Diabetes Mellitus Explained

Overview

Diabetes Mellitus commonly known as Diabetes is a metabolic disorder characterized by high sugar levels in the blood. Glucose is vital for the energy production and proper functioning of our body. When we eat food, it breaks down into glucose and is available in the bloodstream. This glucose is absorbed by the body organs with the help of insulin secreted by the pancreas. 

When one is diagnosed with diabetes and neglects the treatment, the body doesn’t utilize the insulin-like it should. This leads to an increased presence of glucose in the blood which can cause serious health issues and sometimes even become life-threatening. Although diabetes is incurable, with lifestyle changes and treatment one can lead a long and healthy life.

Depending upon cause it can be in different forms:

Diabetes type I: Also called insulin-dependent diabetes. In this, the body’s antibodies attack the pancreas thus impacting insulin production. It is an auto-immune condition. It is also known as juvenile diabetes due to its early onset in life. No gender predilection is noted and the prevalence is around 2.3 per 1000 in people under 20.

Diabetes type II: It is also called adult-onset or non-insulin dependent diabetes. Here the pancreas produces some insulin, but it is either not sufficient or the body is resistant to utilize it. Insulin resistance usually happens in muscle, liver, and fat cells. Worldwide, 1 in 11 adults has type II diabetes mellitus. It is 2-6 times more common among Blacks than Whites.

Signs and Symptoms

There are certain telltale warning signs of diabetes:

  • Increased thirst
  • Extreme hunger
  • Frequent urination
  • Tiredness
  • Blurry vision
  • Unintentional weight loss (frequently associated with Diabetes type I)
  • Sores that are slow to heal (commonly observed in Diabetes type II)
  • Mood changes
  • Dry and itchy skin
  • Yeast infection
  • Decreased libido
  • Erectile dysfunction.
  • Urinary tract infections, found often in women than men.

Risk factors

Depending on the type of diabetes risk factors also vary. 

In diabetes type I, even though the cause is unknown there are certain factors associated with increased risk:

  • Hereditary: Having a parent or sibling with similar history increases the chances of getting diagnosed with type I diabetes.
  • Presence of impaired auto-antibodies: Getting tested with the presence of damaged diabetes immune cells in the body also increases the risk. However, not every person tested with its presence develops diabetes.
  • Environmental factors: Exposure to some viral diseases can also predispose to developing diabetes type I.
  • Geography: Some countries have a higher incidence of diabetes type I like Finland and Sweden.

Similar to type I diabetes, type II can also develop in a certain individual with these risk factors:

  • Family history 
  • Age: The chances of developing diabetes tend to increase as one grows old.
  • Inactivity: Increased activity makes the cells sensitive to insulin thus utilization of glucose.
  • Weight: More fat predisposes to insulin resistance.
  • Ethnicity
  • High blood pressure
  • Abnormal cholesterol and triglyceride levels
  • Gestational diabetes: Diabetes during pregnancy can increase type II diabetes.
  • Polycystic ovary syndrome.

Complications

Patients with uncontrolled diabetes mellitus may have persistent hyperglycemia that may result in certain complications. It can be either acute or chronic in nature. The common acute complications are hypoglycemia, hyperglycaemic diabetic coma, and diabetic ketoacidosis (symptoms include nausea, vomiting, and abdominal pain). Chronic complications cause blood vessel diseases which can result in microvascular and macrovascular complications. Microvascular complications include retinopathy, nephropathy, and neuropathy whereas macrovascular complications result in peripheral artery disease (PAD), coronary artery disease (CAD), and cerebrovascular disease.

Diagnosis

When the doctor suspects a patient to be diabetic based on the initial screening, these tests are advised to confirm the diagnosis:

  • Random blood sugar: Test is done at a random time. Value 200mg/dl or above is considered to be diabetic.
  • Fasting blood sugar: Sample collected after overnight fasting. Value 126mg/dl or higher on two separate tests confirms diabetes.
  • Oral glucose tolerance test: testing is done after overnight fasting, then a sugary liquid is consumed and glucose levels are tested periodically after two hours. Value more than 200mg/dl after two hours suggests diabetes.
  • Glycated hemoglobin (A1C) test: It produces an average blood glucose level for the past three months. 6.5% and above on two separate tests suggest diabetes.

Treatment

Depending on the type of diabetes treatment also varies. 

The common line of treatment includes:

  • Healthy eating: Food rich in fiber, nutrition and low in calories, fat, and sugar should be consumed. Diet should be focussed on more fruits, vegetables, whole grains, and lean protein. One should cut down on refined sugars, carbohydrates, and saturated fats. Eat in smaller portions.
  • Exercise: Increased activity and exercise increases glucose consumption, and increases the cell sensitivity towards insulin thereby help in controlling blood sugar levels. Hence, a moderate exercise of 150 minutes a week or 30 minutes of light exercise daily is considered good enough.
  • Insulin: Type I diabetes patients need insulin as the treatment, sometimes type II patients also require insulin therapy. It is available as short, long, intermediate, and rapid-acting. Based on the condition the doctor may prescribe a mixture of these to be used day and night. It cannot be used orally due to the action of the enzyme on it. It is used with the help of an injection.
  • Oral medications: Type II diabetes is usually managed with oral medications. Most commonly prescribed is Metformin, another set of medications called SGLT2 inhibitors are also used.
  • Other uncommon treatment options are pancreas transplantation for type I diabetes and bariatric surgery for people with type II diabetes and obesity.

Prevention

Type I diabetes is not preventable, however, the prevention methods for type II can be employed in life to have the minimum impact of diabetes on the body. Some prevention options are:

  • Healthy food habits: Focus on veggies, fruits, and fiber and less consumption of sugary content and fat.
  • Physical activity: Try to make a habit of 30-minute exercise or walk daily for a healthy life and body.
  • Shedding off excess weight: Maintaining an appropriate BMI also reduces the risk of developing diabetes. If one is overweight or obese, losing 7% of the bodyweight is also good.
References
  • Sapra A, Bhandari P. Diabetes Mellitus. [Updated 2021 Jun 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551501/
  • Vijan S. In the clinic. Type 2 diabetes. Ann Intern Med. 2015 Mar 3;162(5):ITC1-16. doi: 10.7326/AITC201503030. PMID: 25732301.
  • Gillespie KM. Type 1 diabetes: pathogenesis and prevention. CMAJ. 2006 Jul 18;175(2):165-70. doi: 10.1503/cmaj.060244. PMID: 16847277; PMCID: PMC1489998.
  • Tan SY, Mei Wong JL, Sim YJ, Wong SS, Mohamed Elhassan SA, Tan SH, Ling Lim GP, Rong Tay NW, Annan NC, Bhattamisra SK, Candasamy M. Type 1 and 2 diabetes mellitus: A review on current treatment approach and gene therapy as potential intervention. Diabetes Metab Syndr. 2019 Jan-Feb;13(1):364-372. doi: 10.1016/j.dsx.2018.10.008. Epub 2018 Oct 10. PMID: 30641727.
  • Terri D’Arrigo. Early signs and symptoms of diabetes. WebMD.June 22,2021
  • Stephanie Watson.Everything you need to know about diabetes.Healthline.Feb 26, 2020Create stylish call-to-action buttons with Qubely Buttons. Play around with typography, design, border and more. Add animations and personalize it to engage visitors instantly.

The content shared on the Health Literacy Hub website is provided for informational purposes only and it is not intended to replace advice, diagnosis, or treatment offered by qualified medical professionals in your State or Country. Readers are encouraged to confirm the information provided with other sources and to seek the advice of a qualified medical practitioner with any question they may have regarding their health. The Health Literacy Hub is not liable for any direct or indirect consequence arising from the application of the material provided.

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