Diabetes Mellitus

Definition

Diabetes mellitus is a serious chronic disease of absolute or relative insulin deficiency or resistance that's characterized by disturbances in carbohydrate, protein, and fat metabolism. It may be occurs in four forms such as type 1, type 2, other specific types, and gestational diabetes mellitus. Type 1 is further subdivided into immune mediated diabetes and idiopathic diabetes. If you have type 1 immune-mediated diabetes, then you may develop ketoaddosis. If you have type 2 or non insulin-dependent diabetes, then diabetes group also fall into this category. A leading cause of death by disease is a contributing factor in about 50% of myocardial infarctions and about 75% of strokes as well as in renal failure and Peripheral vascular disease. It's also the leading cause of new blindness. About 90% to 95% of women with diabetes have type 2. If you have type 2 or non insulin-dependent diabetes (NIDDM), then diabetes group also fall into this category. Another type of diabetes is GDM, it may occurs during pregnancy. But it usually ends after the baby is born, but women with GDM have up to a 45% risk of recurrence in the next pregnancy and up to a 63% risk of developing type 2 diabetes later in life.

Causes of diabetes mellitus

• Obesity, risk decreases with weight loss and drug therapy
• Lack of physical activity
• History of GDM
• Hypertension or dyslipidemia
• Black, Latino, or Native American origin
• Strong family history of diabetes
• Increasing age

If you have type 1 diabetes, then pancreatic beta-cell destruction or a primary defect in beta-cell function results in failure to release insulin and ineffective glucose transport. Type 1 immune-mediated diabetes may be cause by cell-mediated destruction of pancreatic beta cells and the rate of beta-cell destruction is usually higher in children than in adults. In type 2 diabetes, beta cells release insulin, but receptors are insulin-resistant and glucose transport is variable and ineffective. Other types of diabetes mellitus result from various conditions. They may also result from use of or exposure to certain drugs or chemicals.

Symptoms of diabetes mellitus

• Fatigue
• Ketoacidosis or insidiously
• Retinopathy
• Nephropathy
• Atherosclerosis
• Peripheral neuropathy usually affects the hands and feet and may also cause numbness or pain.
• Autonomic neuropathy may manifest itself in several ways, such as gastroparesis leading to delayed gastric emptying, nocturnal diarrhea, impotence, and orthostatic hypotension.

Insulin deficiency may causes hyperglycemia which pulls fluid from body tissues, causing osmotic diuresis, polyuria, dehydration, polydipsia, dry mucous membranes, poor skin turgor and, in most patients, unexplained weight loss. If you have ketoacidosis and hyperosmolar hyperglycemic nonketotic syndrome, then dehydration may cause hypovolemia and shock. Another common complication of diabetes is Heart disease.

Treatment of diabetes mellitus

• Treatment for type 1 diabetes is achieved with insulin replacement, diet, and exercise. Current forms of insulin replacement such as single dose, mixed-dose, split-mixed dose, and multiple-dose regimens.
• Islet cell transplantation is another treatment that is less complicated than whole pancreas transplantation, but also requires chronic immunosuppression.
• Treatment for type 2 diabetes may require oral anti-diabetic drugs to stimulate endogenous insulin production, increase insulin sensitivity at the cellular level, and suppress hepatic gluconeogenesis.