Diabetes mellitus is a disease of the body’s metabolism functions. It is detected by the presence of an increased level of blood sugar (hyperglycemia). The person develops a disturbance of carbohydrate, protein, and fat metabolism, which occurs due to the defect in the insulin hormone secretion and/or action.
Insulin
Glucose is produced in the liver and is used as an energy source by the body. The major portion of glucose is used by our muscles. The level of glucose in the blood is maintained within a narrow range by the insulin hormone. This hormone is produced by beta cells in the pancreas, a finger-like organ located in the belly. A reduction in insulin secretion decreased glucose utilization and increased glucose production results in diabetes.
Types of diabetes mellitus
Diabetes can be divided into two types depending on the disease process that results in increased blood glucose. The two broad categories of diabetes are type 1 and type 2. Type 1 diabetes is the result of a complete or almost complete deficiency of insulin. It can be caused because of genetic, environmental, or immunologic factors which lead to the destruction of the pancreatic beta cells and insulin deficiency. Type 2 diabetes is characterized by a variable amount of resistance to the action of insulin, decreased insulin secretion, and increased glucose production. So there is a relative deficiency of insulin.
Gestational diabetes
There is a type of diabetes that develops during pregnancy. It occurs due to resistance to the action of insulin which develops during the later part of pregnancy. It may occur in 2 – 10% of pregnant women. Most of these patients become normal after delivery. However, these patients have an increased risk of 35 – 60% of developing diabetes during the next 10 to 20 years.
Clinical features
The common modes of presentation in diabetic patients include thirst, increased amount of urine production (polyuria), blurring of vision, and weight loss. The person may be totally asymptomatic or can present with severe symptoms due to long-standing undetected disease. It is an important cause of widespread complications. Clinical features may be acute and present dramatically, which can be life-threatening, or patients can suffer chronic complications, which progress gradually. Not treating diabetes may lead to many serious conditions.
Eyes – blindness due to retinopathy (disease of the retina)
Neuropathy – a disease of the nerves (sensory neuropathy) resulting in numbness of legs and arms. Weakness of muscles due to disease of their nerves (motor neuropathy). Dryness of skin results due to autonomic neuropathy.
Nephropathy – a disease of kidneys leads to reduction of urine production. Finally, the kidneys fail and levels of urea and creatinine in the blood increase.
Coronary heart disease – blood supply to the heart is reduced due to the deposition of cholesterol in the blood vessels of the heart. It presents with chest pain (angina) or heart attack (myocardial infarction).
Peripheral arterial disease – narrowing of blood vessels of the legs due to atherosclerosis (fat deposition) results in pain in the legs on walking and later even at rest. It may result in gangrene (black discoloration of toes or foot) due to complete blockage of blood vessels. It is usually associated with infection and requires a lifesaving amputation of the leg.
Sexual dysfunction – impotence occurs due to disease of nerves and blood vessels. The patient develops impotence due to failure to maintain an erection.
Other complications include stroke, cataract, diarrhea, infections, cataract, glaucoma, hearing loss, and dental caries.
Health education
Patients with Diabetes should receive regular information about Diabetes and its complication with the aim of prevention and to assume greater responsibility in the management of this lifelong treatment. It should include education about the following:
Nutrition
Exercise
Medications to lower the plasma glucose
Diabetes mellitus is a chronic disease characterized by increased blood glucose. It results in widespread damage to various organs. Patients should be well aware of their condition and should play an active role in its management and prevention of its complications. Regular medical consultation is essential to assess blood glucose control and early detection of complications.
