DIABETES MELLITUS

Picture of main symptoms of diabetes

 

What are Diabetes mellitus (DM)?

Diabetes mellitus is a disease of inadequate control of blood glucose level. It has many subclassifications, including type 1, type 2, maturity-onset diabetes of the young (MODY), gestational diabetes, neonatal diabetes, and steroid-induced diabetes. 

Type-1 Diabetes  –known as juvenile diabetes or insulin-dependent diabetes. A chronic condition in which the pancreas produces little or no insulin. It typically appears in adolescence. It can also occur in children and adolescents depending on how many B-cells of the pancreas are non-functioning. The onset of symptoms corresponds to an 80% reduction in beta cell mass. Symptoms include increased thirst, frequent urination, hunger, fatigue and blurred vision.

Type 2 diabetescalled as adult onset diabetes. A chronic condition that affects the way the body processes blood sugar (glucose).With type 2 diabetes, the body either doesn’t produce enough insulin, or it resists insulin. Symptoms include increased thirst, frequent urination, hunger, fatigue and blurred vision. In some cases, there may be no symptoms.

Symptoms

*Common symptoms of diabetes include:

*Increased thirst (polydipsia) and dry mouth.

*Frequent urination. 

*Fatigue.

*Blurred vision. 

*Unexplained weight loss. 

*Numbness or tingling in your hands or feet.

*Slow-healing sores or cuts. 

*Frequent skin and/or vaginal yeast infection.

Causes

(1) Insulin resistance (2)  Autoimmune disease (3) Hormonal imbalance (4)  pancreatic damage(5) genetic mutations(6)  Long-term use of certain medications can also lead to Type 2 diabetes, including HIV/AIDS medications and corticosteroids.  

How is diabetes diagnosed?

Three tests can measure your blood glucose level:

(1) Fasting blood glucose test: For this test, you don’t eat or drink anything except water (fast) for at least eight hours before the test. As food can greatly affect blood sugar, this test allows your provider to see your baseline blood sugar.

(2)Random blood glucose test: “Random” means that you can get this test at any time, regardless of if you’ve fasted.

(3)A1c: This test, also called HbA1C or glycated hemoglobin test, provides your average blood glucose level over the past two to three months.

Management/ Treatment

Diabetes is a complex condition, so its management involves several strategies. In addition, diabetes affects everyone differently, so management plans are highly individualized.

The main aspects of managing diabetes include:

(1) Blood sugar monitoring: Monitoring your blood sugar (glucose) is key to determining how well your current treatment plan is working. It gives you information on how to manage your diabetes on a daily  and sometimes even hourly basis.

 (2)Oral diabetes medications: Oral diabetes medications (taken by mouth) help manage blood sugar levels in people who have diabetes but still produce some insulin — mainly people with Type 2 diabetes and prediabetes. People with gestational diabetes may also need oral medication. There are several different types. Metformin is the most common.

(3)Insulin: People with Type 1 diabetes need to inject synthetic insulin to live and manage diabetes. Some people with Type 2 diabetes also require insulin. 

(4)Diet: Meal planning and choosing a healthy diet for you are key aspects of diabetes management, as food greatly impacts blood sugar. If you take insulin, counting carbs in the food and drinks you consume is a large part of management. The amount of carbs you eat determines how much insulin you need at meals. Healthy eating habits can also help you manage your weight and reduce your heart disease risk.

(5)Exercise: Physical activity increases insulin sensitivity and helps reduce insulin resistance, so regular exercise is an important part of management for all people with diabetes.

How can I prevent diabetes?

You can’t prevent autoimmune and genetic forms of diabetes. But there are some steps you can take to lower your risk for developing prediabetes, Type 2 diabetes and gestational diabetes, including:

Eat a healthy diet, such as the Mediterranean diet.

Get physically active. Aim for 30 minutes a day at least five days a week.

Work to achieve a weight that’s healthy for you.

Manage your stress

Limit alcohol intake.

Get adequate sleep (typically 7 to 9 hours) and seek treatment for sleep disorders.

Quit smoking

Take medications as directed by your healthcare provider to manage existing risk factors for heart disease.

Normal value of diabetes mellitus

Comparison of type 1 and 2 diabetes

FeatureType 1 diabetesType 2 diabetes
OnsetSuddenGradual
Age at onsetAny age, average age at diagnosis being 24Mostly in adults
Body sizeThin or normalOften obese
 KetoacidosisCommonRare
 AutoantibodiesUsually presentAbsent
Endogenous insulinLow or absentNormal, decreased
or increased
Heritability0.69 to 0.880.47 to 0.77

Prevalence

(age standardized)

<2 per 1,000~6% (men), ~5% (women)
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