Diabetes mellitus is a chronic disorder of carbohydrate (sugar) metabolism. The word "mellitus" is Latin for "honey." Diabetes mellitus is characterized by abnormal, excessive levels of the sugar glucose in the blood, which is consequently passed through the urine. Most people always have some glucose in the blood to be used by cells for energy...
Diabetics have excessive blood glucose because of a deficiency in the production or utilization of the hormone insulin. Insulin is made by the beta cells of the pancreas in response to the elevated glucose in the blood after a meal. Insulin binds to receptors on the body's cells to allow the passage of glucose into the cell as an energy source...
Type 1 diabetes (previously known as insulin-dependent diabetes)
Type 1 diabetes is an auto-immune disease where the body's immune system destroys the insulin-producing beta cells in the pancreas. This type of diabetes, also known as juvenile-onset diabetes, accounts for 10-15% of all people with the disease. It can appear at any age, although commonly under 40, and is triggered by environmental factors such as viruses, diet or chemicals in people genetically predisposed. People with type 1 diabetes must inject themselves with insulin several times a day and follow a careful diet and exercise plan.
Type 2 diabetes (previously known as non-insulin dependent diabetes)
Type 2 diabetes is the most common form of diabetes, affecting 85-90% of all people with the disease. This type of diabetes, also known as late-onset diabetes, is characterised by insulin resistance and relative insulin deficiency. The disease is strongly genetic in origin but lifestyle factors such as excess weight, inactivity, high blood pressure and poor diet are major risk factors for its development. Symptoms may not show for many years and, by the time they appear, significant problems may have developed. People with type 2 diabetes are twice as likely to suffer cardiovascular disease. Type 2 diabetes may be treated by dietary changes, exercise and/or tablets. Insulin injections may later be required.
THE CAUSES OF both Type 1 and Type 2 diabetes are unknown. A number of precipitating factors have been identified, however. A family history of diabetes increases the risk for both types, indicating there may be a genetic predisposition...
Gestational diabetes mellitus (GDM)
GDM, or carbohydrate intolerance, is first diagnosed during pregnancy through an oral glucose tolerance test. Between 5.5 and 8.8% of pregnant women develop GDM in Australia. Risk factors for GDM include a family history of diabetes, increasing maternal age, obesity and being a member of a community or ethnic group with a high risk of developing type 2 diabetes. While the carbohydrate intolerance usually returns to normal after the birth, the mother has a significant risk of developing permanent diabetes while the baby is more likely to develop obesity and impaired glucose tolerance and/or diabetes later in life. Self-care and dietary changes are essential in treatment.
When diabetes is not well-controlled, the sugar level in your blood goes up. this is called hyperglycemia . High blood sugar can cause damage to many parts of your body, especially: n kidneys n heart n blood vessels n eyes n feet n nerves diabetes can also cause high blood pressure and hardening of the arteries (called arteriosclerosis ). These can lead to heart and blood vessel disease.
Diabetes should be suspected in anyone who unexplainably begins experiencing excessive, almost insatiable thirst; frequent urination, hunger, and loss of weight. There also may be feelings of weakness, mood swings, an increased vulnerability to infection, such as slow-healing cuts or increased vaginal infections in women, fatigue, leg cramps or pins and needles sensations in the toes and fingers; impotence; blurred vision, or hemorrhages of tiny blood vessels in the retina. Sometimes these symptoms are ignored until the approach of ketoacidosis, which is marked by a fruity, sweetish breath odor, tremendous thirst, weakness, dryness of the tongue and skin, nausea, and vomiting...
Insulin lowers blood sugar by allowing it to leave the bloodstream and enter cells. Everyone with type 1 diabetes must take insulin every day.
Insulin is usually injected under the skin. In some cases, a pump delivers the insulin all the time. Insulin does not come in pill form.
Insulin types differ in how fast they start to work and how long they last. The health care provider will choose the best type of insulin for you and will tell you at what time of day to use it. More than one type of insulin may be mixed together in an injection to get the best blood glucose control. You may need insulin shots from one to four times a day.
Your health care provider or diabetes nurse educator will teach you how to give insulin injections. At first, a child's injections may be given by a parent or other adult. By age 14, most children can give their own injections.
People with diabetes need to know how to adjust the amount of insulin they are taking:
When they exercise
When they are sick
When they will be eating more or less food and calories
When they are traveling
If diet and exercise do not help keep your blood sugar at normal or near-normal levels, your doctor may prescribe medication. Since these drugs help lower your blood sugar levels in different ways, your doctor may have you take more than one drug.
Some of the most common types of medication are listed below. They are taken by mouth or injection.
Alpha-glucosidase inhibitors (such as acarbose)
Injectable medicines (including exenatide, mitiglinide, pramlintide, sitagliptin, and saxagliptin)
Meglitinides (including repaglinide and nateglinide)
Sulfonylureas (like glimepiride, glyburide, and tolazamide)
Thiazolidinediones (such as rosiglitazone and pioglitazone). (Rosiglitazone may increase the risk of heart problems. Talk to your doctor.)
These drugs may be given with insulin, or insulin may be used alone. You may need insulin if you continue to have poor blood glucose control. It must be injected under the skin using a syringe or insulin pen device. It cannot be taken by mouth.
More than 24 million Americans have Type 2 diabetes, the version of the disease usually associated with being overweight and living a sedentary lifestyle. By some estimates the number could double by 2025.
Women comprise a slightly larger proportion—54 per cent—of the population with diabetes than in the general population—51 per cent.
In 2000, 3.2 million people died from complications associated with diabetes. In countries with high diabetes prevalence, such as those in the Paciﬁc and the Middle East, as many as one in four deaths in adults aged between 35 and 64 years is due to diabetes. Diabetes has become one of the major causes of premature illness and death in most countries, mainly through the increased risk of cardiovascular disease (CVD). Cardiovascular disease is responsible for between 50% and 80% of deaths in people with diabetes. Diabetes is a leading cause of blindness, amputation and kidney failure. These complications account for much of the social and ﬁnancial burden of diabetes