Diabetes mellitus is a group of metabolic diseases in which the person has high blood glucose (blood sugar) level either due to inadequate insulin production or because the body's cells do not respond properly to insulin or both. The term "Diabetes Mellitus" describes a metabolic disorder of multiple etiology characterized by chronic hyperglycemia with disturbances of carbohydrate, fat (dyslipidaemia) and protein metabolism resulting from defects in insulin secretion, insulin action, or both. The main symptoms are: -
The main types of diabetes are:
Type 1 diabetes: It is due to the body's malfunction to produce insulin in the body, and requires the person to inject insulin. This form was previously referred to as "Insulin-Dependent Diabetes Mellitus" (IDDM) or "Juvenile Diabetes".
Type 2 diabetes: It is due to insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. This form was previously referred to as non insulin-dependent diabetes mellitus (NIDDM) or "adult-onset diabetes".
Type 2 diabetes can be prevented after following healthy life style such as healthy diet, proper exercise or maintaining healthy weight.
The third main form, Gestational diabetes occurs when pregnant women without a previous diagnosis of diabetes develop a high blood glucose level. It may lead to type 2 DM.
Other types of diabetes include those caused by:
References: https://www.who.int/
https://www.niddk.nih.gov/
www.who.int
www.nhs.uk
www.cdc.gov
The main symptoms of diabetes are:
Type 1 diabetes can develop quickly, over weeks or even days. Many people have type 2 diabetes for years without realizing because early symptoms tend to be common.
References: www.nhs.uk
www.cdc.gov
Type 1 Diabetes: The immune system of body attacks and destroys the cells that produce insulin. As no insulin is produced, glucose levels further increase, which can seriously damage the body's organs. Type 1 diabetes is often known as insulin-dependent diabetes. It is also sometimes known as juvenile diabetes or early-onset diabetes because it usually develops before the age of 40, often during the teenage years. Type 1 diabetes is less common than type 2 diabetes.
Type 2 Diabetes: Type 2 diabetes is where the body does not produce enough insulin or the body's cells do not respond to insulin. This is known as insulin resistance. Type 2 diabetes, and is far more common than type 1 diabetes.
Risk factors for type 2 diabetes:
Gestational Diabetes: Some women tend to experience high levels of blood glucose as during pregnancy due to reduced sensitivity of insulin receptors.
References: www.nhs.uk
https://www.cdc.
The clinical diagnosis of diabetics is often prompted by symptoms such as increased thirst and urination and recurrent infections.
Blood Tests - Fasting plasma glucose, two-hour postprandial test and oral glucose tolerance test are done to know blood glucose levels.
Glycated Haemoglobin (HbA1c) may be used to diagnose diabetes(if facilities are easily available).
Diabetes can be diagnosed by blood glucose and HBA1c levels:
Diabetes diagnostic criteria |
|||
Condition |
2 hour* plasma glucose |
Fasting plasma glucose |
HbA1c |
mmol/l(mg/dl) |
mmol/l(mg/dl) |
% |
|
Normal |
<7.8 (<140) |
<6.1 (<110) |
<6.0 |
Impaired Fasting Glucose |
<7.8 (<140) |
≥ 6.1(≥110) & <7.0(<126) |
6.0–6.4 |
Impaired Glucose Tolerance |
≥7.8 (≥140) |
<7.0 (<126) |
6.0–6.4 |
Diabetes mellitus |
≥11.1 (≥200) |
≥7.0 (≥126) |
≥6.5 |
Currently, six classes of oral antidiabetic drugs (OADs) are available: biguanides (e.g., metformin), sulfonylureas (e.g., glimepiride), meglitinides (e.g., repaglinide), thiazolidinediones (e.g., pioglitazone), dipeptidyl peptidase IV inhibitors (e.g., sitagliptin), and α-glucosidase inhibitors (e.g., acarbose).
Medications:
References:
https://www.niddk.nih.gov/not-
The complications of diabetes mellitus are less common and less severe in people who have well-controlled blood sugar levels. Its complications are:
Acute:
Chronic:
(a)Micro vascular diseases (due to damage to small blood vessels):
1. Eye Diseases:
These conditions can lead to serious vision loss or blindness.
2. Neuropathy:
3. Nephropathy: Damage to kidney can lead to chronic renal failure.
(b) Macro vascular diseases:
(c) Other diseases:
Reference: www.diabetes.co.uk
*Diabetic & Metabolic Syndrome: clinical research & review 4(2010) 10-12