Diabetes Mellitus

Diabetes mellitus, often simply diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced.

There are three main types of diabetes:

Type 1 diabetes: results from the body’s failure to produce insulin, and presently requires the person to inject insulin (insulin-dependent diabetes mellitus, IDDM for short, and juvenile diabetes).

Type 2 diabetes results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency (non-insulin-dependent diabetes mellitus, NIDDM for short, and adult-onset diabetes).

Gestational diabetes is when pregnant women who have never had diabetes before, have a high blood glucose level during pregnancy. It may precede development of type 2 DM.

The cause of diabetes depends on the type. Type 1 diabetes is partly inherited and then triggered by certain infections. Type 2 diabetes is due primarily to lifestyle factors and genetics.

All forms of diabetes have been treatable since insulin became available in 1921, and type 2 diabetes may be controlled with medications. Both type 1 and 2 are chronic conditions that usually cannot be cured.

At least 171 million people worldwide suffer from diabetes, or 2.8% of the population. Type 2 diabetes is by far the most common, affecting 90 to 95% of diabetes population, for example, in the U.S.

Signs and symptoms

The classical symptoms of diabetes are polyuria (frequent urinartion), polydipsia (increased thirst) and polyphagia (increased hunger). Symptoms may develop rapidly (weeks or months) in type 1 diabetes while type 2 diabetes they usually develop much more slowly and may be subtle or absent. The elevated plasma glucose levels cause marked glucosouria and an osmotic diuresis resulting in dehydration.

Prolonged high blood glucose causes glucose absorption, which leads to changes in the shape of the lenses of the eyes, resulting in vision changes; blurred vision is a common complaint leading to a diabetes diagnosis; type 1 should always be suspected in cases of rapid vision change, whereas with type 2 change is generally more gradual, but should still be suspected.

The main complications of diabetes mellitus are diabetic retinopathy, diabetic neuropathy, diabetic nephropathy, foot ulcers.

Treatment regimens differ. Patient education is important to ensure the effectiveness of the prescribed therapy. All patients should be instructed in self-glucose monitoring.

Exercise 6. Answer the questions:

1. What is diabetes mellitus?

2. How many types of diabetes you know?

3. What is type 1 diabetes?

4. What is type 2 diabetes?

5. What is gestational diabetes?

6. When did insulin become available?

7. What are the classical symptoms of diabetes?

8. What does prolonged high blood glucose cause?

9. What are the main complications of diabetes?