Diabetes in nutrition

When we eat, food is digested and converted into different components that then pass into the blood, to be carried to the different organs of the body, in order to fulfill various functions. One of these components is glucose (sugar), which is responsible for producing the energy to live.

In order for the glucose transported by the blood to pass into the cells, it needs a hormone called insulin, which is responsible for introducing the glucose into the cells. The pancreas is the organ in charge of producing more or less insulin, depending on the amount of glucose in the blood.

Diabetes mellitus is a group of metabolic disorders, characterized by the presence of persistent or chronic high concentrations of glucose (sugar) in the blood, caused by insufficient production of insulin in the pancreas, or because the body cannot effectively use the insulin it produces. As a consequence of the permanence of high concentrations of glucose in the blood, complications can appear in many organ systems, such as loss of vision, renal failure and myocardial infarction, among others.

Main types of diabetes mellitus

Type 1 diabetes mellitus: It represents between 5% and 10% of the population with diabetes mellitus. It generally occurs in people under 40 years of age, but its highest incidence is observed in those under 15 years of age. It occurs when the body's immune system destroys more than 90% of the beta cells (insulin-secreting cells of the pancreas), leading to an absolute insulin deficiency. It is characterized by:

Deficient production of insulin in the body: sufferers need daily insulin injections and a balanced diet to regulate blood glucose.Individuals without access to insulin cannot survive. There are no ways to prevent it. Symptoms:

• Increased frequency and amount of urine excretion (polyuria).

• Excessive increase of thirst (polydipsia).

• Sensation of incessant hunger (polyphagia).

• Slimming.

• Visual disturbances and tiredness.

• Mood changes, anxiety, loss of sleep.

• Nausea and vomiting.

• Loss of sensation or tingling in the feet.

Diabetes mellitus type 2: It represents between 90% and 95% of the total population with diabetes mellitus. It usually develops in middle-aged people (from 40 years of age), although it is increasingly frequent in young people, adolescents and children. It is caused by a progressive decrease in insulin secretion and an increase in insulin resistance.

Characteristics of type 2 diabetes mellitus:

• It appears more frequently in overweight or obese people.

• It is more frequent in the female sex.

• Initial symptoms are usually very mild, so it is unlikely to be identified early on.

• The diagnosis is made in most cases in asymptomatic individuals.

• It often manifests itself through the complications it causes, such as renal failure, delayed wound healing, blindness and foot ulcerations.

Gestational diabetes mellitus: is a form of pregnancy-induced diabetes mellitus, the specific causes of which are not well determined. It is believed that pregnancy hormones reduce the body's ability to use and respond to insulin. It is estimated that between 3 and 10% of pregnant women suffer from it.

Characteristics of gestational diabetes mellitus:

• It is a transient disorder that occurs during pregnancy.

• It increases the chances of developing diabetes mellitus at another stage of life.

• It increases the risk for the mother and fetus of suffering complications during pregnancy and delivery.

• It is diagnosed by screening tests, before the onset of symptoms.

Complications for the newborn: Excessive development or size of the baby at birth, which can lead to obesity and diabetes later in life.

Other types of diabetes: There are other types of diabetes that together account for less than 6% of all diagnosed cases of diabetes. They can occur due to the following causes:

• Genetic defects in the function of the beta cells (insulin-secreting cells of the pancreas), or in the action of insulin.

• Diseases of the pancreas, such as cystic fibrosis.

• Endocrine disorders.

• Induced by drugs or chemicals.

Diabetes risk factors

Diabetes mellitus type 1: In this type of diabetes the medical community cannot establish a clear cause in most cases. The general belief is that it originates from a complex interaction between genes and environmental factors, however, it has not been demonstrated that any particular environmental factor has caused a significant number of cases.

Type 2 diabetes mellitus: The risk of type 2 diabetes is determined by the interaction of genetic and metabolic factors. The most important factors are the following. Excess body fat, increased waist circumference and body mass index above adequate as a consequence of unhealthy dietary practices. Some of them are the following:

• High consumption of saturated fats and trans fats (fatty meats, butter, coconut or palm oil, and margarines.

• Insufficient consumption of dietary fiber (fruits, vegetables, whole grains and whole legume grains).

• High consumption of sweets, sweetened beverages, honey, syrups, juices and fruit concentrates.

• Ethnic factors, combined with a family history of diabetes.

• High birth weight and inadequate nutrition during early childhood.

Active smoking increases the risk of diabetes, even more in those who smoke a lot. The high risk lasts about 10 years after smoking cessation. Gestational diabetes mellitus: Among the main factors that increase the risk of gestational diabetes mellitus are the following:

• Age, the older the pregnant woman is, the higher the risk of diabetes mellitus.

• Overweight or obesity.

• Excessive weight gain during pregnancy.

• Having had gestational diabetes mellitus in previous pregnancies.

• The presence of a family history of diabetes.

Complications of diabetes

Acute complications that require urgent medical attention: Diabetic ketoacidosis: occurs as a result of elevated blood glucose levels, above normal. It evolves rapidly, causing severe dehydration and electrolyte disturbances. Patients present convulsions, acute renal failure and multiple organ failure, which may lead to death if they do not receive adequate medical attention.

Hyperosmolar hyperglycemic state: also occurs as a result of elevated blood glucose levels above normal. It evolves in a matter of days and occurs most frequently in people over 70 years of age with type 2 diabetes mellitus. It also causes severe dehydration and electrolyte disturbances. Patients present convulsions, acute renal failure and multiple organ failure, which may lead to death if they do not receive adequate medical attention.

Diabetic hypoglycemia: it is caused by a drop in blood glucose below its lower limit. It can occur with any type of diabetes and can cause seizures and loss of consciousness. It can occur when the person skips a meal, exercises more than usual, the insulin dose is too high, or when vomiting or diarrhea occurs. Long-term complications of diabetes: Diabetic retinopathy is an eye disorder caused by diabetes. It is caused by the deterioration of the blood vessels that supply the retina. If the disease progresses, new blood vessels form and fibrous tissue proliferates in the retina, causing vision to deteriorate, as the image sent to the brain becomes blurred. This disorder is one of the main causes of blindness.

Diabetic nephropathy: it is caused by microvascular involvement of the diabetic patient's kidney. Its progression can lead to chronic renal failure, with the patient requiring dialysis or renal transplantation.

Diabetic neuropathy: it is caused by microvascular involvement of the peripheral nervous system. It may affect motor, sensory or vegetative function. It causes pain in the limbs, ulcers and disability. Rarely causes death.

Ischemic heart disease: angina pectoris and acute myocardial infarction are two to three times more frequent in diabetic patients than in the general population. Cases of sudden death of coronary origin are also more frequent.

Arteriopathy in the lower extremities: in diabetic patients the decrease in arterial flow in the lower extremities is more frequent, causing difficulties in wound healing, contributing to the appearance of ulcers, diabetic foot and gangrene.

Guidelines to follow for the prevention of type 2 diabetes

• Follow a healthy diet.
• Regular physical activity.
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