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Is Diabetes just a disease of blood sugar?? When should we start the treatment of Diabetes? It is very dangerous to think so. In type 1 diabetes there is total absence of insulin and blood sugar goes up, leading to atherosclerosis or narrowing of the small vessel in nerves, eyes and kidneys. But type II diabetes is a very complex metabolic disease. It is this type of diabetes that is rapidly increasing. The first thing that sets in is central obesity i.e. weight gain around the belly button and insulin resistance as a consequence. At this stage the cholesterol gets deranged with decrease in the good cholesterol HDL and increase in Free Fatty Acid and Triglycerides. These have a toxic effect on various muscles in the body, called apoptosis. This is also responsible for the damaging effect on the liver, leading to fatty liver and liver failure.The Cholesterol continues to get deranged and as a result we have disease and narrowing of large vessels in the body. A number of patients will present with Heart attack, stoke or kidney failure. There is further increase in insulin resistance as time goes on, leading to high insulin levels. High Insulin causes the BP to slowly and progressive increase and atherosclerosis or hardening of the large vessels to progressively get worse. So we have to remember that far before blood sugar rises in type II diabetes the vascular disease has started playing havoc in the body. When this process has gone on for 15 to 18 years then the blood sugars start to rise. We have a very casual approach to diabetes and it can cause significant damage by the time it is diagnosed. We should amtocipate the problem and start treating at Pre Diabetes stage. Dr. Narendra Gupta, Best Diabetes doctor in Delhi. Best Diabetes doctor in Gurgaon. Best Diabetes doctor in INdia
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