Diabetes: Complications And Conditions
What is "metabolic syndrome" or "syndrome X"?
Metabolic syndrome, which has also been called syndrome X or the insulin resistance syndrome, is a syndrome in people which gives them a high risk for heart disease and a risk for going on to get diabetes. It's kind of inseparable from type 2 diabetes, in a way, or prediabetes. But basically, it is people who are at risk for type 2 diabetes who gain weight in their center. Gaining weight in your center leads to a higher blood pressure level, to abnormal lipid or cholesterol levels, and to an increase in insulin resistance, which means increases in insulin levels and eventually, potentially, to diabetes. So, if you have the metabolic syndrome, first and foremost, it means you need to be assessed for your risk for cardiovascular disease, for heart attack or stroke. Then you also need to be assessed for your risk for going on to develop diabetes.
What is "prediabetes"?
Prediabetes means an elevation in blood sugar levels above the normal level, but an elevation that's not really considered to be diabetes yet. So the definition is if the blood sugar level fasting, without eating overnight, is between 100 and 125, then that's considered "prediabetes." The point of this is that it's not that one day you wake up with the disease that is prediabetes, it means that you slowly started and gradually have gotten your blood sugar levels higher, higher, and higher. What you want to do is not only be aware of what your fasting blood sugar levels are, but to track the change over time. So, if you start out with a blood sugar level of 95 when you're 38, and when you're 45 it's 105, and 2 years later it's 110, you're really getting worse.
What is "hypoglycemia"?
Hypoglycaemia means a blood sugar level that's fallen below normal, and for most people, that means below a blood sugar of 7. And as your blood sugar falls from 7 to 5 in a case of hypoglycaemia, most people will feel it; they'll feel weak, shaky, hungry. And as your blood sugar level falls much below 5 in a case of hypoglycaemia, you stop being able to think normally: you become fuzzy, you can't do math in your head if you could do it before, and you just get sort of out of it, until you might fall into a hypoglycaemic coma. But hypoglycaemia simply means that the blood sugar is falling and the brain is not getting the glucose it needs to function normally. And your brain must have glucose to function.
What is "diabetic ketoacidosis"?
Diabetic ketoacidosis is a very serious complication that happens only in people with type one diabetes. What diabetic ketoacidosis means is that the body has so little insulin in it that it starts to break down fat. It turns out we need insulin to keep fat in our cells as well as glucose in our cells and when the fat breaks down, it causes a build-up of acid, and that build-up of acid can very quickly cause people to become comatose, they become really hypotensive and their blood pressure falls. It's very serious but also very easy to treat, you just give somebody fluid and insulin, generally by vein, until they get better. You could die from it if you have underlying heart disease, if you're elderly or if somebody doesn't treat you soon enough, because in a day or two in this state, you would be dead. So it's a very serious problem, but very very rare.
