DIABETES MELLITUS

DIABETES MELLITUS

• What is Diabetes mellitus?

Diabetes mellitus, simply referred to as diabetes is a group of metabolic diseases in which a person has high blood sugar. Metabolism refers to the way in which our body utilise digested food for energy and growth. Most of what we eat is broken down into glucose. Glucose is the sugar in the blood which is the principal source of fuel for our body.

When our food is digested the glucose makes its way into our bloodstream. Our cells use the glucose for energy and growth. However, glucose cannot enter our cells without insulin. Insulin makes it possible for our cells to take in the glucose.

Insulin is a hormone that is produced by the pancreas. After eating, pancreas secretes an adequate quantity of insulin to move the glucose present in our blood into the cells, hence lowers the blood sugar level.

A person with diabetes has a condition in which the quantity of glucose in the blood is too high (hyperglycemia). This is because the body either does not produce enough insulin, produces no insulin, or our body cells that do not respond to the insulin. This results in too much glucose building up in the blood. This high blood sugar produces the classical symptoms of polyurea (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger) and the excess blood glucose eventually passes out of the body in urine (glycosuria). So, even though the blood has plenty of glucose, the cells are not getting it for their essential energy and growth requirements.

• Prediabetes

Prediabetes also known as Borderline diabetes, Chemical Diabetes, Touch of Diabetes, impaired glucose tolerance etc is the state in which some but not all of the diagnostic criteria for diabetes are met. It is a condition where the body's cells begin to show resistance to insulin. Glucose circulates in the blood instead of being used by the cells for energy. Blood sugar levels become elevated. Increased weight, unhealthy diet and a sedentary lifestyle can lead to pre-diabetes. It is an alarming sign for upcoming diabetes. While in this range, patients are at risk for not only developing type 2 diabetes, but also for cardiovascular complications.

• Type1 diabetes

Insulin is a hormone produced by beta cells present in pancreas. Insulin is needed to move glucose from blood into cells, where it is stored and later used for energy. In type 1 diabetes, beta cells produce little or no insulin at all. Without enough insulin the glucose builds up in the bloodstream instead of going into the cells. The body is unable to use this glucose for energy. This leads to the symptoms of type 1 diabetes.

type 1 diabetes ia an autoimmune disorder. An infection causes the body to mistakenly attack the cells in the pancreas that make insulin. This kind of disorder can be passed down through families. Type 1 diabetes can occur at any age. However, it is most often diagnosed in children, adolescents, or young adults.

• Symptoms:

These symptoms may be the first signs of type1 diabetes

• Very thirsty
• Feeling hungry
• Fatigue or feeling tired
• blurred vision
• Feeling tingling in your feet
• Losing weight without trying
• Frequent urination
• Hypoglycemia (low blood sugar) can develop quickly in people with diabetes who are taking insulin. Symptoms usually appear when the blood sugar level falls below 70 mg/dL. They are
• Headache
• Hunger
• Nervousness
• Rapid heartbeat (palpitations)
• Shaking
• Sweating
• Weakness
  

• Diabetes mellitus type 2

Diabetes mellitus type 2, formerly known as non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes is a lifelong (chronic) disease in which there are high levels of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes. About 95% of all diabetic cases are of type 2.

Diabetes is caused by a problem in the way your body makes or uses insulin. Insulin is necessary to move blood sugar (glucose) into cells, where it is stored and later used for energy. When you have type 2 diabetes, your fat, liver, and muscle cells do not respond correctly to insulin. This is called insulin resistance. As a result the blood sugar does not get into these cells to be stored for energy. When sugar cannot enter cells, high levels of sugar build up in the blood. This is called hyperglycemia. Type 2 diabetes usually occurs slowly over time. Most people with the disease are overweight. Increased fat makes it harder for your body to use insulin. Type 2 diabetes can also develop in people who are thin. This is more common in the old age. Family history and genes play a large role in type 2 diabetes. Low activity level, poor diet, and excess body weight around the waist increase your risk. Diabetes is often initially managed by increasing exercise and dietary modification. If the condition progresses, medications may be needed.

• Symptoms

They are

• very thirsty
• frequent urination
• blurred vision
• irritability
• tingling or numbness in the hands or feet
• frequent skin, bladder or gum infections
• wounds that don’t heal
• extreme unexplained fatigue

In some cases of type 2 diabetes, there are no symptoms. In this case, people can live for months, even years, without knowing they have the disease. This form of diabetes comes on so gradually that symptoms may not even be recognised.

• Gestational diabetes

Gestational diabetes affects about 4% of pregnancy women. It usually appears during the 2nd trimester and disappears later. This is because the placental hormone makes the mother's insulin resistant. So insulin cant transport glucose to the cells, hence blood glucose level increases. The risk of gestational diabetes is that there is a chance for developing diabetes to both mother and the baby in the later life.

There is a greater chance for gestational diabetes if you

• are older than 25 yrs when you are pregnant
• have a family history of diabetes
• high blood pressure
• gave birth to a baby weighted more than 9 pounds or had a birth defect
• have too much amniotic fluid
• were over weight before your pregnancy

• Insulin and blood sugar

Insulin is the only hormone which decreases the blood glucose level (hypoglycemic hormone). insulin helps the transport of glucose from blood to the body cells, hence blood glucose level is regulated. In case of type 1 diabetes, insulin deficiency leads to increased blood glucose level. The patients has to check blood glucose level frequently and inject correct amount of insulin to reduce blood glucose level. U have to be very careful on injecting the insulin. The amount should be correct. If it is high, it leads to a severe condition called hypoglycemia (low blood glucose level)

• SIGNS OF DIABETES

Diabetes and hyperglycemia

Hyperglycemia, or high blood sugar (glucose), is a serious health problem for those with diabetes. Several factors can contribute to hyperglycemia, including food and physical activity choices, illness, or not taking enough glucose-lowering medication. It's important to treat hyperglycemia because if left untreated, hyperglycemia can become severe and lead to serious complications such as diabetic ketoacidosis, hyperosmolar syndrome and diabetic coma. These conditions require emergency medical assistance. In the long term, persistent hyperglycemia, even if not severe can lead to diabetes related complications affecting your eyes, kidneys, nerves and heart.

Symptoms of Hyperglycemia in Diabetes

If you have diabetes it is important to know the early signs of hyperglycemia. If hyperglycemia is left untreated, it may develop into ketoacidosis (if you have type 1 diabetes) or hyperglycemic hyperosmolar syndrome (if you have type 2 diabetes), both of which are clinical emergencies..

Early signs of hyperglycemia in diabetes include:

• Increased thirst
• Headaches
• Difficulty in concentrating
• Blurred vision
• Frequent urination
• Fatigue (weak, tired feeling)
• Weight loss
• Blood sugar more than 180 mg/dL

Prolonged hyperglycemia in diabetes may result in:

• Vaginal and skin infections
• Slow-healing cuts and sores
• Decreased vision
• Nerve damage causing painful cold or insensitive feet, loss of hair on the lower extremities, and erectile dysfunction
• Stomach and intestinal problems such as chronic constipation or diarrhoea

• Diabetes and poly urea

Diabetes Mellitus is a metabolic syndrome characterised by chronic hyperglycemia due to absence of insulin (Type I) or resistance to it (Type II) in the GLUT-4 receptors in the body. GLUT-4 receptors allow glucose to enter the cell from the blood.

Thus a diabetic have too much glucose in the blood (hyperglycemia). So much in fact that the tubules in the kidney that normally reabsorb every drop of glucose cannot cope with the increased load and are said to be saturated so some glucose ends up in the urine (glycosuria). This increases the osmotic pressure of the urine which means that it is harder for water to leave the urine back into the body. Hence polyurea (increased volume of urine) is experienced in a diabetic.

• Diabetes and Polydipsia

Polydipsia is a medical symptom in which the patient displays excessive thirst. As the concentration of glucose increases in the blood, brain receives signal for diluting it and, in its counteraction we feel thirsty.

• Diabetes Type1 and Weight loss

Untreated type 1 diabetes can make people lose weight. In type 1 diabetes, the body stops producing the hormone insulin which is needed to use glucose, the main type of sugar in the blood. In type 1 diabetes, the body can't use glucose properly, so flushes the glucose out of the body in urine.

As a result, kids who develop type 1 diabetes, the cells doesn't get any glucose for the production of energy for their needs, they depend on fat as their energy source. So they use body fat for their energy needs, hence the fat deposited in the body is used up and it leads to weight loss. Once they're diagnosed and treated, their weight usually returns to normal. But incase of type 2 diabetes mellitus obesity is a risk factor.

• DIABETES AND FATIGUE

Glucose from the food we eat travels into the bloodstream where insulin is supposed to help its transition into the cells of our body. The cells use it to produce the energy we need to live. When there is insulin deficiency or if the cells don't react to it anymore, then the glucose stays outside the cells in the bloodstream. The cells become energy starved and you feel tired and run down.

• DIABETES AND BLURRED VISION

Diabetes is a disorder of metabolism that prevents glucose from being converted and stored into the body's cells. The pancreas is responsible for producing insulin. In people with diabetes pancreas either produces no insulin, type 1 diabetes, or the body cells become resistant to insulin, type 2 diabetes. Without this insulin glucose begins to accumulate in the blood stream and when your body begins to have a surplus of glucose a whole host of symptoms may develop; including those that affect the eyes and vision

When a diabetics body begins to become saturated in glucose, the lens of the eye can swell, which changes the shape and flexibility of the eye. This fluctuation causes the vision to become blurry. To correct this kind of blurred vision, you need to get your blood sugar back into the target range . It may take as long as three months after your blood sugar is well controlled for your vision to fully get back to normal. But if this condition is not regulated, immediately a wide range of complications could develop. It is not uncommon for blurry vision to lead to more progressive problems such as double vision, cloudy vision, seeing spots in front of the eyes, and also retinal detachment. A retinal detachment in particular can lead to blindness; as the eye changes shape the delicate construction of the eye lens and retina are strained, resulting in tearing.

Another thing is the longer you have diabetes, the more risk you have of being diagnosed with glaucoma. Having diabetes gives you a 40 percent greater chance of developing glaucoma at some time during your life. Glaucoma is a condition marked by increased pressure in the eyeball. Blurred vision and vision loss occurs with glaucoma because increased pressure damages blood vessels, the retina, and the optic nerve

• DIABETES AND SLOW HEALING OF WOUND

Diabetic patients wound heals slowly. here are the reasons:

• Poor circulation : If you have had diabetes for a long while and you probably have fatty deposits in your arteries which slows down blood flow causing poor circulation. This poor circulation can limit the amount of oxygen and healing nutrients that reach a wound.

• Nerve damage: Diabetes can lead to neuropathy which is a form of nerve damage that causes numbness in the feet.

• Immune system issues: To heal a wound, your body needs to clear away dead and damaged tissue and build new skin cells. Your immune system handles this job. But immune cells do not work efficiently when blood sugar levels are high. The reason is immune cells don't function as well as usual might relate to the water content of the cells. High sugar levels in the blood can cause water to soak into some tissues and seep out of others in unusual ways. If they don't have their usual water balance, cells may not function perfectly to heal a wound.

• Infection: It is common for a wound to develop an infection, particularly in a person with poorly controlled diabetes. An infected wound should be treated before it can begin to heal.

  

• RISK FACTORS OF DIABETES

The risk factors of diabetes are :

• Pre-diabetes
• Obesity
• Hereditary
• Improper food habit
• Lack of exercise
• Increased age
• History of gestational diabetes
• Ethnic
• pre-diabetes

Here there is insulin deficient or insulin resistant, but not as much as in case of diabetes. The blood glucose level is high. It is also known as impaired glucose tolerance. Diagnosis of pre-diabetes is important because it is a warning sign for diabetes mellitus

• Obesity

Number 1 risk factor for type 2 diabetes is the obesity. Insulin resistance is more for the person with greater weight, because fat interferes with the cells ability to use insulin. So obese persons attain insulin resistance and chance for getting diabetes is very high

• Hereditary

If your parents are diabetic, then risk of having diabetes is more. However lifestyle plays an important role in determining who gets diabetes

• Improper food habit

Most of the people diagnosed with type 2 diabetes are overweight. Improper food habit contributes largely to obesity which leads to diabetes

• Lack of exercise

If there is no physical activity, the glucose cannot be used and is stored as glycogen, hence more insulin is secreted by pancreas. Over activity of pancreas in due coarse stops the secretion of insulin

• Increased age

As we get old, the chance of getting diabetes is very high. As we get old, pancreas also get old and cant produce enough insulin. As we get old means the cells are getting old and become resistant to insulin. This also is a factor for diabetes

History of gestational diabetes

The hormone from the placenta makes the mothers insulin resistant. many women who had gestational diabetes developed diabetes in later life. The babies are also at a risk of developing diabetes in later life

• Ethnic

Certain countries, region, community, food habit, climate and lifestyle have some increased risk factor towards diabetes.