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Diabetes mellitus is a disorder marked by chronically elevated blood sugar levels (glucose). Diabetes comes in a variety of forms. Type 1 diabetes and type 2 diabetes are the two most frequent types. Simple sugars, primarily glucose, are formed when carbohydrates are broken down. Glucose must leave the bloodstream and enter the cells to supply energy to the cells. The pancreas, an organ in the belly, generates the hormone insulin, which is necessary for glucose to enter the body's cells. When blood glucose levels rise in a person without diabetes, the pancreas generates more insulin, which instructs the body's cells to take in the glucose. The ability of the pancreas to produce insulin or the cells' sensitivity to insulin is affected in diabetes.
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Key Terms: Diabetes Mellitus, Type 1 Diabetes, Type 2 Diabetes, Insulin, Exercise, Blood Sugar Level, Balanced Diet, Chronic Illness, Pancreas, Glucose, Carbohydrate
Types of Diabetes Mellitus
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Type 1 Diabetes is an autoimmune illness. This means it starts when the body's immune system kills healthy cells by mistake. In type 1 diabetes, the immune system attacks the pancreas' insulin-producing cells (known as beta cells). This results in the person's body having little or no insulin. Glucose accumulates in the bloodstream rather than entering the cells without insulin. As a result, the body is unable to use this glucose as an energy source.
Furthermore, elevated blood glucose levels promote excessive urine and dehydration, as well as tissue damage. Insulin resistance occurs when your body's cells become less sensitive to insulin's attempts to push glucose into the cells, resulting in type 2 diabetes. As a result, glucose levels in the blood begin to rise. This is due to the fact that it almost often began in middle or late adulthood.
Diabetes type 2 is far more common than diabetes type 1. Obesity also raises your chances of developing type 2 diabetes. It is a distinct condition from type 1 diabetes, despite the fact that both include high blood glucose levels and the risk of complications.
Types of Diabetes Mellitus
Symptoms of Diabetes Mellitus
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Diabetes may not cause any symptoms at first. This disease sometimes may be detected early on with a routine blood test before symptoms appear.
- Excessive urine and thirst, which leads to a lot of fluid consumption and weight loss, are common signs of diabetes. People with diabetes are more susceptible to infections, particularly yeast infections (Candida).
- Extremely high blood sugar levels can lead to serious problems when the amount of insulin in the bloodstream is too low. Diabetic ketoacidosis is a condition in which the body becomes overly acidic or the person's blood sugar level rises to the point where they get seriously dehydrated which is known as Hyperosmolar syndrome.
- Confusion, weakness, nausea, vomiting, and even seizures and coma are all signs of severe problems.
Read More: Difference between Diabetes Mellitus and Diabetes Insipidus
Complications of Diabetes Mellitus
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Over time, having too much glucose in your blood can cause multiple complications such as eye disease, due to changes in fluid levels, swelling in the tissues, and damage to the blood vessels in the eyes. Foot problems are caused by damage to the nerves and reduced blood flow to your feet. Gum disease and other dental problems are also a result of this disease because a high amount of blood sugar in your saliva helps harmful bacteria grow in your mouth.
Damage to your blood vessels and the nerves that control your heart and blood vessels causes heart disease and stroke. Damage to the nerves and restricted blood flow in the genitals and bladder create sexual and bladder difficulties.
Complications of Diabetes Mellitus
Diagnosis of Diabetes Mellitus
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Diabetes is diagnosed through blood tests that measure glucose levels in the blood.
- Fasting Plasma Glucose (FPG) Test: After fasting overnight, a blood sample is collected in the morning. Blood sugar levels in the fasting state should be between 70 and 100 milligrams per deciliter (mg/dL).
- OGTT (Oral Glucose Tolerance Test): Two hours after drinking a liquid containing 75 grams of glucose, your blood sugar is measured. If your blood sugar level is 200 mg/dL or greater, you have diabetes.
- A blood sugar level of 200 mg/dL or higher at any time of day, in combination with diabetes symptoms, is sufficient to diagnose diabetes.
Read More: Insulin and Glucagon
Expected Duration of Diabetes Mellitus
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- Type 1 diabetes is a chronic condition. Type 2 diabetes is usually a lifelong condition. People with type 2 diabetes, on the other hand, can sometimes return to normal blood sugar levels by eating a balanced diet, exercising regularly, and decreasing weight.
- After childbirth, gestational diabetes normally disappears. Women who develop gestational diabetes, on the other hand, are at significant risk of getting type 2 diabetes later in life.
- Insulin resistance can rise in patients with diabetes due to age and episodic diseases. As a result, more treatment is frequently required over time.
Prevention of Diabetes Mellitus
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Even if you don't achieve your desired weight, go for a vigorous walk of 1-2 miles in 30 minutes at least five times a week. This is because even if you don't lose weight, consistent exercise reduces insulin resistance. It is important having a balanced diet. Maintain blood sugar management.
Most complications are reduced as a result of this. Reduce your chances of developing heart problems. Manage other atherosclerotic risk factors aggressively, such as high blood pressure, cholesterol, and triglycerides. Every year, see an eye doctor and a foot specialist. This can help you avoid difficulties with your eyes and feet.
Treatment of Diabetes Mellitus
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Insulin injections are always used to treat type 1 diabetes. Treatment for type 2 diabetes initially begins with weight loss through the means of diet and exercise. A diabetic's diet should be modest in total calories, Trans fat-free, and nutritionally balanced, with plenty of whole grains, fruits and vegetables, and monounsaturated fats.
To regulate blood sugar, most persons with type 2 diabetes require medication. Weight loss, a nutritious diet, and regular exercise can all help you reach normal blood sugar levels. Type 2 diabetes treatment options include tablets and injections. Some obese persons with type 2 diabetes may benefit from weight loss surgery.
Read More: Difference between Saturated and Unsaturated Fats
Things to Remember
- Diabetes Mellitus is a condition in which the pancreas fails to generate enough insulin or the body fails to use it to produce energy.
- Feeling hungry even after eating, increased thirst, frequent urination, exhaustion, and weight loss are all common diabetes symptoms.
- Diagnosis of blood sugar levels at regular intervals, a food plan based on your blood sugar level, regular exercise, medications, and injections as prescribed by your doctor are all part of the treatment for Diabetes Mellitus.
- Type 1 Diabetes Mellitus occurs when the pancreas fails to create enough insulin in the body, causing the immune system to be destroyed, whereas Type 2 Diabetes Mellitus, also known as insulin resistance diabetes, occurs when the pancreas produces some insulin but does not have enough.
Sample Questions
Ques. How one can manage diabetes? (5 Marks)
Ans. One can manage diabetes with the help of the following steps:
- Follow a diet that includes vegetables, whole grains, beans, fruits, healthy fats, and low sugar. Such kinds of diets are high in fiber and nutrition, and low in fats and calories. For assistance with nutrition and meal planning, consult a qualified dietician.
- For most of the days of the week, try that you are involved in exercise for at least 30 minutes. Take a walk, swim, or do something else you enjoy.
- Taking medication and insulin as recommended and adhering to the instructions on how and when to take it.
- At home, keep track of your blood glucose and blood pressure.
- Maintain regular contact with the concerned doctors and complete laboratory testing as directed by your doctor.
Ques. State some oral medications approved for treating diabetes. (5 Marks)
Ans. Some oral medications approved for treating diabetes are
- Sulfonylureas: This medication primarily causes the pancreas to release more insulin, thus, lowering blood glucose levels. Glimepiride (Amaryl), glipizide (Glucotrol), and glyburide are other examples (Micronase, DiaBeta).
- Glinides, also known as meglitinides, reduce blood glucose by stimulating the pancreas to produce more insulin. Repaglinide (Prandin) and nateglinide are the examples of this.
- Biguanides are medications that reduce the amount of glucose produced by the liver. It also enhances insulin sensitivity and reduces the conversion of carbs to sugar in the body. One example is metformin (Glucophage).
- Alpha-glucosidase inhibitors: These medications reduce blood sugar by slowing carbohydrate breakdown and limiting glucose absorption in the small intestine. Acarbose is an example (Precose).
Ques. What insulin medications are approved to treat diabetes? (5 Marks)
Ans. The medications are as follows:
- Sulfonylureas: These medications lower blood glucose by encouraging the pancreas to produce more insulin. Rapid-acting insulins: These insulins are taken 15 minutes before meals, peak at one hour, and work for another two to four hours. Insulin glulisine (Apidra), insulin lispro (Humalog), and insulin aspart are among examples (NovoLog).
- Short-acting insulins take around 30 minutes to reach your bloodstream, peak in two to three hours and last three to six hours. Regular insulin is an example (Humulin R).
- Intermediate-acting insulins enter your system in two to four hours, peak in four to twelve hours, and last up to 18 hours.
- Long-acting insulins work to keep your blood sugar constant throughout the day. These insulins last about 18 hours. Insulin glargine (Basaglar, Lantus, and Toujeo), insulin detemir (Levemir), and insulin degludec are examples.
Ques. Are there other treatment options for diabetes? (5 Marks)
Ans. For a small number of Type 1 diabetes patients, there are two types of transplants. It's feasible to get a pancreatic transplant. Getting an organ transplant means taking immunosuppressive medicines for the rest of your life and dealing with their negative effects. If the transplant goes well, you'll probably be able to quit using insulin.
Immunotherapy is another Type 1 diabetes treatment that is being studied. Because Type 1 is an immune system disease, immunotherapy has the potential to utilise medication to switch off the immune system components that cause Type 1 disease.
Another therapeutic option for diabetes is bariatric surgery. If you have Type 2 diabetes, are obese (BMI above 35), and are deemed a good candidate for bariatric surgery, it may be a possibility for you. People who have significantly lost a large amount of weight have significantly better blood glucose levels.
Ques. Can you prevent prediabetes, Type 2 diabetes and gestational diabetes? (5 Marks)
Ans. Consume a nutritious diet and keep a meal diary and track your calories. You can lose 12 pounds per week by cutting 250 calories from your daily diet. One must aim to exercise for 30 minutes five days a week. If you're pregnant, don't try to reduce weight; instead, talk to your doctor about how to gain weight safely during your pregnancy. Reduce your anxiety through relaxation techniques, deep breathing exercises, focused meditation, and yoga.
Limit your alcohol consumption. Men should limit themselves to two alcoholic beverages per day, while women should limit themselves to one. Make sure you get enough sleep (typically 7 to 9 hours). Take medications as advised by your healthcare provider to control current heart disease risk factors (e.g., high blood pressure, cholesterol) or to lower the chance of acquiring Type 2 diabetes.
Ques. When to call a doctor in case of diabetes? (3 Marks)
Ans. If you haven’t been diagnosed with diabetes, you should see your healthcare provider if you have any symptoms of diabetes. If you are diagnosed with diabetes, contact your provider if your blood glucose levels are outside of your target range, if current symptoms worsen or if you develop any new symptoms.
Ques. Does eating sugary food cause diabetes? (3 Marks)
Ans. Sugar does not induce diabetes on its own. Consuming foods high in sugar can contribute to weight increase, which is a risk factor for diabetes. Apart from the weight gain, intake of more sugar (no more than six teaspoons (25 grams) for women and nine teaspoons (36 grams) for men) causes a variety of health problems.
Ques. How often do I need to see diabetes healthcare professional? (3 Marks)
Ans. If you're taking insulin shots, you should see your doctor every three to four months. If you're taking diabetic medicines or treating them with a diet, you should see your doctor every four to six months. If your blood sugar is not under control or if diabetes problems are worsening, you may require more frequent visits.
Ques. How does COVID-19 affect a person with diabetes? (3 Marks)
Ans. Although diabetes does not necessarily raise your risk of getting COVID-19, it does make you more likely to develop serious problems if you do. As your body works to clear the infection, your blood sugar levels are likely to rise if you get COVID-19. If you contract COVID-19, notify your healthcare team as soon as possible.
Ques. How does diabetes affect your heart, eyes, feet, nerves and kidneys? (4 Marks)
Ans. Blood vessels can be found in all of the tissues and organs of our body. They encircle our body's cells, transporting oxygen, nutrients, and other substances utilising blood as the medium of exchange. Diabetes prevents glucose (the body's fuel) from entering cells and destroys blood arteries in and around these organs, as well as those that nourish neurons.
Organs, nerves, and tissues can start to fail if they don't obtain the nutrients they require to function properly. The term "proper function" refers to the health of your heart's blood vessels, particularly arteries (narrowed or blocked). This means that waste items can be filtered out of your blood by your kidneys. This indicates that your nerves are being nourished and that blood is flowing to your feet.
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