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Am Diabetes Mellitus

Diabetes Mellitus

Diabetes mellitus is the metabolic disorder characterized by high blood glucose (sugar) level caused by decreased produce of insulin from pancreas or due to diminished effectiveness of insulin to the body (insulin resistance). Diabetes is the most common disease. According to American diabetes association prevalence of diabetes on 2011 Jan 26, 25.8 million adults and children in the united stated which is 8.3% of the total population have diabetes. Diabetes can’t not be cured but can control effectively.

What are the Types of Diabetes Mellitus?

  1. Type1 diabetes mellitus: This is also known as insulin-dependent diabetes or childhood-onset diabetes due to decreased or lack of insulin production. Type 1 DM is mostly occur in young, usually before 30 years of old but occasion older patients also present with this from which is called as latent autoimmune diabetes in adults (LADA)
  2. Type2 diabetes mellitus: This is also known as non-insulin dependent diabetes or adult onset diabetes mellitus (AODM) due to decreased effectiveness of insulin to the body often from overweight and decreased physical activity.
  3. Gestational diabetes: Excessive blood glucose levels first recognized during pregnancy.

What are the risk factors for diabetes Mellitus?

A) Risk factors for type 1 diabetes mellitus include:

  1. Family history (risk factors increase if parent or siblings have type 1 diabetes mellitus)
  2. Autoimmune disease
  3. Viral infection
  4. Low vitamin D consumption

B) Risk factors for type 2 diabetes mellitus include:

  1. Overweight or obese people: Insulin is resistance to fatty cells.
  2. Inactivity: Exercise increases the uptake of insulin to the cells.
  3. Family history
  4. Age: Older age increases the risk of type 2 diabetes mellitus
  5. Polycystic ovary syndrome
  6. Hypertension patients
  7. High cholesterol and triglycerides levels

C) Risk factors for gestational diabetes mellitus:

  1. Baby weight more than 4 kg
  2. Women older than 25 years old
  3. Polyhydramnios
  4. Twins
  5. Preeclampsia, eclampsia and HEELP syndrome
  6. Family history of gestational diabetes

What are the symptoms and signs of diabetes mellitus?

  1. Increased thirst (polydipsia)
  2. Increased urination (polyuria)
  3. Excessive eating (polyphagia)
  4. Unexplained weight loss
  5. Fatigue (tired easily)
  6. Blurred vision
  7. Poor wound healing
  8. Easily get infection
  9. Altered mental status

What are the complications of diabetes mellitus?

A) Early complications:

  1. Diabetes Ketoacidosis
  2. Hyperosmolar Non-Ketotic Coma (HONK)
  3. Low blood glucose level( hypoglycemia)

B) Chronic complications:

  1. Neuropathy (never damage)
  2. Diabetes retinopathy (Damage the blood vessels of the retina)
  3. Diabetes Nephropathy (Kidney damage)
  4. Diabetes foot and foot ulcer
  5. Increased risk of heart attack, stoke and angina pectoris
  6. Mouth and skin infection
  7. Alzheimer’s disease
  8. Excessive growth of baby, low blood sugar in baby, Respiratory distress syndrome, and neonatal jaundice are the complications in gestational diabetes.

How is diabetes mellitus diagnosed?

A) Diagnosis of Type 1 and type 2 diabetes mellitus relies on clinical features and laboratory tests:

  1. Increased glycated hemoglobin (A1C) test (normal level is less than 6.5 present)
  2. Random blood glucose test more or equal than 200mg/dL (11.1mmol/L)
  3. Fasting plasma glucose level is more or equal to 126 mg/dL (7.0 mmol/L)
  4. Urine blood sugar more than 15mg/dL (0.8mmol/L)

Diagnostic criteria diabetes mellitus according to WHO is:

  1. Symptoms of diabetes plus random glucoses level is more or equal to 200mg/dL (11.1mmol/L) or
  2. Fasting plasma glucose level is more or equal to 126 mg/dL (7.0 mmol/L) or
  3. two hour postprandial glucose level is more or equal to 200mg/dL (11.1mmol/L) after taking 75g glucose load.

B) Diagnosis of gestational diabetes rely on laboratory tests which include:

  1. Abnormal glucose challenge test
  2. Random blood glucose test more or equal than 200mg/dL (11.1mmol/L)
  3. Fasting plasma glucose level is more or equal to 126 mg/dL (7.0 mmol/L)

How is diabetes mellitus managed?

The aims of treatment are to control the blood glucose and avoidance of the complications which include:

A) Diet and life style change:

  1. Regular exercise: Everyone needs regular exercise .Exercise increases the insulin sensitivity leads to increase the transport of sugar into cells results in low blood glucose level.
  2. Healthy eating: There is no any hard and fast rule for diabetes diet. Take a lot of fruits, vegetables and grains. Take food which have low fat and calories and have high in nutrition’s. Consult dietitian for create meal plan that fit on patients health.
  3. Take diabetes education classes
  4. Regular visit to physician
  5. Avoid alcohol intake
  6. Stop smoking
  7. Foot care
  8. Monitoring blood glucose regularly
  9. Take care of gums and teeth
  10. Regular eye check up at least one in a year
  11. Always take sweats on you pocket

B) Medical management of diabetes mellitus:

  1. Insulin: Anyone who has type 1 diabetes and some patients of type 2 diabetes who is not responding in oral hypoglycemic medication needs insulin therapy.
  2. Oral hypoglycemic medication is used for type 2 diabetes mellitus, drugs include:
  3. Sulfonylureas: Increase stimulation of insulin from pancreas
  4. Biguanides (metformin): It is the first line dugs for obese diabetes patients. This drug decreases the amount of glucose produced by the liver.
  5. Thiazolidinediones: Increase sensitivity to insulin in the body.
  6. Alpha-glucosidase inhibitors: Slow absorption of glucose from the intestine.
  7. Meglitinides: This drug increase stimulation of insulin from pancreas
  8. D-phenylalanine derivatives: Increases stimulation of insulin from pancreas
  9. Sometimes beta cell transplant may help in type1 diabetes patients.

C) Management of gestational diabetes mellitus includes:

  1. Regular blood glucose monitor
  2. Insulin: gestational diabetes mellitus patients need insulin to control high blood level.

What is the prognosis of diabetes mellitus?

Diabetes mellitus can not be cured but with proper management it may control the blood glucose level and avoidance of the complications. Prognosis also depends upon the type of diabetes mellitus, level of blood glucose and present of complications




This blog post was originally published by, written by, and first published on Oct 20, 2011.

This post contains the opinions of the author. Autoimmune Association is not a medical practice and does not provide medical advice, diagnosis, or treatment. It is your responsibility to seek diagnosis, treatment, and advice from qualified providers based on your condition and particular circumstances. Autoimmune Association does not endorse nor recommend any products, practices, treatment methods, tests, physicians, service providers, procedures, clinical trials, opinions or information available on this website. Your use of the website is subject to our Privacy Policy.

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