DIABETES MELLITUS refers to a group of diseases that affect how the body uses blood sugar (glucose). The main cause of diabetes varies by type. But no matter what type of diabetes you have, it can lead to excess sugar in the blood. Too much sugar in the blood can lead to serious health problems.

Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes and gestational diabetes. Prediabetes happens when blood sugar levels are higher than normal; but the blood sugar levels aren't high enough to be called diabetes. Gestational diabetes happens during pregnancy. But it may go away after the baby is born.

HOMOEOPATHIC TREATMENT FOR DIABETES

Homoeopathy emphasis on the holistic management of diabetes. Its aim is primarily focussed on maintaining ‘normal’ levels of insulin, or keeping conventional anti- diabetic drugs at the minimum possible doses, and in preventing the progression or complications of the disease.

If you are on conventional diabetic treatment from a very long time, it is strongly recommended not to stop your medicines suddenly even if you have started taking homoeopathic medicines. The medicines are gradually tapered off under the guidance of an expert homoeopathic doctor and results may vary from case to case.

Type 2 diabetes is a constitutional disorder as it is an offshoot of constitutional defects (genetic factors, altered immunity) having an impact on the entire constitution of an individual. Hence it calls for an in- depth constitutional approach for its management.

The role of healthy diet and exercise cannot be underestimated along with the above treatment measures.

KNOW YOUR DISEASE

Diabetes develops when your pancreas doesn’t make enough insulin or any at all, or when your body isn’t responding to the effects of insulin properly. Diabetes affects people of all ages. Most forms of diabetes are chronic (lifelong), and all forms are manageable with medications and/or lifestyle changes.

TYPES OF DIABETES

There are several types of diabetes. The most common forms include:

• Type 2 diabetes. With this type, your body doesn’t make enough insulin and/or your body’s cells don’t respond normally to the insulin (insulin resistance). This is the most common type of diabetes. It mainly affects adults, but children can have it as well.
• Prediabetes This type is the stage before Type 2 diabetes. Your blood glucose levels are higher than normal but not high enough to be officially diagnosed with Type 2 diabetes.
• Type 1 diabetes. This type is an autoimmune disease in which your immune system attacks and destroys insulin producing cells in your pancreas for unknown reasons.
• Gestational diabetes. This type develops in some people during pregnancy. Gestational diabetes usually goes away after pregnancy.

SYMPTOMS OF DIABETES

Diabetes symptoms depend on your blood sugar levels. Some people, especially if they have prediabetes, gestational diabetes or type 2 diabetes, may not have symptoms. In type 1 diabetes, symptoms tend to come on quickly and be more severe. Some of the symptoms of type 1 diabetes and type 2 diabetes are.

• Feeling more thirsty than usual
• Urinating often
• Losing weight without trying
• Presence of ketones in the urine. Ketones are a by-product of the breakdown of muscle and fat that happens when there's not enough available insulin
• Feeling tired and weak
• Feeling irritable or having other mood changes
• Having blurry vision
• Having slow-healing sores
• Getting a lot of infections, such as gum, skin and vaginal infections

WHAT CAUSES DIABETES?

Too much glucose circulating in your bloodstream causes diabetes, regardless of the type. However, the reason why your blood glucose levels are high differs depending on the type of diabetes.

Causes of diabetes include:

• Insulin resistance. Type 2 diabetes mainly results from insulin resistance. Insulin resistance happens when cells in your muscles, fat and liver don’t respond as they should to insulin. Several factors and conditions contribute to varying degrees of insulin resistance, including obesity, lack of physical activity, diet, hormonal imbalances, genetics and certain medications.
• Autoimmune disease: Type 1 diabetes and LADA happen when your immune system attacks the insulin-producing cells in your pancreas.
• Hormonal imbalances: During pregnancy, the placenta releases hormones that cause insulin resistance. You may develop gestational diabetes if your pancreas can’t produce enough insulin to overcome the insulin resistance. Other hormone related conditions like acromegaly and Cushing syndrome can also cause Type 2 diabetes.
• Pancreatic damage. Physical damage to your pancreas from a condition, surgery or injury can impact its ability to make insulin, resulting in Type 3c diabetes.
• Genetic mutations. Certain genetic mutations can cause MODY and neonatal diabetes.

COMPLICATIONS

Acute diabetes complications. Can be life-threatening, includes

Hyperosmolar hyperglycemic state (HHS): This complication mainly affects people with Type 2 diabetes. It happens when your blood sugar levels are very high (over 600 milligrams per decilitre or mg/dL) for a long period, leading to severe dehydration and confusion. It requires immediate medical treatment.

• Diabetes-related ketoacidosis (DKA). This complication mainly affects people with Type 1 diabetes or undiagnosed T1D. It happens when your body doesn’t have enough insulin. If your body doesn’t have insulin, it can’t use glucose for energy, so it breaks down fat instead. This process eventually releases substances called ketones, which turn your blood acidic. This causes laboured breathing, vomiting and loss of consciousness. DKA requires immediate medical treatment.
• Severe low blood sugar (hypoglycemia). Hypoglycemia happens when your blood sugar level drops below the range that’s healthy for you. Severe hypoglycemia is very low blood sugar. It mainly affects people with diabetes who use insulin. Signs include blurred or double vision, clumsiness, disorientation and seizures. It requires treatment with emergency glucagon and/or medical intervention.

Long term diabetes complications. Develop gradually. Possible complications includes.

Heart and blood vessel (cardiovascular) disease. Diabetes majorly increases the risk of many heart problems. These can include coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis )

• Nerve damage from diabetes (diabetic neuropathy). Too much sugar can injure the walls of the tiny blood vessels (capillaries) that nourish the nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward.
  • Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhoea or constipation. For men, it may lead to erectile dysfunction.
• Kidney damage from diabetes (diabetic nephropathy).  Diabetes can damage this delicate filtering system.
• Eye damage from diabetes (diabetic retinopathy). Diabetes can damage the blood vessels of the eye. This could lead to blindness.
• Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of many foot complications.
• Skin and mouth conditions. Diabetes may leave you more prone to skin problems, including bacterial and fungal infections.
• Hearing impairment. Hearing problems are more common in people with diabetes.
• Alzheimer's disease. Type 2 diabetes may increase the risk of dementia, such as Alzheimer's disease.
• Depression related to diabetes. Depression symptoms are common in people with type 1 and type 2 diabetes.

DIAGNOSIS OF DIABETES

Diabetes is diagnosed by checking your glucose level in a blood test. Three tests can measure your blood glucose level:

• Fasting blood glucose test. For this test, you don’t eat or drink anything except water (fast) for at least eight hours before the test.
• Random blood glucose test. “Random” means that you can get this test at any time, regardless of if you’ve fasted.
• HbA1c. This test, also called HbA1C or glycated haemoglobin test, provides your average blood glucose level over the past two to three months.

Type of Test	In-range (mg/dL)	Prediabetes (mg/dL)	Diabetes (mg/L)
Fasting Blood Glucose Test	< 100	100 to 125	126 or Higher
Random Blood Glucose Test	N/A	N/A	200 or Higher (with classic symptoms of hyperglycemia or hyperglycemic crisis
HBA1c	< 5.7%	5.7 % to 6.4%	6.5% or higher

To screen for and diagnose gestational diabetes, doctors order an oral glucose tolerance test.

MANAGEMENT OF DIABETES

Diabetes is a complex condition, so its management involves several strategies. In addition, diabetes affects everyone differently, so management plans are highly individualized.

The main aspects of managing diabetes include:

• Blood sugar monitoring. Monitoring your blood sugar (glucose) is a key to determining how well your current treatment plan is working.
• Diet.  Meal planning and choosing a healthy diet for you are key aspects of diabetes management, as food greatly impacts blood sugar.



• Exercise. Physical activity increases insulin sensitivity (and helps reduce insulin resistance), so regular exercise is an important part of management for all people with diabetes.

PREVENTION

Type 1 diabetes can't be prevented. But the healthy lifestyle choices can help treat prediabetes, Type 2 diabetes and gestational diabetes can also help prevent them by.

• Eat healthy foods. Choose foods lower in fat and calories and higher in fiber. Focus on fruits, vegetables and whole grains
• Get more physical activity. Try to get about 30 minutes of moderate aerobic activity on most days of the week. Or aim to get at least 150 minutes of moderate aerobic activity a week. For example, take a brisk daily walk. If you can't fit in a long workout, break it up into smaller sessions throughout the day.

AN OUTLOOK ON DIABETES - BY DR. SMRITI’S HOMOEOPATHIC HEALING

Being diagnosed with diabetes is a life-changing event, but it doesn’t mean you can’t live a happy and healthy life. Managing diabetes involves consistent care and diligence. Homoeopathic treatment is primarily focussed on maintaining ‘normal’ levels of insulin, or keeping conventional anti- diabetic drugs at the minimum possible doses, and in preventing the progression or complications of the disease. While it’ll likely be very overwhelming at first, over the time you’ll get a better grasp on managing the condition and being in tune with your body.

It is strongly advised not to stop your conventional diabetic treatment suddenly, even if you have started homoeopathic treatment. These medicines are generally tapered off under the guidance of an expert homoeopathic doctor depending upon the case.

Homoeopathy is based on the principle of individualisation and symptom similarity by using holistic approach. The aim of homoeopathy is not only to treat the disease condition but to address its underlying cause and individual susceptibility. Several remedies are available to treat diabetes and its complications; that can be selected on the basis of individualisation and symptom similarity. For individualized remedy selection and treatment, the patient should consult a qualified homoeopathic doctor in person.