Diabetes Mellitus

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Diabetes Mellitus, more commonly referred to as “diabetes,” is a chronic disease associated with abnormally high blood sugar levels and glucose levels. It is due to one of two mechanisms: inadequate production of insulin (which is made by the pancreas and lowers blood glucose) or inadequate sensitivity of cells to the action of insulin. Read More

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Diabetes Mellitus

What is Diabetes Mellitus?

Diabetes Mellitus, more commonly referred to as “diabetes,” is a chronic disease associated with abnormally high blood sugar levels and glucose levels. It is due to one of two mechanisms: inadequate production of insulin (which is made by the pancreas and lowers blood glucose) or inadequate sensitivity of cells to the action of insulin.

Diabetes Mellitus
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What are the types of diabetes mellitus?

types of diabetes mellitus
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The two major types of diabetes conform to these two mechanisms. They are called insulin-dependent (type 1) and non-insulin-dependent (type 2) diabetes. When you have type one diabetes, there’s either no insulin or there is not enough of it. In the case of type 2 diabetes, there’s usually enough insulin. However, the cells that it’s supposed to act on are not usually sensitive to its action. 

Gestational Diabetes Mellitus: Gestational Diabetes Mellitus is a condition with an increased sugar level during pregnancy. 

Causes

causes of diabetes
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  • Heredity and family history
  • Obesity
  • Physical Inactivity
  • Climate
  • Genetic Mutations
  • Hormone Disorder
  • Cystic Fibrosis
  • Hemochromatosis (blood creating too much iron)
  • Pregnancy

Symptoms

diabetes symptoms
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  • Frequent urination, especially waking up frequently at night 
  • Increased thirst
  • Increased hunger
  • Constant bad breath
  • Feeling tired, even after a good night’s sleep
  • Blurry vision that changes from day to day
  • Inflicting wounds and cuts which are difficult to heal
  • Tingling, numbness or pain in the hands and feet
  • Skin changes, such as sudden dark spots around the nape of the neck or under the armpits
  • Getting frequent urinary tract, yeast, or vaginal infections
  • Losing or gaining weight 
  • Having frequent gum infections
  • Persistent itchiness because of dry skin, yeast infections, or poor blood circulation.

How is diabetes mellitus diagnosed?

Diabetes mellitus is diagnosed by blood glucose testing, the glucose tolerance test, and testing of the level of glycosylated hemoglobin (glycohemoglobin or hemoglobin A1C). The mode of treatment depends on the type of diabetes.

What are the complications associated with diabetes mellitus?

complications of diabetes
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The major complications of the diabetes mellitus are listed below:

  • Heart and blood vessels diseases (cardiovascular)
  • Neuropathy (nerve damage)
  • Retinopathy (retina damage)
  • Nephropathy (kidney damage)
  • Hearing damage
  • Foot damage
  • Depression
  • Alzheimer’s disease [1]

The purpose of diabetes management is to maintain blood sugar levels within the normal range feasible. Since diabetes may greatly increase the risk for heart disease and peripheral artery disease, measures to control blood pressure and cholesterol levels are also an essential part of diabetes treatment.

Diabetes sufferers must accept the charge of their day-to-day health. This involves checking blood glucose levels, diet management, maintaining fitness, maintaining weight and stress under control, evaluating oral medication and, when needed, insulin pumps or injections.

FAQ

Can diabetes mellitus be prevented?

Type 1 diabetes mellitus cannot be prevented since it is caused by an issue with the immune system. A few of the causes of type 2 diabetes cannot be prevented, such as hereditary, age-related issues, shortage of insulin production etc. However, a few risk factors can be prevented by following a healthy diet, exercising regularly, cutting down carbohydrates and fat in the diet, adding a lot of fruits and vegetables to the diet, maintaining a healthy weight, etc.

What is diabetes ketoacidosis?

Diabetes ketoacidosis is a condition seen more commonly in type 1 diabetes mellitus and less commonly seen in type 2 diabetes. It is a condition caused due to high levels of blood sugar in the body resulting in the build-up of acidic substances like ketone, which is dangerous to the body [2].

How common is diabetes mellitus?

In the past few years, the incidence of diabetes mellitus has been high due to poor lifestyle or various other factors. The number of people diagnosed with diabetes mellitus increases with age. More than26% of adults aged 65 years and older (about 1 in 4) are diagnosed with diabetes mellitus.

How is diabetes mellitus treated?

The treatment regimen for diabetes mellitus depends upon the type of diabetes the patient is diagnosed with. The treatment methods are listed below:
1)       Insulin injections: The patient diagnosed with type 1 diabetes mellitus has to take insulin for the rest of their lives to maintain their blood sugar levels. People diagnosed with type 2 diabetes and gestational diabetes also need to take insulin if medications do not maintain their blood sugar levels.
glucose monitors and insulin pump
continuous glucose monitors and insulin pump
Picture Courtesy: mayoclinic

2)       Medications- To control the blood sugar levels, the doctor will prescribe the patient oral or injected medications. Some medications prescribed are sulfonylureas, glinides (meglitinides), biguanides, alpha-glucosidase inhibitors, etc.
3)       Transplantation- pancreas transplant may be a treatment option for patients diagnosed with type 1 diabetes. 
4 )       Bariatric surgery: Also called weight loss surgery. This procedure is done for type 2 diabetes who are obese and have a body mass index higher than 35.

How many types of insulin medications are approved to treat diabetes mellitus?

Many types of insulin are used to treat diabetes mellitus. A few of them are listed below:
1)       Rapid-acting insulin- this insulin is taken 15min before the meals. They peak at one hour (work best to lower blood glucose) and work for another 2-4hours. Examples- are insulin lispro, insulin aspart, glulisine, etc.
2)       Short-acting insulin- they take about 30min to reach the bloodstream and reach their peak in 2-3 hours and lasts for 3-6hours. Examples- regular insulin (Humulin R)
3)       Intermediate-acting insulin: they reach the bloodstream in 2-4hours and reach a peak in 4-12 hours and work up to 18 hours. 
4)       Long-acting insulin works to keep the blood sugar level stable throughout the day. Usually, they last for about 18 hours. Example- insulin glargine, insulin detemir, insulin degludec [3]. 

References

  1. https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
  2. https://www.healthline.com/health/type-2-diabetes/ketoacidosis#What-is-diabetic-ketoacidosis?
  3. https://my.clevelandclinic.org/health/diseases/7104-diabetes-mellitus-an-overview