Diabetes

Diabetes is a chronic metabolic disorder caused by a lack of insulin, reduced response to insulin by the body, or both, leading to elevated blood sugar levels.

Insulin is a hormone secreted by the pancreas that regulates blood sugar levels. Normally, after eating, blood glucose levels increase, and the pancreas releases insulin to stabilize blood sugar. When the pancreas produces insufficient insulin or the insulin cannot effectively function, blood glucose levels rise, resulting in diabetes.

The following people have a higher risk of developing diabetes:

• Family history of diabetes, especially immediate relatives
• Hypertension (high blood pressure) and high cholesterol levels
• Adults aged over 45
• Unhealthy lifestyle habits and lack of physical activity
• Overweight or obese, with a BMI exceeding 23

Diabetes is mainly classified into three types based on its causes and symptoms:

Type 1 Diabetes (Insulin-Dependent Diabetes)

An autoimmune disorder where the immune system mistakenly attacks the insulin-producing cells in the pancreas, destroying the cells responsible for insulin production. As a result, the pancreas cannot produce insulin. Causes are related to genetics, autoimmune responses, or environmental factors.

Type 2 Diabetes (Non-Insulin-Dependent Diabetes)

The most common form of diabetes. The body’s insulin secretion is normal or relatively reduced, or the body develops resistance to insulin, preventing insulin from effectively lowering blood glucose. Causes include genetics, unhealthy dietary habits, obesity, or lack of physical activity. Both Type 1 and Type 2 diabetes can occur simultaneously in some cases.

Gestational Diabetes

Can be divided into two categories:
Women who have pre-existing diabetes or are in a pre-diabetic state before pregnancy and are diagnosed during pregnancy. Temporary high blood sugar levels caused by hormonal and physiological changes during pregnancy.

Usually no obvious signs in prediabetes; patients may not notice any symptoms.

As the condition progresses, diabetics may experience:

• Increased thirst
• Frequent urination
• Fatigue
• Increased appetite
• Weight loss
• Retinal vascular changes leading to blurred vision
• Numbness, tingling, or weakness in the feet
• Slow-healing wounds and recurrent or persistent infections

Acute complications:

Self-Check for Diabetes

The RUBY (Risk Understanding By Yourself) diabetes risk calculator, developed by the Asian Diabetes Foundation, is tailored for Hong Kong and Asian populations. Created based on local Chinese data by The Chinese University of Hong Kong, it uses a simple questionnaire considering factors like age, weight, and family history to generate a personalized risk report. By answering a few questions, you can assess your risk of developing diabetes and its complications, enabling early intervention and better disease management.

Click here for more:
https://rubyapp.adf.org.hk/

Diabetes Clinic Tests

Diabetes diagnosis is primarily based on blood tests conducted during medical examinations. Key tests include:

• Fasting Blood Glucose
• HbA1c (glycated hemoglobin)
• Insulin Resistance Indicators (HOMA-IR)
• Oral Glucose Tolerance Test (OGTT)

According to the American Diabetes Association standards, a fasting glucose level below 100 mg/dl and HbA1c below 5.7% are normal. Pre-diabetes is indicated by fasting glucose of 100-125 mg/dl or HbA1c of 5.7-6.4%. Diabetes is diagnosed if fasting glucose reaches 126 mg/dl or higher, or HbA1c is 6.5% or above. These tests help confirm the diagnosis and guide treatment planning.

Diabetes treatment includes medications that can be oral or injectable.

Oral Drugs

• Biguanides (like Metformin)
• Sulfonylureas
• Meglitinides
• Thiazolidinediones
• α-glucosidase inhibitor
• DPP-4 inhibitors
• SGLT-2 inhibitors

Injectable Options

Injectable options include non-insulin agents such as GLP-1 receptor agonists, which mimic natural gut hormones to increase insulin secretion and suppress glucagon.

Insulin injections, essential for type 1 diabetes and sometimes used in type 2 diabetes during specific conditions. Insulin types vary from rapid-acting to long-acting formulations. Patients must follow their doctor’s prescription carefully, and avoid altering dosages without medical advice to ensure safety and effectiveness.