Diabetes mellitus is a chronic disease in which patients
present with absolute or relative insulin deficiency. It
affects about 6% of western populations and is a major
contributing factor for heart attacks, strokes, kidney failure
and peripheral vascular disease. Diabetes mellitus is also the
leading cause of new blindness without a cure.
1. Types of Diabetes
There are four forms of the disease, classified as: types 1
and 2, gestational and other specific types.
a. Type 1
Diabetes
In people with type 1 diabetes the pancreas is not
producing insulin, so blood glucose levels are higher than
normal. People with this form of diabetes require daily
insulin therapy to survive. This form is further split into
idiopathic diabetes and immune mediated diabetes.
Type 1 accounts for around 10% to 15% of all people with
diabetes. It is one of the most serious and common chronic
diseases of childhood, with about half of the people with
this form of diabetes developing the disease before age 18.
It is also known as insulin dependent diabetes mellitus
(IDDM) or juvenile-onset diabetes.
b. Type 2
Diabetes
Type 2 diabetes is marked by reduced levels of insulin
(insulin deficiency) and/or the inability of the body to
use insulin properly (insulin resistance). This form of the
disease is most common among people aged 40 years and over
and accounts for 85% to 90% of all people with diabetes.
Most people with type 2 diabetes are obese.
c. Gestational
Diabetes
Gestational diabetes occurs during pregnancy in about 3%
to 8% of females not previously diagnosed with diabetes. It
is a temporary form of diabetes and usually disappears
after the baby is born. However, it is a marker of much
greater risk of developing Type 2 diabetes later in life.
Screening tests for gestational diabetes are usually
performed around the 24th-28th week of pregnancy.
d. Other Specific Diabetes
Types
This includes people who have diabetes as a result of a
genetic defect, or exposure to certain drugs or
chemicals.
2. Causes of Diabetes
Mellitus
Diabetes is caused by resistance to, or deficient production
of, the hormone insulin, which helps glucose move from the
blood into the cells.
In type 1 immune mediated diabetes, pancreatic beta cell
destruction results in failure to release insulin and
ineffective transport of glucose. There is no known cause for
idiopathic diabetes.
In type 2 diabetes, the beta cells release insulin but,
receptors are insulin resistant and glucose transport is
variable and inefficient. Some people may have conditions that
can cause diabetes, such as Cushing's syndrome, pancreatitis or
liver disease.
Risk factors for type 2 diabetes
include;
a. Obesity
b. History of Gestational diabetes
c. Lack of physical activity
d. Hypertension
e. Age 45+
f. Ethnic groupings other than anglo-saxon
g. Low HDL cholesterol levels
h. Impaired glucose tolerance
i. Family history
3. Signs and Symptoms of
Diabetes
Symptoms of diabetes include; dehydration, unexplained
weight loss, excessive thirst, frequent need to urinate,
fatigue, lethargy, severe irritation and itching, excessive
hunger, blurred vision, skin and urinary infections and
vaginitis.
4. Diagnosis
Diabetes or impaired glucose tolerance may be detected on
routine blood tests as part of a general health check up or
investigation for other symptoms or diseases. Diabetes tests
check blood glucose levels.
Fasting blood glucose levels are classified as:
Normal - less than 100 mg/dl
Prediabetes - 100 to 125 mg/dl
Diabetes - greater than 125mg/dl
Because symptoms can be mild, diabetes is often detected
when a person suffers a problem that is caused by diabetes,
such as a heart attack, stroke, neuropathy, poor wound healing
or a foot ulcer, certain eye problems, certain fungal
infections, or delivering a baby with macrosomia or
hypoglycemia.
5. Diabetes
Treatment
Effective treatment endeavors to normalize blood glucose and
reduce complications using insulin replacement, diet and
exercise. For those with very mild diabetes, diet plus weight
loss plus exercise may be enough to keep blood glucose within
reasonable levels.
Dietary changes should focus on the ideas of weight loss and
blood sugar regulation by keeping the blood sugar levels
relatively stable throughout the day, avoiding big peaks or
troughs.
The principal treatment of type 1 diabetes, even from its
earliest stages, is replacement of insulin combined with
careful monitoring of blood glucose levels using blood testing
monitors.
Type 2 diabetes may require oral anti-diabetic drugs to
stimulate the body’s insulin production and increase insulin
sensitivity. Various forms of natural supplements for diabetes
treatment have also been postulated as effective.
New empirical evidence suggests that a
combination of the rather unique LifeWave energy
patches and Y-age patches used as a detoxing regime can have a
major beneficial effect on Diabetes.
People with unstable diabetes, or those requiring many
injections a day, may benefit from an insulin pump which is
worn on the body and delivers a continuous infusion of insulin
via a needle implanted into the body.
Gestational diabetes is fully treatable but requires careful
medical supervision throughout the pregnancy. Even though it
may be transient, untreated gestational diabetes can damage the
health of the fetus or the mother.
Treatment for all forms of diabetes need not significantly
impair normal activities, if sufficient patient training,
awareness, appropriate care, discipline in testing and dosing
of insulin is taken
6. Complications
Diabetes mellitus is the most common cause of adult kidney
failure worldwide in the developed world. If undetected or
poorly controlled, diabetes can lead to blindness, kidney
failure, lower limb amputation, heart attack, stroke and
impotence.