DIABETES: THE BASICS

Diabetes Mellitus (DM) is a group of metabolic diseases in which high blood sugar results over time. Diabetes is caused by a deficiency of insulin and is characterized by impaired glucose utilization, hyperglycemia (high blood sugar) and glycosuria (presence of sugar in urine). If left untreated, it may cause many complications such as diabetic ketoacidosis, cardiovascular disease, stroke, chronic kidney failure, damage to the eyes.

DM is a disorder in metabolism, hence the way our bodies digest food for energy and growth. Most of what we eat is broken down into glucose. Glucose is a form of sugar in the blood and it is the principal source of fuel in our bodies.

When our food is digested, the glucose makes its way into our bloodstream. Our cells use the glucose for metabolic processes such as growth. However glucose cannot enter our cells without insulin being present – insulin makes it possible for our cells to take in the glucose.

Insulin is a hormone that is produced by the pancreas. After eating, the pancreas automatically releases an adequate quantity of insulin to move the glucose present in our blood into the cells, as soon as glucose enters the cells blood glucose levels drop.

A person with diabetes has a condition in which the quantity of glucose in the blood is too high (i.e hyperglycemia). This is because the body does not produce enough insulin, produces no insulin, or has cells that do not respond properly to the insulin the pancreas produces. This results in too much glucose rising up in the blood. This excess blood glucose eventually passes out of the body in urine. So, even though the blood has plenty of glucose, the cells are not getting enough for their essential energy and growth requirements.

Types

There are three main types of DM

Type 1 DM or insulin dependent diabetes: This type is due to deficiency of insulin (i.e plasma levels of insulin are low). It is characterized by loss of the insulin produced by beta cells of the islets of langerhans in the pancreas, leading to the insulin deficiency.

Type 2 DM or non insulin dependent diabetes: This is characterized by insulin resistance which may be combined with relatively reduced insulin secretion. In the early stage of type 2, the predominant abnormality is reduced insulin sensitivity. At this stage, high blood sugar can be reversed by a variety of measures and medications that improve insulin sensitivity or reduce the liver glucose production.

Gestational diabetes: This is the type that occurs in pregnancy in which women have very highlevels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, thus high levels of glucose results. It is usually known during pregnancy, hence in a well developed medical center pregnant women are to be checked of any symptoms.

Causes

·        Heredity

·        Diseases of the pancreas

·        Endocrinopathies such as acromegaly cushing syndrome e.t.c.

·        Infections

·        Drugs

    

     Symptoms

    

As earlier mentioned, there is frequent urination, increased thirst, increased hunger. Also,

it may develop rapidly especially in the type 1, while they usually develop much more

slowly in the type 2. In addition, blurry vision may occur, headache, fatigue, slow healing

of cuts and itchy skin.

Complications involved

Eye complications

Foot complications – neuropathy, gangrene

Skin problems

Cardiovascular complications

Hypertension

Impaired hearing

Ketoacidosis: combination of acidosis (acidity in the blood) and ketosis (ketone bodies).

Neuropathy

Nephropathy

Stroke

Male impotency i.e erectile dysfunction

Infections arise

Healing of wounds takes longer time.

Treatment

Insulin injection is given for insulin dependent diabetes

Treatment of the associated complications should do.

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