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Understanding Diabetes

Diabetes is a metabolic disorder, primarily caused by prolonged elevated levels of sugar in the blood, leading to an excess of sugar beyond the kidney's capacity. Consequently, this excess sugar is excreted through urine, giving rise to the term "diabetes."

According to the International Diabetes Federation (IDF) estimates, as of 2021, approximately 537 million adults (aged 20-79) globally have diabetes, with a prevalence rate of around 9.8%. By the year 2045, the number of people with diabetes is projected to rise to 783 million. Alarmingly, a substantial number, nearly 212 million adults with diabetes, are currently undiagnosed.

Diabetes is a metabolic disorder, primarily caused by prolonged elevated levels of sugar in the blood, leading to an excess of sugar beyond the kidney's capacity. Consequently, this excess sugar is excreted through urine, giving rise to the term "diabetes."

According to the International Diabetes Federation (IDF) estimates, as of 2021, approximately 537 million adults (aged 20-79) globally have diabetes, with a prevalence rate of around 9.8%. By the year 2045, the number of people with diabetes is projected to rise to 783 million. Alarmingly, a substantial number, nearly 212 million adults with diabetes, are currently undiagnosed.

According to the "National Nutrition and Health Survey" conducted by the Health Promotion Administration of the Ministry of Health and Welfare in Taiwan from 2017 to 2020, the prevalence of diabetes among Taiwanese individuals aged 18 and above has exceeded 11%. It is estimated that approximately one in every 9 to 10 adults may suffer from diabetes. Notably, individuals with diabetes also face a 2-4 times higher risk of developing cardiovascular diseases compared to the general population. This heightened risk not only increases the likelihood of vascular and neurological complications but may also lead to various serious complications.

Diabetes patients typically exhibit the so-called "Three Highs and One Low" symptoms: excessive eating, drinking, and urination, accompanied by weight loss. If left untreated, diabetes can lead to various serious complications, including cardiovascular diseases, chronic kidney disease, and diabetic foot, among others. Complications arising from diabetes are often irreversible, and as time goes by, they can lead to complete organ dysfunction or even death. In fact, diabetes is a major cause of limb amputation, blindness, and kidney failure.

Diabetes can be classified into Type 1 or Type 2 diabetes, and gestational diabetes.

  1. Type 1 Diabetes：

    This type is associated with genetics and heredity. It often manifests in childhood or adolescence and is primarily caused by the autoimmune destruction of pancreatic beta cells, leading to the inability to produce insulin and eventually resulting in diabetes.

  2. Type 2 Diabetes：

    The most common type of diabetes, it is believed to be related to family history, lifestyle, and obesity. Individuals with visceral obesity are at a higher risk. The main cause of Type 2 diabetes is reduced sensitivity or resistance of cells to insulin. As a result, the pancreas secretes more insulin, but when the limited insulin production becomes insufficient, excess glucose remains in the bloodstream, causing high blood sugar and leading to diabetes.

  3. Gestational Diabetes：

    Primarily caused by elevated blood sugar levels during pregnancy, gestational diabetes may lead to complications for both the mother and the baby. While gestational diabetes typically disappears after childbirth, affected women and their children face an increased risk of developing Type 2 diabetes in the future.

The diagnostic criteria for diabetes include the following four parameters. In non-pregnant individuals, meeting any one of these criteria is sufficient for a diagnosis of diabetes (the first three criteria require confirmation through repeated testing)
  • Glycated Hemoglobin (HbA1c) level ≥ 6.5%
  • Fasting Plasma Glucose ≥ 126 mg/dL
  • 2-hour Plasma Glucose in the Oral Glucose Tolerance Test (OGTT) ≥ 200 mg/dL
  • Random Plasma Glucose ≥ 200 mg/dL, accompanied by typical symptoms of polyuria, polydipsia, polyphagia, and weight loss

Diabetes is a complex chronic disease that requires comprehensive management, including dietary control, exercise, medication, and regular blood glucose monitoring. Regular treatment, follow-up, and discussions with a professional healthcare team are essential to implement a healthy lifestyle effectively, delaying and preventing the onset of complications.

（Photo credit: ShutterStock）