What Is Diabetes (Diabetes Mellitus)?
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Overview
Diabetes mellitus—often called diabetes or “high blood sugar”—is a chronic metabolic condition in which the body cannot make enough insulin or cannot use insulin effectively. Insulin is a hormone made by the pancreas that moves glucose (sugar) from the bloodstream into cells to be used for energy. When insulin is insufficient or ineffective, blood glucose rises, which over time can damage blood vessels and organs.
At MedicalPoint Hospital, our Endocrinology, Nutrition & Dietetics, and Diabetes Education teams deliver evidence-based care—from early diagnosis to advanced therapies—tailored to each person’s needs.
Types of Diabetes
- Type 1 diabetes
An autoimmune condition in which the immune system destroys pancreatic beta cells that produce insulin. It typically starts in childhood or adolescence but can occur at any age. Lifelong insulin therapy is required. Blood sugar may fluctuate quickly, so regular monitoring is essential. - Type 2 diabetes
The most common form. The body makes insulin but does not use it effectively (insulin resistance), and insulin production may decline over time. It is seen in adults and increasingly in younger people. Risk is higher with excess weight, sedentary lifestyle, family history, gestational diabetes, or certain ethnic backgrounds. Treatment starts with lifestyle changes, often followed by oral medicines and sometimes injectables or insulin. - Gestational diabetes (GDM)
High blood glucose first recognized during pregnancy. It increases the risk of complications for mother and baby and raises the mother’s future risk of type 2 diabetes. Specialized obstetric and endocrine care is required.
Common Symptoms
Symptoms can be similar in type 1 and type 2 diabetes, but type 1 often develops rapidly and type 2 more gradually. Not everyone has symptoms.
- Frequent urination and excessive thirst
- Increased hunger and unintentional weight loss (more typical in type 1)
- Fatigue, blurred vision
- Slow-healing wounds, frequent skin or urinary infections
- Tingling or numbness in hands/feet (neuropathy)
- Dry, itchy skin
Seek urgent care for symptoms of very high sugar (e.g., abdominal pain, vomiting, deep breathing, confusion) or very low sugar (sweating, tremor, confusion, loss of consciousness).
Why Does Diabetes Occur?
Diabetes appears when the insulin–glucose system fails:
- Type 1: Autoimmune destruction of beta cells → absolute insulin deficiency.
- Type 2: Insulin resistance in muscle, liver, and fat tissue plus relative insulin deficiency.
- Contributors/Risk factors (mainly type 2):
- Family history of diabetes
- Overweight/obesity and physical inactivity
- Unhealthy dietary patterns and high-calorie intake
- History of gestational diabetes or delivering a large-for-gestational-age baby
- Polycystic ovary syndrome (PCOS)
- Hypertension, dyslipidemia, or cardiovascular disease
How Is Diabetes Diagnosed?
Diagnosis is based on blood glucose and/or HbA1c (glycated hemoglobin, reflecting ~3 months of average glucose). Values below follow widely used clinical thresholds:
- Fasting Plasma Glucose (FPG) (no calories for ≥8 hours):
- Normal: <100 mg/dL (5.6 mmol/L)
- Prediabetes: 100–125 mg/dL (5.6–6.9 mmol/L)
- Diabetes: ≥126 mg/dL (7.0 mmol/L) on two separate days (or once with classic symptoms)
- 2-Hour Oral Glucose Tolerance Test (OGTT) (75 g glucose):
- Normal: <140 mg/dL (7.8 mmol/L)
- Prediabetes: 140–199 mg/dL (7.8–11.0 mmol/L)
- Diabetes: ≥200 mg/dL (11.1 mmol/L)
- HbA1c:
- Normal: <5.7%
- Prediabetes: 5.7–6.4%
- Diabetes: ≥6.5%
- Random plasma glucose ≥200 mg/dL (11.1 mmol/L) with classic symptoms also supports a diagnosis.
Pediatric glucose targets and interpretation depend on age and clinical context; children should be assessed by a pediatric endocrinologist.
At MedicalPoint Hospital, we confirm results with repeat testing when needed and evaluate overall cardiometabolic risk (blood pressure, lipids, weight, kidney function, eye and nerve health).
Monitoring: What Do the Numbers Mean?
- Self-monitoring of blood glucose (SMBG) with a glucometer helps dose medicines and identify highs/lows.
- Continuous glucose monitoring (CGM) provides round-the-clock trends and time-in-range metrics.
- HbA1c every 3 months (or 6 months when stable) tracks long-term control. Targets are individualized (commonly <7% for many adults; different targets for pregnancy, older adults, or those at hypoglycemia risk).
Treatment of Diabetes
1) Lifestyle Foundations (for all types)
- Medical nutrition therapy: Balanced meals emphasizing vegetables, whole grains, legumes, lean proteins, healthy fats; limit refined sugars and ultra-processed foods.
- Physical activity: Aim for 150 minutes/week of moderate aerobic activity plus 2–3 sessions/week of resistance exercise, as advised by your clinician.
- Weight management: Even 5–10% weight loss can improve insulin sensitivity in type 2 diabetes.
- Quit smoking, optimize sleep, manage stress.
- Education: Diabetes self-management education and support (DSMES) with a certified educator improves outcomes.
2) Medications
- Type 1 diabetes: Requires insulin therapy (basal–bolus injections or insulin pump). Carbohydrate counting, correction doses, and hypoglycemia prevention are key.
- Type 2 diabetes: Usually begins with metformin, if tolerated. Depending on glucose levels, cardiovascular/renal status, and weight goals, clinicians may add:
- SGLT2 inhibitors (cardio-renal benefits; reduce heart failure and kidney risk)
- GLP-1 receptor agonists (aid weight loss; cardiovascular benefit in selected patients)
- DPP-4 inhibitors, thiazolidinediones, sulfonylureas (selected situations)
- Basal or basal-bolus insulin if targets are not met or if symptomatic hyperglycemia is present
- Gestational diabetes: Managed with nutrition, glucose monitoring, and insulin when needed to keep pregnancy-specific targets.
Medication choice is personalized—our endocrinologists consider efficacy, hypoglycemia risk, weight effects, comorbidities, cost, and patient preference.
3) Preventing and Managing Hypoglycemia
- Recognize signs: sweating, shaking, hunger, confusion, irritability.
- Treat promptly with 15–20 g fast-acting carbs (glucose tablets, juice), recheck in 15 minutes, repeat if needed.
- Carry ID and teach family/friends how to help. For those at risk, ask about glucagon rescue options.
Potential Complications (and How We Prevent Them)
Long-term high glucose can affect blood vessels and nerves:
- Eyes (retinopathy) → annual dilated eye exam
- Kidneys (nephropathy) → urine albumin-to-creatinine ratio and eGFR checks
- Nerves (neuropathy) → foot checks each visit; daily self-inspection at home
- Heart & brain → aggressive control of blood pressure, cholesterol, and smoking cessation
- Feet → proper footwear; treat calluses, fungal infections, and cuts early
With regular follow-up, individualized targets, and modern therapies, many people live long, healthy lives with diabetes.
Practical Targets & Tips (speak with your clinician for your plan)
- HbA1c: commonly <7% for many non-pregnant adults
- Blood pressure: often <130/80 mmHg if tolerated
- LDL-cholesterol: statin therapy considered for most adults with diabetes
- Vaccinations: influenza, pneumococcal, hepatitis B per age/risk
- Sick-day rules: Check glucose/ketones more often; never stop basal insulin in type 1; seek help if vomiting, ketones persist, or glucose remains very high.
Care at MedicalPoint Hospital
- Comprehensive assessment with labs and complication screening
- Personalized nutrition & exercise plans with our dietitians and physiotherapists
- Access to CGM, insulin pumps, and smart pens
- Cardio-renal risk reduction integrated with Cardiology & Nephrology
- Diabetes education programs for patients and families
Key Takeaways
- Diabetes is caused by insulin deficiency (type 1) or insulin resistance ± deficiency (type 2).
- Screening and early diagnosis prevent complications.
- Lifestyle, education, and appropriate medications are the pillars of care.
- Targets are individualized—what is “right” for you depends on age, comorbidities, and risk profile.
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Endocrinology and Metabolism
Hormones are responsible for performing many functions in the body. Endocrine glands, which produce hormones, constitute the endocrine (hormonal) system. Pituitary, hypothalamus, thyroid and parathyroid, pancreas, ovaries and testes, adrenal glands and endothelial cells covering the inner surface of the vessels are among the glands that make up the endocrine system. Insufficient secretion, no secretion, or excessive secretion of hormones produced in the body causes hormonal diseases. Additionally, metabolic disorders may occur as a result of hereditary disorders or due to environmental factors. In our Endocrinology and Metabolism Diseases Department, our specialist doctors diagnose, treat and monitor diseases and metabolic disorders related to hormones that ensure the healthy functioning of the body.
