Diabetes Management

Introduction

Diabetes mellitus affect approximately 5 to 8 % of the population. A large number of individuals are asymptomatic and do not know they have the disease.

Diabetes mellitus is heterogeneous group of disorders characterized by abnormalities in carbohydrate, protein and lipid metabolism. The central disturbance in diabetes mellitus is an abnormality in insulin production or action or both, although others factors can be involved.

There are mainly three types of Diabetes mellitus:

  1. Type 1(Insulin dependent Diabetes Mellitus)

  2. Type 2( Non Insulin dependent Diabetes Mellitus)

  3. Gestational diabetes.

With all three, your body can’t make or use insulin.

                                     Features of Type 1 and Type 2 Diabetes mellitus.

 

Characteristics

Type 1

Type 2

Onset ( age)

Usually <30

Usually >40

Type of onset

Abrubt

Gradual

Nutritional status

Often thin

Often obese

Clinical symptoms

Polydipsia, polyuria, polyphagia

often asymptomatic

Ketosis

Present

Usually absent

Endogeneous insulin

Absent

Variable

Insulin therapy

Required

Sometimes

Oral hypoglycemic

Usually not effective

Often effective

Diet

Mandatory with insulin

Mandatory with or without drugs.

 

Type 1 ( Insulin dependent diabetes)

  • The disease is characterized by absolute deficiency of insulin caused by massive B-cell necrosis.

  • Loss of B- cell function is triggered by invasion of viruses or the action of chemical toxins.

  • As a result the pancreas fails to respond to glucose and type 1 diabetes show classical symptoms of insulin deficiency ( polydipsia, polyphagia, polyuria, and weight loss.)

 

Symptoms

Signs and symptoms can appear relatively suddenly and may include:

  • Increased thirst.

  • Frequent urination

  • Bed wetting in children who previously didn’t wet the bed during the night.

  • Extreme hunger

  • Unintended weight loss

  • Irritability and other mood changes

  • Fatigue and weakness

  • Blurred vision.

Risk factors

  • Family history: Anyone with a parent or sibling with type1 diabetes has slightly increased risk of developing the condition.

  • Genetics: The presence of certain genes indicates an increased risk of developing type1 diabetes.

  • Geography: The incidence of type1 diabetes tends to increase as you travel away from the equator.

  • Age: Although type1 diabetes can appear at any age, it appears at two noticeable peaks. The first peak occurs in children between 4 and 7 years old, and the second is in children between 10 and 14 years old.

Complications

Type1 Diabetes can affect major organs in your body, including heart, blood vessels, nerves, eyes and kidneys.

  • Heart and blood vessel disease.

  • Nerve damage ( neuropathy)

  • Kidney damage(Nephropathy)

  • Eye damage

  • Foot damage

  • Skin and mouth conditions

  • Pregnancy complication

 

Diagnosis

  1. Glycolated hemoglobin(A1C) test: It measures the blood sugar attached to the oxygen carrying protein in red blood cells(hemoglobin). An A1C level of 6.5% or higher on two separate tests indicates diabetes.

  2. Random blood sugar test: Random blood sugar level of 200mg/dl(11.1mMol/l) or higher suggests diabetes.

  3. Fasting and blood sugar test:

  • A fasting blood sugar level less than 100mg/dl(5.6mMol/l) is normal

  • A  fasting blood sugar level from 100 to 125mg/dl(5.6 to 6.9mMol/l)is considered pre-diabetes.

  • If it’s 126mg/dl(7mMol/l) or higher on two separates test, indicate diabetes.


 

Treatment

  1. Taking insulin

  2. Carbohydrate, fat and protein counting.

  3. Frequent blood sugar monitoring

  4. Eating healthy foods

  5. Exercising regularly and maintaining a healthy weight.