Diabetes is a condition in which the amount of glucose (blood sugar) in the blood exceeds a certain percentage.

Diabetes is a metabolic disorder characterized by higher than normal blood sugar levels. This condition, if prolonged, can lead to complications in many other organs such as: heart, causing myocardial infarction; brain, causing stroke, cerebrovascular accident, hemiplegia; risk of infection causing wounds to heal slowly, potentially leading to necrosis; kidney, end-stage chronic kidney failure, requiring regular dialysis; eye, retinal hemorrhage, retinal detachment and leading to blindness.

Currently, the World Health Organization classifies 4 types of diabetes: type 1, type 2, special forms and gestational diabetes. Type 2 diabetes accounts for the highest rate of about 85-95% of cases, so I would like to emphasize type 2 diabetes. This type of disease has been common in the US for many years, often has no obvious symptoms and develops silently in the early stages. Patients only discover it by chance when going for a routine health check-up or doing other pre-surgical tests (for example: kidney stone surgery, appendectomy, prostate fibroid surgery, cancer). When the disease has entered the late stage, patients come to the clinic with quite obvious symptoms such as: eating a lot, drinking a lot of water, urinating a lot and losing a lot of weight (commonly known as the 4-a-lot syndrome). Sometimes patients also have symptoms such as: seeing ants when urinating, impotence in bed and slow healing wounds.

Yes. Diabetes should be treated immediately if diagnosed and you do not have complications. The important goal in treating diabetes is to prevent complications and inhibit the progression of complications.

Complications are new diseases that develop in association with a disease. If diabetes is not controlled, it can cause small blood vessel disorders throughout the body, eventually leading to eye, kidney, and nerve problems. These are some of the complications of diabetes.

Even if hyperglycemia (higher than normal blood sugar) does not appear in functional symptoms, this condition still places a burden on the body. That burden causes various damages throughout the body. Simply put, hyperglycemia is a condition that accelerates the aging of the body. The result will cause dangerous complications that need to be prevented, leading to an irreversible condition. It can be affirmed that diabetic complications will still develop and progress even if hyperglycemia does not appear in functional symptoms.

Insulin is a hormone secreted by the pancreas. Insulin works to help all cells in the body absorb glucose (blood sugar) and use this sugar as energy for all body activities. When insulin does not work effectively, sugar cannot be brought into the cells. As a result, there will be excess sugar in the blood and cause hyperglycemia.

There are two reasons. One is that the insulin secretion function of the pancreas is impaired and the amount of insulin in the blood is reduced. Another reason is that the sensitivity of the cells to insulin is reduced. The reduced sensitivity of the cells to insulin is called “insulin resistance”. In a state of insulin resistance, although the amount of insulin secreted is sufficient, it still causes hyperglycemia.

Diabetes is increasing in the world, especially in the Asia Pacific region, including Vietnam. According to statistics from the World Health Organization, in 2015, there were 415 million people with diabetes, but if calculated 25 years later (ie in 2040), this number will reach 642 million people (an increase of 54%). In Vietnam, according to statistics from the Ministry of Health in 2012, the whole country has more than 5 million people with diabetes, this number is still increasing, and it is estimated that in 10 years, it will be at 200%, that is, about 10 million people with the disease. So we need to have solutions to detect the disease earlier, treat it effectively and prevent complications.

Most people think that diabetes can be cured, but in reality, this is a disease that cannot be cured completely. People do not die from diabetes, but from its complications. So I hope to share with you about diet, exercise and proper medication, thereby preventing and controlling complications of the disease.

Pathogenesis or risk factors of diabetes are related to genetics, genetic diseases or environment. Depending on the type of diabetes, different causes and risk factors are distinguished. For example, type 1 diabetes often occurs in younger people, due to destruction of the pancreas leading to absolute insulin deficiency, requiring the use of exogenous insulin. When the pancreas is destroyed by 75-80%, the disease will appear clinically and the patient often comes to the hospital with complete insulin depletion.

In patients with type 2 diabetes or gestational diabetes, the causes are similar: genetics (having a family member with the disease); due to the increasingly developed environment and society, causing us to have a sedentary lifestyle, often using cars/motorbikes and rarely walking or cycling; a diet high in saturated fat, too much excess energy leading to overweight and obesity.

Normally, the pancreas has both endocrine and exocrine functions. In terms of endocrine function, beta cells secrete a hormone called insulin, which has the effect of lowering blood sugar levels, regulating and stabilizing them, so that blood sugar levels do not become unbalanced. In normal people, when eating, blood sugar levels increase, stimulating beta cells to produce insulin, bringing blood sugar levels back to normal levels. When the pancreas no longer secretes insulin, we will develop diabetes.

If the patient has a special type of diabetes, it is related to genetic diseases that reduce the function of beta cells (cells that secrete insulin). It may be due to the patient being exposed to drugs such as rat poison, corticosteroids for arthritis treatment, chemicals... or having an infection, virus infection, or pancreatic trauma (pancreatic cancer, pancreatectomy).

Evaluation criteria when checking “glucose tolerance test”:

– Meeting one or both of the following conditions: fasting blood sugar level of 126 mg/dL, blood sugar level after 2 hours of glucose tolerance at ≥ 200 mg/dL will be diagnosed with diabetes.

– Fasting blood sugar levels below 110 mg/dL and blood sugar levels after 2 hours of glucose tolerance at < 140 mg/dL are considered normal.

A person is diagnosed with diabetes when they are found to have high blood sugar levels. To test their blood sugar levels, people suspected of having diabetes will have to undergo a test called: “glucose tolerance test”. The person conducting the test will give you 75 grams of glucose-soluble liquid to drink (adding glucose load to the body), to monitor changes in blood sugar levels, thereby determining diabetes. The test will be evaluated by criteria. When blood sugar levels are close to the dangerous limit, the test is performed twice to check the accuracy.

In addition to being diagnosed by blood sugar levels, it can be diagnosed by the HbA1c test value. HbA1c is a test value that checks the average blood sugar level over the past 1-2 months from the time of testing. Even if the blood sugar level is normal at the time of testing, but the HbA1c index is high (blood sugar level has remained high for the past 1-2 months), it can be a sign of diabetes diagnosis.

– If you do not fall into the above two categories, you will be diagnosed with prediabetes, “borderline level”.