DIABETES MELLITUS

 

INTRODUCTION: Diabetes mellitus is a group of metabolic disorders characterized by elevated levels of blood glucose (hyperglycemia) resulting from defects in insulin secretion, insulin action, or both. INSULIN AS A CHEMICAL OF LIFE  Three major acute complications of diabetes related to short-term imbalances in blood glucose levels are hypoglycemia, diabetic ketoacidosis (DKA), and hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Long-term hyperglycemia may contribute to chronic microvascular complications such as kidney and eye disease, and neuropathic complications. Diabetes is also associated with an increased occurrence of macrovascular diseases, including coronary artery disease (myocardial infarction), cerebrovascular disease (stroke), and peripheral vascular disease. [coronaryartery disease]

TYPES OF DIABETES TYPE 1 (FORMERLY INSULIN-DEPENDENT DIABETES MELLITUS): About 5% to 10% of patients with diabetes have type 1 diabetes. It is characterized by destruction of the pancreatic beta-cells due to genetic, immunologic, and possibly environmental factors. In this medical condition, insulin injections are needed to control the blood glucose levels. Type 1 diabetes has a sudden onset, usually before the age of 30 years.

TYPE 2 (FORMERLY NON–INSULIN-DEPENDENT DIABETES MELLITUS): About 90% to 95% of patients with diabetes have type 2 diabetes. It results from a decreased sensitivity to insulin also known as insulin resistance, or from a decreased amount of insulin production. Type 2 diabetes is first treated with diet and exercise, and then with oral hypoglycemic agents as needed. Type 2 diabetes occurs most frequently in patients older than 30 years and in patients with obesity.

Gestational Diabetes Mellitus: Gestational diabetes is characterized by any degree of glucose intolerance with onset during pregnancy (second or third trimester). Risks for gestational diabetes include marked obesity, a personal history of gestational diabetes, glycosuria, or a strong family history of diabetes. High-risk ethnic groups include Hispanic Americans, Native Americans, Asian Americans, African Americans, and Pacific Islanders. It increases their risk for hypertensive disorders of pregnancy. 

Clinical Manifestations: Polyuria, polydipsia, and polyphagia. Fatigue and weakness, sudden vision changes, tingling or numbness in hands or feet, dry skin, skin lesions or wounds that are slow to heal, and recurrent infections. Onset of type 1 diabetes may be associated with sudden weight loss or nausea, vomiting, or stomach pains. Type 2 diabetes results from a slow (over years), progressive glucose intolerance and results in long-term complications if diabetes goes undetected for many years such as in case of eye disease, peripheral neuropathy, or peripheral vascular disease. Complications may have developed before the actual diagnosis is made.

Signs and symptoms of DKA: These include; abdominal pain, nausea, vomiting, hyperventilation, and a fruity breath odor. Untreated DKA may result in altered level of consciousness, coma, and death.

RELATED;

1.  DRUG ADMINISTRATION TECHNIQUES USED IN MEDICINE  

2.  DIABETES INSPIDUS

3.  INSULIN AND THE HUMAN BODY

4.  MEDICINE AND SURGERY 

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