Diabetes Mellitus
Diabetes
mellitus refers to a group of diseases that affect how your body uses blood
sugar (glucose). Glucose is vital to your health because it's an important
source of energy for the cells that make up your muscles and tissues. It's also
your brain's main source of fuel. If you have diabetes, no matter what type, it
means you have too much glucose in your blood, although the causes may differ.
Too much glucose can lead to serious health problems.
Type
There are
three type of diabetes that we see in people.
Type 1
diabetes
The body
does not produce insulin. Some people may refer to this type as
insulin-dependent diabetes, juvenile diabetes, or early-onset diabetes. People
usually develop type 1 diabetes before their 40th year, often in early
adulthood or teenage years. Type 1 diabetes is nowhere near as common as type 2 diabetes. Approximately 10% of all diabetes cases are type
1. Patients with type 1 diabetes will need to take insulin injections for the
rest of their life. They must also ensure proper blood-glucose levels by
carrying out regular blood tests and following a special diet.
Type 2
diabetes
Some
people may be able to control their type 2 diabetes symptoms by losing weight,
following a healthy diet, doing plenty of exercise, and monitoring their blood
glucose levels. However, type 2 diabetes is typically a progressive disease -
it gradually gets worse - and the patient will probably end up have to take
insulin, usually in tablet form. Overweight and obese people have a much higher
risk of developing type 2 diabetes compared to those with a healthy body weight.
Gestational
diabetes
This type
affects females during pregnancy. Some women have very high levels of glucose
in their blood, and their bodies are unable to produce enough insulin to
transport all of the glucose into their cells, resulting in progressively
rising levels of glucose. Diagnosis of gestational diabetes is made during
pregnancy.
Symptoms
Diabetes
symptoms vary depending on how much your blood sugar is elevated. Some people,
especially those with prediabetes or type 2 diabetes, may not experience symptoms initially. In type 1
diabetes, symptoms tend to come on quickly and be more severe.
Some of
the signs and symptoms of type 1 and type 2 diabetes
are:
Increased
thirst
Frequent
urination
Extreme
hunger
Unexplained
weight loss
Presence
of ketones in the urine (ketones
are a byproduct of the breakdown of muscle and fat that happens when there's
not enough available insulin)
Fatigue
Irritability
Blurred
vision
Slow-healing
sores
Frequent
infections, such as gums or skin infections and vaginal infections
Although
type 1 diabetes can develop at any age, it typically appears during childhood
or adolescence. Type 2 diabetes, the more common type, can develop at any age,
though it's more common in people older than 40.
Risk
factors
The risk
factors for type 1 diabetes are still being researched. However, having a
family member with type 1 diabetes slightly increases the risk of developing
the disease. Environmental factors and exposure to some viral infections have
also been linked to the risk of developing type 1 diabetes.
Several
risk factors have been associated with type 2 diabetes and include:
Family
history of diabetes
Overweight
Unhealthy
diet
Physical
inactivity
Increasing
age
High
blood pressure
Ethnicity
Impaired
glucose tolerance (IGT)
History
of gestational diabetes
Poor
nutrition during pregnancy
Cause
Cause
of type 1 diabetes
Type 1
diabetes mellitus is characterized by loss of the insulin-producing beta cells
of the pancreatic islets, leading to insulin deficiency. This type can be
further classified as immune-mediated or idiopathic. The majority of type 1
diabetes is of the immune-mediated nature, in which a T cell-mediated
autoimmune attack leads to the loss of beta cells and thus insulin.
Cause
of type 2 diabetes
Type 2 DM
is characterized by insulin resistance, which may be combined with relatively
reduced insulin secretion. The defective
responsiveness of body tissues to insulin is believed to involve the insulin
receptor. However, the specific defects are not known. Diabetes mellitus cases
due to a known defect are classified separately. Type 2 DM is the most common
type of diabetes mellitus.
Cause of
gestational diabetes
Gestational
diabetes mellitus (GDM) resembles type 2 DM in several respects, involving a combination
of relatively inadequate insulin secretion and responsiveness. It occurs in
about 2–10% of all pregnancies and may improve or disappear after delivery. However,
after pregnancy approximately 5–10% of women with gestational diabetes are
found to have diabetes mellitus, most commonly type 2. Gestational diabetes is
fully treatable, but requires careful medical supervision throughout the
pregnancy. Management may include dietary changes, blood glucose monitoring,
and in some cases, insulin may be required.
Complications
Long-term
complications of diabetes develop gradually. The longer you have diabetes — and
the less controlled your blood sugar — the higher the risk of complications.
Eventually, diabetes complications may be disabling or even life-threatening.
Possible complications include:
Cardiovascular
disease. Diabetes
dramatically increases the risk of various cardiovascular problems, including
coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis). If you
have diabetes, you are more likely to have heart disease or stroke.
Nerve
damage (neuropathy).
Excess sugar can injure the walls of the tiny blood vessels (capillaries) that
nourish your nerves, especially in your legs. This can cause tingling,
numbness, burning or pain that usually begins at the tips of the toes or
fingers and gradually spreads upward. Left untreated, you could lose all sense
of feeling in the affected limbs. Damage to the nerves related to digestion can
cause problems with nausea, vomiting, diarrhea or constipation. For men, it may
lead to erectile dysfunction.
Kidney
damage (nephropathy). The
kidneys contain millions of tiny blood vessel clusters (glomeruli)
that filter waste from your blood. Diabetes can damage this delicate filtering
system. Severe damage can lead to kidney failure or irreversible end-stage
kidney disease, which may require dialysis or a kidney transplant.
Eye
damage (retinopathy). Diabetes
can damage the blood vessels of the retina (diabetic retinopathy), potentially
leading to blindness. Diabetes also increases the risk of other serious vision
conditions, such as cataracts and glaucoma.
Foot
damage. Nerve damage in the feet or poor
blood flow to the feet increases the risk of various
foot complications. Left untreated, cuts and blisters can develop serious
infections, which often heal poorly. These infections may ultimately require
toe, foot or leg amputation.
Skin
conditions. Diabetes may leave you more
susceptible to skin problems, including bacterial and fungal infections.
Hearing
impairment. Hearing
problems are more common in people with diabetes.
Alzheimer's disease. Type 2 diabetes may increase the risk of Alzheimer's disease. The poorer your blood sugar control, the greater the risk appears to be. Although there are theories as to how these disorders might be connected, none has yet been proved.
Prevention
Type 1
diabetes can't be prevented. However, the same healthy lifestyle choices that
help treat prediabetes, type 2
diabetes and gestational diabetes can also help prevent them:
Eat
healthy foods. Choose
foods lower in fat and calories and higher in fiber. Focus on fruits,
vegetables and whole grains. Strive for variety to prevent boredom.
Get
more physical activity. Aim
for 30 minutes of moderate physical activity a day. Take a brisk daily walk.
Ride your bike. Swim laps. If you can't fit in a long workout, break it up into
smaller sessions spread throughout the day.
Lose
excess pounds. If
you're overweight, losing even 7 percent of your body weight — for example, 14
pounds (6.4 kilograms) if you weigh 200 pounds (90.9 kilograms) — can reduce
the risk of diabetes. To keep your weight in a healthy range, focus on
permanent changes to your eating and exercise habits. Motivate yourself by
remembering the benefits of losing weight, such as a healthier heart, more
energy and improved self-esteem.
Treatments
All types
of diabetes are treatable. Diabetes type 1 lasts a lifetime, there is no known
cure. Type 2 usually lasts a lifetime, however, some
people have managed to get rid of their symptoms without medication, through a
combination of exercise, diet and body weight control.
Patients
with type 1 are treated with regular insulin injections, as well as a special
diet and exercise.
Patients
with Type 2 diabetes are usually treated with tablets, exercise and a special
diet, but sometimes insulin injections are also required. If diabetes is not
adequately controlled the patient has a significantly higher risk of developing
complications.