Biolife Focus: Diabetes

Diabetes mellitus is a group of metabolic disease in which defects in insulin secretion or action result in elevated blood glucose.   Simply put diabetes can be described as a problem with your body that causes your blood glucose (sugar) levels to rise higher than normal. This is also termed hyperglycemia. There are two types of diabetes mellitus namely Type 1 and Type 2.  

Type 1 diabetes (formerly called juvenile-diabetes, insulin dependent diabetes mellitus, or IDDM) is caused by destruction of the beta cells in the islets of Langerhans of the pancreas. When the beta cells are destroyed they are unable to produce insulin. Insulin must be injected for the body to use food for energy.  Only about 5% of persons with diabetes have Type 1 diabetes.  This type of diabetes is usually diagnosed in children and young adults. Type 2 diabetes is the most common form of diabetes (formerly called adults-onset diabetes, or NIDDM).  In this case the body does not use insulin properly also referred to as insulin resistance.  Insulin is still made by the pancreas but in inadequate amounts. Sometimes the amount of insulin is normal or even high, but because the tissues are resistant to it, hyperglycemia result.  As the pancreas eventually wear out insulin production decreases.  When this occurs the patient will likely require insulin injections.

Research has shown that heredity is responsible for up to 90% of the cases of Type 2 Diabetes.  Obesity is also a major contribution factor, along with lifestyle issues. Often the patient with a new diagnosis of Type 2 Diabetes is obese, relates with a family history of diabetes, and has had a recent life changing incident such as the death of a family member, illness, loss of a job or some other incident to cause undue stress.

 

The Signs and Symptoms

Some of the symptoms of diabetes are fairly typical; however some persons with Type 2 diabetes have symptoms so mild it may go undetected for a while. Common symptoms include excessive thirst (polydipsia), excessive urination (polyuria) and excessive hunger (polyphagia). The large amount of glucose in the blood also causes an increase in serum concentration, or osmolality.  High blood glucose levels can also cause symptoms of fatigue, blurred vision, abdominal pain, and headaches. Patients suffering from diabetes will also notice that cuts and wounds take longer to heal. There are also in some cases noticeably weight loss although the individual is eating more (Type 1 Diabetes) and tingling, pain or numbness in the hands and feet (Type 2 Diabetes).

Diagnostic Tests

There are several ways to test if you may be suffering from diabetes and these are best administered by a health care provider. Tests include:

Fasting Plasma Glucose level:  This is based on plasma glucose levels measured by a laboratory.  A normal plasma glucose level is less than 100mg/dl.  When the fasting plasma glucose drawn after at least 8 hours without eating is 126mg/dl or greater, diabetes is diagnosed.

Random Plasma Glucose:  Is checked without regard to the last meal. Diabetes is diagnosed if the RPG is 200mg/dl or greater, with symptoms of diabetes.

Oral Glucose Tolerance Test:  It measures blood glucose at intervals after the patient drinks a concentrated carbohydrate drink. Diabetes is diagnosed when the blood glucose level is 200mg/dl or greater after 2 hours.  A result between 140 and 199 mg/dl at 2 hours leads to a diagnosis of impaired glucose tolerance and prediabetes.

Glycohemoglobin: Is used to gather baseline data and to monitor the progress of diabetes control. Glucose in the blood attaches to hemoglobin in the red blood cells, which live about 3 months. 

Additional Tests:   Diabetes affects so many body systems so baseline data include a lipid profile, serum creatinine, urine microalbumin levels to monitor kidney function, urinalysis, and electrocardiogram.

Treatment/Prevention

Diabetes is a serious illness and as such is not something one should aim to treat on their own. While there are no cures your doctor or health care provider are the best ones to assist you in the necessary treatment plan as best suits the type of diabetes you are suffering from. Diabetes affects the entire system and it is best to seek professional help. It is imperative that a healthy watch is maintained on a patients’ blood sugar level, with a combination of medications, exercise and diet.

One of the main treatments for Type 1 diabetes is insulin which helps to control blood sugar. This is usually taken in an injection format. Type 2 diabetes usually requires following a diet and exercise program along with using oral drugs and insulin. It is very important that diabetics eat a balanced diet. Patients may also discuss the best forms of exercise to do. Research shows that exercise helps some persons with Type 2 diabetes lower their blood glucose level. Exercise is also beneficial in helping to lower the chance of having a heart attack and stroke and also improve circulation it also assists those who are trying to lose weight.

Most diabetics are also encouraged to take care of their eyes and their feet as having diabetes makes them more susceptible to blindness and because of the numbness which may be experienced in the feet they may not be aware of wounds received until it is too late. As there is no cure for diabetes it is best to try prevention of the disease.  The same basic principles that is followed to treat the disease may be followed to prevent it by maintaining a balanced diet, exercising and getting regular checkup from your health care provider who will be able to help you identify if you are showing any signs or symptoms of the disease. Statistics have shown that about a third of all persons with diabetes are not aware that they have the disease.

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