Diabetes Mellitus: Everything you need to know

Diabetes Mellitus is a metabolic disorder characterized by abnormally high blood glucose levels. After eating carbohydrates, our body breaks them down into sugar (glucose) regulated by insulin hormone, secreted from B-cells of the pancreas. Insulin permits blood glucose to enter our body cells to be stored or to act as an energy fuel for our cells. However, in diabetic patients, insulin isn’t secreted or secreted in insufficient amounts. Otherwise, the cells may not respond to the secreted insulin.

Types of Diabetes Mellitus

1. Type 1 Diabetes Mellitus

Type 1 Diabetes Mellitus, also referred to as insulin-dependent diabetes mellitus or Juvenile-onset diabetes mellitus, is an autoimmune disease in which the immune system attacks β-cells of the pancreas, causing its destruction. As a result, insulin isn’t secreted or secreted in extremely few amounts leading to hyperglycemia. Patients with this type contribute to only 5-10% of all diabetic patients, and the majority are children or adolescents; however, few cases develop in adults.

2. Type 2 Diabetes Mellitus

This type is also called non-insulin-dependent diabetes mellitus or adult-onset diabetes mellitus. In this type, β-cells of the pancreas aren’t affected, and insulin is secreted normally, but body cells don’t respond to the secreted insulin, referred to as insulin resistance. This type is widely-spread among adults and the elderly. Patients with this type represent more than 90% of diabetic patients, and the majority are obese, as obesity is one of the fundamental causes of insulin resistance.

3. Gestational Diabetes

This type may develop during pregnancy and usually disappears after delivery. During pregnancy, some hormonal changes may occur, making body cells more resistant to insulin. While in most cases, the pancreas overcomes insulin resistance during pregnancy by secreting more insulin, in some cases, insulin resistance can’t be avoided resulting in gestational diabetes.

4. Prediabetes:

Prediabetes is a condition in which the blood glucose level is higher than normal, but it’s not high enough to be diagnosed as diabetes-mellitus. People with this condition are at a higher risk for diabetes-type-2.

Symptoms:

The most common symptoms of diabetes-mellitus include:

• Increased Thirst
• Increased Hunger
• Frequent Urination
• Fatigue
• Weight loss
• Slow wound healing
• Dry skin
• Numbness of hands and feet
• Blurred vision
• Frequent infection

Risk Factors:

• Family History: Having parents or siblings with diabetes-mellitus increases the risk of type 1 diabetes mellitus.
• Environmental factors: Exposure to viral infection increases the risk of type 1 diabetes mellitus
• Age: the risk of type 2 diabetes increases as we get older.
• Obesity: Obesity is one of the main risk factors for type 2 diabetes due to its role in insulin resistance
• Sedentary lifestyle: a regular exercise may lead to weight loss, and it increases the sensitivity of our body cells to insulin; therefore, inactivity is considered one of the risk factors for type 2 diabetes.
• Gestational Diabetes: pregnant women who have gestational diabetes are more willing to develop type 2 diabetes later.
• Polycystic Ovary Syndrome: a condition in women characterized by obesity, Insulin resistance, and irregular menstrual cycle and increases the risk of type 2 diabetes.
• High Blood Pressure: High blood pressure increases the risk of type 2 diabetes.
• Abnormal Cholesterol and Triglycerides: low HDL-Cholesterol and high triglycerides increase the risk of type 2 diabetes.

Diagnosis:

• Fasting Blood Glucose: It is the most essential to diagnose diabetes mellitus and is performed after fasting from 8 to 10 hours.
• Random Blood Glucose: We can measure random blood glucose without fasting
• Post-Prandial Blood Glucose: It is performed to evaluate how our body responds to glucose after a meal. Blood glucose level is measured 2hrs after eating a meal.
• HBA1C test: It is used to monitor diabetes over the past two to three months. Fasting is not required before performing this test.
• Glucose Tolerance Test: It measures the body’s tolerance to glucose, and it is used as a screening test for gestational diabetes. It is divided into:

1. O’Sullivan test: It performed to diagnose gestational diabetes. In this test, the blood glucose level is measured 1 hour after drinking 50 gm of glucose solution.
2. Oral Glucose Tolerance Test: Blood glucose level is measured after fasting from 8 to 10 hours followed by drinking 75 gm or 100 gm glucose solution, then blood glucose level is measured every ½ hour for 2 hours or every 1 hour for 3 hours, respectively.

Complications:

1. Nephropathy: Persistent high blood glucose levels can damage blood vessels in the kidney, causing its inability to perform its functions to remove waste products and to balance fluids and minerals in our body.
2. Retinopathy: Retinopathy is one of the diabetic complications which damages the retina blood vessels, leading to vision problems.
3. Neuropathy: Neuropathy is one of the most common complications of diabetes, which can lead to nerve damage throughout the body.
4. Diabetic Foot: This can happen over time when high blood glucose levels damage nerves in the feet or legs. That may result in numbness, tingling, and loss of sensation in the legs and feet.
5. Cardiovascular Disease: Diabetic patients are more prone to develop cardiovascular diseases, including heart attacks, heart failure, and strokes.
6. Brain Stroke: Diabetic patients are 1.5 times more likely to develop a stroke than non-diabetics. Diabetes can block blood flow to the brain causing damage to the brain tissue and stroke.

Prevention:

Although Diabetes Type 1 is neither preventable nor curable, some measurements may help to overcome its complications. Moreover, these measurements may prevent diabetes type 2 and avoid the development of prediabetic conditions to diabetes type 2.

1. Weight loss: It has been reported that losing 5-10% of your weight may lower your risk for diabetes-Type-2 by 50%.
2. Regular Exercise: It is essential for weight loss and increases the sensitivity of our body cells to insulin.
3.  Balanced Diet: avoid food rich in carbohydrates and fats and eat more vegetables and fruits.
4. Follow blood glucose levels regularly: particularly for diabetic patients to avoid complications of diabetes mellitus by keeping blood glucose levels within normal range. Also in prediabetic conditions to prevent its progression to diabetes type 2.

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