Diabetes Mellitus: Risk Factors, Treatment & Prevention!

Diabetes Mellitus is a metabolic disease/disorder that is caused due to prolonged high blood sugar.

TYPES OF DIABETES MELLITUS

  1. Type 1 Diabetes
  2. Type 2 Diabetes
  3. Gestational Diabetes

Comparison between Type 1 & Type 2 Diabetes:

Feature Type 1 diabetes Type 2 diabetes
Onset Sudden Gradual
Age at onset Mostly in children Mostly in adults
Body size Thin or normal Often obese
Ketoacidosis Common Rare
Autoantibodies Usually present Absent
Endogenous insulin Low or absent Normal, decreased
or increased
Presence
in identical twins		 50% 90%
Prevalence ~10% ~90%

 

SIGNS & SYMPTOMS OF DIABETES MELLITUS

  • Unintended weight loss
  • Increased urination
  • Increased thirst
  • And also an increase in hunger
  • Fatigue
  • Headache
  • Slow healing cuts
  • Itchy skin & rashes
  • Change in vision
  • Nausea & vomiting
  • Abdominal pain
  • Acetone breath
  • Decreased consciousness

COMPLICATIONS

  • Cardiovascular diseases like coronary artery disease
  • Stroke
  • Peripheral Artery Disease
  • Glaucoma & cataract
  • Damage to the blood vessels in the retina of the eyes which can lead to blindness.
  • Kidney scarring
  • Loss of protein from the urine
  • Damage to the nerves in the kidney
  • Chronic Kidney Disease that can eventually need dialysis & kidney transplant.
  • Damage to the nerve in the body that can cause tingling, numbness & loss of sensation.
  • Severe Foot ulcers that is called diabetic foot & can lead to foot amputation.
  • Severe muscle atrophy/loss due to nerve damage.

CAUSES & RISK FACTORS FOR DIABETES MELLITUS

  • Type 1 Diabetes is caused due to the loss of insulin production ability by the beta cells in pancreas.
  • The cause can be due to an immune mediated response on the cells or an unknown cause.
  • Type 1 is also linked to genetics.
  • Type 2 Diabetes is caused due to insulin resistance & reduced insulin secretion.
  • This type is characterized by the decreased response of the insulin receptors to the insulin, therefore, less sugar is metabolized & gets accumulated.
  • Type 2 is associated with lifestyle factors & presence of other diseases.
  • Obesity
  • Gestational Diabetes occurs due to decreased insulin production & responsiveness in 2-10% of pregnant women, although it is gradually resolved after delivery.
  • Some diet factors like sugary diet, diet high in fats & carbohydrates can be a risk factor for Diabetes Mellitus.
  • Some disorders that are risk factors for Diabetes are; Chronic Pancreatitis, Cystic Fibrosis, thyroid hormone disorders, hormone deficiencies, cardiovascular diseases, etc.

DIAGNOSIS

Diabetes Mellitus is diagnosed & the extent of the disorder is determined by measuring the glucose levels in the blood:

Condition 2-hour glucose Fasting glucose
Unit mmol/L(mg/dL) mmol/L(mg/dL)
Normal <7.8 (<140) <6.1 (<110)
Impaired fasting glucose <7.8 (<140) ≥6.1(≥110) & <7.0(<126)
Prediabetes ≥7.8 (≥140) <7.0 (<126)
Diabetes mellitus ≥11.1 (≥200) ≥7.0 (≥126)

TREATMENT FOR DIABETES MELLITUS

  • Anti-diabetic medicines;
  • Type 1 Diabetes is treated by treating with insulin analogs.
  • Type 2 Diabetes is treated by various classes of anti-diabetic medications that include drugs like metformin, Sitagliptin, Pioglitazone, glimeperide, etc.
  • Drugs that reduce high blood pressure like CCBs, ACE inhibitors, beta blockers, etc.
  • Drugs that reduce the buildup of cholesterol & fats, like statins.
  • Weight loss surgery in people with obesity.
  • Kidney transplant in people that have developed CKD.

PREVENTION & MANAGEMENT

  • Following a Diabetic diet;
  • Low in sugar
  • Low in fats
  • Also low in carbohydrates
  • Diet that is rich in fiber like green leafy vegetables & fruits.
  • Legumes, dairy products & whole grains.
  • Diet high in multivitamins.
  • Diet rich in micronutrients.
  • Proper timing of meals.
  • Controlled eating & avoiding multiple munching hours.
  • Limiting alcohol consumption & smoking
  • Maintaining a healthy weight.
  • Management of disease & conditions like hypertension that can put a person at higher risk for diabetes.