St. George Obesity & General Surgery


Diabetes is a chronic metabolic disorder characterised by hyperglycaemia, the presence of high blood sugar (glucose) levels.

The level of glucose in the blood is regulated by insulin hormone. The normal level of glucose in the blood should be between 70 and 100mg/dL (fasting) and <140 mg/dL (random). (There are different views about the normal range of blood glucose. Please discuss the same with your healthcare team.) Impaired production or function of insulin increases glucose levels in the blood.

Types of Diabetes

Type 1 diabetes

Type 1 diabetes is an autoimmune disease, in which the insulin producing cells are mistakenly killed by the body’s defence system; hence, decreasing the production of insulin and increasing the accumulation of blood sugar.

Type 2 diabetes

Type 2 diabetes occurs either due to the reduced production of insulin or the inadequate use of the hormone produced by the various cells of the body. This is termed as insulin insensitivity and is the most common type of diabetes.

Gestational diabetes

Gestational diabetes is a temporary condition, which occurs during pregnancy. Gestational diabetes resolves after child birth, but poses a future risk for the development of type 2 diabetes in the mother.


The pancreas is situated just below the stomach and produces enzymes for the digestion of food, and the hormones insulin and glucagon for the regulation of blood glucose. The pancreas consists of a group of cells called the islets of Langerhans, which produce and store the hormone. Carbohydrates in the food we eat are broken down to form glucose, which is either used immediately by the muscles and liver as energy or stored for later use. When levels of blood sugar start rising after a meal, the islets of Langerhans secretes insulin, which transports sugar to the cells. If the pancreas fails to produce sufficient amounts of insulin or the body’s cells are insensitive to the hormone, glucose starts accumulating in the blood stream, leading to diabetes.

Causes of Diabetes

The various causes of diabetes include:

Impact of Diabetes

Diabetes causes damage to the cardiovascular system, vision, kidneys, nerves, feet, hearing, skin and blood vessels. Gestational diabetes can lead to complications such as high birth weight, requiring C-section delivery, and preeclampsia or high blood pressure that could be life-threatening for both mother and child.

Symptoms of Diabetes

The common symptoms of diabetes mellitus are increased thirst, frequent urination, extreme hunger, unexplained weight loss, fatigue, blurred vision, delayed wound healing, dehydration, altered mental status and frequent infections.

Stages of Diabetes

Stages of diabetes are decided based on blood glucose levels. If your blood glucose levels are between 108 and 126 mg/dL (fasting) and 141 to 200 mg/dL (random) then you are considered to be in the pre-diabetic stage. At this stage, although the blood sugar level is high it cannot be classified as diabetes and the sugar levels can be controlled by weight loss and exercise. Blood glucose levels >126 mg/dL (fasting) and ≥200 mg/dL (random) is considered a diabetic stage and will require medication to keep your blood sugar levels under control. The development of type 2 diabetes at a young age increases the risk of diabetes progressing into complications such as neuropathy.


When you present to your doctor with the above symptoms, your doctor will order a few tests to diagnose diabetes:

Impact of Diabetes

When left untreated, diabetes can damage various parts of the body:

Treatment Options

Treatment of diabetes involves diet, exercise, medications and other lifestyle improvements. These will help to maintain normal blood sugar levels, and prevent or minimise complications of diabetes.

Regular monitoring of blood glucose is necessary to prevent long-term complications of the disease.

Alternative Therapy

Some other treatments that are suggested to control diabetes include: