Increased thirst. Polydipsia; increased urination. polyuria, lack of energy and fatigue, weight loss.
They are main signs of diabetes.
Diabetes mellitus is a disease of inadequate control of blood levels of glucose.
The main characteristic of Diabetes mellitus is, increased glucose level in the blood. Called hyperglycemia.
Chronic hyperglycemia can cause damage to various organ systems, including kidneys, eyes, nerves. And blood vessels.
Eventually development of disabling and life-threatening health complications.
Diabetes mellitus, is broadly classified into three types by etiology and clinical presentation, type 1 diabetes, type 2 diabetes, and gestational diabetes. Some other less common types of diabetes include monogenic diabetes and secondary diabetes.
Type 1 Diabetes Mellitus.
Characterized by autoimmune destruction of insulin-producing beta cells in the islets of the pancreas.
Resulted an absolute deficiency of insulin. Lack of insulin causes hyperglycemia.
Type 1 diabetes mellitus is more common among children and adolescents, though it can develop at any age. Genetic and environmental factors have its role in developing any type of diabetes mellitus.
Type 1 diabetes mellitus accounts 5-10 % of cases of diabetes mellitus.
Type 2 diabetes mellitus
During this state, insulin is ineffective. It is called insulin resistance. Insulin resistance is multifactorial but commonly develops from obesity and aging.
Organism tries to compensate this inefficiency.
And initially countered by an increase in insulin production to maintain glucose homeostasis.
but over time, insulin production decreases, resulting hyperglycemia. Type 2 diabetes mellitus is most commonly seen in persons older than 45 years.
Type 2 diabetes mellitus accounts for around 90% of all cases of diabetes.
Gestational Diabetes Mellitus.
Hyperglycaemia, which is first detected during pregnancy, is classified as gestational diabetes mellitus, also known as hyperglycemia in pregnancy. Although it can occur anytime during pregnancy, generally affects pregnant women during the second and third trimesters.
Risk Factors for Diabetes mellitus.
Overweight or obesity. Persons with a BMI greater than or equal to 25,
First-degree relative with diabetes mellitus,
History of cardiovascular disease or hypertension,
Low HDL-cholesterol or hypertriglyceridemia,
Women with polycystic ovarian syndrome,
Physical inactivity,
Conditions associated with insulin resistance, for example, Acanthosis nigricans.
Diagnosis:
A blood sample is taken after an 8 hour overnight fast. fasting plasma glucose level of more than 126 mg/dL (7.0 mm/L) is consistent with the diagnosis.
In this test, the plasma glucose level is measured before and 2 hours after the ingestion of 75 gm of glucose. DM is diagnosed if the plasma glucose level in the 2-hour sample is more than 200 mg/dL (11.1 mmol/L).
Glycated Hemoglobin, A1C.
This test gives an average of blood glucose over the last 2 to 3 months. Patients with a Hb A1C greater than 6.5% (48 mmol/mol) are diagnosed as having Diabetes mellitus.
Treatment
For both type 1 and type 2 diabetes mellitus, the cornerstone of therapy is diet and exercise.
A diet low in saturated fat, refined carbohydrates, high fructose corn syrup.
And high in fiber and monounsaturated fats needs to be encouraged.
Aerobic exercise for a duration of 90 to 150 minutes per week is also beneficial.
If adequate glycemia cannot be achieved, metformin is the first-line therapy.
If the patient has fatty liver disease, alpha-glucosidase inhibitors, and insulin, are available.
To reduce microvascular complications in the majority, the goal Hb A1C should be less than 7%. Also, the BP goal should be less than 130/85 mmHg with a preference for angiotensin-converting enzyme (ACE)/angiotensin receptor blocker (ARB) therapy. Fundal exams should be undertaken as proposed by guidelines and urine albumin excretion at least twice a year.
Prognosis:
Today, with pharmacotherapy for hyperglycemia, as well as lowering LDL cholesterol and managing blood pressure with ACE/ARB therapy, with other antihypertensive medications and aspirin in secondary prevention, vascular complications can be managed adequately, resulting in a reduction in morbidity and mortality.
By BruceBlaus. When using this image in external sources it can be cited as:Blausen.com staff. "Blausen gallery 2014". Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. – This file was derived from: Blausen 0428 Gallbladder-Liver-Pancreas Location.png, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=35360047
By Mark F. Brady; Prashanth Rawla. – https://www.ncbi.nlm.nih.gov/books/NBK431057/, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=89329542
