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Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. 347 million people worldwide are assumed to have this disease, making diabetes a global health problem. The United Arab Emirates is ranked as the 2nd highest worldwide for diabetes and study reports suggest that approximately 1 in 5 of the adult population have diabetes.

This section covers all of the basics you need to know about diabetes. Whether you are just looking for general information about what diabetes is, the risk factors or the different types of diabetes – we deal with it all here. Paying special attention to diet and exercise is crucial in fighting against diabetes, so tips on healthy lifestyle changes are included in the Prevention section of this site.

If you are concerned that you or a loved one may have diabetes, up-to-date details regarding its symptoms and diagnostic tests are available. Diabetes is a lifelong disease that affects nearly all aspects of daily life, including the food you eat and the activities you pursue, so learning that you have diabetes can be upsetting. To help, we have included information about how you can control your blood glucose levels and what treatment options are on offer.

What is Diabetes?

Diabetes (medically known as diabetes mellitus) is a group of diseases characterised by high levels of blood glucose, commonly called blood sugar. Glucose comes from carbohydrates that you eat and is the main source of fuel for your brain and an important source of energy for the cells that make up your muscles and tissues.  Too much glucose, however, can lead to serious long-term complications like kidney failure, nerve damage and blindness. Left untreated, diabetes also increases your risk for cardiovascular disease, including heart attack and stroke.

Diabetes occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Gestational diabetes, which occurs during pregnancy but may resolve after the baby is delivered, is a potentially reversible type of diabetes.

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Although the exact causes of diabetes are unknown, risk factors for diabetes depend on the specific type of diabetes.

Type 1 diabetes

  • Family history: Having a parent or sibling with type 1 diabetes increases your risk.
  • Race: Type 1 diabetes is more common in white people than other races.
  • Geography: Certain countries, such as Finland and Sweden, have higher rates of type 1 diabetes. The attributes this to cold weather, as type 1 diabetes develops more often in winter than summer and is more common in places with cold climates according to the American Diabetes Association
  • Early diet: Type 1 diabetes is less common in people who were breastfed and in those who first ate solid foods at later ages.

Type 2 diabetes

  • Family history: If a family member has type 2 diabetes, it increases your risk of developing it also. Type 2 diabetes has a stronger link to family history than type 1 diabetes.
  • Weight and physical activity: The more fatty tissue you have, the more resistant your cells become to insulin. Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin. Exercising at least 3 times a week can help reduce your risk of type 2 diabetes.
  • Race: People of certain races, including African Americans, Hispanics and Asians, have more risk of developing this type of diabetes. The exact reason for this is still unclear.
  • Age: Your risk of developing Type 2 diabetes increases with age.
  • Abnormal cholesterol levels: Low levels of high-density lipoprotein (HDL), or "good" cholesterol, and/or high triglyceride levels increase your risk.
  • History of gestational diabetes: If you developed gestational diabetes when you were pregnant, your risk of developing type 2 diabetes later increases. If you gave birth to a baby weighing more than 9 pounds (4 kilograms), you're also at risk of type 2 diabetes.
  • Polycystic ovary syndrome: Women with polycystic ovary syndrome, a common condition characterised by irregular menstrual periods, have a greater chance of developing this type of diabetes.
  • High blood pressure: High blood pressure (hypertension) is linked with type 2 diabetes.

Gestational diabetes

  • Age: Pregnant women over the age of 20 are at greater risk.
  • Weight: Being overweight before pregnancy increases your risk of gestational diabetes.
  • Family history: If a close family member has had type 2 diabetes, your chance of developing gestational diabetes increases.
  • Race: Although unclear why, women of certain races such as African Americans, Native Americans and  Asians, are more likely to develop this type of diabetes. 

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Diabetes symptoms vary depending on how much your blood sugar is elevated. In prediabetes or early type 2 diabetes, the symptoms may be so mild that they go unnoticed. In type 1 diabetes, symptoms tend to come on quickly and be more severe. Common symptoms of diabetes include:

  • Frequent urination
  • Extreme thirst
  • Increased hunger especially after eating
  • Dry mouth
  • Blurry vision
  • Weak, tired feeling
  • Cuts or bruises that are slow to heal
  • Frequent infections such as gums or skin infections and vaginal or bladder infections
  • Dry and itchy skin, usually in the vaginal or groin area
  • In type 1 diabetes, unexplained weight loss may occur even though you are hungry and eating more
  • In type 2 diabetes, numbness and tingling of the hands and feet

While type 1 diabetes typically develops during childhood or adolescence, type 2 diabetes can occur at any age and is often preventable.

Types of Diabetes

There are 3 main types of diabetes. These include:

  • Type 1 diabetes: Type 1 diabetes is usually diagnosed in childhood and adolescence, but can occur in every age. This type of diabetes occurs because the insulin-producing cells (called beta cells) of the pancreas are damaged, meaning that glucose cannot get into the body’s cells for use as energy. People with type 1 diabetes must use insulin injections to control their blood glucose. The cause of type 1 diabetes in not known, therefore it is not currently preventable.
  • Type 2 diabetes: Type 2 diabetes affects mainly adults and is largely the result of excess body weight and physical inactivity. According to the Rashid Centre for Diabetes and Research , type 2 diabetes constitutes around 90% of all cases of diabetes around the world. Unlike people with type 1 diabetes, those with type 2 diabetes are able to produce insulin but the insulin is not enough or doesn’t work properly in the body. Some people with this form of diabetes can manage it effectively by controlling their weight, watching their diet, and exercising regularly. Others may also need to take an oral glucose-lowering medication or insulin injections.
  • Gestational diabetes: During pregnancy, usually around their 24th week, many women can develop gestational diabetes. Due to weight gain and hormone changes during pregnancy, there is an increase in insulin resistance causing greater need of insulin. This results in high glucose levels. Gestational diabetes occurs more often in pregnant women over the age of 25 who are above their normal body weight, and who may have a family history of diabetes. In most cases, blood glucose levels return to normal after childbirth however women who have had gestational diabetes have a greater risk of developing type 2 diabetes later in life. See Diabetes risk factors for more details.

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In general, most people with type 1 diabetes are diagnosed during childhood, whereas type 2 typically develops after age 40. The American Diabetes Association (ADA) ) recommends that all adults over 45 years, of normal weight and with no diabetes risk factors receive an initial blood sugar screening. If the results are normal, screening should occur every 3 years thereafter.

There are several ways to diagnose diabetes, however each method usually needs to be repeated on a second day to diagnose diabetes. The tests used to diagnose diabetes are:

  • Glycated hemoglobin (A1C) test: This test measures your average blood sugar level for the past 2 to 3 months. An A1C level of approximately 5% is normal. A level of 6.5% or higher indicates that you have diabetes. The advantage of this test is that it does not require fasting and can be performed at any time of the day, making it more convenient than some of the other blood glucose tests.
  • Fasting plasma glucose (FPG): The FPG measures your blood glucose after you have fasted for at least 8 hours. This blood test is usually done first thing in the morning. Normal fasting blood glucose is between 70 and 100 mg/dl for people who do not have diabetes. The standard diagnosis of diabetes is made when two blood tests on different days show that your fasting blood glucose level is greater than or equal to 126 mg/dl. A result between 100 and 125 mg/dl is considered prediabetes.
  • Oral glucose tolerance test (OGTT): The OGTT is another test used to detect diabetes, but is not routinely performed except during pregnancy. In an OGTT, a blood sample will be taken after you fast for at least eight hours. Afterwards, you'll drink a sugary solution and your blood sugar level will be measured once more in 2 hours. This tells the doctor how your body processes glucose. A blood sugar level less than 140 mg/dL is normal. A blood sugar level from 140 to 199 mg/dL is considered prediabetes. A person whose glucose level in 200 mg/dL or higher has diabetes.
  • Random (also called casual) plasma glucose test: In a random plasma glucose test, blood glucose is tested without regard to the time since your last meal. This is often conducted if you have severe diabetes symptoms. A glucose level greater than 200 mg/dL suggests diabetes.

What is prediabetes?

Prediabetes is a condition when your blood glucose is higher than normal but not high enough to be diabetes. This condition puts you at risk for developing type 2 diabetes.

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Due to the amount of self-care required, diabetes can place a huge burden on those it affects. Paying special attention to diet and exercise plays a vital part in managing all types of diabetes. Depending on your type of diabetes, you may also need to test your blood glucose levels several times a day, take oral medication or give yourself daily insulin injections. Below are some key treatment options.

  • Healthy eating: Once diagnosed with diabetes, you will need to centre your diet on foods that are high in nutrition and fiber and low in fat and calories, such as fruits, vegetables and whole grains. Cutting down on animal products, refined carbohydrates and sweets is also important. A registered dietitian can help you create a meal plan that fits your health goals, food preferences and lifestyle.
  • Physical activity: Exercise lowers your blood sugar level by transporting sugar to your cells, where it's used for energy. It also increases your sensitivity to insulin, which means your body needs less insulin to transport sugar to your cells. Aim for 30 minutes of aerobic exercise, at least 5 days a week. Choosing activities you enjoy, such as walking, swimming or cycling, is an effective way of making physical activity part of your daily routine.
  • Monitoring your blood sugar: Depending on your exact treatment plan, you may check and record your blood sugar level several times a day or week. Regular monitoring helps ensure that your blood sugar level remains within your target range.
  • Oral or other medications: Your doctor may prescribe oral or injected medications based on your requirements and preferences. When treating Type 2 Diabetes, treatment usually starts with lifestyle modification and, as the disease progresses, the need may arise to combine several classes of medication to achieve normal blood glucose levels. These medications may stimulate your own insulin production or enhance the insulin sensitivity in your body.
  • Insulin injections: Most people with type 1 diabetes need insulin therapy to survive. Some people with type 2 diabetes also need insulin therapy. Often insulin is injected using a syringe or an insulin pen. Based on different factors, the insulin injection treatment can consist of one or several injections daily.

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Unfortunately, type 1 diabetes can’t be prevented. However, simple lifestyle measures are effective in preventing or delaying the onset of type 2 diabetes, which is the more common type. To help prevent type 2 diabetes:

  • Eat a healthy diet: Eating well is one of the most important things you can do to reduce your risk of type 2 diabetes. Aim for 3 to 5 servings of fruit and vegetables a day and reduce your intake of sugar and saturated fats. While it may be hard to make healthy food choices at first, it can help to set aside time to plan your weekly meals.
  • Achieve and maintain a healthy body weight: According to Mayo Clinic , losing just 5% of your body weight can reduce the risk of diabetes in those who are overweight.
  • Be physically active: The World Health Organization recommends at least 30 minutes of regular, moderate-intensity activity on most days. If you are too busy to fit a full workout into one session, it is just as effective to break your exercise up into smaller sessions spread throughout the day.

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