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Diabetes Information 8.9
Diabetes mellitus (DM), commonly referredtoasdiabetes, is a group of metabolic diseases in which therearehighblood sugar levels over a prolonged period. Symptoms ofhighbloodsugar include frequent urination, increased thirst,andincreasedhunger. If left untreated, diabetes can causemanycomplications.Acute complications include diabeticketoacidosisand nonketotichyperosmolar coma. Serious long-termcomplicationsincludecardiovascular disease, stroke, kidney failure,foot ulcersanddamage to the eyes.Diabetes is due to either the pancreas notproducingenoughinsulin or the cells of the body not respondingproperly totheinsulin produced. There are three main typesofdiabetesmellitus:Type 1 DM results from the body's failure toproduceenoughinsulin. This form was previously referred toas"insulin-dependentdiabetes mellitus" (IDDM) or "juvenilediabetes".The cause isunknown.Type 2 DM begins with insulin resistance, a condition inwhichcellsfail to respond to insulin properly. As thediseaseprogresses alack of insulin may also develop. This formwaspreviously referredto as "non insulin-dependent diabetesmellitus"(NIDDM) or"adult-onset diabetes".Prevention and treatment involves a healthydiet,physicalexercise, not using tobacco and being a normal bodyweight.Bloodpressure control and proper foot care are alsoimportant forpeoplewith the disease. Type 1 diabetes must bemanaged withinsulininjections. Type 2 diabetes may be treated withmedicationswith orwithout insulin. Insulin and some oralmedications can causelowblood sugar. Weight loss surgery in thosewith obesity isaneffective measure in those with type 2 DM.Gestationaldiabetesusually resolves after the birth of thebaby.The classic symptoms of untreated diabetes areweightloss,polyuria (frequent urination), polydipsia (increasedthirst),andpolyphagia (increased hunger). Symptoms may developrapidly(weeksor months) in type 1 diabetes, while they usuallydevelopmuch moreslowly and may be subtle or absent in type 2diabetes.Several other signs and symptoms can mark the onsetofdiabetes,although they are not specific to the disease. Inadditionto theknown ones above, they include blurry vision,headache,fatigue,slow healing of cuts, and itchy skin. Prolongedhigh bloodglucosecan cause glucose absorption in the lens of theeye, whichleads tochanges in its shape, resulting in visionchanges. A numberof skinrashes that can occur in diabetes arecollectively knownasdiabetic dermadromes.People (usually with type 1 diabetes) may alsoexperienceepisodesof diabetic ketoacidosis, a type of metabolicproblemscharacterizedby nausea, vomiting and abdominal pain, thesmell ofacetone on thebreath, deep breathing known as Kussmaulbreathing,and in severecases a decreased level ofconsciousness.A rare but equally severe possibility ishyperosmolarnonketoticstate, which is more common in type 2diabetes and ismainly theresult of dehydration.Type 1 diabetes mellitus is characterized by lossoftheinsulin-producing beta cells of the islets of Langerhansinthepancreas, leading to insulin deficiency. This type canbefurtherclassified as immune-mediated or idiopathic. The majorityoftype 1diabetes is of the immune-mediated nature, inwhichaT-cell-mediated autoimmune attack leads to the loss ofbetacellsand thus insulin. It causes approximately 10% ofdiabetesmellituscases in North America and Europe. Most affectedpeopleareotherwise healthy and of a healthy weight whenonsetoccurs.Sensitivity and responsiveness to insulin areusuallynormal,especially in the early stages. Type 1 diabetes canaffectchildrenor adults, but was traditionally termed "juvenilediabetes"becausea majority of these diabetes cases were inchildren.
