DIABETES

 You know what is meant by diabetes mellitus? Diabetes mellitus is derived from the Greek word diabetes meaning siphon – to pass through and the Latin word mellitus meaning honeyed or sweet.

Diabetes is a chronic disease marked by high levels of sugar in the blood. Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. The pancreas does not make enough insulin.The muscle, fat, and liver cells do not respond to insulin normally. 

Types Of Diabetes           

There are  three main types of diabetes-

  • Type 1 diabetes
  • Type 2 diabetes
  • Gestational diabetes

CAUSES—

Type 1 IDDM—

  1.  Type 1 diabetes is usually a progressive autoimmune disease, in which the beta cells that produce insulin are slowly destroyed by the body’s own immune system.               
  • Genetics

                       At least 18 genetic locations, labeled IDDM1 – IDDM18, are related

  • Viral infections

                        Enteric viruses- Coxsackie viruses ;mumps and congenital rubella                                    

  • Age

                        Appears between infancy and the late 30s, most typically in childhood or adolescence

  • Race

                 Found among Caucasian youth

  • Early infancy illness
  • Diabetic father
  • Mother age>30 years
  • Mother having pre-eclampsia during pregnancy
  • Autoimmune disorders

                                     Grave’s disease, Hashimoto’s, thyroiditis, Addison’s disease, Multiple sclerosis, or Pernicious anemia

 

CAUSES

Type 2 NIDDM 

                  Type 2 diabetes is caused by insulin resistance, in which the body does not properly use insulin.

  • Genetic—

Genetic mutations likely affect parts of the insulin gene and various other physiologic components involved in the regulation of blood sugar.

  • Poor diet–

Diets high in refined foods and sweets

low in fresh fruits, vegetables, whole grains, and lean protein

  • Sedentary lifestyle
  • Overweight or obese
  • Old age–

               Diabetes is more common in people age 50 or older

  • High alcohol intake
  • Race–

                    African- American, Hispanic/Latin American, American-Indian, Alaska Native, Asian-American.

  • High blood pressure
  • Gestational diabetes
  • Baby birth weight> 9 pounds
  • Polycystic ovary syndrome
  • Acanthosis nigricans (dark, thickened skin around neck or armpits)
  • Blood vessels diseases
  • Depression

                       Severe clinical depression may modestly increase the risk for type 2 diabetes.            

  • Schizophrenia.

Symptoms And Signs

A.   IDDM(type1)

  1. Being very thirsty
  2. Deep, rapid breathing
  3. Dry skin and mouth
  4. Feeling hungry
  5. Feeling tingling in feet
  6. Feeling tired
  7. Flushed face
  8. Fruity breath odor
  9. Having blurry eyesight
  10. Increased urination
  11. Losing weight without trying
  12. Nausea or vomiting
  13. Stomach pain

B.  NIDDM(TypeII)

  1. Acanthosis, characterized by velvety, dark colored patches of skin
  2. Blurred vision
  3. Erectile dysfunction in men
  4. Excessive thirst
  5. Fatigue
  6. Increased urination
  7. Itching
  8. Severe gum problems
  9. Unusual sensations(tingling or burning, in the extremities)
  10. Vaginal yeast/ fungal infections under the breasts/in groin in women
  11. Weight gain in children   
  12. Weight loss in adults

Investigations–

  1. FBS
  2. RBS
  3. Glycosylated hemoglobin or hemoglobin A1c
  4. Oral glucose tolerance test
  5. Urine c/e —especially for ketone bodies.

Treatment—

 

 A. Type 1 diabetes

1. Medicines
2. Eating a consistent, healthy diet according to weight and size

B. Type 2 diabetes 

1. Lose weight, if obese and begin an exercise program.
2. Oral medication
3. Eat a healthy diet
4. Engage in moderate physical activity

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