Definition of diabetes mellitus
Diabetes mellitus refers to a group of diseases
that affect how the body uses blood sugar (glucose). Glucose is vital to an
individual’s health because it is an important source of energy for the cells
that make up the muscles and tissues. It is also the brain’s main source of
fuel. If an individual has diabetes, no matter the type, it means there is too
much glucose in the individual’s blood. Although the causes may differ, too much
glucose can lead to serious health problems.
that affect how the body uses blood sugar (glucose). Glucose is vital to an
individual’s health because it is an important source of energy for the cells
that make up the muscles and tissues. It is also the brain’s main source of
fuel. If an individual has diabetes, no matter the type, it means there is too
much glucose in the individual’s blood. Although the causes may differ, too much
glucose can lead to serious health problems.
Types of diabetes mellitus
There are three major types of diabetes mellitus
namely;
namely;
·
Type 1 diabetes mellitus
Type 1 diabetes mellitus
·
Type 2 diabetes mellitus
Type 2 diabetes mellitus
·
Gestational diabetes
mellitus.
Gestational diabetes
mellitus.
Type 1 diabetes mellitus
Type 1 diabetes mellitus is characterized
by loss of the insulin-producing beta
cells of the islets of Langerhans in the pancreas, leading to insulin deficiency.
This type can be further classified as immune-mediated or idiopathic. The
majority of type 1 diabetes is of the immune-mediated nature, in which a T-cell-mediated autoimmune attack leads to the loss of beta cells and thus
insulin. Most affected people are otherwise healthy and of a healthy weight
when onset occurs. Sensitivity and responsiveness to insulin are usually
normal, especially in the early stages. Type 1 diabetes can affect
children or adults, but was traditionally termed “juvenile diabetes”
because a majority of these diabetes cases were in children.
by loss of the insulin-producing beta
cells of the islets of Langerhans in the pancreas, leading to insulin deficiency.
This type can be further classified as immune-mediated or idiopathic. The
majority of type 1 diabetes is of the immune-mediated nature, in which a T-cell-mediated autoimmune attack leads to the loss of beta cells and thus
insulin. Most affected people are otherwise healthy and of a healthy weight
when onset occurs. Sensitivity and responsiveness to insulin are usually
normal, especially in the early stages. Type 1 diabetes can affect
children or adults, but was traditionally termed “juvenile diabetes”
because a majority of these diabetes cases were in children.
Type 1 diabetes is partly inherited, with
multiple genes. In genetically susceptible people, the onset of diabetes can be
triggered by one or more environmental factors, such as a viral infection or
diet. There is some evidence that suggests an association between type 1
diabetes and Coxsackie B4 virus.
multiple genes. In genetically susceptible people, the onset of diabetes can be
triggered by one or more environmental factors, such as a viral infection or
diet. There is some evidence that suggests an association between type 1
diabetes and Coxsackie B4 virus.
Type 2 diabetes mellitus
Type 2 diabetes mellitus is characterized
by insulin resistance, which may be combined with relatively reduced
insulin secretion. The defective responsiveness of body tissues to insulin is
believed to involve the insulin
receptor. In the early stage of
type 2, the predominant abnormality is reduced insulin sensitivity. At
this stage, hyperglycemia can be reversed by a variety of measures and medications that improve insulin sensitivity or reduce glucose
production by the liver.
by insulin resistance, which may be combined with relatively reduced
insulin secretion. The defective responsiveness of body tissues to insulin is
believed to involve the insulin
receptor. In the early stage of
type 2, the predominant abnormality is reduced insulin sensitivity. At
this stage, hyperglycemia can be reversed by a variety of measures and medications that improve insulin sensitivity or reduce glucose
production by the liver.
Type 2 diabetes is due primarily to
lifestyle factors and genetics. A number of lifestyle factors are known to be
important to the development of type 2 diabetes, including obesity, lack of physical activity, poor diet, stress,
and urbanization. Dietary factors also influence the risk of developing
type 2 diabetes. Consumption of sugar-sweetened drinks in excess is associated with
an increased risk. The type of fats in the diet is also important, with saturated
fats and trans
fatty acids increasing the risk and polyunsaturated and monounsaturated fat decreasing the risk. Eating lots of white
rice appears to also play a
role in increasing risk. A lack of exercise is believed to cause about 7% of
cases.
lifestyle factors and genetics. A number of lifestyle factors are known to be
important to the development of type 2 diabetes, including obesity, lack of physical activity, poor diet, stress,
and urbanization. Dietary factors also influence the risk of developing
type 2 diabetes. Consumption of sugar-sweetened drinks in excess is associated with
an increased risk. The type of fats in the diet is also important, with saturated
fats and trans
fatty acids increasing the risk and polyunsaturated and monounsaturated fat decreasing the risk. Eating lots of white
rice appears to also play a
role in increasing risk. A lack of exercise is believed to cause about 7% of
cases.
Gestational diabetes
mellitus
Gestational diabetes mellitus (GDM) resembles
type 2 diabetes in several respects, involving a combination of relatively
inadequate insulin secretion and responsiveness. It occurs in about 2–10% of
all pregnancies and may improve or disappear after delivery.
However, after pregnancy approximately 5–10% of women with gestational diabetes
are found to have diabetes mellitus, most commonly type 2.
type 2 diabetes in several respects, involving a combination of relatively
inadequate insulin secretion and responsiveness. It occurs in about 2–10% of
all pregnancies and may improve or disappear after delivery.
However, after pregnancy approximately 5–10% of women with gestational diabetes
are found to have diabetes mellitus, most commonly type 2.
Though it may be transient, untreated
gestational diabetes can damage the health of the foetus or mother. Risks to
the baby include macrosomia (high birth weight), congenital cardiac and
central nervous system anomalies, and skeletal muscle malformations. Increased foetal
insulin may inhibit foetal surfactant production and cause respiratory distress syndrome. In severe cases, perinatal death may occur,
most commonly as a result of poor placental perfusion due to vascular
impairment.
gestational diabetes can damage the health of the foetus or mother. Risks to
the baby include macrosomia (high birth weight), congenital cardiac and
central nervous system anomalies, and skeletal muscle malformations. Increased foetal
insulin may inhibit foetal surfactant production and cause respiratory distress syndrome. In severe cases, perinatal death may occur,
most commonly as a result of poor placental perfusion due to vascular
impairment.
Signs and symptoms of
diabetes mellitus
diabetes mellitus
Diabetes symptoms vary depending on how much the
blood sugar is elevated. Some people, especially those with prediabetes or type
2 diabetes, may not experience symptoms initially. In type 1 diabetes, symptoms
tend to come on quickly and be more severe.
blood sugar is elevated. Some people, especially those with prediabetes or type
2 diabetes, may not experience symptoms initially. In type 1 diabetes, symptoms
tend to come on quickly and be more severe.
Some of the signs and symptoms of type 1 and type 2
diabetes are:
diabetes are:
·
Increased thirst
Increased thirst
·
Frequent urination
Frequent urination
·
Extreme hunger
Extreme hunger
·
Unexplained weight loss
Unexplained weight loss
·
Presence of ketones in the urine
(ketones are a byproduct of the breakdown of muscle and fat that happens when
there’s not enough available insulin)
Presence of ketones in the urine
(ketones are a byproduct of the breakdown of muscle and fat that happens when
there’s not enough available insulin)
·
Fatigue
Fatigue
·
Irritability
Irritability
·
Blurred vision
Blurred vision
·
Slow-healing sores
Slow-healing sores
·
Frequent infections, such as gums
or skin infections and vaginal infections
Frequent infections, such as gums
or skin infections and vaginal infections
Although type 1 diabetes can develop at any age, it
typically appears during childhood or adolescence. Type 2 diabetes, the more
common type, can develop at any age, though it’s more common in people older
than 40.
typically appears during childhood or adolescence. Type 2 diabetes, the more
common type, can develop at any age, though it’s more common in people older
than 40.
Test and diagnosis of
diabetes mellitus
diabetes mellitus
The following methods can be used to tests and diagnose
diabetes:
diabetes:
·
Random blood sugar test: A blood sample will be taken at a random time.
Regardless of when the individual last ate, a random blood sugar level of 200
milligrams per deciliter (mg/dL) — 11.1 millimoles per liter (mmol/L) — or
higher suggests diabetes.
Random blood sugar test: A blood sample will be taken at a random time.
Regardless of when the individual last ate, a random blood sugar level of 200
milligrams per deciliter (mg/dL) — 11.1 millimoles per liter (mmol/L) — or
higher suggests diabetes.
·
Fasting blood sugar test: A blood
sample will be taken after an overnight fast. A fasting blood sugar level less
than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to
125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it’s 126 mg/dL (7
mmol/L) or higher on two separate tests, suggest diabetes.
Fasting blood sugar test: A blood
sample will be taken after an overnight fast. A fasting blood sugar level less
than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to
125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it’s 126 mg/dL (7
mmol/L) or higher on two separate tests, suggest diabetes.
·
Oral glucose tolerance test: For this
test, the individual fast overnight, and the fasting blood sugar level is
measured. Then the individual is made to drink a sugary liquid, and blood sugar
levels are tested periodically for the next two hours. A blood sugar level less
than 140 mg/dL (7.8 mmol/L) is normal. A reading of more than 200 mg/dL (11.1
mmol/L) after two hours indicates diabetes. A reading between 140 and 199 mg/dL
(7.8 mmol/L and 11.0 mmol/L) indicates prediabetes.
Oral glucose tolerance test: For this
test, the individual fast overnight, and the fasting blood sugar level is
measured. Then the individual is made to drink a sugary liquid, and blood sugar
levels are tested periodically for the next two hours. A blood sugar level less
than 140 mg/dL (7.8 mmol/L) is normal. A reading of more than 200 mg/dL (11.1
mmol/L) after two hours indicates diabetes. A reading between 140 and 199 mg/dL
(7.8 mmol/L and 11.0 mmol/L) indicates prediabetes.
Prevention of diabetes mellitus
Type 1 diabetes cannot be prevented. However, the
same healthy lifestyle choices can help to prevent type 2 diabetes and
gestational diabetes. These include:
same healthy lifestyle choices can help to prevent type 2 diabetes and
gestational diabetes. These include:
·
Eating healthy foods: Patients
should choose foods lower in fat and calories and higher in fibre. Focus on
fruits, vegetables and whole grains.
Eating healthy foods: Patients
should choose foods lower in fat and calories and higher in fibre. Focus on
fruits, vegetables and whole grains.
·
Get more physical activity: Aim for
30 minutes of moderate physical activity a day. Take a brisk daily walk. Ride your
bike. Swim laps. If patients are fit in a long workout, break it up into
smaller sessions spread throughout the day.
Get more physical activity: Aim for
30 minutes of moderate physical activity a day. Take a brisk daily walk. Ride your
bike. Swim laps. If patients are fit in a long workout, break it up into
smaller sessions spread throughout the day.
·
Lose excess pounds: If you are
overweight, losing even 7 percent of your body weight can reduce the risk of
diabetes. To keep your weight in a healthy range, focus on permanent changes to
your eating and exercise habits. Motivate yourself by remembering the benefits
of losing weight, such as a healthier heart, more energy and improved self-esteem.
Lose excess pounds: If you are
overweight, losing even 7 percent of your body weight can reduce the risk of
diabetes. To keep your weight in a healthy range, focus on permanent changes to
your eating and exercise habits. Motivate yourself by remembering the benefits
of losing weight, such as a healthier heart, more energy and improved self-esteem.
Dietary management of diabetes
mellitus
mellitus
The following are some of the recommended dietary
management for diabetes mellitus.
management for diabetes mellitus.
·
A dietary pattern that
includes carbohydrate from fruits, vegetables, whole grains, legumes, and
low-fat milk is encouraged for good health.
A dietary pattern that
includes carbohydrate from fruits, vegetables, whole grains, legumes, and
low-fat milk is encouraged for good health.
·
Monitoring carbohydrate,
whether by carbohydrate counting, exchanges, or experienced-based estimation
remains a key strategy in achieving glycemic control.
Monitoring carbohydrate,
whether by carbohydrate counting, exchanges, or experienced-based estimation
remains a key strategy in achieving glycemic control.
·
Sucrose-containing foods
can be substituted for other carbohydrates in the meal plan or, if added to the
meal plan, covered with insulin or other glucose-lowering medications. Care
should be taken to avoid excess energy intake.
Sucrose-containing foods
can be substituted for other carbohydrates in the meal plan or, if added to the
meal plan, covered with insulin or other glucose-lowering medications. Care
should be taken to avoid excess energy intake.
·
As for the general
population, people with diabetes are encouraged to choose a variety of fibre-containing
foods such as legumes, fibre-rich cereals, fruits, vegetables, and whole grain
products because they provide vitamins, minerals, and other substances
important for good health.
As for the general
population, people with diabetes are encouraged to choose a variety of fibre-containing
foods such as legumes, fibre-rich cereals, fruits, vegetables, and whole grain
products because they provide vitamins, minerals, and other substances
important for good health.
·
Limit saturated fat to <7% of total calories.
Limit saturated fat to <7% of total calories.
·
Intake of trans fat should be minimized.
Intake of trans fat should be minimized.
·
In individuals with diabetes, limit dietary
cholesterol to <200 mg/day.
In individuals with diabetes, limit dietary
cholesterol to <200 mg/day.
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