Diabetes and metabolic diseases
Diabetes and metabolic diseases Metabolism is a general term to describe the processes occurring within a living cell or organism and which are necessary for the maintenance of life. One critical aspect
of metabolism involves the breaking down of food to its simpler components: proteins, carbohydrates, and fats. These products are then used as a source of energy or as building blocks for growth. Metabolic disorders occur when these normal processes become disrupted. Disorders in metabolism can be inherited, in which case they are also known as inborn errors of metabolism, or they may be acquired during lifetime.
Diabetes is one of the most common metabolic disorders. It is most often defined as a condition when a person’s ability to metabolize carbohydrates is impaired. All carbohydrates suchas sugar or starch are broken down by the digestive system to form a sugar called glucose, a key source of energy in most living organisms. When glucose stays in the blood stream and does not get burned inside the muscles and tissues, it results in high blood sugar levels that are potentially damaging to a range of different tissue. A person with a sugar level of above 150 mg/dl in the blood in the morning – and a level of long-term blood sugar (HbA1c) above 6.5% – is diagnosed as ‘diabetic’. Insulin, a hormone which is secreted by beta cells in the pancreas, facilitates the transport of sugar into all cells to be used as basic fuel. So, in a diabetes patient, often either no insulin or inadequate amounts of insulin are being produced, or the body’s cells have become insensitive to the insulin produced.
When sugar builds up in the blood instead of going into cells, it can lead to severe micro-vascular complications (e.g. retinopathy; nephropathy or peripheral limb amputations) and macro-vascular complications (e.g. heart disease or stroke).
What is HbA1c?
HbA1c (hemoglobin A1c) is a measure to identify average three months blood glucose concentration and thus is important in diabetes care. The red blood cells are made of hemoglobin molecules, and when glucose sticks to the red blood cells, glycosylated hemoglobin molecules, also know as HbA1c, are formed. The more glucose in the blood, the more hemoglobin A1c or HbA1c will be present.
Red blood cells live on average 8-12 weeks, so measuring HbA1c tells the average blood glucose level over 3 months.
Diagnosing diabetes based on HbA1c levels:
HbA1c > 6.5% = diabetic
HbA1c < 6.0% = not diabetic
6.0% < HbA1c < 6.5% = ‘pre-diabetic’ or ‘at risk of diabetes’
Type 1 and Type 2 diabetes
The two most common forms of diabetes are referred to as Type 1 and Type 2 diabetes, respectively. Type 1 diabetes is when the body cannot produce insulin, patients with Type I diabetes cannot survive without daily insulin administered by injection.
Type 1 diabetes is a chronic disease and often the result of an autoimmune process, by which the body with no known cause produces antibodies to kill its own beta cells. In most cases, Type 1 diabetes is inherited and diagnosed in childhood or adolescence. About 5-7% of those with diabetes are of Type 1.
In Type 2 diabetes, the body either produces insufficient amounts of insulin or, the body is unable to respond efficiently to the insulin produced (this is called insulin resistance) – or both. Type 2 diabetes is acquired mainly as a result of a sub-optimal life style, including a highcalorie processed food diet, a low level of physical activity, and obesity. According to different sources, approximately 90% of diabetic cases are of Type 2. Gestational diabetes occurs in women during pregnancy and disappears following delivery. This type of diabetes accounts for less than 5% of diabetic cases.