Diabetes Mellitus is a metabolic disease/disorder that is caused due to prolonged high blood sugar.
TYPES OF DIABETES MELLITUS
- Type 1 Diabetes
- Type 2 Diabetes
- 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.