essay writing how to prevent diabetes

Essay on Diabetes for Students and Children

500+ words essay on diabetes.

Diabetes is a very common disease in the world. But people may never realize, how did they get diabetes and what will happen to them and what will they go through. It may not be your problem but you have to show respect and care for the one who has diabetes. It can help them and also benefited you to know more about it and have a better understanding of it. Diabetes is a metabolic disorder which is identified by the high blood sugar level. Increased blood glucose level damages the vital organs as well as other organs of the human’s body causing other potential health ailments.

Types of Diabetes

Diabetes  Mellitus can be described in two types:

Description of two types of Diabetes Mellitus are as follows

1) Type 1 Diabetes Mellitus is classified by a deficiency of insulin in the blood. The deficiency is caused by the loss of insulin-producing beta cells in the pancreas. This type of diabetes is found more commonly in children. An abnormally high or low blood sugar level is a characteristic of this type of Diabetes.

Most patients of type 1 diabetes require regular administration of insulin. Type 1 diabetes is also hereditary from your parents. You are most likely to have type 1 diabetes if any of your parents had it. Frequent urination, thirst, weight loss, and constant hunger are common symptoms of this.

2) Type 2 Diabetes Mellitus is characterized by the inefficiency of body tissues to effectively respond to insulin because of this it may be combined by insulin deficiency. Type 2 diabetes mellitus is the most common type of diabetes in people.

People with type 2 diabetes mellitus take medicines to improve the body’s responsiveness to insulin or to reduce the glucose produced by the liver. This type of diabetes mellitus is generally attributed to lifestyle factors like – obesity, low physical activity, irregular and unhealthy diet, excess consumption of sugar in the form of sweets, drinks, etc.

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Causes of Diabetes

By the process of digestion, food that we eat is broken down into useful compounds. One of these compounds is glucose, usually referred to as blood sugar. The blood performs the job of carrying glucose to the cells of the body. But mere carrying the glucose to the cells by blood isn’t enough for the cells to absorb glucose.

This is the job of the Insulin hormone. Pancreas supply insulin in the human body. Insulin acts as a bridge for glucose to transit from blood to the body cells. The problem arises when the pancreas fails to produce enough insulin or the body cells for some reason do not receive the glucose. Both the cases result in the excess of glucose in the blood, which is referred to as Diabetes or Diabetes Mellitus.

Symptoms of Diabetes

Most common symptoms of diabetes are fatigue, irritation, stress, tiredness, frequent urination and headache including loss of strength and stamina, weight loss, increase in appetite, etc.

Levels of Diabetes

There are two types of blood sugar levels – fasting blood sugar level and postprandial blood sugar level. The fasting sugar level is the sugar level that we measure after fasting for at least eight hours generally after an overnight fast. Blood sugar level below 100 mg/dL before eating food is considered normal. Postprandial glucose level or PP level is the sugar level which we measure after two hours of eating.

The PP blood sugar level should be below 140 mg/dL, two hours after the meals. Though the maximum limit in both the cases is defined, the permissible levels may vary among individuals. The range of the sugar level varies with people. Different people have different sugar level such as some people may have normal fasting sugar level of 60 mg/dL while some may have a normal value of 90 mg/dL.

Effects of Diabetes

Diabetes causes severe health consequences and it also affects vital body organs. Excessive glucose in blood damages kidneys, blood vessels, skin resulting in various cardiovascular and skin diseases and other ailments. Diabetes damages the kidneys, resulting in the accumulation of impurities in the body.

It also damages the heart’s blood vessels increasing the possibility of a heart attack. Apart from damaging vital organs, diabetes may also cause various skin infections and the infection in other parts of the body. The prime cause of all type of infections is the decreased immunity of body cells due to their inability to absorb glucose.

Diabetes is a serious life-threatening disease and must be constantly monitored and effectively subdued with proper medication and by adapting to a healthy lifestyle. By following a healthy lifestyle, regular checkups, and proper medication we can observe a healthy and long life.

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Simple Steps to Preventing Diabetes

Keeping weight in check, being active, and eating a healthy diet can help prevent most cases of type 2 diabetes.

If type 2 diabetes were an infectious disease, passed from one person to another, public health officials would say we’re in the midst of an epidemic. This difficult disease is striking an ever-growing number of adults, and with the rising rates of childhood obesity, it has become more common in youth, especially among certain ethnic groups ( learn more about diabetes, including the other types and risk factors ).

The good news is that prediabetes and type 2 diabetes are largely preventable. About 9 in 10 cases in the U.S. can be avoided by making lifestyle changes. These same changes can also lower the chances of developing heart disease and some cancers. The key to prevention can be boiled down to five words: Stay lean and stay active.

What if I already have diabetes?

Simple steps to lowering your risk, control your weight.

Excess weight is the single most important cause of type 2 diabetes. Being overweight increases the chances of developing type 2 diabetes seven-fold. Being obese makes you 20 to 40 times more likely to develop diabetes than someone with a healthy weight. [1]

Losing weight can help if your weight is above the healthy-weight range. Losing 7-10% of your current weight can cut your chances of developing type 2 diabetes in half.

Get moving—and turn off the television

Inactivity promotes type 2 diabetes. [2] Working your muscles more often and making them work harder improves their ability to use insulin and absorb glucose. This puts less stress on your insulin-making cells. So trade some of your sit-time for fit-time.

Long bouts of hot, sweaty exercise aren’t necessary to reap this benefit. Findings from the Nurses’ Health Study and Health Professionals Follow-up Study suggest that walking briskly for a half hour every day reduces the risk of developing type 2 diabetes by 30%. [3,4] More recently, The Black Women’s Health Study reported similar diabetes-prevention benefits for brisk walking of more than 5 hours per week. [5] This amount of exercise has a variety of other benefits as well. And even greater cardiovascular and other advantages can be attained by more, and more intense, exercise.

Television-watching appears to be an especially-detrimental form of inactivity: Every two hours you spend watching TV instead of pursuing something more active increases the chances of developing diabetes by 20%; it also increases the risk of heart disease (15%) and early death (13%). [6] The more television people watch, the more likely they are to be overweight or obese, and this seems to explain part of the TV viewing-diabetes link. The unhealthy diet patterns associated with TV watching may also explain some of this relationship.

Tune Up Your Diet

Four dietary changes can have a big impact on the risk of type 2 diabetes.

There is convincing evidence that diets rich in whole grains protect against diabetes, whereas diets rich in refined carbohydrates lead to increased risk [7]. In the Nurses’ Health Studies I and II, for example, researchers looked at the whole grain consumption of more than 160,000 women whose health and dietary habits were followed for up to 18 years. Women who averaged 2-3 servings of whole grains a day were 30% less likely to have developed type 2 diabetes than those who rarely ate whole grains. [8] When the researchers combined these results with those of several other large studies, they found that eating an extra two servings of whole grains a day decreased the risk of type 2 diabetes by 21%.

Whole grains don’t contain a magical nutrient that fights diabetes and improves health. It’s the entire package—elements intact and working together—that’s important. The bran and fiber in whole grains make it more difficult for digestive enzymes to break down the starches into glucose. This leads to lower, slower increases in blood sugar and insulin, and a lower glycemic index. As a result, they stress the body’s insulin-making machinery less, and so may help prevent type 2 diabetes. [9] Whole grains are also rich in essential vitamins, minerals, and phytochemicals that may help reduce the risk of diabetes.

In contrast, white bread, white rice, mashed potatoes, donuts, bagels, and many breakfast cereals have what’s called a high glycemic index and glycemic load . That means they cause sustained spikes in blood sugar and insulin levels, which in turn may lead to increased diabetes risk. [9] In China, for example, where white rice is a staple, the Shanghai Women’s Health Study found that women whose diets had the highest glycemic index had a 21% higher risk of developing type 2 diabetes, compared with women whose diets had the lowest glycemic index. [10] Similar findings were reported in the Black Women’s Health Study. [11]

More recent findings from the Nurses Health Studies I and II and the Health Professionals Follow-Up Study suggest that swapping whole grains for white rice could help lower diabetes risk: Researchers found that women and men who ate the most white rice—five or more servings a week—had a 17% higher risk of diabetes than those who ate white rice less than one time a month. People who ate the most brown rice—two or more servings a week—had an 11% lower risk of diabetes than those who rarely ate brown rice. Researchers estimate that swapping whole grains in place of even some white rice could lower diabetes risk by 36%. [12]

Like refined grains, sugary beverages have a high glycemic load, and drinking more of this sugary stuff is associated with increased risk of diabetes. In the Nurses’ Health Study II, women who drank one or more sugar-sweetened beverages per day had an 83% higher risk of type 2 diabetes, compared with women who drank less than one sugar-sweetened beverage per month. [13]

Combining the Nurses’ Health Study results with those from seven other studies found a similar link between sugary beverage consumption and type 2 diabetes. For every additional 12-ounce serving of sugary beverage that people drank each day, their risk of type 2 diabetes rose 25%. [14] Studies also suggest that fruit drinks— powdered drinks, fortified fruit drinks, or juices—are not the healthy choice that food advertisements often portray them to be. Women in the Black Women’s Health study who drank two or more servings of fruit drinks a day had a 31% higher risk of type 2 diabetes, compared with women who drank less than one serving a month. [15]

How do sugary drinks lead to this increased risk? Weight gain may explain the link. In both the Nurses’ Health Study II and the Black Women’s Health Study, women who drank more sugary drinks gained more weight than women who cut back on sugary drinks. [13,15] Several studies show that children and adults who drink soda or other sugar-sweetened beverages are more likely to gain weight than those who don’t. [15-17] and that switching from these to water or unsweetened beverages can reduce weight. [18] Even so, weight gain caused by sugary drinks may not completely explain the increased diabetes risk. There is mounting evidence that sugary drinks contribute to chronic inflammation, high triglycerides, decreased “good” (HDL) cholesterol, and increased insulin resistance, all of which are risk factors for diabetes. [19]

What to drink in place of the sugary stuff? Water is an excellent choice. Coffee and tea are also good calorie-free substitutes for sugared beverages (as long as you don’t load them up with sugar and cream). And there’s convincing evidence that coffee may help protect against diabetes; [20,21] emerging research suggests that tea may hold diabetes-prevention benefits as well, but more research is needed.

There’s been some controversy over whether artificially sweetened beverages are beneficial for weight control and, by extension, diabetes prevention. [22] Some studies have found that people who regularly drink diet beverages have a higher risk of diabetes than people who rarely drink such beverages, [23,24] but there could be another explanation for those findings. People often start drinking diet beverages because they have a weight problem or a family history of diabetes; studies that don’t adequately account for these other factors may make it wrongly appear as though the diet soda led to the increased diabetes risk. A long-term analysis on data from 40,000 men in the Health Professionals Follow-up Study found that drinking one 12-ounce serving of diet soda a day did not appear to increase diabetes risk. [25] So, in moderation diet beverages can be a sugary-drink alternative for adults.

The types of fats in your diet can also affect the development of diabetes. Healthful fats, such as the polyunsaturated fats found in liquid vegetable oils, nuts, and seeds can help ward off type 2 diabetes. [26] Trans fats do just the opposite. [1,27] These harmful fats were once found in many kinds of margarine, packaged baked goods, fried foods in most fast-food restaurants, and any product that listed “partially hydrogenated vegetable oil” on the label. Eating polyunsaturated fats from fish—also known as “long chain omega 3” or “marine omega 3” fats—does not protect against diabetes, even though there is much evidence that these marine omega 3 fats help prevent heart disease. [28] If you already have diabetes, eating fish can help protect you against a heart attack or dying from heart disease. [29]

The evidence is growing stronger that eating red meat (beef, pork, lamb) and processed red meat (bacon, hot dogs, deli meats) increases the risk of diabetes, even among people who consume only small amounts. A meta-analysis combined findings from the Nurses’ Health Studies I and II, the Health Professionals Follow-up Study, and six other long-term studies. The researchers looked at data from roughly 440,000 people, about 28,000 of whom developed diabetes during the course of the study. [30] They found that eating just one 3-ounce serving of red meat daily—say, a steak that’s about the size of a deck of cards—increased the risk of type 2 diabetes by 20%. Eating even smaller amounts of processed red meat each day—just two slices of bacon, one hot dog, or the like—increased diabetes risk by 51%.

The good news from this study: Swapping out red meat or processed red meat for a healthier protein source , such as nuts, low-fat dairy, poultry, or fish, or for whole grains lowered diabetes risk by up to 35%. Not surprisingly, the greatest risk reductions came from ditching processed red meat.

How meat is cooked may matter too . A study of three large cohorts followed for 12-16 years—including more than 289,000 men and women from the Nurses’ Health Studies and the Health Professionals Follow-up Study—found that participants who most frequently ate meats and chicken cooked at high temperatures were 1.5 times more likely to develop type 2 diabetes, compared with those who ate the least. [31] An increased risk of weight gain and developing obesity in the frequent users of high-temperature cooking methods may have contributed to the development of diabetes.

Why do these types of meat appear to boost diabetes risk? It may be that the high iron content of red meat diminishes insulin’s effectiveness or damages the cells that produce insulin. The high levels of sodium and nitrites (preservatives) in processed red meats may also be to blame. Red and processed meats are a hallmark of the unhealthful “Western” dietary pattern, which seems to trigger diabetes in people who are already at genetic risk. [32]

Furthermore, a related body of research has suggested that plant-based dietary patterns may help lower type 2 diabetes risk, and more specifically, those who adhere to predominantly healthy plant-based diets may have a lower risk of developing type 2 diabetes than those who follow these diets with lower adherence:

• A 2019 meta-analysis that included health data from 307,099 participants with 23,544 cases of type 2 diabetes examined adherence to an “overall” predominantly plant-based diet (which could include a mix of healthy plant-based foods such as fruits, vegetables, whole grains, nuts, and legumes, but also less healthy plant-based foods such as potatoes, white flour, and sugar, and modest amounts of animal products). The researchers also looked at “healthful” plant-based diets, which were defined as those emphasizing healthy plant-based foods, with lower consumption of unhealthy plant-based foods. They found that people with the highest adherence to overall predominantly plant-based diets had a 23% lower risk of type 2 diabetes compared to those with weaker adherence to the diets. The researchers also found that the association was strengthened for those who ate healthful plant-based diets [41]

 Don’t smoke

Add type 2 diabetes to the long list of health problems linked with smoking. Smokers are roughly 50% more likely to develop diabetes than nonsmokers, and heavy smokers have an even higher risk. [33]

Light to moderate alcohol consumption

Evidence has consistently linked moderate alcohol consumption with reduced risk of heart disease. The same may be true for type 2 diabetes. Moderate amounts of alcohol—up to a drink a day for women, up to two drinks a day for men—increases the efficiency of insulin at getting glucose inside cells. And some studies indicate that moderate alcohol consumption decreases the risk of type 2 diabetes. [1, 34-39], but excess alcohol intake actually increases the risk. If you already drink alcohol, the key is to keep your consumption in the moderate range, as higher amounts of alcohol could increase diabetes risk. [40] If you don’t drink alcohol, there’s no need to start—you can get the same benefits by losing weight, exercising more, and changing your eating patterns.

Beyond individual behavior

Type 2 diabetes is largely preventable by taking several simple steps: keeping weight under control, exercising more, eating a healthy diet, and not smoking. Yet it is clear that the burden of behavior change cannot fall entirely on individuals. Families, schools, worksites, healthcare providers, communities, media, the food industry, and government must work together to make healthy choices easy choices. For links to evidence-based guidelines, research reports, and other resources for action, visit our diabetes prevention toolkit .

• Diabetes – overview, types, and risk factors
• Asian Diabetes Prevention Initiative 
• Hu FB, Manson JE, Stampfer MJ, Colditz G, Liu S, Solomon CG, Willett WC. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. New England journal of medicine . 2001 Sep 13;345(11):790-7.
• Rana JS, Li TY, Manson JE, Hu FB. Adiposity compared with physical inactivity and risk of type 2 diabetes in women. Diabetes care . 2007 Jan 1;30(1):53-8.
• Tanasescu M, Leitzmann MF, Rimm EB, Hu FB. Physical activity in relation to cardiovascular disease and total mortality among men with type 2 diabetes. Circulation . 2003 May 20;107(19):2435-9.
• Hu FB, Sigal RJ, Rich-Edwards JW, Colditz GA, Solomon CG, Willett WC, Speizer FE, Manson JE. Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study. JAMA . 1999 Oct 20;282(15):1433-9.
• Krishnan S, Rosenberg L, Palmer JR. Physical activity and television watching in relation to risk of type 2 diabetes: the Black Women’s Health Study. American journal of epidemiology . 2008 Dec 4;169(4):428-34.
• Grøntved A, Hu FB. Television viewing and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a meta-analysis. JAMA . 2011 Jun 15;305(23):2448-55.
• AlEssa H, Bupathiraju S, Malik V, Wedick N, Campos H, Rosner B, Willett W, Hu FB. Carbohydrate quality measured using multiple quality metrics is negatively associated with type 2 diabetes. Circulation . 2015;1:31.
• de Munter JS, Hu FB, Spiegelman D, Franz M, van Dam RM. Whole grain, bran, and germ intake and risk of type 2 diabetes: a prospective cohort study and systematic review. PLoS medicine . 2007 Aug 28;4(8):e261.
• Ludwig DS. The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA . 2002 May 8;287(18):2414-23.
• Villegas R, Liu S, Gao YT, Yang G, Li H, Zheng W, Shu XO. Prospective study of dietary carbohydrates, glycemic index, glycemic load, and incidence of type 2 diabetes mellitus in middle-aged Chinese women. Archives of internal medicine . 2007 Nov 26;167(21):2310-6.
• Krishnan S, Rosenberg L, Singer M, Hu FB, Djoussé L, Cupples LA, Palmer JR. Glycemic index, glycemic load, and cereal fiber intake and risk of type 2 diabetes in US black women. Archives of Internal Medicine . 2007 Nov 26;167(21):2304-9.
• Sun Q, Spiegelman D, van Dam RM, Holmes MD, Malik VS, Willett WC, Hu FB. White rice, brown rice, and risk of type 2 diabetes in US men and women. Archives of internal medicine . 2010 Jun 14;170(11):961-9.
• Schulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MJ, Willett WC, Hu FB. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA . 2004 Aug 25;292(8):927-34.
• Malik VS, Popkin BM, Bray GA, Després JP, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes care . 2010 Nov 1;33(11):2477-83.
• Palmer JR, Boggs DA, Krishnan S, Hu FB, Singer M, Rosenberg L. Sugar-sweetened beverages and incidence of type 2 diabetes mellitus in African American women. Archives of internal medicine . 2008 Jul 28;168(14):1487-92.
• Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. The Lancet . 2001 Feb 17;357(9255):505-8.
• Vartanian LR, Schwartz MB, Brownell KD. Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis. American journal of public health . 2007 Apr;97(4):667-75.
• Ebbeling CB, Feldman HA, Osganian SK, Chomitz VR, Ellenbogen SJ, Ludwig DS. Effects of decreasing sugar-sweetened beverage consumption on body weight in adolescents: a randomized, controlled pilot study. Pediatrics . 2006 Mar 1;117(3):673-80.
• Malik VS, Popkin BM, Bray GA, Després JP, Hu FB. Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation . 2010 Mar 23;121(11):1356-64.
• Huxley R, Lee CM, Barzi F, Timmermeister L, Czernichow S, Perkovic V, Grobbee DE, Batty D, Woodward M. Coffee, decaffeinated coffee, and tea consumption in relation to incident type 2 diabetes mellitus: a systematic review with meta-analysis. Archives of internal medicine . 2009 Dec 14;169(22):2053-63.
• Van Dam RM, Willett WC, Manson JE, Hu FB. Coffee, caffeine, and risk of type 2 diabetes: a prospective cohort study in younger and middle-aged US women. Diabetes care . 2006 Feb 1;29(2):398-403.
• Bellisle F, Drewnowski A. Intense sweeteners, energy intake and the control of body weight. European journal of clinical nutrition . 2007 Jun;61(6):691.
• Lutsey PL, Steffen LM, Stevens J. Dietary intake and the development of the metabolic syndrome. Circulation . 2008 Feb 12;117(6):754-61.
• Dhingra R, Sullivan L, Jacques PF, Wang TJ, Fox CS, Meigs JB, D’Agostino RB, Gaziano JM, Vasan RS. Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community. Circulation . 2007 Jul 31;116(5):480-8.
• De Koning L, Malik VS, Rimm EB, Willett WC, Hu FB. Sugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men. The American journal of clinical nutrition . 2011 Mar 23;93(6):1321-7.
• Risérus U, Willett WC, Hu FB. Dietary fats and prevention of type 2 diabetes. Progress in lipid research . 2009 Jan 1;48(1):44-51.
• Mozaffarian D, Katan MB, Ascherio A, Stampfer MJ, Willett WC. Trans fatty acids and cardiovascular disease. New England Journal of Medicine . 2006 Apr 13;354(15):1601-13.
• Kaushik M, Mozaffarian D, Spiegelman D, Manson JE, Willett WC, Hu FB. Long-chain omega-3 fatty acids, fish intake, and the risk of type 2 diabetes mellitus. The American journal of clinical nutrition . 2009 Jul 22;90(3):613-20.
• Hu FB, Cho E, Rexrode KM, Albert CM, Manson JE. Fish and long-chain ω-3 fatty acid intake and risk of coronary heart disease and total mortality in diabetic women. Circulation . 2003 Apr 15;107(14):1852-7.
• Pan A, Sun Q, Bernstein AM, Schulze MB, Manson JE, Willett WC, Hu FB. Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. The American journal of clinical nutrition . 2011 Aug 10;94(4):1088-96.
• Liu G, Zong G, Wu K, Hu Y, Li Y, Willett WC, Eisenberg DM, Hu FB, Sun Q. Meat cooking methods and risk of type 2 diabetes: results from three prospective cohort studies. Diabetes care . 2018 May 1;41(5):1049-60.
• Qi L, Cornelis MC, Zhang C, Van Dam RM, Hu FB. Genetic predisposition, Western dietary pattern, and the risk of type 2 diabetes in men. The American journal of clinical nutrition . 2009 Mar 11;89(5):1453-8.
• Willi C, Bodenmann P, Ghali WA, Faris PD, Cornuz J. Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA . 2007 Dec 12;298(22):2654-64.
• Djoussé L, Biggs ML, Mukamal KJ, Siscovick DS. Alcohol consumption and type 2 diabetes among older adults: the Cardiovascular Health Study. Obesity . 2007 Jul;15(7):1758-65.
• Rimm EB, Chan J, Stampfer MJ, Colditz GA, Willett WC. Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men. BMJ . 1995 Mar 4;310(6979):555-9.
• Koppes LL, Dekker JM, Hendriks HF, Bouter LM, Heine RJ. Moderate alcohol consumption lowers the risk of type 2 diabetes: a meta-analysis of prospective observational studies. Diabetes care . 2005 Mar 1;28(3):719-25.
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Diabetes prevention: 5 tips for taking control.

Changing your lifestyle could be a big step toward diabetes prevention — and it's never too late to start. Consider these tips.

Lifestyle changes can help prevent the onset of type 2 diabetes, the most common form of the disease. Prevention is especially important if you're currently at an increased risk of type 2 diabetes because of excess weight or obesity, high cholesterol, or a family history of diabetes.

If you have been diagnosed with prediabetes — high blood sugar that doesn't reach the threshold of a diabetes diagnosis — lifestyle changes can prevent or delay the onset of disease.

Making a few changes in your lifestyle now may help you avoid the serious health complications of diabetes in the future, such as nerve, kidney and heart damage. It's never too late to start.

1. Lose extra weight

Losing weight reduces the risk of diabetes. People in one large study reduced their risk of developing diabetes by almost 60% after losing approximately 7% of their body weight with changes in exercise and diet.

The American Diabetes Association recommends that people with prediabetes lose at least 7% to 10% of their body weight to prevent disease progression. More weight loss will translate into even greater benefits.

Set a weight-loss goal based on your current body weight. Talk to your doctor about reasonable short-term goals and expectations, such as a losing 1 to 2 pounds a week.

2. Be more physically active

There are many benefits to regular physical activity. Exercise can help you:

• Lose weight
• Lower your blood sugar
• Boost your sensitivity to insulin — which helps keep your blood sugar within a normal range

Goals for most adults to promote weight loss and maintain a healthy weight include:

• Aerobic exercise. Aim for 30 minutes or more of moderate to vigorous aerobic exercise — such as brisk walking, swimming, biking or running — on most days for a total of at least 150 minutes a week.
• Resistance exercise. Resistance exercise — at least 2 to 3 times a week — increases your strength, balance and ability to maintain an active life. Resistance training includes weightlifting, yoga and calisthenics.
• Limited inactivity. Breaking up long bouts of inactivity, such as sitting at the computer, can help control blood sugar levels. Take a few minutes to stand, walk around or do some light activity every 30 minutes.

3. Eat healthy plant foods

Plants provide vitamins, minerals and carbohydrates in your diet. Carbohydrates include sugars and starches — the energy sources for your body — and fiber. Dietary fiber, also known as roughage or bulk, is the part of plant foods your body can't digest or absorb.

Fiber-rich foods promote weight loss and lower the risk of diabetes. Eat a variety of healthy, fiber-rich foods, which include:

• Fruits, such as tomatoes, peppers and fruit from trees
• Nonstarchy vegetables, such as leafy greens, broccoli and cauliflower
• Legumes, such as beans, chickpeas and lentils
• Whole grains, such as whole-wheat pasta and bread, whole-grain rice, whole oats, and quinoa

The benefits of fiber include:

• Slowing the absorption of sugars and lowering blood sugar levels
• Interfering with the absorption of dietary fat and cholesterol
• Managing other risk factors that affect heart health, such as blood pressure and inflammation
• Helping you eat less because fiber-rich foods are more filling and energy rich

Avoid foods that are "bad carbohydrates" — high in sugar with little fiber or nutrients: white bread and pastries, pasta from white flour, fruit juices, and processed foods with sugar or high-fructose corn syrup.

4. Eat healthy fats

Fatty foods are high in calories and should be eaten in moderation. To help lose and manage weight, your diet should include a variety of foods with unsaturated fats, sometimes called "good fats."

Unsaturated fats — both monounsaturated and polyunsaturated fats — promote healthy blood cholesterol levels and good heart and vascular health. Sources of good fats include:

• Olive, sunflower, safflower, cottonseed and canola oils
• Nuts and seeds, such as almonds, peanuts, flaxseed and pumpkin seeds
• Fatty fish, such as salmon, mackerel, sardines, tuna and cod

Saturated fats, the "bad fats," are found in dairy products and meats. These should be a small part of your diet. You can limit saturated fats by eating low-fat dairy products and lean chicken and pork.

5. Skip fad diets and make healthier choices

Many fad diets — such as the glycemic index, paleo or keto diets — may help you lose weight. There is little research, however, about the long-term benefits of these diets or their benefit in preventing diabetes.

Your dietary goal should be to lose weight and then maintain a healthier weight moving forward. Healthy dietary decisions, therefore, need to include a strategy that you can maintain as a lifelong habit. Making healthy decisions that reflect some of your own preferences for food and traditions may be beneficial for you over time.

One simple strategy to help you make good food choices and eat appropriate portions sizes is to divide up your plate. These three divisions on your plate promote healthy eating:

• One-half: fruit and nonstarchy vegetables
• One-quarter: whole grains
• One-quarter: protein-rich foods, such as legumes, fish or lean meats

When to see your doctor

The American Diabetes Association recommends routine screening with diagnostic tests for type 2 diabetes for all adults age 45 or older and for the following groups:

• People younger than 45 who are overweight or obese and have one or more risk factors associated with diabetes
• Women who have had gestational diabetes
• People who have been diagnosed with prediabetes
• Children who are overweight or obese and who have a family history of type 2 diabetes or other risk factors

Share your concerns about diabetes prevention with your doctor. He or she will appreciate your efforts to prevent diabetes and may offer additional suggestions based on your medical history or other factors.

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• Robertson RP. Prevention of type 2 diabetes mellitus. https://www.uptodate.com/contents/search. Accessed April 12, 2021.
• American Diabetes Association. Prevention or delay of type 2 diabetes: Standards of Medical Care in Diabetes — 2021. Diabetes Care. 2021; doi:10.2337/dc21-S003.
• Diabetes mellitus. Merck Manual Professional Version. https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/diabetes-mellitus-dm. Accessed April 14, 2021.
• American Diabetes Association. Facilitating behavior change and well-being to improve health outcomes: Standards of Medical Care in Diabetes — 2021. Diabetes Care. 2021; doi:10.2337/dc21-S005.
• Your game plan to prevent type 2 diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/all-content. Accessed April 8, 2021.
• Melmed S, et al. Therapeutics of type 2 diabetes mellitus. Williams Textbook of Endocrinology. 14th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed April 8, 2021.
• Interactive Nutrition Facts label: Dietary fiber. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/scripts/interactivenutritionfactslabel/dietary-fiber.cfm. Accessed April 16, 2021.
• 2020-2025 Dietary Guidelines for Americans. U.S. Department of Health and Human Services and U.S. Department of Agriculture. https://www.dietaryguidelines.gov. Accessed April 16, 2021.
• Interactive Nutrition Facts label: Monounsaturated and polyunsaturated fats. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/scripts/interactivenutritionfactslabel/fat.cfm. Accessed April 16, 2021.
• American Diabetes Association. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes — 2021. Diabetes Care. 2021; doi:10.2337/dc21-S002.

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How to Prevent Diabetes

What is type 2 diabetes.

If you have diabetes, your blood sugar levels are too high. With type 2 diabetes , this happens because your body does not make enough insulin, or it does not use insulin well (this is called insulin resistance). If you are at risk for type 2 diabetes, you might be able to prevent or delay developing it.

Who is at risk for type 2 diabetes?

Many Americans are at risk for type 2 diabetes. Your chances of getting it depend on a combination of risk factors such as your genes and lifestyle. The risk factors include:

• Having prediabetes , which means you have blood sugar levels that are higher than normal but not high enough to be called diabetes
• Being overweight or having obesity
• Being age 45 or older
• A family history of diabetes
• Being African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander
• Having high blood pressure
• Having a low level of HDL (good) cholesterol or a high level of triglycerides
• A history of diabetes in pregnancy
• Having given birth to a baby weighing 9 pounds or more
• An inactive lifestyle
• A history of heart disease or stroke
• Having depression
• Having polycystic ovary syndrome (PCOS)
• Having acanthosis nigricans, a skin condition in which your skin becomes dark and thick, especially around your neck or armpits

How can I prevent or delay getting type 2 diabetes?

If you are at risk for diabetes, you may be able to prevent or delay getting it. Most of the things that you need to do involve having a healthier lifestyle. So if you make these changes, you will get other health benefits as well. You may lower your risk of other diseases, and you will probably feel better and have more energy. The changes are:

• Losing weight and keeping it off. Weight control is an important part of diabetes prevention. You may be able to prevent or delay diabetes by losing 5 to 10% of your current weight. For example, if you weigh 200 pounds, your goal would be to lose between 10 to 20 pounds. And once you lose the weight, it is important that you don't gain it back.
• Following a healthy eating plan. It is important to reduce the amount of calories you eat and drink each day, so you can lose weight and keep it off. To do that, your diet should include smaller portions and less fat and sugar. You should also eat a variety of foods from each food group, including plenty of whole grains, fruits, and vegetables. It's also a good idea to limit red meat, and avoid processed meats.
• Get regular exercise. Exercise has many health benefits , including helping you to lose weight and lower your blood sugar levels. These both lower your risk of type 2 diabetes. Try to get at least 30 minutes of physical activity 5 days a week. If you have not been active, talk with your health care professional to figure out which types of exercise are best for you. You can start slowly and work up to your goal.
• Don't smoke. Smoking can contribute to insulin resistance, which can lead to type 2 diabetes. If you already smoke, try to quit .
• Talk to your health care provider to see whether there is anything else you can do to delay or to prevent type 2 diabetes. If you are at high risk, your provider may suggest that you take one of a few types of diabetes medicines .

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

• Diabetes Prevention: 5 Tips for Taking Control (Mayo Foundation for Medical Education and Research) Also in Spanish
• Diabetes Risk Factors (American Heart Association)
• Prevent Type 2 Diabetes in Kids (Centers for Disease Control and Prevention) Also in Spanish

• Simple Steps to Preventing Diabetes (Harvard School of Public Health)

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From Research to Reflection: A Step-by-Step Guide to Writing an Essay on Diabetes

Diabetes is a chronic disease that affects millions of people worldwide. It is characterized by high blood glucose levels, which can lead to various complications if left untreated. One of the most significant complications of diabetes is its impact on cardiovascular health.

The link between diabetes and cardiovascular disease is well-established. People with diabetes are two to four times more likely to develop cardiovascular disease than those without the disease.

The reasons for this are complex, but they include that diabetes can damage blood vessels and nerves throughout the body, including those that supply the heart and brain. This can lead to a range of cardiovascular problems, such as heart attacks, strokes, and peripheral artery disease .

We can guarantee you that most people are not even aware of this much information on diabetes. This is why writing an essay on diabetes makes sense.

What’s more, while writing an essay on diabetes, you make yourself aware of this disease and work towards reflecting on it.

Influence Of Diabetes On The Society

Diabetes can have a significant impact on society in a number of ways.

Here are some examples:

• Healthcare costs: Diabetes is a chronic disease that requires ongoing medical care, including regular check-ups, medications, and in some cases, hospitalization. The cost of treating diabetes can be substantial, both for individuals and for society as a whole. In 2017, the total cost of diabetes in the US was estimated to be $327 billion, including direct medical costs and lost productivity.
• Public health: Diabetes is a major public health issue , with an estimated 463 million adults worldwide living with the disease. Diabetes can lead to various health complications, including heart disease, stroke, kidney disease, and blindness. As a result, diabetes is a leading cause of death and disability worldwide.
• Lifestyle changes: Diabetes is closely linked to lifestyle factors such as diet and physical activity. As a result, efforts to prevent or manage diabetes often involve promoting healthy lifestyle habits such as regular exercise and a balanced diet. These lifestyle changes can have a broader impact on society by promoting overall health and well-being.
• Stigma: Diabetes can be stigmatized, with some people blaming individuals with diabetes for their disease. This can lead to discrimination and social isolation, which can have a negative impact on mental health and well-being.
• Education and awareness: Diabetes education and awareness campaigns can play an important role in reducing the impact of diabetes on society. By promoting an understanding of the disease and its risk factors and encouraging early diagnosis and treatment, these campaigns can help to improve health outcomes and reduce healthcare costs.

Diabetes can significantly impact society, both in terms of healthcare costs and public health outcomes. By promoting education and awareness and encouraging healthy lifestyle habits, we can work to reduce the impact of diabetes on individuals and society as a whole.

Why Such A Subject?

While there are many subjects to write essays on, why write an essay on such a difficult subject? Well, when an educational institution asks you to write an essay, they look at your writing skills and try to figure out your personality along with it.

If you are writing about something that can bring change in society, it can impress them. Writing an essay on diabetes will allow you to stand out from all the other students who have submitted essays on almost the same topic.

Below are a few reasons why writing an essay on diabetes is a good idea.

• To Raise Awareness: Diabetes is a chronic disease that affects millions of people worldwide, yet many people are still unaware of its causes, symptoms, and complications. Writing an essay on diabetes can help raise awareness about the disease, its impact on individuals and communities, and the importance of prevention and management.
• To Educate: Diabetes is a complex disease that requires careful management and monitoring. Writing an essay on diabetes can help educate individuals about the different types of diabetes, risk factors, signs and symptoms, and treatment options.
• To Promote Research: There is ongoing research on diabetes, including new treatments and management strategies. Writing an essay on diabetes can help promote research by highlighting the importance of funding and supporting research efforts.
• To Advocate For Change: Writing an essay on diabetes can help advocate for policy changes that improve access to diabetes care, support for those with diabetes, and prevention efforts.
• To Demonstrate Understanding: Writing an essay on diabetes can be an opportunity to demonstrate an understanding of the disease and its impact on individuals and communities. It can also showcase critical thinking skills and research abilities.

Writing an essay on diabetes can help raise awareness, educate, promote research, advocate for change, and demonstrate an understanding of the disease. It can be an important way to promote public health and improve the lives of individuals with diabetes.

A Step-by-Step Guide To Writing An Essay On Diabetes

Writing an essay on diabetes requires thorough research and reflection. You can’t just proceed with a diabetes essay like any normal essay topic. When writing an essay on diabetes, you can’t get wrong with your facts and information. One mistake in your information can affect your whole efforts.

When you are doing research for your essay, ensure that you are picking information from credible resources.

Follow the steps below to write a high-quality essay.

Step 1: Choose A Specific Topic

The topic of diabetes is vast, so it is essential to narrow it down to a specific area you can thoroughly explore in your essay. Consider the audience, the essay’s purpose, and the assignment’s scope. For instance, you could focus on the causes of diabetes, the different types of diabetes, the impact of diabetes on a particular population, or the latest treatment options for diabetes.

Step 2: Conduct Research

Once you have a specific topic, conduct thorough research to gather relevant information from credible sources such as academic journals, government publications, and reputable websites. Take notes on key points, statistics, and quotes that you can use to support your arguments.

Step 3: Develop A Thesis Statement

Based on your research, develop a clear and concise thesis statement that summarizes the main argument of your essay. Your thesis statement should be debatable and provide a roadmap for the rest of your essay.

Step 4: Create An Outline

Use your research and thesis statement to create an outline for your essay. Organize your ideas into logical sections and subsections, and ensure each point supports your thesis statement.

Step 5: Write The Essay

Using your outline as a guide, write your essay. Start with an introduction that provides background information and a clear thesis statement. Use the body paragraphs to present your arguments and support them with evidence from your research. End with a conclusion that restates your thesis and summarizes your main points.

Step 6: Edit And Proofread

After you have written your essay, edit and proofread it carefully to ensure it is clear, concise, and error-free. Check for spelling and grammatical errors, and ensure your ideas flow logically.

Step 7: Reflect On Your Essay

Finally, take some time to reflect on your essay. Consider the strengths and weaknesses of your argument, and think about what you could have done differently. This reflection can help you improve your writing skills and prepare for future assignments.

By following this step-by-step guide, you can write a well-researched and thoughtful essay on diabetes. Remember to choose a specific topic, conduct thorough research, develop a clear thesis statement, create an outline, write the essay, edit and proofread, and reflect on your work.

However, if you find it difficult to write an essay on diabetes, but the opportunity is too good to miss, ask a professional to ‘ write my essay for me ’.

Things To Consider!

Define your purpose.

Before you start writing, it’s important to clarify why you’re writing about diabetes.

Are you trying to educate readers about the disease? Discuss a specific aspect of diabetes research or treatment. Argue for a particular approach to diabetes prevention or management.

Defining your purpose can help guide your writing and ensure that you stay focused on your main goals.

Know Your Audience

Who will be reading your essay? Are they experts in diabetes, or are they general readers who may not be familiar with the disease? Understanding your audience can help you tailor your writing style and language to make your essay as accessible and engaging as possible.

Research Thoroughly

Diabetes is a complex and multi-faceted disease, so it’s important to do your research to ensure you comprehensively understand the topic. Find reputable sources, such as peer-reviewed journals, government websites, or expert organizations like the American Diabetes Association.

Consider Multiple Perspectives

There are many different viewpoints on diabetes, from healthcare providers to patients to public health advocates. When writing your essay, consider different perspectives and present a balanced view of the topic.

Use Clear, Concise Language

Diabetes is a technical topic with many medical terms and concepts that may be unfamiliar to some readers. To make your essay as accessible as possible, try to use clear, concise language that is easy to understand. Use layman’s terms when appropriate, and define any technical terms you use.

Use Examples And Anecdotes

Diabetes can be a dry and technical topic, so using examples and anecdotes can help to bring your writing to life and make it more engaging for readers. Consider including real-life stories of people with diabetes or describing specific research studies or medical interventions in detail.

Edit And Proofread Carefully

Finally, edit and proofread your essay carefully before submitting it. Look for spelling and grammar errors and any unclear or confusing language. Consider having someone else read your essay to get a fresh perspective and catch any mistakes you may have missed.

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What Is Diabetes?

• Español

Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Glucose is your body’s main source of energy. Your body can make glucose, but glucose also comes from the food you eat.

Insulin is a hormone  made by the pancreas  that helps glucose get into your cells to be used for energy. If you have diabetes, your body doesn’t make enough—or any—insulin, or doesn’t use insulin properly. Glucose then stays in your blood and doesn’t reach your cells.

Diabetes raises the risk for damage to the eyes, kidneys, nerves, and heart. Diabetes is also linked to some types of cancer. Taking steps to prevent or manage diabetes may lower your risk of developing diabetes health problems.

What are the different types of diabetes?

The most common types of diabetes are type 1, type 2, and gestational diabetes.

Type 1 diabetes

If you have type 1 diabetes , your body makes little or no insulin. Your immune system  attacks and destroys the cells in your pancreas that make insulin. Type 1 diabetes is usually diagnosed in children and young adults, although it can appear at any age. People with type 1 diabetes need to take insulin every day to stay alive.

Type 2 diabetes

If you have type 2 diabetes , the cells in your body don’t use insulin properly. The pancreas may be making insulin but is not making enough insulin to keep your blood glucose level in the normal range. Type 2 diabetes is the most common type of diabetes. You are more likely to develop type 2 diabetes if you have risk factors , such as overweight or obesity , and a family history of the disease. You can develop type 2 diabetes at any age, even during childhood.

You can help delay or prevent type 2 diabetes  by knowing the risk factors and taking steps toward a healthier lifestyle, such as losing weight or preventing weight gain.

Gestational diabetes

Gestational diabetes is a type of diabetes that develops during pregnancy. Most of the time, this type of diabetes goes away after the baby is born. However, if you’ve had gestational diabetes, you have a higher chance of developing type 2 diabetes later in life. Sometimes diabetes diagnosed during pregnancy is type 2 diabetes.

Prediabetes

People with prediabetes  have blood glucose levels that are higher than normal but not high enough to be diagnosed with type 2 diabetes. If you have prediabetes, you have a higher risk of developing type 2 diabetes in the future. You also have a higher risk for heart disease than people with normal glucose levels.

Other types of diabetes

A less common type of diabetes, called monogenic diabetes , is caused by a change in a single gene . Diabetes can also come from having surgery to remove the pancreas, or from damage to the pancreas due to conditions such as cystic fibrosis or pancreatitis .

How common are diabetes and prediabetes?

More than 133 million Americans have diabetes or prediabetes. 1

As of 2019, 37.3 million people—or 11.3% of the U.S. population—had diabetes. 1 More than 1 in 4 people over the age of 65 had diabetes. Nearly 1 in 4 adults with diabetes didn’t know they had the disease. 2

About 90% to 95% of diabetes cases are type 2 diabetes. 3

In 2019, 96 million adults—38% of U.S. adults—had prediabetes. 4

What other health problems can people with diabetes develop?

Over time, high blood glucose can damage your heart , kidneys , feet , and eyes . If you have diabetes, you can take steps to lower your chances of developing diabetes health problems  by taking steps to improve your health  and learning how to manage the disease . Managing your blood glucose, blood pressure, and cholesterol levels can help prevent future health problems.

This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.

NIDDK would like to thank: Daniel Bessesen, M.D., University of Colorado; Domenico Accili, M.D., Columbia University

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Management of Type 2 Diabetes: Current Strategies, Unfocussed Aspects, Challenges, and Alternatives

Swapnil p. borse.

a AYUSH-Center of Excellence, Center for Complementary and Integrative Health (CCIH), Interdisciplinary School of Health Sciences, Savitribai Phule Pune University (SPPU), Pune, India

b Department of Pharmacology and Toxicology, B. V. Patel Pharmaceutical Education and Research Development (PERD) Centre, Thaltej, India

Abu Sufiyan Chhipa

c Institute of Pharmacy, Nirma University, Ahmedabad, India

Vipin Sharma

d Translational Health Science and Technology Institute, Faridabad, India

Devendra Pratap Singh

e Sun Pharmaceutical Industries Ltd., Vadodara, India

Manish Nivsarkar

Type 2 diabetes mellitus (T2DM) accounts for >90% of the cases of diabetes in adults. Resistance to insulin action is the major cause that leads to chronic hyperglycemia in diabetic patients. T2DM is the consequence of activation of multiple pathways and factors involved in insulin resistance and β-cell dysfunction. Also, the etiology of T2DM involves the complex interplay between genetics and environmental factors. This interplay can be governed efficiently by lifestyle modifications to achieve better management of diabetes. The present review aims at discussing the major factors involved in the development of T2DM that remain unfocussed during the anti-diabetic therapy. The review also focuses on lifestyle modifications that are warranted for the successful management of T2DM. In addition, it attempts to explain flaws in current strategies to combat diabetes. The employability of phytoconstituents as multitargeting molecules and their potential use as effective therapeutic adjuvants to first line hypoglycemic agents to prevent side effects caused by the synthetic drugs are also discussed.

• Type 2 diabetes is a multifactorial disorder that leads to a disturbed glucose homeostasis.
• Lifestyle management along with pharmacological approaches is crucial to achieve a successful management of diabetes.
• Complex interplays between genetics and environmental factors play important roles in the development of diabetes.
• Combinational therapies employed after failure of monotherapy result in comorbidities.
• Phytoconstituents are better alternatives owing to their multitargeting capability.

Introduction

Insulin resistance and β-cell dysfunction are the 2 major hallmarks of type 2 diabetes mellitus (T2DM) that appear as the result of disturbed homeostasis [ 1 ]. Failure of β-cells (∼80% of their β-cell function) and insulin resistance in muscles and the liver is a vicious triumvirate responsible for the core physiological defects. However, T2DM is classically viewed as a disorder of insulin deficiency and resistance, and further insights into the pathophysiology of T2DM suggest the role of other key players in insulin deficiency and its functional inability. Pancreatic islets are composed of insulin-releasing β-cells (48–59%), glucagon-releasing α-cells (33–46%), somatostatin (SsT)-releasing δ-cells, and F cells that release polypeptides (PPs) in similar proportion [ 2 ]. Moreover, paracrine interactions occur in the sequence from β-cell to α-cells followed by δ-cells and PP-cells/F-cells [ 3 ]. While the β-cell interactions are emphasized at present, the interaction of other cells in pancreas is of crucial importance that needs to be explored further to understand their roles in glucose homeostasis [ 2 ]. Also, the development of glucose resistance in T2DM is largely influenced by fat cells (accelerated lipolysis), gastrointestinal tract (incretin deficiency/resistance), α-cells (hyperglucagonemia), kidneys (increased glucose reabsorption) and brain (insulin resistance), and complex interactions that occur between these factors and T2DM associated genes [ 4 ]. Changes in the lifestyle of T2DM patients are crucial along with pharmacological interventions to improve the overall health status of the patient. The present review discusses our current understanding of the pathogenesis of T2DM and attempts to emphasize on generally unfocused aspects of T2DM pathogenesis and treatment that may contribute significantly to treatment approaches and patient-related outcomes.

Understanding the Diabetes Machinery: The Unfocused Aspects

Amylin proteins and pancreatic β-cell function.

β-Cells are the most extensively studied pancreatic cells for their roles in glucose homeostasis in T2DM. Islet amyloid PP (amylin) is a β-cell peptide hormone that is secreted along with insulin in the ratio of approximately 100:1. Its secretion is also altered in diabetic patients. Amylin functions as an inhibitor of glucagon secretion and delays gastric emptying thus acting as a satiety agent [ 5 ]. Amylin action is executed through an area postrema (glucose-sensitive part of the brain stem) that collectively aims to reduce the demand of total insulin [ 6 ]. Besides these functions, amylin also plays roles in the destruction of β-cell via the formation of amyloid aggregates and fibers [ 7 ]. Findings from histopathology have shown the accumulation of extracellular amyloid proteins, hyperphosphorylated tau, ubiquitin, apolipoprotein E, apolipoprotein (a), c-Jun N-terminal kinases (JNK1), and islet-brain 1/JNK1 interacting protein-1 (IB1/JIP-1) as the characteristic feature of pancreatic islets in T2DM individuals, suggesting that amylin in association with endocrine system plays important roles in physiology, pathology, and progression of T2DM [ 8 ].

α-Cells

α-cells are known to play crucial roles in the pathophysiology of T2DM. The secretion of glucagon from α-cell is regulated by glucose, hormones, and other substrates that work in unison. Any abnormality in α-cells is reflected in altered glucose homeostasis [ 9 ]. In T2DM, a relative elevated secretion of glucagon takes place in fasting and postprandial states during normal and increased glucose levels along with altered hypoglycemic response [ 10 ]. According to the bi-hormonal hypothesis, T2DM is the consequence of insulin resistance/deficiency with a relative excess glucagon secretion, leading to a rate of hepatic glucose production that is much higher than the rates of glucose utilization. This consequently results in hyperglycemia. The hypothesis is supported by a plethora of clinical and experimental investigations [ 11 , 12 ]. Reduced suppression of glucagon release under hyperglycemic conditions is a contributing factor to postprandial hyperglycemia [ 13 ]. Interestingly, α-cells do not show this behavior in the presence of adequate insulin levels, suggesting that impairment in insulin machinery also cause the abnormalities in glucagon release in T2DM [ 14 ]. In addition to this, hypoglycemia is remarkably influenced by glucagon secretion in T2DM patients treated with insulin. In such patients, the secretory response of α-cells to low-glucose concentrations is compromised, which further aggravates the risks of severe hypoglycemia [ 15 ]. The deficiency of glucagon action in response to hypoglycemia is linked with multiple failures in α-cell regulation [ 16 ]. Even in the situation of islet allotransplantation that helps diabetes patients to remain independent to insulin for a long time, the retarded response of α-cell response to hypoglycemia usually remains unaffected, indicating that the procedure does not completely restore the physiological functions of α-cells [ 17 ]. Collectively, defects in α-cell regulation and glucagon secretion lead to defective glucose sensing, loss of β-cell function, and insulin resistance.

δ-Cells, SsT, and Pancreatic PP Cells (F-Cells)

The δ-cells are located in the stomach, intestine, neuroendocrine cells, and pancreas. They secrete SsT in a pulsatile manner in response to fluctuations in glucose levels [ 18 ]. SsT regulates the endocrine functions and also plays an important role in the gut-brain axis. The receptors of SsT are present on α- and β-cells where they act as inhibitory receptors for the secretion of insulin and glucagon. SsT exerts a tonic inhibitory effect on the secretion of insulin and glucagon and facilitates the islet response to cholinergic activation. In addition, SsT is also involved in the suppression of nutrient-induced glucagon secretion [ 19 ]. Further, SsT significantly alters the normal glucose homeostasis and feedback loops [ 20 ].

F-cells of the pancreas release pancreatic PP after the food intake. It exerts inhibitory postprandial effects on gastric emptying, intestinal motility, exocrine pancreatic secretion, hepatic glucose production, and gallbladder contraction. Functional abilities of PP significantly affect food intake and energy metabolism [ 21 ]. When administered through intracerebroventricular route, PP exerts an orexigenic (appetite stimulating) effect in the brain. On contrary, intraperitoneal administration of PP reduces the food intake and lowers body weight by enhancing energy expenditure [ 22 , 23 ]. Increased plasma levels of PP are implicated in obesity and diabetes.

Adipose Tissue and Resistin

Adipose tissue consists of adipocytes, connective tissue matrix, nerve tissue, stromovascular cells, and immune cells. The role of adipose tissue as an endocrine organ is well established [ 24 ]. It releases leptin, cytokines, adiponectin, complement components, plasminogen activator inhibitor-1, proteins of the renin-angiotensin system, and resistin. Apart from secreting factors/hormones, adipose tissue also functions in coordination with other hormone systems and the central nervous system. Typically, adipose tissues serve as a store house for fat under normal conditions, while they also release free fatty acids (FFAs) in metabolic disorders. Consistent decline in the function of β-cell in normal individuals has been shown to be associated with progressive secretion of FFAs and insulin resistance in adipose tissue [ 25 ]. Resistin or adipose tissue-specific secretory factor released from adipose tissue is largely implicated in the progression and development of T2DM [ 24 ]. It acts as an inhibitory hormone that causes resistance to insulin [ 26 ]. Levels of circulating resistin increase in T2DM, resulting in oxidative stress, insulin resistance, and platelet activation [ 27 ]. Expression of the resistin gene is also observed in the pancreatic islets, pituitary, and hypothalamus [ 28 ]. Although resistin is primarily secreted by macrophages in humans [ 29 ] where it is involved in the recruitment of immune cells and pro-inflammatory factors, the involvement of resistin is also seen in hyperglycemia and insulin resistance [ 30 , 31 ]. Resistin-induced hyperglycemia and obesity are induced through the activation of AMP-protein kinase and decreased expression of gluconeogenic enzymes in the liver. Induction of insulin resistance is also evident in rodents after the administration of recombinant resistin that reverses with the immune neutralization [ 32 ].

T2DM is notorious for being “the geneticist's nightmare.” Occurring due to the combined contribution of genetic and environmental factors, leading to multiple gene alterations [ 33 ]. Multiple mechanisms act either directly or in association with other factors to influence the development and progression of T2DM. These include defects in pancreatic angiogenesis, innervation, and modification of parental imprinting [ 34 ]. The pathogenesis of T2DM depends on the intensity of both maternal and paternal insulin resistivity and/or insulin sensitivity [ 35 ]. According to one study, the first-degree relatives of T2DM patients live at a higher risk of developing T2DM and have a strong genetic predisposition to β-cell failure [ 36 ]. Moreover, β-cell dysfunction, autosomal dominance, and heterozygous mutations in β-cell transcription factors are some of the major causes leading to early onset of T2DM. The identified genes responsible for the early-onset T2DM include insulin promoter factor-1, hepatocyte nuclear factor (HNF)-4α, NeuroD1/BETA2, HNF-1α, and HNF-1β [ 37 ]. A hyperglycemic intrauterine environment has also been implicated in T2DM or pre-diabetes in the offspring of women suffering from gestational diabetes [ 38 ]. Also, during gestational diabetes, the expression of insulin receptor-β, PI3K (phosphatidylinositol 3-kinase) with its subunit p85α and GLUT-4 decreases with a compensatory elevation in the expression of GLUT-1 mRNA in placental tissues [ 39 ]. Polymorphism in resistin gene 299 (G>A) and increase in serum resistin is also known to be a contributing factor to increased insulin resistance with a subsequent higher risk of T2DM in offspring. Moreover, offspring carrying AA and combined GA + AA genotypes tend to be at higher risk [ 40 ]. On the other hand, diabetes also has the capacity to make genetic alterations leading to associated comorbidities. For instance, alterations in genes involved in vitamin synthesis leads to lowering of levels of riboflavin and glycemia, microalbumineria, and altered levels of uric acid in T2DM individuals and development of insulin resistance due to vitamin D deficiency [ 41 , 42 , 43 , 44 , 45 , 46 ]. Importantly, the genes of vitamin D receptor and its binding protein along with CYP1α show polymorphisms in diabetics [ 42 , 43 , 44 ].

The gut serves as a prominent link between the brain and the enteric nervous system [ 47 ]. The secretion of gastrointestinal hormones (incretin, glucagon-like peptide-1 [GLP-1], and glucose-dependent insulinotropic polypeptide [GIP]) increases after food intake. These hormones assist insulin and glucagon in maintaining glucose homeostasis and improve α-cell glucose sensing. GLP-1 promotes assimilation of ingested nutrients through glucose-stimulated insulin secretion and evidently improves β-cell sensitivity to glucose [ 48 ]. Moreover, GLP-1 also suppresses glucose-dependent glucagon secretion, retards gastric emptying, and promotes satiety [ 49 ]. In the pancreas, β-cell proliferation and inhibition of apoptosis are promoted by GIP and GLP-1 that ultimately expand pancreatic β-cell mass. In addition, fat deposition is also facilitated by GIP. In the brain, GIP and GLP-1 are involved in appetite control. GIP also decreases gastric acid secretion, while GLP-1 decreases the duration of gastric emptying. Moreover, the insulinotropic effects of GIP and GLP-1 differ in T2DM patients such that GLP-1 secretion is impaired, while the secretion of GIP remains unaffected [ 50 ]. Alterations in incretin functioning and the associated pathways result in increased gastrointestinal permeability in T2DM and form one of the basic underlying mechanisms responsible for diabetic comorbidities in the latter phase [ 48 , 49 , 51 ].

The gut also releases other hormones which are involved in multiple signaling cascades. These include (but not limited to) ghrelin, galanin, cholecystokinin (CCK or pancreozymin) and leptin [ 52 ]. The enteroendocrine cells (I cells of the duodenum and jejunum) and neurons synthesize and release CCK in response to meals and induce pancreatic acinar cells to secrete pancreatic digestive enzymes. CCK also reduces gastric emptying and enhances the digestion process [ 53 ]. Vagus stimulation causes trypsin release from pancreas that hydrolyzes CCK to maintain homeostasis through the feedback mechanism. CCK is positively associated with leptin and insulin levels resulting in disrupted glucose homeostasis and diabetic complications in T2DM [ 53 , 54 ].

Gut Microbiota

Diabetes is considered as a disease of the intestine where gut microbiota plays a crucial role [ 55 , 56 ]. The concentration of microflora distally increases along the length of the gastrointestinal tract [ 57 ]. The flora of the upper intestine generally accounts for <10 5 cfu/mL of the total microflora content. The concentration of microflora increases in the mid-ileum to 10 7 cfu/mL and ultimately populates the colon heavily [ 57 , 58 ]. Commonly populating bacteria in humans are (a) Firmicutes (60–80%): Ruminiococcus , Clostridium , and Lactobacillus ; (b) Bacteroidetes (20–30%): Bacteroides , Prevotella , and Xylanibacter ; (c) Actinobacteria (<10%): Bifidobacterium ; (d) Proteobacteria (<1%): Escherichia and Enterobacteriaceae ; and (e) yeast Saccharomyces boulardi [ 59 ]. Obesity/adiposity is undoubtedly a pivotal contributing factor in T2DM. Interestingly, the level of Staphylococcus , Enterobacteriaceae , Faecalibacterium prausnitzii , and E. coli increases during obese conditions, while Bacteroides concentration decreases [ 60 ]. Moreover, in T2DM, Firmicutes , Lactobacillus gasseri , Streptococcus mutans , and E. coli are increased, while proteobacteria, butyrate-producing bacteria, Bacteroidetes , Roseburia , Eubacterium halii , and Faecalibacterium prauznitzii are decreased considerably [ 59 ]. Changes in gut microbiota/gut-brain microbiota result in insulin resistance and disease/metabolic syndrome [ 59 , 61 ]. Also, low-grade inflammation is remarkably influenced by obesity in association with alteration of gut-brain-microbiota interactions that render T2DM as an inflammatory disorder [ 62 ]. An increased intestinal permeability due to inflammation is evident in obesity and diabetes that may reach to leak gut conditions to facilitate the entry of gut microbes into circulation. This increases circulating LPS and thereby activates inflammasome formation [ 63 ]. Moreover, vagal control is significantly compromised in diabetes in association with chronic hyperglycemia, damaged interstitial cells of Cajal and gastroparesis (5–12% diabetic patients) [ 64 ]. Increase in mucosal surface area, intestinal weight, and number of goblet cells per villus leads to disrupted esophagus peristalsis and lower sphincter tone [ 65 ]. The overall disturbances in intestinal motor functions lead to stasis and bacterial outgrowth; thus, possibly disturbing the intestinal barrier and affecting permeability to allow the entry of microbes [ 63 , 64 , 65 ]. Moreover, circulating LPS are involved in the insulin resistance and diabetes progression toward comorbidities [ 63 , 65 , 66 ]. Gut microbes influence the metabolic and immune networks of the host to cause obesity and diabetes through enhanced nutrient absorption from the diet, cellular uptake of circulating triglycerides, prolonged intestinal transit time, altered bile acid enterohepatic cycle, enhanced de novo lipogenesis, reduced FFA oxidation, altered tissue composition of biologically active polyunsaturated fatty acid, chronic low-grade inflammation triggered by the endotoxin TLR-4 axis, and altered intestinal barrier function [ 67 ].

Lifestyle Modifications, Environmental Factors, and Management of T2DM

The pharmacological approach to treat T2DM can be only partly effective in the long-term management of diabetes. Major modifications in the lifestyle of patients along with the interventions through pharmacological approaches are crucial to ensure an effective management of the disease. These include changes in physical activity, dietary modifications, management of stress or associated factors, and improved sleeping patterns. The next few sections of this review will discuss and explore the potential of these factors in the management of diabetes when followed in parallel with the pharmacological management of the disease.

Physical Activity

Physical activity is positively associated with controlled glycemic levels among T2DM patients. Moderate but daily physical activity has been found to be an effective way to control the long-term manifestations of diabetes. These include walking, gardening, and performing common household chores. Walking is the most effective physical activity in T2DM, as it allows significant glycemic control with limited physical burden in patients who are already physically weak [ 68 ]. Moreover, a much warranted lifestyle alteration in T2DM patients are changes in sedentary patterns. Sedentary behavior leads to considerably low expenditure of energy. An extended sedentary period in T2DM patients is also associated with uncontrolled glycemic levels. A reduced sedentary time, therefore, is crucial in diabetes patients, which can be achieved by increasing the physical work [ 69 ]. In addition, regular aerobic exercise is acknowledged to improve HbA1c levels in patients with diabetes [ 70 ]. Aerobic exercise tends to improve health outcomes in patients through multiple mechanisms that include the manifold increase in mitochondrial densities, improved sensitivity to insulin, improved compliance of blood vessels, and lung functions with enhanced cardiac output [ 71 ].

Dietary Changes and Medical Nutrition Therapy

Insulin resistance and subsequent appearance of T2DM are closely linked with high intake of sugars, fried food, and red meat [ 72 ]. On the contrary, reduced risk of T2DM development is observed in case of intake of vegetables having high content of antioxidants, fiber, and other nutrients [ 73 , 74 ]. The average energy intake of diabetes patients differs with their obesity status. Usually, for a nonobese diabetic patient, an average energy intake of 1,500–2,500 calories per day is recommended, while for obese patients, the average calorie intake is reduced to 800–1,500 calories per day. Limited intake of refined sugars is highly recommended in T2DM patients. Non-nutritive sweeteners (aspartame, saccharine, etc.) can be the good substitutes for sugar in such patients. Moreover, the restricted intake of food rich in saturated fats and cholesterol and its replacement with food rich in polysaturated fats is also recommended. In addition, changes in eating patterns, such as dividing meals into small fractions over the day rather than taking 1 or 2 large meals can prevent vigorous postprandial peaks in blood glucose levels [ 75 ]. Strict adherence to controlled diet with sufficient physical activity is largely associated with lower incidence of diabetes [ 76 ]. Incorporation of Paleolithic diet (a diet rich in lean meat, fish, fruits, and vegetables) in the daily routine of diabetic patients results in marked improvement in glucose handling [ 77 ]. The employment of nutritional therapy in the management of diabetes is also widely suggested. Nutritional therapy is an approach to treat a disease through the modifications in food and nutrition intake. The application of evidence-based nutrition care therapy in diseased patients by a qualified and registered dietician is termed as medical nutrition therapy [ 78 ]. Reduced reliance on oral hypoglycemic therapy is evident in diabetes patients receiving nutritional therapy [ 79 ]. Also, considerable improvements in clinical outcomes are observed in diabetes patients receiving intensive nutritional education by registered dietician in comparison to patients receiving basic nutrition information (BE) [ 80 ]. Taken together, simple but profound changes in dietary pattern in diabetic patients is a potential approach to curb the long-term implications of diabetes. Moreover, successful application of nutritional therapy in individuals with diabetic conditions can be a lucrative approach to achieve a better management of diabetes with improved health outcomes.

Increased levels of stress are associated with poor treatment adherence and glycemic control in T2DM patients [ 81 ]. In a longitudinal study, moderate/high levels of stress were found to be accountable for multifold increase in the incidences of diabetes [ 82 ]. Moreover, consistent exposure to stressors, compromised mental health, and psychological stress are highly implicated in increasing risk of T2DM development [ 83 ]. Allostatic load (wear and tear in the body occurring as a result of chronic exposure to psychological stress) is assumed to be the major factor responsible for this increased risk of T2DM in such individuals [ 84 ]. In addition, consistent stress is also implicated in worsening of clinical outcomes in T2DM patients. Chronic stress is associated with dysregulated glucose metabolism and neuroendocrine function accompanied with low-grade inflammation. A majority of factors that are implicated in T2DM are largely influenced by psychological stress including the release of glucose (and lipids) in circulation, expression of inflammatory cytokines, and elevated blood pressure [ 85 ]. In one study, in type 2 diabetes patients when exposed to acute stress during the postprandial period, considerable increases in blood glucose levels were observed [ 86 ]. Apparently, treatment strategies, including stress management interventions, are a promising approach in effectively preventing or controlling the incidence of type 2 diabetes.

Sleep Patterns and Chronopharmacology

Although physical activity and maintained dietary pattern result in considerable improvements in the management of T2DM, they cannot be envisioned as the sole contributors to the worsening of diabetes incidences. Sleep is another modifiable lifestyle behavior that has proven roles in influencing metabolic health and energy status. Optimization of sleeping patterns is crucial in diabetes control [ 87 ]. A population-based study suggests that short sleep (<5 h) or insomnia is associated with increased risk of T2DM [ 88 ]. In similar studies, poor sleep was associated with higher HbA1c levels (>7%) and insulin resistance in T2DM patients [ 88 ]. Disturbed circadian rhythms and sleep-wake patterns also result in significant effect on onset, development, and management of diabetes [ 89 ]. Shift workers tend to remain much prone to metabolic disorders due to consistent sleep loss and disrupted circadian rhythm [ 90 ]. In addition, developed propensity of napping as a consequence of poor or insufficient nocturnal sleep is also associated with high risk of T2DM [ 91 ]. In one study, experimental manipulation of sleep and circadian pattern resulted in significant reduction in insulin response to standardized meal which could be recovered with restored sleeping patterns [ 92 ]. Changes in hormones that regulate appetite (leptin and ghrelin) are observed to be associated with short sleep causing an increased urge for carbohydrate-rich food and increased calorie intake [ 89 , 93 ]. Moreover, lack of sleep also results in oxidative stress and release of orexin or hypocretin, a neuropeptide that regulates sleep and appetite and causes the stimulation of sympathetic nervous system and increased release of cortisol with simultaneous decrease in growth hormone secretion, all leading to considerable hyperglycemia [ 89 , 94 ].

Pharmacokinetics and pharmacodynamics (PK-PD) are markedly influenced by daily rhythms in physiology. This phenomenon is termed chronopharmacology [ 95 ]. Indeed, the pathogenesis of diabetes largely depends on hormonal and body homeostasis. Chronopharmacology should be considered as part of treatment strategies for diabetes. The failing β-cells in T2DM do not lose all their capability to respond to glucose. Insulin secretion in response to stimulation through amino acids or other hormones such as glucagon-like peptide 1 (GLP-1), remains preserved [ 96 ]. The levels of leptin (satiety hormone) in blood generally remain higher between midnight and early morning, conceivably to suppress appetite during the night [ 97 ]. Moreover, the levels of ghrelin increase with increase in the duration of sleep [ 93 ]. In addition, the time dependency in GLUT4-mediated glucose uptake is also a function of circadian variation [ 98 ]. Furthermore, meal timings can modify the diurnal rhythm of blood leptin levels [ 99 ]. Both ghrelin and leptin work with other hormones and HPA axis through feedback loops to indirectly affect the psychophysiological satisfaction in diabetic patients [ 100 ]. Chronopharmacology, therefore, may considerably affect diabetic pathophysiology and PK-PD of administered drugs.

Interplay of Genetics, Gut Microbiota, Lifestyle, and Environmental Factors

Multiple epidemiological investigations have suggested that the effects of multiple T2DM-associated loci can be attenuated by improving lifestyle, dietary patterns, and other associated environmental factors. For instance, the Ala12 variant of PPARγ is associated with improved insulin sensitivity. Apparently, the Ala12 carriers are more responsive to unsaturated fat and less responsive to saturated fat. On contrary, the Pro12 variant carriers of PPARγ are more responsive to the deleterious effects of saturated fat and altered glucose homeostasis. Seemingly, unsaturated fat interacts with PPARγ Ala12 variant and upregulates the activity of latter [ 101 ]. Potential gene-environment (G × E) interactions also occur between TCF7L2 risk-variant (rs7903146) and lifestyle modifications (physical activity, MNT, and dietary changes). Decreased insulin resistance and reduced risk in TCF7L2 risk-variant carriers is significantly affected by lifestyle modifications [ 102 , 103 ]. A common SNP in fat mass and obesity associated gene (FTO rs9939609) is associated with increased risk of T2DM. Increased physical activity reduces the FTO rs9939609-induced obesity and associated risk of T2DM [ 104 ]. SNP in glucokinase regulatory protein gene results in an insulin-raising allele, GCKRrs780094. Its interaction with the whole grain (increased whole grain intake) results in reduced fasting insulin in the carriers [ 105 ]. The po­tassium voltage-gated channel subfamily Q member 1 (KCNQ1) is a susceptible gene in T2DM. Mutations in KCNQ1 are associated with decreased insulin secretion. Reduced expression of noncoding RNA Kcnq1ot1 in Kcnq1 genetic region leads to increase in cyclin-dependent kinase inhibitor 1C (Cdkn1c) expression, resulting in reduced pancreatic β-cell mass and insulin release. The CCAAT sequence in the promoter region of Cdkn1c gene serves as the binding site for transcription factor C/EBP that increases the further expression of Cdkn1c. Evidently, the expression of C/EBPβ results in endoplasmic reticulum stress to cause dysfunctions in β-cells. The accumulation of C/EBPβ in pancreatic β-cells increases in the presence of high fat diet, thereby potentiating the β-cells dysfunction in the vulnerable population [ 106 ]. Collectively, the emerging investigations to explore the interactions between gene and environmental factors suggest a high influence of dietary patterns, physical exercise, and other lifestyle interventions on the expression of genes that are peculiar to the development of T2DM.

Apart from gene expression, environmental factors also tend to exert a potential impact on gut microbiota. The gut environment is affected by a number of factors including the diet, pH, and nutrient absorption. While the presence of Firmicutes and Proteobacteria increases under the influence of carbohydrates and simple sugar-rich diet, saturated fats, and animal protein-rich diet encourages the proliferation of Bacteroidetes and Actinobacteria [ 107 ]. Moreover, a high −at diet is also accountable for significant alterations in intestinal flora, including the Bifidobacterium and Bacteroides (increased Gram-negative/Gram-positive bacteria ratio). This allowed and increased secretion of LPS, fat content, body weight, and inflammatory reactions associated with T2DM [ 108 ]. Reduction in butyrate is largely responsible for the loss of tight intestinal barrier. An intestinal pH of 5.5 favors the proliferation of butyrate-producing Phytophthora which starts to diminish with a pH value of 6.5 [ 109 ]. In addition, the hypoglycemic agents utilized for the antidiabetic therapy also pose a remarkable influence on the gut microbiota. Metformin and acarbose are known to increase the proliferation of lactobacilli, Akkermansia, and several other bacteria that are acknowledged to exert beneficial effects in diabetes [ 110 ].

Gut microbiota composition also affects the regulation of expression of different genes in T2DM. Although reports are limited in terms of potential interactions between gut microbes and T2DM associated gene variants, existing reports on the influence of gut microbes in the expression genes that are crucial in T2DM are highly suggestive of a complex gene-microbes interplay in the etiology of T2DM. Also, microbiome plays a crucial role in the epigenetic regulation of genes by the modification of DNA methylation [ 111 ]. F. prausnitzii , a short-chain fatty acid-producing bacteria was found crucial in epigenetic regulation of FFA receptor gene in patients of T2DM. A significant reduced presence of F. prausnitzii was evident in such patients. As a result, a considerably low methylation in the promoter region of FFA receptor gene is observed in these individuals [ 112 ]. Increased release of pro-inflammatory cytokines is a key event in T2DM. Microbes are largely known to be associated with increased release of inflammatory cytokines by producing the products such as LPS that promote low-grade inflammation and endotoxemia. On contrary, several microbes are known to induce the expression of anti-inflammatory cytokines, including the IL-10 and IL-22, that have proven roles in improving the insulin sensitivity Roseburia intestinalis , Bacteroides fragilis , Akkermansia muciniphila , Lactobacillus plantarum , and Lactobacillus casei [ 113 ]. Two other beneficial microbes − Bacteroides vulgatus and Bacteroides dorei − are observed to increase the expression of tight junction genes in T2DM to compensate with the compromised gut permeability (leaky gut) [ 114 ]. A major contribution of probiotics is observed in the case of glucose metabolism and homeostasis. For instance, L. gasseri BNR17 is known to increase the expression of GLUT-4 transporter gene [ 115 ]. Another gut microbe, L. casei is witnessed to increase the expression of multiple T2DM-related genes, including ClC1-7, GlyRα1, ­SLC26A3, SLC26A6, GABAAα1, Bestrophin-3, and CFTR, thus resulting in a significant reduction in hyperglycemia [ 116 ]. It appears to be of vital importance to consider the potential interplay between various T2DM-related genes and these microbes. Undoubtedly, the absence of these microbes among the gut microbiota can be largely responsible for the altered regulation of different genes in T2DM patients. Also, exploring the interactions between different T2DM-associated gene variants and gut microbiota is warranted to further understand the complex interactions between environmental factors, gut microbiota, and genetics in the development of T2DM.

Current Approaches for Diabetes Management: What Are We Missing?

The guidelines for the pharmacological management of diabetes provided by American Diabetes Association suggest that metformin be prescribed as the initial intervention to T2DM patients. However, the same guideline also indicates that vitamin B 12 deficiency is a prominent side effect observed in metformin consumers and a periodic vitamin B 12 measurement is required in such patients [ 117 , 118 ]. Furthermore, metformin is also notorious for causing lactic acidosis, especially in patients with kidney disease, liver injury, or other CVS complications that create a low level of oxygen in circulation [ 119 ]. For T2DM patients with cardiovascular or CKDs, the guidelines recommend adding sodium-glucose cotransporter 2 (SGTL2) inhibitors and/or glucagon-like peptide 1 receptor agonists along with hypoglycemic agents [ 118 ]. The employability of SGTL2 inhibitors with almost all classes of hypoglycemic agents makes them ideal candidates to be combined when dual and triple combination therapies are warranted [ 120 ]. In an ideal scenario, a drug used in combination should be able to reverse the pathology with an improved overall health status of the patient and ensure that no new complications arise due to the existing management strategies. In case of T2DM, drug combination should not only be able to just merely reduce the glycosylated hemoglobin levels (HbA1C) but also an improved overall metabolic condition of the patient is expected through such interventions [ 120 ]. The combination of SGTL2 inhibitors with metformin may have proved beneficial in curbing hyperglycemia that cannot be controlled by metformin alone [ 120 ], but the adverse effects associated with the SGTL2 inhibitors still remain unresolved. Genital infections caused by SGTL2 inhibitors due to high glycosuria still remain an unfocussed aspect while prescribing such combinations. In addition, during the event of excessive osmotic diuresis caused by SGTL2 inhibitors, a low extracellular fluid volume and subsequent hypotension is another complication that may arise [ 121 ]. Multiple reports have also raised concerns regarding the use of SGTL2 inhibitors in diabetes due to their substantial involvement in causing diabetic ketoacidosis [ 122 ]. Two separate reports published in 2015 claimed that canagliflozin, an SGTL2 inhibitor is implicated in pancreatitis in T2DM patients [ 123 , 124 ]. GLP-1 agonists are also a preferred class of adjuvant hypoglycemic agents that are combined with first-line hypoglycemics [ 125 ]. Apart from gastrointestinal disorders (nausea, vomiting, and constipation), infections and acute renal injury, a major raising concern regarding the use of GLP-1 agonists is their association with pancreatitis [ 125 , 126 ]. Cases of acute pancreatitis are reported with the use of liraglutide and exenatide [ 127 , 128 ]. More importantly, recent reports also raise concerns regarding the long-term reliance on incretin-based therapies due to frequently reported cases of their association with pancreatitis and pancreatic cancer [ 129 ]. Studies based on FDA Adverse Events Reporting System demonstrated that incretin-based therapies are associated with the increased incidences of pancreatic and thyroid cancer [ 130 , 131 ]. Exenatide use is also positively associated with the incidences of bone fractures [ 132 ].

Alternatives: Phytoconstituents

Failure of monotherapy in diabetes is simply managed by the dual or triple drug combination therapies that involve the addition of supportive hypoglycemic agents with the first-line drugs. However, adding the supportive or second-line drugs in combination seldom includes the assessment of risk factors associated with these new additions. The sole aim of these therapies remains to be a controlled glycemic condition. Unfortunately, in the pursuit of maintaining normal blood glucose levels, the occurrence of new complications is largely taken for granted. Monotherapies supplemented with herbal extracts or phytoconstituents have showed appreciable improvements in the blood glucose levels in diabetic patients. Chemical constituents from plants have also proved to be promising alternatives. Table ​ Table1 1 represents the known effects of different phytoconstituents in diabetes exerted through multiple targets. As a result, unlike in the case of conventional single target therapy where chances of treatment failures are high, therapy failures with multi-targeting approach are rare.

Multiple targets of different phytoconstituents in the management of T2DM and their possible outcomes [133–140]

T2DM, type 2 diabetes mellitus; G6Pase, glucose-6-phosphatase; PEPCK, phosphoenolpyruvate carboxykinase.

Conclusions

Diabetes is a metabolic disorder that is influenced by a variety of factors. Recent insights into the pathogenesis of diabetes have unraveled newer pathways and factors that contribute substantially in disease development and progression. Insulin resistance and β-cell dysfunction are the 2 major events that are largely responsible for the onset of diabetes. A major objective of this review is to focus on the unfocused aspects of diabetes to develop better strategies for diabetes treatment. In this review, we have discussed the factors that have played crucial roles in the etiology of T2DM but have not received adequate attention. We have also discussed the efficiency of existing approaches in the treatment of T2DM. Lifestyle modifications that favor the improvement of management of diabetes and their complex interplays with genetics and gut environment is a crucial factor that warrants further research in the development of more efficient and individualized therapy approaches for disease treatment. The use of multidrug combination therapy in diabetes may have improved health outcomes in T2DM patients and also result in additional complications that need serious consideration. Moreover, more attention is required toward the developing comorbidities during diabetes. The diabetic milieu accelerates the formation of advanced glycation end products that may encourage the development of diabetic complications and even cancer in diabetic patients. Multiple pathways are involved in diabetes that can contribute to the manifestation of comorbidities that are largely neglected during disease treatment.

Multitargeting is a promising approach for the treatment of T2DM as it includes multiple pathways. The failure of single target approaches is the major challenge faced in T2DM treatment. Phytoconstituents are promising as they interact with multiple pathways simultaneously. However, the reluctance to rely on phytoconstituents as the main therapy still remains as a limiting factor for such drugs to serve as mainstream interventions.

Conflict of Interest Statement

All authors have read the journal's policy on disclosure of potential conflicts of interest and have none to declare.

Acknowledgement

The authors are thankful to B. V. Patel Pharmaceutical Education and Research Development (PERD) Center, Ahmedabad, and AYUSH − Center of Excellence, Center for Complimentary and Integrative Health (CCIH), Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, for providing facilities for the successful completion of the work. The authors are also thankful to those colleagues whose work could not be cited directly owing to space constraints.

Swapnil P. Borse and Abu Sufiyan Chhipa contributed equally; Vipin Sharma and Devendra Pratap Singh contributed equally.

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Overview of Diabetes Mellitus

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Diabetes Mellitus: Definition, Types, Effects and Causes

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Diabetes mellitus, commonly known as diabetes, is a group of metabolic disorders characterized by a high blood sugar level (hyperglycemia) over a prolonged period of time.

Symptoms often include frequent urination, increased thirst and increased appetite.

There are three main types of diabetes mellitus: Type 1 diabetes, Type 2 diabetes, and Gestational diabetes.

Family history, obesity, lack of exercise, genetics, air pollution, etc.

More than 37 million people in the United States have diabetes, and 1 in 5 of them don’t know they have it. Diabetes is the 7th leading cause of death in the United States. In the last 20 years, the number of adults diagnosed with diabetes has more than doubled as the American population has aged and become more overweight or obese.

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Essay on Diabetes

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100 Words Essay on Diabetes

What is diabetes.

Diabetes is a chronic disease where the body can’t control blood sugar levels. This happens because the body either doesn’t make enough insulin or can’t use it properly.

Types of Diabetes

There are two main types: Type 1 and Type 2. Type 1 is when the body doesn’t produce insulin. Type 2 is when the body doesn’t use insulin well.

Managing Diabetes

Diabetes can be managed through a healthy diet, regular exercise, and medication. Regular check-ups are also important to monitor blood sugar levels.

The Impact of Diabetes

If not managed, diabetes can lead to serious health problems like heart disease, kidney disease, and vision loss.

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250 Words Essay on Diabetes

Introduction.

Diabetes, a chronic metabolic disorder, is characterized by an increased level of glucose in the blood. It arises due to the body’s inability to produce or effectively utilize insulin, a hormone responsible for glucose regulation.

Etiology of Diabetes

Diabetes is classified into two major types: Type 1 and Type 2. Type 1 diabetes, an autoimmune disorder, is a result of the body’s immune system attacking insulin-producing cells in the pancreas. On the other hand, Type 2 diabetes, the more prevalent form, is primarily associated with insulin resistance and often linked to obesity and sedentary lifestyle.

Impact and Management

Diabetes can lead to severe complications like heart disease, kidney failure, and blindness if left unmanaged. Management involves lifestyle modifications, including a healthy diet, regular physical activity, and medication or insulin therapy as needed.

Prevention and Future Research

Prevention strategies for Type 2 diabetes involve promoting healthier lifestyles and early detection. For Type 1 diabetes, research is still ongoing to understand its triggers. Advances in technology and medicine, such as artificial pancreas systems and islet cell transplantation, show promise for future diabetes management.

Diabetes, a global health crisis, requires comprehensive understanding and management strategies. With ongoing research and advancements, the future holds potential for improved diabetes care and prevention.

500 Words Essay on Diabetes

Introduction to diabetes.

Diabetes is a chronic health condition that affects millions of people worldwide. It is characterized by an elevated level of glucose in the blood, which can lead to a variety of health complications if not properly managed. The disease occurs when the body fails to produce enough insulin or is unable to effectively use the insulin it produces, resulting in glucose build-up.

There are primarily two types of diabetes: Type 1 and Type 2. Type 1 diabetes is an autoimmune condition where the body’s immune system attacks the insulin-producing cells in the pancreas. This type is less common and usually develops early in life. Type 2 diabetes, on the other hand, is more prevalent and typically develops in adulthood. It occurs when the body becomes resistant to insulin or doesn’t produce enough to maintain a normal glucose level.

Risk Factors and Symptoms

Several factors increase the risk of developing diabetes, including genetics, obesity, lack of physical activity, and poor diet. Additionally, certain ethnic groups are at a higher risk.

Diabetes often presents with symptoms such as frequent urination, excessive thirst, unexplained weight loss, constant hunger, blurry vision, and fatigue. However, many people with Type 2 diabetes remain undiagnosed as the symptoms can be subtle and develop slowly.

Management and Treatment

While there is currently no cure for diabetes, it can be effectively managed with a combination of lifestyle changes and medication. Regular exercise, a balanced diet, and maintaining a healthy weight are crucial for managing both types of diabetes.

For Type 1 diabetes, insulin injections or use of an insulin pump are necessary. Type 2 diabetes can often be managed with lifestyle changes and oral medication, but insulin may be required as the disease progresses.

Complications and Prevention

If left uncontrolled, diabetes can lead to serious health complications, including heart disease, stroke, kidney disease, and nerve damage. Regular monitoring of blood glucose levels, along with routine medical check-ups, are essential to avoid these complications.

Prevention strategies for Type 2 diabetes include regular physical activity, a healthy diet, maintaining a normal body weight, and avoiding tobacco use. Early detection through regular health screenings is also critical, as early treatment can prevent or delay the onset of complications.

Diabetes is a significant global health concern that requires concerted efforts for effective management and prevention. Understanding the disease, its risk factors, and the importance of early detection can go a long way in reducing the impact of this chronic condition. Through lifestyle changes and medical intervention, individuals with diabetes can lead healthy and fulfilling lives.

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Diabetes Essay: Example and Tips

• 1 How to talk and write about diabetes. 10 taboo phrases
• 2 Examples of topics for diabetes essay
• 3 Example of introduction of diabetes essay
• 4.1 Diabetes: causes and factor of development
• 4.2 Classification of diabetes
• 4.3 Symptoms of diabetes
• 4.4 Diagnostics of diabetes, its treatment and complications
• 5 Example of conclusion of diabetes essay
• 6 Finishing the work on informative essay on diabetes

How to talk and write about diabetes. 10 taboo phrases

Talking and writing about diabetes must be approached with great care. No matter whether the person been diagnosed with diabetes long time ago, or he only learnt his diagnosis, he will not want to hear how extraneous people indicate him, and how the illness determines his life. Alas, sometimes even close people do not know how to help and instead try to take someone else’s illness under control. It is important to convey to them what exactly a person needs, and how to offer constructive help. When it comes to diabetes, even if the speaker’s intentions are good, some words and phrases can be perceived as bayonets. Introducing you a hit parade of phrases that you do not need to say to people with diabetes ever.

• “I did not know you were diabetic!”

The word “diabetic” is offensive. For someone it won’t matter, and somebody will feel that a label has been hung on him. Having diabetes does not say anything about a person as a person, people do not choose diabetes consciously. It is more correct to say “a person with diabetes”.

• “Are you sure you are allowed to eat that?”

People with diabetes should think about what they eat before each meal. That is constantly on their mind, and they constantly have to think about what they can not do. If you are not the one who is responsible for the health of your loved one (for example, not the parent of a child with diabetes), it is better not to consider under the magnifying glass everything that he wants to eat and not give unwanted advice. Instead of releasing passive-aggressive comments such as “Are you sure you can eat this” or “Do not eat it, you have diabetes”, ask a person if he does not want some healthy food instead of a chosen one. For example: “I know that cheeseburger with potatoes looks very appetizing, but I think you might like a salad with a grilled chicken and cooked vegetables, and this is more beneficial for health, what will you say?” People with diabetes need support and encouragement, not restrictions.

• “Do you have injections of insulin all the time?” This is chemistry! Maybe it’s better to sit on a diet? “(For people with type 1 diabetes)

Industrial insulin began to be used to treat diabetes almost 100 years ago. Technologies are constantly evolving, modern insulin is of very high quality and allows people with diabetes to live a long and full life, which without this medicine simply would not be possible. So before you speak it, study the question.

• “Did you try homoeopathy, grass, hypnosis, go to the healer, church, etc.?”

Probably most people with diabetes have heard this question more than once. Alas, acting out of good intentions and offering these wonderful alternatives to chemistry and niche, you are unlikely to imagine the true mechanism of the disease and do not know that one healer is not able to revive insulin-producing pancreatic cells (if we are talking about type 1 diabetes) or change lifestyle for a person and reverse metabolic syndrome (if we are talking about type 2 diabetes).

• “My grandmother has diabetes, and she has cut off her leg”

A person who has recently been diagnosed with “diabetes” does not necessarily need to be told horror stories about your grandmother. People can live with diabetes for many years without complications. Medicine does not stand still and constantly offers new methods and drugs that keep diabetes under control and do not trigger it until amputation and other terrible consequences.

• “Diabetes? Not scary, worse things can happen.”

Surely, in such a way you want to cheer up a man. But you have almost the opposite effect. Yes, of course, there are various illnesses and problems. But comparing other people’s illness is just as useless as trying to understand what is best: being poor and healthy or rich and sick. Every one has his own. So it is much better to say: “Yes, I know that diabetes is very unpleasant. But you seem to be doing great. If I can help with something, say (offer help only if you are really ready to give it, if not, the last phrase is better not to pronounce.

• “Do you have diabetes? You do not look sick!”

Let’s start with the fact that such a phrase sounds not tactically in any context. Discuss someone else’s disease aloud (if the person did not make a conversation about it) is indecisive, even if you tried to say something nice. But even if one does not take into account the elementary rules of behavior, one must understand that each person responds to his illness in his own way. For somebody it leaves an indelible trace, and he makes a huge effort to look good, and somebody does not experience problems. Your remark can be perceived as an invasion to another’s space, and all that you will achieve will only be irritation or even insult.

• “Oh, you have high sugar level, how did you get that?”

The level of glucose in the blood from day to day varies. If somebody has high sugar, the reasons for it can be different, and some of them can not be controlled – for example, cold or stress. For a person with diabetes it is not so easy to see bad numbers, and often he has a sense of guilt or disappointment. Try not to comment at all, if he does not speak about it himself.

• “Oh, you’re so young and already sick, poor man!”

Diabetes does not spare anyone, the old, the young, or even the children. No one is insured from it. When you tell a person that the disease at his age is not a norm that this is something unacceptable, you scare him and cause him a sense of guilt. And although you only wanted to pity him, you can hurt someone and he will shut himself up, which will make the situation even worse.

• “Do you feel not good?” Oh, everyone has a bad day, everyone gets tired “

Talking to a person who has diabetes, you do not need to talk about “everyone.” Yes, they get tired of everything, but the energy resource is healthy and different in the patient. Because of the disease, people with diabetes can quickly get tired, and focus on this topic, so once again remind the person that he is in an unequal environment with others and is powerless to change anything in his position. It undermines his moral strength. And in general, for a person with such a disease, there may be discomfort every day, and the fact that he is here and now with you may mean that today he was able to assemble with the strength, and you in vain reminded him of his condition.

Examples of topics for diabetes essay

• Psychological support to the patients with diabetes
• Causes of diabetes and ways of treatment
• Types of diabetes and difference between them
• Diabetes: how to accept your diagnosis?

Example of introduction of diabetes essay

Diabetes mellitus is an endocrine disorder caused by an absolute or relative insufficiency of the insulin hormone that develops hyperglycaemia. The disease proceeds in chronic form and is characterized by a violation of not only carbohydrate, but also fatty, protein, mineral, and water-electrolyte metabolism.

We react in different ways to life problems. Someone prefers to experience everything in himself, not wanting to look weak in the eyes of others. And someone, on the contrary, needs support from others. Should friends, relatives or colleagues know that you have diabetes? The answer may vary. But it is definite that you need to know as much about diabetes as possible.

Example of main body of diabetes essay

Diabetes: causes and factor of development.

Currently, diabetes is proven to be developing as a result of genetic predisposition. The discovery of a number of genetic variations, which are much more common in diabetics, has made it possible to establish the hereditary nature of this disease. Some studies show that diabetes mellitus of the first type is inherited from 3-7% probability from the father and 8-10% probability from the mother. If both parents are suffering from type 1 diabetes, the risk of transmission to their children increases to 70%. With regard to type 2 diabetes, it is inherited with almost 80% probability from both the mother and the father. If both parents have type II diabetes, the probability of its development in children is approaching 100%, although the disease is most commonly realized in adulthood.

As for the pre-requisites for the development of diabetes mellitus, among them are the following:

• With obesity, tolerance to glucose develops in the body, which worsens its penetration into muscle cells. So glucose accumulates in the blood, which contributes to the development of diabetes of type II. Obesity refers to those factors that a person can change. Proper nutrition and exercise will change the situation for the better.
• Some diseases in which pancreatic beta cells are damaged. Such diseases include pancreatitis, pancreatic cancer and the disease of other glands of the internal secretion. One of the provocative factors in this case may also be injury.
• Viral infections. Certain viral infections (such as rubella, influenza, chicken pox, hepatitis, etc.) can be a serious provocation, especially for people with predisposition to diabetes and obesity.
• Nerve stress is a serious factor for people with hereditary predisposition.
• Naturally, the older the person, the higher the likelihood of getting diabetes with the second type is. As for diabetes mellitus type one, it is usually diagnosed in adolescence and young age.
• Low-active lifestyle.
• Taking some medications (such as thiazide diuretics and steroid hormones).

Classification of diabetes

Diabetes mellitus is distinguished by types 1 and 2. The pathogenesis of type 1 diabetes is the insufficiency of secretion of insulin with beta-cells of the pancreas. Type 2 diabetes develops due to reduced insulin sensitivity of the cells (insulin resistance).

Also, there are gestational diabetes mellitus, which occurs during pregnancy, and MODY diabetes, representing a group of autosomal dominant diseases characterized by deterioration of secretory activity of beta-cells of the pancreas.

Symptoms of diabetes

Symptoms of diabetes differ depending on its type. Let’s consider the main symptoms of type 1 diabetes, type 2 diabetes and diabetes in children.

• Symptoms of the first type of diabetes. Typically, the symptoms of type 1 diabetes grow fast enough. Characteristic manifestations of the disease develop within a few days. In a number of cases, the patient suddenly falls into a diabetic coma. In this case, the patient should be immediately sent to the hospital. Symptoms of diabetes include heightened thirst, the smell of acetone in exhaled air, frequent urination, poor healing of wounds, itching of the skin, and others.
• Symptoms of type 2 diabetes . For a long time, type 2 diabetes occurs without obvious symptoms. This is the so-called condition of prediabetes, when the patient still has chances to avoid the development of the pathology. One of the first symptoms of type 2 diabetes is increased fatigue, but few people pay attention to it, all counting on overwork, weather and other vital circumstances. Over time, the patient experiences worsened eyesight, problems with memory occur. Due to the high level of glucose in the blood, a person tends to develop infectious diseases (especially fungal infections). Women often have a thrush on a background of diabetes. Patients have an increased thirst (they use up to 3-5 liters of fluid per day). In severe cases, ulcers appear on the legs due to a violation of the trophy in the tissues.
• Symptoms of diabetes mellitus in children . Symptoms of diabetes in children are similar to the classic manifestations of this disease in adults, however, the sooner the child develops diabetes mellitus, the symptoms will differ from those that are observed in adults.

And now we will tell you why diabetes has some of the above symptoms. This information is useful for people with diabetes.

Increased thirst and increased urination . Why does diabetes cause increased thirst? The point is that when blood levels rise in blood sugar, glucose begins to penetrate the urine. However, it passes there not in pure form, but in water bound to several molecules. In this way, the body loses fluid, and the patient shows a rapid urination. He is forced to wake up several times in the night.

The smell of acetone in exhaled air . With diabetes, glucose levels are high in the blood, but the cells are not able to absorb sugar (because of low levels of insulin or because of the development of tolerance to it). In such circumstances, when the body is not able to fully eat glucose, it is converted to nutrition by fat stores. In the fission of fats, ketone bodies are formed (among which beta-oximasilic acid, acetate acetic acid and acetone). With a significant increase in the level of ketone bodies in the blood, they begin to stand out with exhaled air. This creates a characteristic smell of acetone.

Ketoacidosis. With an increase in ketone bodies in the body, the acidity of the blood increases. The pH of the blood should be clearly within the range of 7.35 – 7.45. Even minor deviations from these indicators lead to serious consequences up to the diabetic coma.

Increased appetite . As diabetes insufficiency of insulin, or the tolerance of cells to glucose is noted, the organism constantly feels its hunger. The hunger signals are sent to the brain, and the person, because of this, naturally, feels increased appetite. And, despite the fact that the patient eats a lot, carbohydrates from food are assimilated very badly. So far, the problem with insulin deficiency is not resolved, the patient will feel hunger.

Infections . Why does diabetes increase the risk of developing infections? The fact is that the level of sugar in diabetes mellitus increases not only in the blood, but in all the fluids of the body, including sweat. And fungi and bacteria only need this – a humid environment and abundance of glucose. With the normalization of blood sugar, the tendency to infectious diseases of the skin and skin itch disappear.

Bad wound healing . With diabetes, the wound heals poorly due to the toxic effects of elevated glucose levels on the walls of the blood vessels. As skin tissues are exposed to permanent toxic effects, the processes of healing in them occur very slowly.

Diagnostics of diabetes, its treatment and complications

Diabetes mellitus is diagnosed with the following laboratory tests: determination of fasting glucose concentration; glucose tolerance test; determination of glycosylated hemoglobin; urine analysis for sugar content; urine analysis for acetone content (acetone may be present in urine with other disorders).

The main goal of treating diabetes is to lower blood glucose levels. In case of type 1 diabetes, insulin injections are required. In diabetes mellitus type 2, as a rule, a doctor prescribes depressant drugs and diet therapy, which is calculated taking into account the weight of the patient’s body, sex and physical activity.

Acute complications of diabetes mellitus are diabetic ketoacidosis, hypoglycemia, hyperosmolar coma, lacto-cytotoxic coma. The late complications of the disease include: retinopathy, diabetic micro- and macroangiopathy, polyneuropathy, nephropathy, arthropathy, diabetic foot, mental impairment.

Example of conclusion of diabetes essay

Prevention of diabetes is to avoid the negative factors contributing to the development of the disease in the present genetic predisposition. This is especially true of obesity. Timely weight correction significantly reduces the likelihood of developing diabetes mellitus.

If you find at least one of the above symptoms, you should immediately contact your doctor and go through all relevant studies. When a patient is diagnosed with diabetes, all doctor’s recommendations regarding the use of medicines and dietary restrictions must be clearly observed.

Finishing the work on informative essay on diabetes

When the work on writing an essay seems to be completed, there comes the stage of editing and proofreading. Do not neglect this stage. After working hard on writing a paper, your typos and mistakes can spoil the impression of the teacher and he will evaluate the paper lower.

Experienced writers recommend to relax for a couple of days and not think about the paper. Of cause, this advice works if you have enough time. Come back to the paper later and read it once again. What impression do you get? Are you satisfied with the essay? If everything seems fine, you are done. If you find some mistakes, correct them and check the paper again.

Essay on Diabetes in English for Children and Students

Table of Contents

Essay on Diabetes: Diabetes is a metabolic disease, in which the human body fails to utilize the sugar (glucose) content in blood, thus resulting in high blood sugar levels over a prolonged period of time. Sugar present in our blood is a carried by a hormone called Insulin, to the cells and stored or used as a source of energy. Diabetes occurs when the body doesn’t produce enough insulin or the insulin is unable to effectively transfer the produced glucose to the body tissues.

Diabetes is a serious health concern and requires regular medical care. Most common symptoms of diabetes include – frequent urination, unusual weight loss, increased appetite and a desire to consume sweets.

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Long and Short Essay on Diabetes in English

Below we have provided long and short essay on diabetes of varying length on various aspects of diabetes. After going through the essay you will be able to speak or write on various issues like – causes, symptoms, types, levels and effects of diabetes.

It will also focus on diet that should be taken by a diabetic person and its effects on other vital organs of human body.

Also, you will know about the global spread of diabetes and its preventive measures as well as the significance of the World Diabetes Day.

You can choose any Diabetes essay of your choice from the essays given below and use the information in competitions, debates, class tests etc.

Short Essay on Diabetes –200 words

A Silent Threat to Humanity

Diabetes is a metabolic disease which is caused due to the excess of sugar (glucose) in human blood. It is also called as Diabetes Mellitus (DM). Our body produces a hormone – Insulin, which is primarily responsible for carrying glucose present in our blood to the cells to be stored and used as energy source. Problem occurs when either the pancreas doesn’t produce enough insulin, or the insulin produced is somehow unable to effectively transfer the glucose from blood to the cells.

A persistent increased blood sugar level is a potential threat to the vital organs and other parts of human body. Initial symptoms of diabetes are frequent urination, dizziness, weight loss, increased hunger etc. Diabetes may cause severe complications like – consciousness loss, kidney failure, brain stroke, foot ulcers and damage to the eyes.

Diabetes Mellitus has become the most common disease and around 425 million people globally are suffering from diabetes; out of which 82 million belong to the south-east Asian region. India, which is also a part of south-east Asia, has over seven crores cases of diabetes recorded annually.

With lifestyle changes and less physical exercise, more and more people are getting affected by diabetes. It is estimated that given to the present state of affairs, total number of diabetes patients in south-east Asia alone, will rise to 151 million.

Essay on Diabetes – 300 Words

Effects of Diabetes and Diabetes Day

Diabetes or Diabetes Mellitus is a metabolic disease caused due to the excess of blood sugar level in human body. An excessive quantity of sugar in blood, damages other vital organs like – kidney, heart and brain. Though, it is caused by the under production of insulin hormone by the pancreas, it is also a life style disease, caused due to unhealthy dietary habits and lack of physical exercise.

Effects of Diabetes on Health

Diabetes has wide range of effects on human body and health. It is the condition in which the glucose present in the human blood is somehow fails to be utilized as the source of energy. It could be either due to under production of insulin hormone, which carries sugar from blood to the cells, or it could be due to the unresponsiveness of cells to receive the sugar.

Whatever the reason may be, it results in excess blood sugar (glucose) content. Diabetes may potentially affect the vital organs like heart, kidney, brain and eyes. It may cause cardiovascular diseases, heart attack, kidney failure, hearing loss, bacterial and fungal skin infections and brain stroke.

World Diabetes Day and its Significance

Globally, around 425 million people are suffering from diabetes and the number is about to increase significantly in coming years if the preventive measures are not taken. Therefore, to raise awareness of people about diabetes, International Diabetes Federation (IDF) observes World Diabetes Day every year on 14 th November.

World Diabetes Day was first launched in 1991, as a counter measure to the increasing number of diabetes patients around the world.

Diabetes Mellitus is a global threat, with billions affected globally by it, it becomes imperative to raise public awareness about the causes, symptoms and effects of diabetes in order to effectively reduce the number of patients globally. Global events like World Diabetes Day play a significant role in freeing the world from Diabetes Mellitus.

Essay on Diabetes – 400 Words

Diabetes Mellitus and Kidney Problems

Diabetes Mellitus is a condition when human body is unable to effectively utilize the sugar (glucose) present in its blood ultimately leading to high blood glucose level. Blood is a vital body fluid that reaches all the body parts, and an abnormally high glucose level in blood could potentially damage the vital body organs and other body parts.

Causes and Symptoms of Diabetes Mellitus

Diabetes is identified by high sugar (glucose) content in human blood. Glucose is a source of energy for the body and is normally present in blood which supplies glucose to other parts of body. The body parts that receive glucose do so with help of a hormone called Insulin. As long as the pancreas normally produces insulin, the blood glucose level is maintained. But, an abnormality in insulin production or its inefficiency to effectively transfer the glucose to the body tissues, leads to excess of glucose in blood. This metabolic condition is identified as Diabetes or Diabetes Mellitus.

Common symptoms of diabetes mellitus include tiredness, loss of stamina, sweating, persistent hunger, loss of weight and frequent urination. Any such symptoms must not be neglected and proper medical advice must be sought.

How Diabetes is Related to the Health of Kidney

Diabetes is one of the most common causes of kidney failure. Kidneys are the vital body organ which cleans the blood. A high content of glucose in blood damages the blood vessels of kidney, resulting in a medical condition called Diabetic Nephropathy.

With damaged blood vessels, your kidneys will not be able to effectively clean the blood, resulting in waste accumulation in your blood and body as well. This cycle continues, further damaging the kidneys and also other body parts. If the damage continues, it might result in serious complications including kidney failure.

The damage to the kidneys begins long before the other symptoms of diabetes actually appear. Patients suffering from diabetes should get their kidneys examined from time to time. Retention of urine in the bladder caused due to diabetes might also result in pressure on kidneys, further damaging them.

It is recorded that around 30 to 40% of diabetes patients will eventually face kidney failure. The number is disturbing given the billions of diabetes patients worldwide. Apart from raising people’s awareness on diabetes, there is also a need to make the tests of kidneys affordable for a common man. Diabetes patients must be regularly tested for the health of their kidneys and other vital organs.

Essay on Diabetes – 500 Words

Diabetes Mellitus and Heart Attack

Diabetes is a metabolic condition in which the blood retains more glucose, than it should under normal conditions. A high blood glucose level may damage the vital organs of human body like kidney, eyes, ear, heart and brain. Diabetes is caused due to under production of insulin hormone by the pancreas, which acts as a bridge for blood sugar (glucose), to move from blood to the other cells of the body.

Signs of Diabetes Mellitus

Some of the typical symptoms of Diabetes include anxiety, tiredness, blurred vision, headache, irritation, weakness, loss of stamina and faster heartbeat. These are only initial symptoms of diabetes and indicate the forthcoming severe consequences. Every sign of diabetes speaks volumes about the effects of the disease. For example, tiredness, dizziness is caused due to the inability of one’s body cells to successfully convert blood glucose into energy. Increased blood sugar levels in the blood damages the vital organs including heart.

Person suffering from diabetes is more likely to have cardiovascular complications including heart attack. Diabetes leads to high blood pressure and high cholesterol levels, escalating the possibility of a heart attack.

High glucose content in the blood damages the blood vessels of heart. Damaged blood vessels are unable to pump the required blood at the required rate, ultimately causing heart attack and other heart diseases. People suffering from diabetes are more likely to have cardiovascular disorders from a very early age, than the people who are not suffering from diabetes.

There are also certain factors which might increase one’s chance of heart attack, like smoking, drinking liquor, obesity, high cholesterol level and unhealthy lifestyle. The given factors, if present with diabetes, substantially increase the chances of a heart attack.

Prevention is Better than Cure

The best way for a diabetic person to stop a heart attack from occurring is by keeping a check on his/her blood sugar level. A diabetic person should always take necessary precautions to keep his/her blood sugar level under control. The precautions include – routine checkup of sugar level and heart, avoiding unhealthy and oily food, quit smoking, adapting to healthy lifestyle, regular exercise, and early morning walks etc.

The blood vessels of a diabetic patient are already weaker as compared to that of a normal human being. If a diabetic patient consumes unhealthy or junk food, he/she increases his/her cholesterol level, which together with the damaged blood vessels makes a heart attack most likely possibility. Activities like exercising and walking keep one’s cholesterol level under control, hence decreasing the chances of a heart attack.

A diabetic person must also take precautionary measures to keep his/her high blood pressure under control. Such patients are more likely to get a heart attack when compared to any normal patient of high blood pressure.

Diabetes is a silent killer; when unchecked, it slowly damages the vital organs resulting in their malfunction and severe health complications. Necessary precautionary measures should be taken, especially by a diabetic person to keep his/her heart and other vital organs in a healthy condition. Diabetes damages the heart’s blood vessels increasing the possibility of a heart attack.

Long Essay on Diabetes – 600 Words

This one is a complete essay providing information about “Meaning, Types, Causes, Symptoms, Effects and Levels of Diabetes.”

Diabetes is a metabolic disorder which is identified by the high blood sugar (glucose) level. An increased blood glucose level damages the vital organs as well as other organs of the human’s body causing other potential health ailments.

Types of Diabetes

Diabetes Mellitus could be further classified into the following two types –

1) Type 1 Diabetes Mellitus

Type 1 Diabetes Mellitus is classified by deficiency of insulin in blood. The deficiency is caused by the loss of insulin producing beta cells in pancreas. This type of diabetes is found more common in children. It is characterized by an abnormally high or low blood sugar levels.

The patients of type 1 diabetes require regular administration of insulin. The type 1 diabetes is hereditary i.e. you are most likely to have type 1 diabetes if any of your parents had it. Symptoms of Type 1 diabetes include frequent urination, thirst, weight loss and constant hunger.

2) Type 2 Diabetes Mellitus

Type 2 Diabetes Mellitus is characterized by the inefficiency of body tissues to effectively respond to insulin, which may be combined by insulin deficiency. Type 2 diabetes mellitus is the most common type of diabetes.

People with type 2 diabetes mellitus take medicines to improve the body’s responsiveness to insulin or to reduce the glucose produced by the liver. This type of diabetes mellitus is generally attributed to lifestyle factors like – obesity, low physical activity, irregular and unhealthy diet, excess consumption of sugar in form of sweets, drinks etc.

Causes of Diabetes

The food that we eat is broken down into useful compounds through the process of digestion. One of these compounds is glucose, usually referred to as blood sugar. Glucose is food for the cells of human body i.e. body cells rely on the availability of glucose for further using it as a source of energy. The job of carrying glucose to the cells of the body is done by the blood.

But mere carrying the glucose to the cells by blood isn’t enough for the cells to absorb glucose, a job which is done by hormone insulin, supplied by the pancreas. Insulin acts as a bridge for glucose to transit from blood to the body cells. Problem arises when the pancreas fails to produce enough insulin or the body cells for some reason doesn’t respond to receive the glucose; both the cases result in the excess of glucose in blood, which is referred as Diabetes or Diabetes Mellitus.

Symptoms of Diabetes

Most common symptoms of diabetes are fatigue, irritation, stress, tiredness, frequent urination and headache including loss of strength and stamina, weight loss, increase in appetite etc.

Levels of Diabetes

There are two types of blood sugar levels – fasting blood sugar level (blood sugar test before food) and postprandial blood sugar level (blood sugar test two hours after having meal). Sugar level measured after fasting for at least eight hours generally after an overnight fast is called fasting sugar level. Blood sugar level below 100 mg/dL (milligrams per deciliter) before eating food is considered normal.

Sugar level measured after two hours of eating is called postprandial glucose level or PP level. The PP blood sugar level should be below 140 mg/dL, two hours after the meals.

Though, the maximum limit in both the cases is defined, the permissible levels may vary among individuals. Some people may have normal fasting sugar level of 60 mg/dL while some may have the normal value of 90 mg/dL.

Effects of Diabetes

Diabetes may have severe health consequences and it affects vital body organs. Excessive glucose in blood damages kidneys, blood vessels, skin resulting in various cardiovascular and skin diseases and other ailments. Diabetes damages the kidneys, resulting in accumulation of impurities in body. It also damages the heart’s blood vessels increasing the possibility of a heart attack.

Apart from damaging vital organs, diabetes may cause various skin infections and the infection in other parts of the body. The prime cause of all type of infections is the decreased immunity of body cells due to their inability to absorb glucose.

Diabetes is a serious life threatening disease and must be constantly monitored and effectively subdued with proper medication and by adapting to a healthy life style. By following a healthy lifestyle, regular checkups and proper medication one can observe a healthy and long life.

Essay on Diabetes FAQs

Can eating too much sugar cause diabetes.

No, eating too much sugar doesn't directly cause diabetes, but it can increase the risk of developing type 2 diabetes over time.

What are the 3 main symptoms of diabetes?

The 3 main symptoms of diabetes are frequent urination, excessive thirst, and unexplained weight loss.

Who gets diabetes and why?

Anyone can get diabetes, but it's more common in those with a family history, poor diet, or lack of physical activity.

How can I prevent diabetes naturally?

You can prevent diabetes naturally by maintaining a healthy weight, eating a balanced diet, and staying physically active.

What is the main prevention of diabetes?

The main prevention of diabetes involves lifestyle changes, like eating well and exercising regularly.

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Acknowledgments

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In a special series of the ADA Journals' podcast Diabetes Core Update , host Dr. Neil Skolnik interviews special guests and authors of this clinical compendium issue. Listen now at Special Podcast Series: Focus on Diabetes or view the interviews on YouTube at A Practice Guide to Diabetes-Related Eye Care .

Summary and Conclusion

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Thomas W. Gardner; Summary and Conclusion. ADA Clinical Compendia 1 July 2022; 2022 (3): 20. https://doi.org/10.2337/db20223-20

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Diabetes is a multifactorial disease process, and its long-term management requires the active involvement of people with diabetes and their families, as well as a large multidisciplinary care team to ensure optimal health, quality of life, and productivity. Keeping up with new medications, emerging technology, and evolving treatment recommendations can be challenging, and the language and care processes commonly used by practitioners in one discipline may be less familiar to other diabetes care professionals.

In the realm of diabetes-related eye care, our ability to prevent the progression of diabetes-related retinal disease and thereby preserve vision has never been greater. However, far too many people with diabetes still are not receiving appropriate screening to identify eye disease early and ensure its timely treatment.

It is our hope that this compendium has provided information and guidance to improve communication and encourage collaboration between eye care professionals and other diabetes health care professionals and allow them to more effectively cooperate to reduce barriers to care and improve both the ocular and systemic health of their shared patients.

Editorial and project management services were provided by Debbie Kendall of Kendall Editorial in Richmond, VA.

Dualities of Interest

B.A.C. is a consultant for Genentech and Regeneron. S.A.R. is a speaker for Allergan, Inc., and VSP Vision Care. No other potential conflicts of interest relevant to this compendium were reported.

Author Contributions

All authors researched and wrote their respective sections. Lead author T.W.G. reviewed all content and is the guarantor of this work.

The opinions expressed are those of the authors and do not necessarily reflect those of VSP Vision Care, Regeneron, or the American Diabetes Association. The content was developed by the authors and does not represent the policy or position of the American Diabetes Association, any of its boards or committees, or any of its journals or their editors or editorial boards.

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How to prevent diabetes: Here are tips to control the condition, according to a doctor.

I n the U.S., over 37 million people have diabetes , according to the Centers for Disease Control and Prevention. Around 1.4 million Americans are diagnosed with the condition each year.

Diabetes is among the leading causes of death and disability in the country. While some types of diabetes are not preventable, others are. This is why it is important to keep track of your habits and health, especially if you are pre-diabetic (an estimated 1 in 3 adults are, according to the CDC).

Here is what you need to know about diabetes, including what causes each type and how you can prevent the condition.

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What causes diabetes?

Diabetes develops when your blood sugar levels get too high, or an excess of glucose in the bloodstream , according to Dr. Kevin Peterson, Vice President of Primary Care at the American Diabetes Association. When you eat carbohydrates, your body breaks them down into blood sugar, which is used for energy. If there is too much glucose in the blood, it can lead to health issues, such as diabetes.

The direct cause for the condition varies depending on type.

Type 1 diabetes occurs when the cells responsible for insulin production do not function properly, said Peterson. In this case, beta cells in the pancreas make little to no insulin.

Insulin  is an essential hormone that regulates blood sugar. The hormone helps glucose reach the body’s other cells. Without insulin, glucose would build up in the bloodstream. Because of this, people with Type 1 require regular insulin injections .

Type 2 occurs when your body stops producing enough insulin or is not using it properly, said Peterson. The latter is known as " insulin resistance ." When someone is insulin resistant, it makes it harder for them to regulate blood sugar levels.

What is diabetes? From types to causes, what to know about one of the deadliest diseases.

The Diabetes Dilemma: Solutions exist to end the Type 2 diabetes dilemma but too few get the help they need

How do you get diabetes?

Type 1 diabetes is an autoimmune disease , while Type 2 is impacted by a multitude of factors, including weight gain, lack of exercise and diet.

Type 1 is not "directly inherited," but "it has a higher likelihood in people that have had a brother or sister or parent with diabetes," said Peterson. Type 2 is not considered a hereditary disorder, but you are substantially more likely to develop it if a first-degree relative has the condition.

The symptoms for Type 1 and Type 2 are similar, according to Peterson. Common symptoms include:

• Polyuria, or urinating often
• Polydipsia, or feeling thirsty
• Extreme fatigue, or feeling very tired

The difference, however, comes through the onset of these symptoms. "With Type 1, it usually comes on very quickly," Peterson explained. "With Type 2 diabetes, it can come on more slowly, and so, sometimes people don't notice (the symptoms) as much."

How to prevent diabetes

Only Type 2 is largely preventable, and lifestyle changes are the main prevention method. "We know that changes in physical activity and weight loss and lifestyle changes can substantially reduce the risk of developing Type 2," said Peterson.

Fat decreases the effectiveness of insulin. To reduce the likelihood of getting Type 2, it is key to maintain a healthy lifestyle, said Peterson. This includes:

• Dietary changes : Eating a healthy, balanced diet that is low in carbohydrates, sugar and saturated fats; and high in fruits, vegetables and grains.
• Exercise : Engaging in at least 30 minutes of physical activity several times a week.

Diabetes is a "a serious problem," but it is a disease that can be monitored and managed with proper care, said Peterson. "A person with diabetes can have a completely normal life."

More: American can prevent (and control) Type 2 diabetes. So why aren’t we doing it?

Just Curious for more? We've got you covered

USA TODAY is exploring the questions you and others ask every day. From " How do you get diabetes? " to " What does DNA stand for? " to " How to treat dehydration? " − we're striving to find answers to the most common questions you ask every day. Head to our  Just Curious section  to see what else we can answer for you.

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This article originally appeared on USA TODAY: How to prevent diabetes: Here are tips to control the condition, according to a doctor.

Community Health Promotion: The Fight Against Diabetes in a Community Setting Essay

Community and health.

A community is established when a group of individual’s band together because of shared values. The concept of community has been brought up in the context of health promotion. Healthcare professionals are aware that there are limitations when it comes to using conventional methods in health promotion. Thus, it is extremely difficult to help those who are in need. This is especially true when it comes to lifestyle-related diseases such as Type 2 diabetes. It is imperative that healthcare workers to promote health in the context of a community in order to ensure effective communication and better results.

In the past, Type 2 diabetes was linked to old age. However, in the past few decades, a sedentary lifestyle coupled with excessive consumption of high-calorie food has brought about a health crisis. Men and women under the age of forty are suffering from Type 2 diabetes. In the United States alone, 85 to 90 percent of people with type 2 diabetes are overweight (Metzger & Kotulak, 2006, p.10). It is nearing epidemic levels and many families are suffering because of medical expenses and shortened lifespan. It is therefore imperative to inform the public on how to prevent Type 2 diabetes. But it was discovered that traditional means of health promotion is not effective. There is a need to go to the community level in order to increase the effectiveness of health promotion.

According to experts in community healthcare, communicating with the community is the most rewarding when it comes to public health because successful communication results in protection or promotion of the health of the community (Novick et al., 2008, p.575). Applying principles of community-based health promotion it is important to focus on Type 2 diabetes and the people that are prone to acquiring this medical condition (Lundy & Janes, 2009, p.304). It is also imperative to recognize the bitter truth that “poorer health status is correlated with race/ethnicity and socioeconomic status” (Maurer & Smith, 2005, p.46). Health promotion must be tailor-made so that it can be understood by the target audience.

It has now been made clear why conventional methods of health promotion are ineffective. Failure is due to the non-consideration of social factors. A community-based health promotion campaign can easily deal with race, ethnicity and socioeconomic status and even the shared culture of the community members. Healthcare professionals are then made sensitive to the circumstances of the people that they are trying to help. It is easy to put up walls and be antagonistic to strangers that appear to intrude into the lives of the people. By being sensitive to the culture and needs of the community, healthcare workers are no longer viewed as threats but people that are sympathetic to the community. As a result they are welcome with open arms.

Type-2 diabetes is a lifestyle-related disease that is oftentimes the result of a lack of exercise and overeating high-calorie food. In order to deal with this problem healthcare professional must initiated a health promotion campaign. The best way to do it is through a community setting where they can adjust their communication strategies so that it would be sensitive to the needs and culture of the community members. Thus, they can expect effective communication and as a result the whole community would listen to what they have to say.

Lundy, K. & S. Janes. (2009). Community Health Nursing: Caring for the Public’s Health . MA: Jones and Bartlett Publishers.

Maurer, F. & M. Smith. (2005). Community/Public Health Nursing Practice: Health for Families and Populations . MO: Elsevier-Saunders.

Metzger, B. & D. Kotulak. (2006). American Medical Association Guide to Living with Diabetes . New Jersey: John Wiley & Sons, Inc.

Novick, L., et al. (2008). Public Health Administration: Principles for Population- based Management . MA: Jones and Bartlett Publishers.

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IvyPanda. (2022, March 29). Community Health Promotion: The Fight Against Diabetes in a Community Setting. https://ivypanda.com/essays/community-health-promotion-the-fight-against-diabetes-in-a-community-setting/

"Community Health Promotion: The Fight Against Diabetes in a Community Setting." IvyPanda , 29 Mar. 2022, ivypanda.com/essays/community-health-promotion-the-fight-against-diabetes-in-a-community-setting/.

IvyPanda . (2022) 'Community Health Promotion: The Fight Against Diabetes in a Community Setting'. 29 March.

IvyPanda . 2022. "Community Health Promotion: The Fight Against Diabetes in a Community Setting." March 29, 2022. https://ivypanda.com/essays/community-health-promotion-the-fight-against-diabetes-in-a-community-setting/.

1. IvyPanda . "Community Health Promotion: The Fight Against Diabetes in a Community Setting." March 29, 2022. https://ivypanda.com/essays/community-health-promotion-the-fight-against-diabetes-in-a-community-setting/.

Bibliography

IvyPanda . "Community Health Promotion: The Fight Against Diabetes in a Community Setting." March 29, 2022. https://ivypanda.com/essays/community-health-promotion-the-fight-against-diabetes-in-a-community-setting/.

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