Diabetes

What is Diabetes

Diabetes mellitus (DM) is a condition in which the body cannot manage blood glucose (sugar) properly. Blood glucose is the body's main source of energy. It comes mostly from carbohydrates in food and drink. Normally, the pancreas produces a hormone called insulin, which helps glucose move from the blood into the cells to be used as energy. In diabetes, this process breaks down: either the pancreas produces little or no insulin, or the body's cells stop responding to insulin as they should. Glucose then builds up in the blood instead of reaching the cells, and over time, this causes damage to organs, nerves, and blood vessels.

Types of Diabetes

There are several types of diabetes, each with a different cause and pattern.

• Type 1 diabetes (T1D) is an autoimmune disease. The immune system attacks and destroys the insulin-producing cells in the pancreas. The body then makes little or no insulin at all. Type 1 is usually diagnosed in children and young adults, though it can appear at any age. It accounts for up to 10% of all diabetes cases and requires daily insulin therapy to survive.
• Type 2 diabetes (T2D) is the most common form, making up 90–95% of all cases. In T2D, the body either does not produce enough insulin or the cells do not respond to it properly, a problem called insulin resistance. It mainly affects adults but is increasingly seen in younger people. Unlike T1D, it often develops gradually and can sometimes be managed or reversed with lifestyle changes, particularly in its earlier stages. There are also several surprising facts about Type 2 diabetes that many people are unaware of. 
• Prediabetes is the stage before T2D. Blood glucose is higher than normal but not yet high enough to be diagnosed as type 2. There are usually no symptoms, which is why it often goes undetected. Without intervention, prediabetes frequently progresses to T2D. 
• Gestational diabetes develops during pregnancy. The hormonal changes of pregnancy interfere with how the body uses insulin, causing blood glucose to rise. It usually resolves after birth, but women who have it carry a higher risk of developing T2D later in life. Screening is done between 24 and 28 weeks of pregnancy. 

Causes of Diabetes

The cause of diabetes differs by type. In T1D, the immune system mistakenly destroys the insulin-making cells in the pancreas. Researchers believe genetic factors and certain environmental triggers play a role, though the exact cause is still not fully understood.

T2D develops from a combination of lifestyle and genetic factors. The body's cells gradually stop responding well to insulin, a state called insulin resistance. The pancreas tries to compensate by producing more insulin, but over time it cannot keep up with demand, and blood glucose rises. 

Gestational diabetes occurs when the hormonal changes of pregnancy make it harder for the body to use insulin effectively. The pancreas cannot produce enough extra insulin to compensate, and blood glucose climbs as a result. 

Risk Factors

Not everyone with risk factors will develop diabetes, but knowing them helps with early action.

For T1D, having a parent or sibling with the condition raises your personal risk. It can develop at any age, but diagnosis is most common in childhood and early adulthood.

The risk factors for T2D are more varied, and many are modifiable. Being overweight or obese is one of the strongest risk factors, particularly when excess weight is carried around the abdomen. Physical inactivity compounds this risk, as regular movement helps the body use insulin more effectively. Age is also a factor; the risk rises after 35, though T2D is no longer rare in younger adults and teenagers. 

A family history of T2D increases your likelihood of developing it, as does a personal history of prediabetes or gestational diabetes. Women who have given birth to a baby weighing 4 kg (9 pounds) or more are also at higher risk. Certain health conditions, including high blood pressure and polycystic ovary syndrome (PCOS), are associated with increased risk. 

Ethnicity plays a role too. African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander carry a higher genetic predisposition to T2D.

For gestational diabetes, the risk is higher in women who are overweight, have a family history of diabetes, had gestational diabetes in a previous pregnancy, or have PCOS. 

Symptoms of Diabetes

Symptoms vary by type and can be easy to miss, particularly in T2D. Common symptoms across types include:

• Increased thirst and dry mouth
• Frequent urination (including at night)
• Fatigue
• Blurred vision
• Unexplained weight loss
• Numbness or tingling in the hands and feet
• Slow-healing cuts or sores
• Recurring skin or vaginal infections

In T1D, symptoms tend to come on quickly, sometimes over just a few weeks. A serious complication called diabetic ketoacidosis (DKA) can develop, with symptoms including vomiting, stomach pain, fruity-smelling breath, and difficulty breathing. DKA is a medical emergency. 

In T2D, symptoms usually develop slowly over months or years. Some people have no noticeable symptoms at all and are only diagnosed when a routine blood test shows raised glucose levels. Gestational diabetes also rarely causes symptoms, which is why routine screening during pregnancy is important. 

Diagnosis

Diabetes is diagnosed through blood tests that measure glucose levels. Your doctor may use one or more of the following.

The fasting blood glucose test measures blood sugar after a period of not eating, usually overnight. A result of 126 mg/L or higher. or higher on two separate tests points to diabetes. A value between 100 and 125 is indicative of prediabetes.

The HbA1c test (glycated haemoglobin test) gives an average of blood sugar levels over the past two to three months. An HbA1c of 6.5% or above is used to diagnose diabetes. A result between 5.7% and 6.4% indicates prediabetes.

The oral glucose tolerance test (OGTT) involves measuring blood glucose before and two hours after drinking a glucose solution. It is commonly used during pregnancy to screen for gestational diabetes. A random blood glucose test can be done at any time of day. A result of 200 mg/L or higher alongside symptoms of diabetes is diagnostic.

Treatment

There is no cure for diabetes, but all types are manageable. The goal of treatment is to keep blood glucose within a healthy range and prevent complications. People with T1D need insulin every day. This can be delivered through injections or an insulin pump. The dose is adjusted according to food intake, activity, and blood glucose readings. Continuous glucose monitors (CGMs) can help track levels in real time without repeated finger-prick tests. 

People with T2D may be able to lower their blood glucose significantly through dietary changes, weight management, and regular physical activity. When these alone are not enough, medications are added. Metformin is commonly the first prescribed. Other classes of medicines, including sulfonylureas, sodium-glucose co-transporters type 2 (SGLT-2) inhibitors, and glucagon-like peptide-1 (GLP-1) receptor agonists, may also be used, and some people with T2D will eventually need insulin. 

Complications

Persistently high blood glucose damages blood vessels and nerves throughout the body. The longer diabetes goes uncontrolled, the greater the risk of complications.

Cardiovascular disease is one of the most common complications; people with diabetes have a higher risk of heart attack and stroke. Diabetic neuropathy causes damage to the nerves, often beginning in the feet and legs, with symptoms of numbness, tingling, or pain. Diabetic retinopathy affects the blood vessels in the eyes and is a leading cause of preventable blindness. Diabetic nephropathy is kidney damage caused by high blood glucose, and in serious cases, it can lead to kidney failure. Poor circulation and nerve damage in the feet also increase the risk of foot ulcers and infections, which in severe cases can require amputation. 

Managing Diabetes Day-to-day

Living well with diabetes depends on routine self-management. Blood glucose monitoring, whether by finger-prick tests or a CGM, helps track how food, activity, and medication are working. Regular check-ups with a doctor allow for early detection of complications before they become serious.

Diet plays a central role. Meals that are balanced in carbohydrates, high in fibre, and low in added sugars help keep blood glucose steady. Physical activity improves the body's response to insulin and supports weight control, both of which matter in T2D management. Staying at a healthy weight, not smoking, and limiting alcohol all reduce the risk of complications. 

Can Diabetes be Prevented?

T1D cannot currently be prevented. T2D, however, is largely preventable or at least delayable. Maintaining a healthy body weight, eating a balanced diet, and getting regular physical activity can significantly reduce the risk, even for those with a family history of the condition or a prior diagnosis of prediabetes.

Diabetes Care at Home in Dubai

Managing diabetes well requires consistent monitoring, medication, and regular reviews, and fitting all of that around daily life in Dubai is not always straightforward. First Response Healthcare (FRH) provides at-home healthcare services across Dubai, including nursing visits, blood glucose monitoring, and chronic disease management support. FRH brings clinical care to your doorstep so you can manage your condition in a comfortable, familiar environment without repeated clinic trips.

FAQs

Is diabetes hereditary? 

Both T1D and T2D have a genetic component, but having a family history does not mean diabetes is inevitable. Lifestyle factors play a large role in whether T2D develops. 

Can you have diabetes without knowing? 

Yes. Type 2 diabetes and prediabetes often have no symptoms in their early stages. Many people are diagnosed only during routine screening. 

Does eating sugar cause diabetes? 

Eating sugar alone does not cause diabetes. T1D is an autoimmune condition unrelated to diet. Excess sugar intake can contribute to weight gain, which is a risk factor for T2D, but the cause is more complex than sugar alone. 

Can diabetes be cured? 

Type 1 diabetes cannot currently be cured. Type 2 diabetes can go into remission in some people, particularly with significant weight loss and lifestyle changes, but it is not technically a cure, and blood glucose must still be monitored.