Introduction to Diabetes

More than 72 million people with diabetes live in India

The first step to manage diabetes is to understand diabetes

What is Diabetes?

Diabetes is a condition that causes higher than normal blood sugar levels.

Diabetes occurs when your body cannot make or effectively use its own insulin, a hormone made by special cells in the pancreas called islets

How is Diabetes caused?

Glucose comes from your food – it passes from your digestive system into your bloodstream and then travels in the blood around the body to where it is needed as a source of energy.

Your body needs glucose – it provides the fuel that makes your muscle cells ‘work’ and brain cells ‘think’.

Glucose can’t just pass into the cells. It goes through tiny cell ‘doors’, but these only open when insulin is there to help. Insulin acts a bit like a key.

If your body doesn’t make enough insulin, your blood glucose cannot get into the cells, and so more and more glucose builds up in the blood.

If your blood glucose levels stay high, they can cause damage to tiny blood vessels and nerves. You can feel well when this starts to happen, but the damage happens slowly and isn’t obvious until much later on.

If the pancreas stops making enough insulin, things start to go wrong. You won’t get enough glucose into your cells, which will make you feel tired and sometimes irritable. Eventually, high glucose levels can cause damage to your circulation and nerves.

In persons with diabetes, insulin is absent (as in type 1) or is present in insufficient amounts (as in type 2 diabetes). 

Being in control of your blood glucose levels may help you feel more energised, sleep better and feel better.

How is Diabetes classified?

According to the most recent WHO classification the different defects in Glucose metabolism are classified as follows as shown in the table below:

Type 1


Absolute insulin deficiency.

Insulin administration is necessary for survival of the patients with this disorder.


Type 2

May range from predominately insulin resistance with relative insulin deficiency to a predominately secretory defect with insulin resistance


Gestational Diabetes (GDM)

Defined as Diabetes that occurs for the first time in pregnancy


Other specific Types

Genetic defects of ß-cell or insulin action

How is Diabetes diagnosed?

American diabetes association recommends the following glycaemic targets to be followed for diagnosis of diabetes:


Diabetes (mg/dl)

Fasting plasma glucose



2 h Post load Glucose


Let us learn about Diabetes monitoring

How to monitor glycemic control?

Regular testing of FPG and PPPG (1.5- 2 hrs after meal) is recommended in people with both type 1 and type 2 diabetes (frequency is decided based on several factors by the treating physician) and HbA1c test.

What is HbA1c test?

Regular testing of FPG and PPPG (1.5- 2 hrs after meal) is recommended in people with both type 1 and type 2 diabetes (frequency is decided based on several factors by the treating physician) and HbA1c test

What is HbA1c?

Haemoglobin (Hb) is a protein in red blood cells (RBC). Haemoglobin helps carry O2 as it has high affinity to it. This hemoglobin, picks up glucose from bloodstream, as it has high affinity to it also, becoming ‘glycated’.

A1c is a particular fragment of haemoglobin A (adult type). As BG rises, so does level of glycated Hb. Once Hb becomes glycated, it remains that way for the life of an RBC which is 120 days i.e. 3-4 m. HbA1c test -provide a picture of glucose control over several months

How to interpret HbA1c test results?

The test results reflect the %age of glycated haemoglobin in the blood. In people without diabetes, HbA1c is less than 5.5.

With Diabetes, if one is able to keep HbA1c at 7% or less, it can help to reduce the risk for diabetic complications. 

In people with type 2 diabetes, it is recommended to test HbA1c once every 6 months. 

How to manage diabetes?

Important pillars of diabetes management

Diet, exercise, monitoring and following the medicine regimen prescribed by your doctors are the main pillars of diabetes management

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