Diabetes mellitus is a chronic metabolic disorder characterized by persistently elevated blood glucose levels. This disease is directly related to impaired insulin secretion or action, affecting the normal function of multiple organ systems throughout the body. According to statistics from the World Health Organization, diabetes has become a major public health challenge worldwide in the 21st century, with the number of patients continuously rising, posing a serious threat to human health.
The development of diabetes is closely associated with modern lifestyles, dietary habits, and genetic factors. The disease is classified into four major types: Type 1 diabetes, Type 2 diabetes, gestational diabetes, and other specific types of diabetes, with over 90% of cases being Type 2 diabetes globally. Early diagnosis and scientific management can effectively delay the progression of complications, but many individuals are unaware of their high-risk status in the early stages. This article systematically analyzes the causes, symptoms, diagnostic methods, and treatment strategies for diabetes to help readers establish correct disease awareness.
The pathogenesis of diabetes involves two core issues: dysfunction of pancreatic beta cells and resistance to insulin action. In Type 1 diabetes, the immune system mistakenly attacks pancreatic beta cells, leading to severe insulin deficiency. This process may be related to genetic susceptibility and environmental triggers such as viral infections. Type 2 diabetes primarily involves insulin resistance, where initially the pancreas can still produce insulin, but tissue cells respond less effectively, eventually leading to pancreatic beta-cell failure.
Genetic predisposition plays a key role in the onset of diabetes. Family history can increase the risk by 2-3 times, especially with a higher prevalence among first-degree relatives of Type 2 diabetic patients. Environmental factors such as obesity, lack of exercise, and unhealthy dietary patterns (high-calorie, high-fat diets) exacerbate insulin resistance. Age is also a significant risk factor, with incidence rates rising markedly after age 50. Gestational diabetes is related to hormonal changes during pregnancy that increase metabolic load.
The symptoms of diabetes vary depending on the type and disease stage. Patients with Type 1 diabetes often exhibit acute symptoms such as polydipsia, polyuria, unexplained weight loss, and persistent fatigue. These symptoms usually worsen rapidly over weeks to months, and if not diagnosed promptly, may lead to diabetic ketoacidosis (DKA) and other emergencies. Symptoms of Type 2 diabetes tend to develop gradually, with early signs such as mild thirst or frequent nocturia, and some patients are diagnosed only after complications appear.
Typical symptoms can be summarized as the "three polys and one loss": polydipsia (excessive thirst), polyuria (more than 8 urinations per day), polyphagia (frequent hunger), and weight loss (not intentional). Atypical symptoms include blurred vision (due to blood glucose fluctuations affecting lens osmotic pressure), slow wound healing (high blood glucose impairs immune function), and recurrent infections. Gestational diabetes may present only with pregnancy-related symptoms such as prolonged gestation or polyhydramnios.
Diagnosis of diabetes mainly relies on blood glucose testing and oral glucose tolerance test (OGTT). Fasting blood glucose (FBG) requires at least 8 hours of fasting, with normal values below 100 mg/dL. FBG between 100-125 mg/dL indicates prediabetes. The OGTT involves fasting before ingesting 75 grams of glucose solution, with blood glucose exceeding 140 mg/dL after two hours meeting diagnostic criteria.
Glycated hemoglobin (HbA1c) reflects the average blood glucose level over the past 2-3 months. Values between 5.7% and 6.4% indicate prediabetes, while 6.5% or higher confirms diabetes. In special cases, clinical presentation and other indicators are combined; for example, pregnant women undergo a 50-gram glucose screening, and if abnormal, proceed with a 100-gram OGTT. The diagnostic process should exclude other metabolic diseases such as pancreatic disorders or drug-induced hyperglycemia.
Diabetes management requires a multifaceted approach. Patients with Type 1 diabetes must use insulin therapy lifelong. Basal insulin provides stable blood glucose levels throughout the day, while mealtime insulin addresses postprandial glucose spikes. Early-stage Type 2 diabetes can be managed with oral hypoglycemic agents, such as secretagogues (e.g., sulfonylureas) or glucose absorption inhibitors (e.g., acarbose). Newer GLP-1 receptor agonists not only regulate blood glucose but also promote weight loss and cardiovascular protection.
Lifestyle interventions form the foundation of all treatment plans. Nutritional therapy should be tailored to individual needs, recommending a low-carbohydrate diet and calorie control. Exercise therapy involves at least 150 minutes of moderate-intensity aerobic activity per week (such as brisk walking or swimming) to enhance insulin sensitivity. Blood glucose monitoring is central to treatment, with modern continuous glucose monitoring systems (CGM) providing 24-hour glucose trends to help adjust medication and diet plans.
Proactive intervention in prediabetic individuals can significantly reduce the risk of progressing to diabetes. The Finnish Diabetes Prevention Study showed that weight loss of 7% and increased physical activity reduced the incidence of Type 2 diabetes by 58%. Recommended measures include 30 minutes of daily aerobic exercise, choosing high-fiber foods, limiting refined sugar intake, and regular blood glucose monitoring. High-risk groups should undergo blood glucose screening every three years, especially those with a family history of diabetes.
Targeted measures for specific high-risk groups include screening pregnant women at 24-28 weeks of gestation and annual comprehensive metabolic screening for seniors over 65. Patients with diagnosed diabetes experiencing significant blood glucose fluctuations, peripheral numbness, or recurrent infections should seek immediate medical attention to adjust treatment. Early medical intervention can effectively prevent severe complications such as diabetic foot ulcers and nephropathy.
Public health education is key to prevention. Information dissemination should be tailored to different populations. School health curricula should include basic knowledge of metabolic diseases, and workplaces can offer health screenings and nutritional counseling. Healthcare institutions should establish high-risk diabetes case tracking systems for regular follow-up of individuals with impaired glucose tolerance.
Immediate medical consultation is advised when experiencing typical symptoms such as frequent urination, unexplained weight loss, or blurred vision. Even without obvious symptoms, individuals meeting any of the following criteria should proactively seek medical care: age over 45, BMI over 25, a first-degree relative with diabetes, history of gestational diabetes, or presence of metabolic syndrome such as hypertension or hyperlipidemia.
Special populations should be monitored more closely: women planning pregnancy should evaluate metabolic status before conception; seniors over 65 should undergo annual comprehensive metabolic screening. Patients with diagnosed diabetes experiencing severe blood glucose fluctuations, peripheral numbness, or recurrent infections should seek prompt medical attention to adjust therapy. Early treatment can prevent serious complications like diabetic foot ulcers and kidney disease.
Choose low glycemic index (GI) foods such as whole grains, legumes, and non-starchy vegetables, and control portion sizes. The "plate method" is recommended: divide the plate into half vegetables, one-quarter whole grains, and one-quarter lean protein (such as fish or skinless chicken), paired with a small amount of healthy fats. Consulting a nutritionist to develop a personalized diet plan can more effectively balance nutrition and blood sugar management.
Exercise enhances muscle insulin sensitivity, helping the body utilize blood glucose more effectively and aiding weight control. It is recommended to perform at least 150 minutes of moderate-intensity aerobic activity per week (such as brisk walking or swimming) combined with resistance training twice a week. Monitoring blood glucose before and after exercise is important to prevent hypoglycemia, especially for those on insulin or oral hypoglycemic agents.
Corticosteroids, certain antipsychotics, and diuretics can elevate blood glucose levels, while beta-blockers may mask hypoglycemia symptoms. When taking other medications, inform your healthcare provider about your diabetes history and regularly monitor blood glucose. If medications affect blood sugar control, your doctor may adjust dosages or combine them with diabetes medications to maintain stability.
If not properly controlled, gestational diabetes can increase the risk of fetal macrosomia, preterm birth, and neonatal hypoglycemia. Mothers are also at higher risk of developing Type 2 diabetes later. Regular screening every three years during pregnancy and maintaining healthy diet and exercise habits can reduce long-term risks.
Unsweetened black coffee or tea does not directly affect blood sugar, but added sugar or cream increases blood glucose. It is advisable to choose sugar-free beverages and be aware that caffeine may interfere with sleep quality, affecting blood sugar regulation. For those with hypertension, some teas (such as strong black tea) may interact with antihypertensive medications; consult your doctor before consumption.
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