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DIABETES

Men's Health, Women's Health / By

DIABETES

The major sources of the glucose that circulates in the blood are through the absorption of ingested food in the gastrointestinal tract and formation of glucose by the liver from food substances.

  • Diabetes mellitus is a group of metabolic diseases that occurs with increased levels of glucose in the blood.
  • Diabetes mellitus most often results in defects in insulin secretion, insulin action, or even both.

CLASSIFICATION

Diabetes has major classifications that include:

Type 1 Diabetes Mellitus
Type 2 Diabetes Mellitus
Gestational Diabetes Mellitus

Epidemiology

Diabetes mellitus is now one of the most common disease all over the world. Here are some quick facts and numbers on diabetes mellitus.

  • More than 23 million people in the United States have diabetes, yet almost one-third are undiagnosed.
  • By 2030, the number of cases is expected to increase more than 30 million.
  • Diabetes is especially prevalent in the elderly; 50% of people older than 65 years old have some degree of glucose intolerance.

CAUSES

The exact cause of diabetes mellitus is actually unknown, yet there are factors that contribute to the development of the disease.

Type 1 Diabetes Mellitus
  • Genetics. Genetics may have played a role in the destruction of the beta cells in type 1 DM.
  • Environmental factors. Exposure to some environmental factors like viruses can cause the destruction of the beta cells.
Type 2 Diabetes Mellitus
  • Weight. Excessive weight or obesity is one of the factors that contribute to type 2 DM because it causes insulin resistance.
  • Inactivity. Lack of exercise and a sedentary lifestyle can also cause insulin resistance and impaired insulin secretion.
Gestational Diabetes Mellitus
  • Weight. If you are overweight before pregnancy and added extra weight, it makes it hard for the body to use insulin.
  • Genetics. If you have a parent or a sibling who has type 2 DM, you are most likely predisposed to GDM.

SIGNS AND SYMPTOMS

Clinical manifestations depend on the level of the patient’s hyperglycemia.

  • Polyuria or increased urination. Polyuria occurs because the kidneys remove excess sugar from the blood, resulting in a higher urine production.
  • Polydipsia or increased thirst. Polydipsia is present because the body loses more water as polyuria happens, triggering an increase in the patient’s thirst.
  • Polyphagia or increased appetite. Although the patient may consume a lot of food but glucose could not enter the cells because of insulin resistance or lack of insulin production.
  • Fatigue and weakness. The body does not receive enough energy from the food that the patient is ingesting.
  • Sudden vision changes.The body pulls away fluid from the eye in an attempt to compensate the loss of fluid in the blood, resulting in trouble in focusing the vision.
  • Tingling or numbness in hands or feet. Tingling and numbness occur due to a decrease in glucose in the cells.
  • Dry skin. Because of polyuria, the skin becomes dehydrated.
  • Skin lesions or wounds that are slow to heal. Instead of entering the cells, glucose crowds inside blood vessels, hindering the passage of white blood cells which are needed for wound healing.
  • Recurrent infections. Due to the high concentration of glucose, bacteria thrives easily.

DIAGNOSIS

Symptoms of type 1 diabetes often appear suddenly and are often the reason for checking blood sugar levels.

Tests for type 1 and type 2 diabetes and prediabetes

Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells.An A1C between 5.7 and 6.4 percent indicates prediabetes. Below 5.7 is considered normal.

Random blood sugar test. A blood sample will be taken at a random time. Regardless of when you last ate, a random blood sugar level of 200 milligrams per deciliter (mg/dL) — 11.1 millimoles per liter (mmol/L) — or higher suggests diabetes.

  • Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it’s 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes.
  • Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours. A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal. A reading of more than 200 mg/dL (11.1 mmol/L) after two hours indicates diabetes. A reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes.

TREATMENT

Depending on your treatment plan, you may check and record your blood sugar as often as several times a week to as many as four to eight times a day.

Insulin. People with type 1 diabetes need insulin therapy to survive. Many people with type 2 diabetes or gestational diabetes also need insulin therapy.

Oral or other medications. Sometimes other oral or injected medications are prescribed as well. Some diabetes medications stimulate your pancreas to produce and release more insulin. Others inhibit the production and release of glucose from your liver.

Transplantation. In some people who have type 1 diabetes, a pancreas transplant may be an option.