DIABETES IN BRIEF
Diabetes Mellitus (DM) is a multisystem disease with great health consequences. It is characterized by elevated blood sugar level above normal due to relative or absolute lack of a hormone called insulin in the body. It is a chronic disease that affects carbohydrate, fat, and protein utilization by the body. It is classified into type 1, type 2 and gestational (occurring only during pregnancy). There is an interplay between genetic and environmental factors.
When carbohydrates are digested, they are absorbed into the blood in the form sugar called glucose. Glucose must leave the blood and enter into the cell for it to be used for energy generation by the cells. There are specialized channels through which glucose enter the cells (like doors). The opening of these “doors” to allow glucose enter the cell is controlled by insulin. In diabetes mellitus where there is lack of insulin, the glucose in the blood cannot enter the cells because the “door keeper” is unavailable. Glucose remains in the blood unutilized. More glucose arrive from more digestion of carbohydrates, until the normal blood glucose level is exceeded. The result is that the cells are starved of glucose while there is high level in blood. Starvation in the midst of plenty!
Types of Diabetes Mellitus
Diabetes mellitus is more commonly classified into type 1, type 2 and gestational diabetes. There are other classifications.
Type 1 diabetes is also called insulin dependent diabetes mellitus (IDDM) or Juvenile onset diabetes mellitus. In this type, insulin is functionally absent because of the destruction of the specialized cells of the pancreas, the organ in charge of producing insulin in the body. Type 1 DM occurs most commonly in juveniles but can occur in adults. The onset is often before 40 years. Since insulin in is either completely absent or too little, individuals suffering from type 1 DM depend on insulin from external sources for survival. Individuals with type 1 DM, generally, are not obese, but may rather lost weight and may present initially with sudden collapse and loss of consciousness that is often attributed to a demonic attack.
Type 2 Diabetes is also called noninsulin dependent diabetes mellitus (NIDDM) or maturity onset diabetes mellitus. Most sufferers are affected by type 2 DM. It is commoner in adults above 40 years. It is strongly associated with obesity and weight gain. It is due to relative lack of insulin. In this case, there is insulin circulating in blood but it cannot play the “door opening” role because key-like substance called receptors are either absent or defective. It is comparable to a situation where a door keeper is at the door to open but there is no key, or the key is spoilt. The insulin receptor defect has been attributed to certain factors including genetic and excess fat.
While the type 2 diabetes mellitus traditionally has been thought to affect individuals older than 40 years, it is being increasingly recognized in younger individuals, particularly in highly predisposed racial and ethnic groups. In some areas, more type 2 than type 1 diabetes mellitus is being diagnosed in teenagers and young adults. Type 2 diabetes mellitus is observed even in some obese children. Almost all cases of the disease in older individuals are type 2 diabetes mellitus
Symptoms and Signs of Diabetes Mellitus
- Excessive urination: This is because glucose in blood drags water from the cells into the blood. This is known as osmotic dieresis. Urination occurs more at nights than day
- Excessive thirstdue to excessive loss of fluid (dehydration).
- Excessive eating: There is weight loss with a normal or increased appetite
- Fatigue and weakness
- Muscle cramps
- Blurred vision
- Gastrointestinal symptoms: Nausea, abdominal discomfort or pain, and change in bowel movements (from diarrhea to constipation and vice versa)
- Patients may maintain their normal weight or exhibit weight loss, depending on the interval between the onset of the disease and initiation of treatment.
- Nerve problems: It presents as numbness and tingling in both hands and feet, in a glove and stocking pattern.
- Boils, abscess formation forms of skin infection and other
- Chronic ulcer (long standing wound) that refuse to heal.
- Recurrent urinary tract infections
- Recurrent chest infections
Complications of Diabetes
Diabetes mellitus is one of the leading causes of illness and death in our environment, due to its effects on the kidneys, blood vessels, eye, terminal nerves and other vital organs. These complications are also the major sources of expenses for patients with diabetes mellitus.
- Diabetes is the leading cause of blindness in working-age adults in our environment.
- Diabetes mellitus is the leading cause of kidney or renal diseases.
- Diabetes mellitus is the leading cause of nontraumatic limb amputations even in the United States of America.
Summarily, complications of DM include
- Sudden collapse,
- Numbness,
- Hypertension,
- Poor vision,
- Blindness
- Kidney failure
- Chronic leg ulcer.
TO BE CONTINUED...