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What to Know About Diabetes Mellitus

Diabetes Mellitus

What happens to a person with diabetes mellitus? Diabetes Mellitus popularly called Diabetes is a lifelong chronic metabolic disorder that occurs as a result of little to no insulin production by the beta islet cells of the pancreas or the body’s inability to respond appropriately to the insulin that is being produced. 

There are three types of Diabetes: Type 1 (insulin-dependent or Juvenile Diabetes), Type 2 ( insulin-independent or adult-onset diabetes), and Gestational Diabetes.

Type 1 diabetes

Type 1 Diabetes, also termed insulin-dependent or juvenile diabetes, is a type of Diabetes that most commonly begins in childhood (the first peak begins at 4 and 7-year-olds) and adolescents (the second peak begins at 10 and 14-year-olds). It can occur in a small percentage of adults as well.

Type 1 diabetes is believed to be triggered by an unknown factor that causes the immune system to attack the islets of Langerhans. 

Islet of Langerhans is clustered of cells found in the pancreas. They are responsible for the production of insulin, which is a hormone that regulates the amount of glucose in the body by allowing glucose to enter into various cells — the absence of insulin or the under the production of insulin cause the elevation of glucose in the blood. 

In type 1 diabetes, the immune system’s destruction of the islet cells causes low production or sometimes no production of insulin at all, and this leads to dysfunction of every other cell that needs glucose for survival. 

Risk Factors of Type 1 Diabetes: 

1. Genetics: 

  • over 50 genes have been linked to Diabetes type 1.
  •  Studies have also discovered that there is a 50% chance of been diagnosed with Diabetes type 1 if your identical twin has diabetes.
  • There are 5% chances for a child to be diagnosed with Diabetes type 1 if the father has diabetes.
  • There are 3% Chance for a child to be diagnosed with Diabetes type 1 if the mother has diabetes and an 8% chance of one of the siblings has diabetes.

2. Family history of juvenile Diabetes

3. Autoimmune diseases: certain autoimmune disorders have been known to co-exist with type 1 diabetes. It is not so clear if they are triggers. Such diseases are:

4. Common human leukocyte antigen such as DR-3, DR-4, and DRB1 has been seriously linked to DM type1.

Type 2 diabetes

In DM type 2, insulin is produced, but the body’s cells are not responding correctly to the insulin. This points to an accumulation of glucose in the blood.

 Type 2 is primarily caused by obesity, genetics, and lack of exercise. 

People with Diabetes type 2 in their family are more likely to have diabetes type 2 than those who don’t. Type 2 DM is preventable by lifestyle modifications such as healthy weight loss and a reasonable amount of exercise.

Risk Factors for type 2 diabetes mellitus

  • Obesity
  • Genetics
  • Increasing age
  • Being female (it is more common in women)
  • Certain medications, such as glucocorticoids, beta-blockers, and thiazides

Gestational diabetes

Gestational diabetes is a type of Diabetes observed in expecting mothers who were non-diabetic before they got pregnant. It increases the risk of stillbirth, giving birth to a macrosomia baby (baby weighing more than the average size), a baby with low blood sugar, and jaundice. Proper management of Diabetes prevents all these risks.

Diabetes mellitus symptoms

Here are signs and symptoms of diabetes:

  • Polyuria (frequent urination)
  • Polydipsia (increased thirst)
  • Consistently feeling hungry
  • Fatigue
  • Blurry vision
  • Delayed wound healing
  • Tingling, pain or numbness of hands and feet
  • Acanthosis nigricans (dark patches formation on skin of neck, armpits, and groin).

Diagnosis of Diabetes:

This tests are used for the analysis of diabetes: Blood glucose levels:

1. Pre-diabetes:

  • Impaired fasting glucose: 5.4 – 6.9 mmol/l
  • Impaired blood glucose: 7.8 – 11.1mmol/l on oral glucose tolerance test, done 2hours after eating.

2. Diabetic:

  • Impaired fasting blood glucose: 7.0mmol/l 
  • Oral glucose tolerance test was done 2 hours after a meal: 11.1 mmol/l and above.

3. Normal glucose level for fasting glucose is 5.6mmol/l, and oral glucose tolerance test 2hours after a meal is less than 7.8mmol/l. 

4. Glycated hemoglobin(A1C) test: use to monitor treatments because it shows the average blood glucose level for the last 2-3months.

Complications of Diabetes:

Acute complications:

  • Hyperosmolar hyperglycemic nonketotic coma
  • Diabetic ketoacidosis (coma)
  • Hypoglycemia (from an overdose of insulin)
  • Lactic acidosis

Chronic complications:

Macrovascular: are large vessel complications. These are due to atherosclerosis. They are:

  • Stroke
  • Myocardial infarction
  • Foot gangrene

Microvascular: small vessels complications, they are:

  • Diabetic retinopathy (eye problems)
  • Diabetic nephropathy (kidney problems)
  • Diabetic neuropathy (nerve problems).

Treatment of diabetes:

For patients diagnosed with type 1 diabetes mellitus, doctors will regularly prescribe insulin. While patients with type 2 diabetes mellitus are prescribed a medication course of treatment such as 

  • Biguanides(Metformin): Is always the first line of drugs given in diabetes type 2.
  • Sulfonylureas: it has 2 generations: First generation is made up of Tolbutamide and Chlorpropamide while the second generation is made up of Gliclazide, Glipizide, Glibenclamide, Glimepiride.
  • Thiazolidinediones(Rosiglitazone, Pioglitazone)
  • Alpha glucosidase inhibitors(Acarbose, Miglitol)
  • Meglitinides(Repaglinide, Nateglinide)

Sometimes in type 2 diabetes, insulin is added to the treatment plan when the patient is not responding well to oral hypoglycemic drugs. Insulin is a specific drug of choice for gestational diabetes.

Lastly, this article is informative, if you experience similar Diabetes Mellitus symptoms, be sure to consult a doctor.