impacts on various bodily systems, particularly the nerves and vasculature.

Epidemiology

In 2014, 8.5% of individuals aged 18 years and older were afflicted with diabetes. The year 2019 witnessed diabetes accounting directly for 1.5 million fatalities, with 48% of these deaths occurring before the age of 70. Diabetes also precipitated roughly 460,000 deaths attributable to kidney disease, while approximately 20% of cardiovascular deaths can be attributed to heightened blood glucose levels. Between 2000 and 2019, a 3% escalation in age-standardized mortality rates arising from diabetes was observed. Lower-middle-income countries, in particular, experienced a 13% surge in the mortality rate attributed to diabetes. In striking contrast, there was a global 22% reduction in the probability of succumbing to any one of the four primary noncommunicable diseases (namely, cardiovascular diseases, cancer, chronic respiratory diseases, or diabetes) between the ages of 30 and 70, witnessed between 2000 and 2019.

Types

Diabetes can have varying causes depending on the type, but regardless of the type, it results in an excess of sugar in the blood, which can lead to serious health issues. Chronic diabetes includes type 1 and type 2, while potentially reversible conditions include prediabetes and gestational diabetes. Prediabetes occurs when blood sugar levels are higher than normal but not high enough to be classified as diabetes, potentially leading to diabetes if not addressed. Gestational diabetes develops during pregnancy but may resolve after childbirth.

Type 1 diabetes, previously referred to as insulin-dependent, juvenile, or childhood-onset diabetes, is characterized by inadequate insulin production, necessitating daily insulin administration. The global prevalence of type 1 diabetes was marked at 9 million in 2017, with the majority of cases reported in high-income countries. The etiology of this condition remains elusive, and preventive measures have not been established.

In contrast, Type 2 diabetes affects the body’s utilization of glucose for energy, disrupting insulin function and potentially leading to elevated blood sugar levels if left unmanaged. Over time, Type 2 diabetes can adversely impact the body, particularly the nerves and blood vessels. Preventive measures can be effective as several factors, including obesity, a sedentary lifestyle, and genetic predisposition, contribute to the development of Type 2 diabetes.

Early detection plays a pivotal role in mitigating the adverse effects of Type 2 diabetes. Routine medical assessments and blood tests are instrumental in identifying this condition in its nascent stage. Symptoms of Type 2 diabetes may manifest insidiously and often resemble those of Type 1 diabetes, albeit with less pronounced attributes. Consequently, delayed diagnosis may precipitate the onset of complications.

Furthermore, gestational diabetes, characterized by hyperglycemia during pregnancy, entails increased risks for maternal and fetal complications during and post-pregnancy. Additionally, individuals affected by gestational diabetes, as well as their offspring, face an elevated susceptibility to Type 2 diabetes in the future.

Notably, impaired glucose tolerance (IGT) and impaired fasting glycemia (IFG) represent intermediate conditions between normoglycemia and diabetes. Individuals with IGT or IFG are predisposed to progressing to Type 2 diabetes, although this progression is not inexorable.

Various other forms of diabetes have been identified, such as Type 3c, LADA, MODY, neonatal diabetes, and brittle diabetes. Type 3c diabetes results from non-autoimmune damage to the pancreas, often due to conditions such as pancreatitis, pancreatic cancer, cystic fibrosis, or hemochromatosis. LADA, similar to Type 1 diabetes, develops gradually and typically occurs in individuals over 30 years of age. MODY, also known as monogenic diabetes, stems from inherited genetic mutations impacting insulin production and utilization, affecting up to 5% of people with diabetes and frequently manifesting within families. Neonatal diabetes, a rare condition, presents within the first six months of life and may either persist as permanent neonatal diabetes mellitus or be transient. Brittle diabetes, a subtype of Type 1 diabetes, is characterized by frequent and severe fluctuations in blood sugar levels, often necessitating hospitalization, with pancreatic transplantation as a potential treatment in extreme cases.

Management and prevention

Managing diabetes encompasses a multitude of strategies uniquely tailored to each individual. Key components of management include blood sugar monitoring, oral diabetes medications, insulin, dietary considerations, and physical activity. Moreover, it is crucial to maintain healthy weight, blood pressure, and cholesterol levels due to the heightened risk of heart disease associated with diabetes.

While autoimmune and genetic forms of diabetes are not preventable, measures can be taken to mitigate the risk of developing prediabetes, Type 2 diabetes, and gestational diabetes. These measures encompass adherence to a healthy diet, regular physical exercise, weight management, stress control, limited alcohol consumption, sufficient sleep, smoking cessation, and adherence to prescribed medications for managing existing risk factors for heart disease.

The prognosis for diabetes varies based on several determinants, including the type of diabetes, long-term management, age at diagnosis, comorbidities, and the emergence of complications. Prolonged hyperglycemia can result in severe, often irreversible complications, adversely impacting longevity and quality of life. However, it is feasible to lead a healthy life with diabetes through lifestyle modifications, regular physical activity, dietary adjustments, and vigilant blood sugar monitoring.

Individuals experiencing symptoms indicative of diabetes should promptly seek medical evaluation for diagnosis. For those diagnosed with diabetes, routine consultations with healthcare providers, such as endocrinologists, are imperative for proactive management.