Diabetes – Types, Symptoms, Causes and Complications

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Diabetes definition


Diabetes is an acute or chronic, hereditary or acquired condition characterised by abnormal or excess urine formation that passes through the kidneys. Depending on the presence or absence of glucose in the urine, diabetes is classified into diabetes mellitus and diabetes insipidus.


Diabetes meaning


The term "diabetes" dates back to Ancient Greece; it means "pass through." As the Latin name "mellitus” states, "honey or sweet," therefore, diabetes mellitus can be defined as an increase in the formation of glucose content in urine. In the case of diabetes insipidus, the word "insipidus" means "tasteless," Hence, it can be defined as the excess formation of non-glucose urine.

Types of Diabetes

As mentioned above, based on the presence of glucose in the urine, they are classified into two types, namely:

  • Diabetes mellitus
  • Diabetes insipidus
different types of diabetes | diabetes and its types | types of diabetes mellitus | types of diabetes insipidus

Diabetes mellitus

Diabetes mellitus is a set of metabolic disorders characterised by hyperglycemia (elevated blood sugar levels). Hyperglycemia is caused by decreased insulin secretion, poor glucose utilisation, and increased glucose production, all of which can be related to the underlying cause of diabetes mellitus. Genetic and environmental factors interact to cause the various forms of diabetes mellitus.

Types of diabetes mellitus

The types of diabetes mellitus are classified based on the pathogenic process leading to hyperglycaemia:

Diabetes insipidus

Diabetes insipidus is a rare hereditary disorder that produces excessive urine. It is characterised by polyuria (frequent urination) and polydipsia (extreme thirst). People with diabetes insipidus often urinate more than 15 to 19 liters daily. In contrast, healthy individuals typically urinate between 2 and 3 liters daily.

Types of diabetes insipidus

The types of diabetes insipidus are based on the decrease in anti-diuretic hormone (ADH) concentration or its binding abnormality to the kidney cells, they are classified into four types:

  1. Central diabetes insipidus
  2. Nephrogenic diabetes insipidus
  3. Gestational diabetes insipidus
  4. Dipsogenic diabetes insipidus or psychogenic polydipsia

Prevalence of diabetes in India

Diabetes mellitus prevalence in India is top-notch, and it is considered the diabetes hub of the world, with a stake of 17% of the total number of diabetes patients globally. In 2019, it was reported diabetes mellitus affects nearly 7.7 crore people in India, with the number expected to rise to 13.4 crores by 2045. As per World Health Organization (WHO) and Non-communicable diseases (NCDs), diabetes mellitus ranked ninth among the top 10 leading causes of death globally in 2019.


Diabetes insipidus is rare in India and globally, affecting about 1 in 25,000 people worldwide.

Causes of diabetes

Causes for diabetes mellitus

The endocrine cells (beta and alpha) of islets of Langerhans present in the pancreas secrete insulin hormone from the beta cells and glucagon hormone from the alpha cells. Both beta and alpha cells adjust their hormone release levels in response to their surrounding glucose concentration and maintain normal glucose levels in the blood.


In normal conditions, when the glucose concentration is higher in the blood, beta cells release more insulin. In the case of low blood glucose, glucagon is released in excess from alpha cells. Diabetes mellitus is caused by hyperglycaemia (increase in blood sugar levels) which occurs either due to low or no amount of insulin production (type 1 diabetes) or reduced insulin activity or insulin resistance (type 2 diabetes).


Damage to the pancreatic beta cells, resulting from an autoimmune response (unknowingly attacking the own cells), leads to type 1 diabetes. As a result, the beta cells in the body are damaged, and insulin levels drop severely low.


In type 2 diabetes, an imbalance between insulin levels and insulin sensitivity results in a functional insulin deficit. The insulin released from the beta cells cannot be utilised by the body (skeletal muscle and adipose tissues), signifying insulin resistance. Insulin resistance is complex; however, it is most typically caused by increased body weight and aging.

what causes diabetes | causes of diabetes mellitus

Causes for diabetes insipidus

Diabetes insipidus is caused either by inadequate or impaired secretion of arginine vasopressin (anti-diuretic hormone) from the pituitary gland or by an insufficient kidney response to the arginine vasopressin, leading to polyuria (excessive urine formation) and underlying polydipsia (a feeling of extreme thirst).


Anti-diuretic hormone or vasopressin that is released from the pituitary gland reaches the kidney (digital convoluted tubule) and binds to arginine vasopressin receptor 2 (AVPR2) in the kidney. This, AVPR2, stimulates the transfer of water (reabsorption) into the bloodstream from the kidney and maintains the blood concentration (osmolality). The unabsorbed waste and a small amount of water from urine are excreted from the body.


During diabetes insipidus, very little water is reabsorbed from the kidney (digital convoluted tubule) to blood vessels, either due to a decrease in pituitary gland vasopressin secretion (which may be due to autoimmune) or because kidney cells are unable to bind with the released vasopressin. This causes an increased amount of urine formation in the kidney, which is commonly called polyuria.


Due to the low amount of water present in the renal blood vessels (due to the low amount of water transported back to the blood vessels from the kidney), the blood osmolality gets disturbed, requiring more water to get balanced in the body. As a result, the osmoreceptors in the hypothalamus trigger the sensation of thirst, causing the person to feel thirsty (polydipsia).

diabetes insipidus causes

Diabetes symptoms

Symptoms of diabetes are characterised by excessive thirst and urination. In addition to this, the symptoms are as follows:

type 1 and type 2 diabetes symptoms | signs and symptoms of diabetes mellitus

Diabetes insipidus symptoms in adults

  • Polydipsia (feeling extremely thirsty)
  • Nocturia (waking up middle of the night to urinate frequently)
  • Excessive production of pale urine
  • Diabetes insipidus symptoms in children
  • Nocturnal enuresis (involuntary urination at sleep)
  • Difficulty to sleep
  • Increased body temperature or fever
  • Difficulty in passing stools
  • Decrease in weight
  • Slow growth
  • Vomiting
diabetes insipidus symptoms

Diabetes mellitus symptoms

  • Frequent urination
  • Ketonuria (high ketone levels in urine)
  • Fluctuations in mood
  • Blurred vision
  • Weight loss
  • Weakness
  • Excessive thirst
  • Slower rate in healing of sores

Risk factors of diabetes

The following are the factors associated with diabetes risk; they may vary depending on the type of diabetes.

type 1 and type 2 diabetes risk factors| diabetes mellitus | risk factors for gestational diabetes and diabetes insipidus

Risk factors of diabetes mellitus

  • The presence of inherited autoantibodies (auto-antibodies in family or parents) increases the risk of developing type 1 diabetes.
  • Being overweight (body mass index >25 kg/m²) or obese (body mass index > 30 kg/m²) is the major risk factor for type 2 diabetes mellitus and gestational diabetes
  • Family history of having diabetes mellitus (type 1 and type 2)
  • Low physical activity
  • History of having gestational diabetes
  • The presence of polycystic ovary syndrome act as a risk factor for gestational diabetes
  • Given birth to a child weighing more than 4 kilograms

Risk factors of diabetes insipidus

Presence of nephrogenic diabetes insipidus (permanent failure of kidney’s ability to concentrate urine) gene in women that can pass to their male babies.

Diabetes prevention

Diabetes cannot be prevented if it results from a hereditary or an autoimmune disease. The prevention factors differ based on the type of diabetes. 

Prevention of diabetes mellitus

Diabetes mellitus, caused by an autoimmune antibody (type 1), is hard to prevent as it is caused by abnormal immune system functions.


In type 2 diabetes mellitus, gene or hereditary-associated diabetes mellitus is unpreventable. However, if a person is diagnosed with prediabetes, the following precautions can be taken to slow down the progression of type 2 diabetes mellitus.

  • Consume healthy food (in smaller proportions) that is lower in fat (saturated and trans-fat), carbohydrate and rich in fiber, including fruits and vegetables
  • Increase physical activity by a least 150 minutes per week (30 minutes a day, five days a week) of moderate aerobic activity (brisk walking or cycling)
  • Losing 5% to 7% of body weight in the case of overweight or obese individuals

Prevention of diabetes insipidus

Diabetes insipidus prevention is primarily concerned with avoiding or resolving the underlying causes. This includes avoiding certain medicines, addressing underlying medical concerns, and regulating fluid intake and output to avoid dehydration. In cases where the cause is uncertain, regular monitoring and management of symptoms might help avert issues.

Difference between diabetes mellitus and diabetes insipidus | diabetes mellitus vs diabetes insipidus

Elements Diabetes mellitus Diabetes insipidus
Definition Group of metabolic disorders characterised by an increase in blood glucose levels It is a rare genetic condition that causes excessive urine production and the sensation of thirst.
Causes Caused either by due to deficiency of insulin production from the pancreatic cells or insulin resistance to muscle tissue. Caused by a reduction in anti-diuretic hormone (ADH) levels or an impairment in ADH binding to kidney cells.
Glucose in urine Presence of glucose in urine. Absence of glucose in urine.
Diet restriction Diet rich in sugar, fat, and processed meat Diet had no role in the cause
Incidence Incidence is more Rare incidence

Diabetes diagnosis

The diagnostic tests used for the detection of diabetes vary based on the type of diabetes.


Diabetes mellitus diagnosis

Diagnosis of diabetes mellitus is made through any of the following, according to American Diabetes Association (ADA):

  • Glycated haemoglobin (HbA1c) test
  • Fasting plasma glucose (FPG)
  • Oral glucose tolerance test (OGTT)
  • Random blood sugar test (RBS)


Diabetes insipidus diagnosis

Diagnostic tests used to detect diabetes insipidus include:

  • Water deprivation test
  • Magnetic resonance imaging (MRI)
type 1 and type 2 diabetes diagnosis | diabetes mellitus | gestational diabetes | diabetes insipidus

Diabetes treatment

The treatment for diabetes is managed by treating underlying conditions through therapeutic therapy and lifestyle management. In a few cases, surgical intervention might be required.


Diabetes mellitus treatment

  • Type 1 diabetes treatment: Treatment for type 1 diabetes includes monitoring blood sugar levels often, measuring the intake of carbohydrates in meals, and injecting insulin. In some cases, pancreas or islet cell transplantation may be a surgical option.
  • Type 2 diabetes treatment: Lifestyle modifications that include diet and exercise, blood sugar monitoring, and the use of oral diabetic medications or oral hypoglycaemic agents, insulin, or both, are the cornerstones of care for people with type 2 diabetes.


Diabetes insipidus treatment

Based on the causative factor of diabetes insipidus, the treatment may vary.

Central diabetes insipidus treatment

  • If there is any abnormality in the pituitary gland that releases ADH hormone, the underlying cause should be resolved.
  • Medical management includes synthetic hormones that replace the functions of anti-diuretic hormone (ADH) and reduces urine formation.

Nephrogenic diabetes insipidus treatment

  • Medical management includes diuretics, nonsteroidal anti-inflammatories, and synthetic hormones.
  • Daily intake of water should be sufficient in order to avoid dehydration.

Complications of diabetes

The complications of diabetes might develop slowly or due to a misdiagnosis of the condition.

 

Complications of diabetes mellitus 

Long term diabetes mellitus leads to complications that develops slowly. The long-term effects of diabetes can be life-threatening that include microvascular and macrovascular complications such as:

  • Cardiovascular diseases
  • Diabetic nephropathy (kidney damage)
  • Diabetic retinopathy (eye damage)
  • Diabetic neuropathy (nerve damage)
  • Skin infections
  • Depression
  • Alzheimer's disease
complications of diabetes mellitus | type 1 and type 2 diabetes

Complications of diabetes insipidus

Complications of diabetes insipidus are more likely to occur if the condition is misdiagnosed or inadequately managed. As diabetes insipidus is characterised by excessive urination and increased sensation of thirst, two major complications can be observed. 

  • Dehydration
  • Imbalance in electrolytes
complications of diabetes insipidus

Frequently asked questions:

  • Can diabetes be cured?

    It depends on the type of diabetes the patient is suffering from. In some cases, diabetes insipidus cannot be cured but can be managed with medication therapy. In other cases, the pituitary gland disorder can be cured by treating the underlying cause or providing medical management. 


    In the case of diabetes mellitus, in some cases, type 1 can be treated (based on case scenarios) by undergoing pancreas transplantation, whereas type 2 diabetes mellitus may not be cured, but it can be managed with proper lifestyle management.

  • Can diabetics donate blood?

    Yes, a diabetic mellitus patient can donate blood under the following conditions.

    • Blood sugar levels should be within the normal range. 
    • Not on insulin therapy
    • There should be no macro or micro complications, such as heart, kidney, and eye diseases. 
    • Absence of infections or other comorbid conditions

  • How to avoid diabetes?

    It is very difficult to avoid diabetes, which is caused by an autoimmune disease (type 1 diabetes mellitus and diabetes insipidus) or an underlying disease (such as a pituitary gland abnormality). 


    A pre-diabetic person can avoid developing type 2 diabetes mellitus (T2DM) by changing their diet and lifestyle. A diet high in fibre and low in glycemic index (below 50), carbohydrates, saturated fats and trans fats is highly recommended. Physical activity of at least 30 minutes a day and a reduction in body weight for overweight or obese individuals aid in preventing T2DM.

  • Which is worse type 1 or 2 diabetes?

    Both types of diabetes mellitus have serious complications associated with increased blood sugar levels (hyperglycaemia). 


    Though type 2 has long-term complications that develop slowly, they are life-threatening. Hence, both types 1 and 2 are fatal if the condition (diabetes mellitus) is not managed adequately.

  • Can diabetes patient take covid vaccine?

    Yes, persons with diabetes and its related comorbidities, such as hypertension and cardiovascular diseases, are considered high-risk. As a result, these individuals require the COVID-19 vaccine to prevent the Coronavirus.

  • How does diabetes affect a man sexually?

    Diabetes patients, particularly those with type 2 diabetes, may experience erectile dysfunction. It is a physical condition characterised by a man's inability to maintain an adequate erection for sexual intercourse. 


    Diabetes may cause erectile dysfunction earlier in males than in men who do not have the disease. It can result from nerve and blood vessel damage induced by inadequate long-term blood sugar control.

  • How to stop frequent urination in diabetes?

    The best strategy to deal with frequent urination caused by diabetes is to treat the disease itself. A fibre-rich diet, regular exercise, and adherence to the prescribed medications, such as insulin and oral anti-diabetic agents, as well as other drugs used to treat underlying conditions, help to manage blood glucose levels and anti-diuretic hormone levels in the patient's body. Following the aforementioned steps can help diabetic patients stop urinating frequently.

  • Which hormone is responsible for diabetes mellitus?

    Glucagon and insulin are key hormones that play important roles in blood glucose regulation. These hormones are produced by the pancreas' alpha cells (glucagon) and beta cells (insulin). Glucagon raises blood sugar levels while insulin lowers them. An increase in blood sugar levels occurs when the beta cells unable to produce enough insulin or the body does not use it properly, leading to diabetes mellitus.

  • Can a diabetic woman get pregnant?

    Yes, a diabetic woman can have a pregnancy, as diabetes doesn't affect the hormones responsible for the pregnancy, such as the human chorionic gonadotropin hormone, oestrogen, progesterone, etc. However, diabetes can damage blood vessels and nerves, which also include those that supply sexual organs, leading to vaginal dryness and low stimulation. This can affect a diabetic woman from being pregnant.

  • Is diabetes a communicable disease?

    No, diabetes is not a communicable disease. Diabetes mellitus is caused by either a decrease in insulin concentration or resistance to insulin. In the case of diabetes insipidus, it may be caused either by an abnormality in the production of anti-diuretic hormone from the pituitary gland or by an insufficient kidney response to the anti-diuretic hormone.

  • What food causes diabetes?

    No, diet is related to aetiology with diabetes insipidus. The following diet can cause an increase in diabetes mellitus:

    • Foods rich in carbohydrates, sugar, saturated and trans fat
    • Increase in intake of red and processed meat

  • Does diabetes insipidus affect blood sugar?

    No, diabetes insipidus does not change blood sugar levels because an increase in urine output does not affect insulin levels in the body. However, there will be an imbalance in sodium and potassium levels, which are responsible for maintaining the body's fluid equilibrium.

  • How do you treat early diabetes?

    Early diabetes can be treatable; however, the condition cannot be cured 

    completely. Nevertheless, it goes into remission (no symptoms of diabetes) 

    by following strict diet changes, weight loss and daily exercise.

  • Is diabetes a deadly disease?

    No, diabetes is not a deadly disease; however, if high blood glucose 

    levels are not maintained for a prolonged stage, it can be led to multiple 

    organ failure and associated complications.

  • What is HbA1c in a diabetic patient?

    The (HbA1c) haemoglobin A1c or glycated haemoglobin test is a common blood test that measures the amount of blood sugar (glucose) attached to haemoglobin. It is performed to help diagnose (identify) type 2 diabetes and to monitor (observe) blood glucose control (how well your diabetes is being controlled) in people who have diabetes. Diabetic people are advised to have this test every 3 to 6 months.

  • What are the normal blood sugar levels?

    Normal blood sugar levels for normal fasting blood glucose concentration generally range between 70 mg/dL (3.9 mmol/L) and 100 mg/dL (5.6 mmol/L) when fasting blood glucose is between 100 to 125 mg/dL (5.6 to 6.9 mmol/L). 

  • Is a blood sugar level of 225 harmful?

    The American diabetes association (ADA) recommends normal levels of 80 to 130 mg/dL before food if an individual has diabetes. Blood glucose levels need to be less than 180 mg/dL within 2 hours of eating a meal. Generally, a blood sugar reading greater than 180 mg/dL or above the target range is too high. A 300 mg/dL or above blood sugar reading can be dangerous. If a person has two readings in a row of 300 or more, immediately, they need to consult the general physician or endocrinologist.

  • How does diabetes affect eating habits?

    While unhealthy eating habits can contribute to the development of diabetes in several ways, diabetes can also demonstrate an impact on eating habits in various ways, such as the necessity to monitor the intake of diabetes-risking nutrition (carbohydrates). Also, diabetics need to prepare for adjustments to their diet and snacks to manage their glycaemic levels as directed by their dieticians, which could include calorie (carbohydrates) counting, opting for foods with lower glycaemic index, implicating the uniformity of carbohydrate intake throughout the day.


     Additionally, in some individuals with diabetes, changes in appetite or feelings of hunger may be experienced due to blood sugar level fluctuations or the use of certain hypoglycaemic medications. 

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