Diabetes mellitus : Causes, Symptoms, Classification

Meaning of Diabetes

“Diabetes  is one of the chronic hormonal disorder in which the imbalance between the insulin secretion by the pancreas and glucose utilization by the body cells”.

As a metabolic disorder it has affected the millions of people entire the world. If once an individual got the diabetes  it is highly difficult to cure it completely but it can be managed effectively.

The pancreas secretes an hormone called insulin. And the glucose is obtained to the body by means of ingested food. the insulin helps in transport of glucose to the tissues.and it also helps in the utilization of glucose by the cells.

Concept of Diabetes

If the insulin secretion is decreased or the tissues are resistant to the insulin i.e. the tissues won’t utilize the insulin. In this condition there is an increased amount of glucose in the body, is known as hyperglycemia. it is the foremost symptom of diabetes .

Classification of Diabetes

On the basis of its nature diabetes  is classified as follows.

1. Type 1 diabetes 
: it is usually seen in children or in younger ones. in this type the insulin secretion is less than normal. Due to the decreased pancreatic insulin secretion, the glucose is not utilized by the body.the replacement of insulin is the treatment for this type.Type 1 diabetes  is seen in hereditary cases. if once it diagnosed life long therapy should be taken.

2.Type 2 diabetes : it is usually seen in adults. in this type there is a normal insulin production but the the tissues are resistant. the deficient uptake of insulin by the tissues leads to increased level of glucose in the blood. the type 2 usually occurs in obese persons. the oral hypoglycemic agents are used as treatment. it can be controlled effectively by medications,exercise, diet and other life style modifications.

3. Gestational diabetes : it occurs in pregnant women. with effective treatment it disappears after the child birth.

Causes of Diabetes

1. Hereditary causes

2. Obesity

3. Increased glyceride level

4. Increased cholesterol in body

5. Pancreatic disease

6. Sedentary life style

7. Sever mental stress

8. Idiopathic i.e. unknown.

Symptoms or signs of Type 1 DIABETES

1. THIRST : is due to increased glucose level in blood draws the water from the tissues. the tissues hydro insufficiency leads to thirst.

2. POLY UREA :when the person drinks the excess of water to compensate thirst, it leads to excess of urine output.

3. FATIGUE :
 IS DUE TO LESS INTAKE OF GLUCOSE BY THE TISSUES.

4. POLY PHAGIA : when the tissues doesn’t get sufficient energy, the person eats more.

5. GLUCOSE UREA : the excess of glucose in the blood is passed in the form of urine.

6. NAUSEA AND VOMITING : due to altered metabolism.

7. DEFICIENT HEALING OF WOUNDS : is due to lack of insulin, which helps in healing process.

Childhood diabetes : causes, types, symptoms of children diabetes

Childhood diabetes

Diabetes can affect individuals irrespective of age, sex, or race. Type 1 Diabetes is the  common type of childhood diabetes. Statistics shows that 90 percent of the children (under the age 16) are affected with Type 1 Diabetes. Type 1 Diabetes in children or childhood diabetes is caused because of pancreatic  inability to produce insulin.

The  rate of beta cell ( Pancreatic cells) destruction in type 1 diabetes is rapid in  infants and children and slow in  older adolescents and adults. ketoacidosis as the first indication of type 1 diabetes is present in both children and adolescents. signs of diabetes in children are  post-meal hyperglycemia, fasting hyperglycemia that rapidly develops to severe hyperglycemia. Main signs of diabetes in children includes  ketoacidosis in the presence of any infection in body.



Causes of childhood Diabetes

cause of type-1 diabetes

Type 1 diabetes in children is caused by immune destruction of the insulin-producing beta cells of pancreas.Production of antibodies against proteins in the islets cells of pancreas is found in children. But in  adolescents, antibodies are produced before some months of onset of diabetes.

The presence of antibodies against proteins of islets such as GAD-65, ICA, IAA and IA-2, have formed the basis for trials and easy to predict who will develop type 1 diabetes. Children with high titer auto immune antibodies and those with more than one antibody are more prone to develop type 1 diabetes.

In addition, young age and being a first degree relative of someone with type 1 diabetes place children at high risk. In general, 70 percent of people with new-onset diabetes will have a positive antibody if only one antibody is tested, whereas 90 percent will have at least one antibody when all four are measured.

cause of type-2 diabetes

Cause of  type 2 diabetes in children and adolescents is because of  obesity or overweight, insulin resistance, and  a family history of type 2 diabetes, are important causes of type 2 children diabetes. Diabetes blood sugar  balance is important to prevent hyperglycemia or increased glucose level.

Childhood diabetes effects normal life of growing children. Some children becomes dull and looks depressed. Dullness and in activeness in children are important signs of diabetes in children.

Cause of diabetes in children are different. Cause of Type 1 diabetes in children  is because of pancreatic abnormality to produce insulin. Cause of type 2 diabetes in children are obesity, family history of diabetes, etc.

Children diabetes diagnosis is very important to start treatment to prevent complications. childhood diabetes onset is not found exactly as the symptoms seen later. Childhood diabetes risk is high to child as the childhood is the growing period. Improper health care and failure to maintain diabetes blood sugar leads to worsened symptoms and complications.

Symptoms of diabetes

More or less symptoms of children diabetes are similar to that of symptoms of diabetes in adults. Most of children are asymptomatic to some years and diagnosing diabetes in children is very critical and important.

The symptoms of childhood diabetes include

  • frequent urination and Increased thirst
  • extreme hunger
  • unusual weight loss
  • irritability
  • repeated infections
  • slow healing of wounds
  • bruises under skin
  • numbness in hand’s and feet
  • tiredness
  • behavioral problems
  • headache increases with mild work also,
  • tummy pains etc

Facts about childhood diabetes

  • Avoid children to become obese as it helps in prevention of type 2 diabetes.
  • Type 1 diabetes in children is common and appropriate insulin administration to maintain diabetes blood glucose in normal range is important.
  • Insulin administration to treat type diabetes should be taught to parents and to grown up children also.
  • Diabetes children may oppose to get injected regularly. Motivation by the parents and health education by the health care member should be given to child.
  • Presence of HLA genes is found in nearly 70 % of type 1 diabetes affected children.
  • Childhood diabetes should be well treated for the better health of child.
  • Follow up medical care and administer medications regularly.

Diabetes symptoms : Type 1 and Type 2 Diabetes symptoms

Diabetes symptoms

Diabetes has affected the millions of people world wide. The main types of diabetes are type 1 and type 2 diabetes mellitus. Both types of diabetes have the same diabetes symptoms. The main symptom of diabetes is imbalanced blood sugar level. Hyperglycemia is the main diabetes symptoms and others are as follows. The diabetes symptoms  are because of poor insulin production or insulin resistance by the peripheral tissues.

Type 1 Diabetes symptoms

In type 1 diabetes,  pancreas is unable to produce sufficient insulin due to autoimmune disorder or viral damage of pancreas. The insulin has the function of converting excess glucose in the blood into glycogen. The decreased insulin level in the body fails to convert glucose into glycogen, and leads to hyperglycemia, is the main diabetes symptoms. when glucose level is less in the body, the fat is broken down excess to produce energy. This  leads to formation of ketone bodies. Excess ketone bodies causes ketoacidosis is another symptoms of diabetes. Dehydration is seen due to electrolyte disturbance. Severe hyperglycemia may lead to coma and death.

Type 2 Diabetes symptoms

Polyuria

Increase in urine production and eliminating excess urine is an important diabetes symptoms. Polyuria leads to  dehydration because both sugar and  a large amount of water from body is also excreted out.

Polydipsia

The person feels frequently drinking water. The increased glucose in blood stimulates central nervous system to provoke thirst.

Polyphagia 

The hormone insulin has a role of stimulating hunger. when blood  sugar level is high  in blood, body produces insulin to maintain homeostasis, this leads to increased hunger by a diabetes patient. Polyphagia is the common one among diabetes symptoms.

Fatigue

When there is no adequate glucose supply to the cells, stored fat of body is metabolized to gain energy. When fat is broken down in the body, excess calorie is burned and it leads to fatigue.

Weight loss

The diabetes symptoms such as glycosuria, polyphagia, polyuria, and excess fat metabolism in body  leads to weight loss. Some individuals will gain weight because of increased appetite.

Blurred vision

Hyperosmolar hyperglycemia nonketotic syndrome occurs when body fluid is pulled out of tissues. Due to hyperglycemia the  fluid inside eye lenses is also pulled out,  and weak ability of lens to focus, results in  blurred vision.

Neuritis

The inadequate blood supply to peripheral parts of the body causes peripheral neuritis, characterized by itching and burning pain in sole, etc..

Poor wound healing

 Increased  blood sugar resists the well development of WBC, (white blood cell) which provides immunity to our body. When WBC cells do not function effectively, wound healing is failed or becomes poor. Another cause of poor wound healing is thickened blood vessels  because of prolonged untreated diabetes. This diabetes symptoms may lead to gangrene formation of infected wound.

These are the main diabetes symptoms. The diabetes symptoms should be treated before the disease becomes complicated.

Diabetes : Type 2 diabetes Treatment, Diabetes diet

Diabetes Mellitus

Diabetes Mellitus is a multi system disease related to abnormal insulin production, impaired insulin utilization, or both. It is a serious health problem throughout the world. Factors that cause diabetes mellitus are as follows: age, hereditary, nutrition, pancreatic disorders etc. Diabetes insipidus and diabetes mellitus are the two types of diabetes and diabetes treatment has lesson the symptoms and relieved from developing complications.

Diabetes Treatment

1) Nutritional Therapy

 Nutritional therapy is the most important step to treat Diabetes Mellitus. The measure steps involved in nutritional therapy is to avoiding high sugar containing foods.

Nutritional therapy For Type-1 Diabetes Treatment

  • Calories- to decrease the body weight and restoring the body tissues help in achieving sugar level in control in diabetes patients.
  • Diet and insulin therapy both helps in the control of blood sugar in diabetes patients.
  • Avoid over intake of glucose by diabetes individual.
  • Flexibility should be avoided in the insulin treatment for diabetes treatment.
  • Moderate physical activities along with the 20 g/hr of Carbohydrates should be maintained for diabetes treatment.
  • Should include more intake of green leafy vegetables in their daily meals and fruits that have low sugar content should be taken.

Nutritional therapy for type 2 diabetes

  • Caloric intake should be reduced in over weight or obese patients, as an effective diabetes treatment.
  • Diet alone can sufficiently control blood glucose level.
  • Weight should be reduced to prevent development of Diabetes for success of diabetes treatment.
  • Avoid bed time snacks.
  • If the patient is in insulin or sulfonylureas diabetes treatment, it is necessary to be in nutritional supplement for exercise programs.
  • Alcohol should be avoided because it is high in calories, has no nutritive value, and alcohol also promotes hypertriglyceridemia.
  • High fat contained foods are strictly avoided.
  • More carbohydrate foods should be included in diet along with the protein and very less fat in food.
  • Carbohydrates decreases the absorption of other foods, hence prevent the hyperglycemic state in the patient.
  • High fiber diet decreases the fat absorption in the gastrointestinal track.
  • Artificial sweeteners should be avoided and all above are the nutritional diabetes treatment methods.

2) EXERCISE -Diabetes treatment 

Exercise decreases the blood glucose level by, increasing the glucose uptake by the body muscles and improving the utilization of the insulin by the body tissues. And also decreases the cardiovascular risk factors, by maintaining the balance in the blood i.e, exercise increases the high-density lipoproteins and decreases the amount of low-density lipoprotein in the blood, and hence it alter the blood lipid level. So exercise is an effective method of diabetes treatment. Exercise also improves the feeling of well being and reduces the emotional stress in diabetic patient.

Exercise should be done preferably at the same time daily and in the same amount each day. Walking is safe and beneficial form of exercise in most of the patient as diabetes treatment and it does not require any special precautions to be taken. It is important to increase the exercise gradually is recommended. Vigorous exercises in diabetes treatment is avoided because it is not safe, vigorous exercise increases the blood glucose rapidly, that may lead to diabetes complication. It is better to the exercises after having meals, when the blood glucose rises. It is also important to monitor the blood glucose level during and as well after and before the exercise you begin. Exercises  are best diabetes treatment method.

  • A precaution that to be taken in exercise therapy for diabetes treatment includes
  • Appropriate use of foot wears and other protective equipments.
  • Exercise should be avoided in an extreme heat or cold.
  • Daily inspection of feet is done by diabetic patient during diabetes treatment.
  • Exercise should be avoided during the periods of metabolic rate, for diabetes treatment.

3) Pharmacological therapy – Diabetes treatment

Insulin therapy: insulin is a hormone secreted by the pancreas, which maintain the normal blood glucose level by increasing glucose transport and glucose absorption by the body tissues. Insulin is available in various forms for example Humulin R. lispro, linte, glargine, NPH etc. Insulin therapy is the effective diabetes treatment.

Types of Insulin for diabetes treatment

Short acting insulin. Eg- regular (Humulin R, Novoli N)
Long acting insulin. Eg- Ultralintel (Humilin U).
Combination therapy. Eg- NPH/regular 50/50 (Humulin 50/50).
Rapidly acting insulin. Eg- Lispro (Humalog), Aspart (Novolog).

Drug Therapy for Diabetes treatment

Sulfonylureas : Since 1950 these are widely used anti diabetic drugs. Sulfonylureas are of 2 types’ first generation and second generation are commonly used drugs for diabetes treatment. Eg-Orinase, Dymelor.

Maglitinides : These drugs increase insulin production from the pancreas. And before administration of maglitinides the patient should be advised to take it 30 min before each meal for successful diabetes treatment.

Biguanides : These primarily action of these drugs include, these drugs reduce glucose production by the liver, and it also enhance the insulin sensitivity at the tissue level. Eg- Metformin, Glucovance.

Alfa Glucosidase inhibitors: Also known as “stomach blocker”. These work by slowing down the absorption of carbohydrate in the small intestine. These taken with the first bite of each meal, they are more effective in lowering post-prandial blood glucose in diabetes treatment.  Eg- Glyset, Precose.

Thiazolidinediones: “insulin sensitizers”. Eg- Pioglitazone (Actos). Rosiglitol (Glyset). Other drugs used for diabetes treatment which affects Blood Glucose Levels are : these drugs involve both Glucose-Lowering effect ( acetaminophen, allopurinol, Biguanides) and Glucose-Raising Effect (acetazolamide, Alcohol, Arginine etc)

4) Monitoring of Blood Glucose for diabetes treatment  

It is the self monitoring of the glucose in the urine. This procedure was used  in the past. The draw back of this diabetes treatment is, it does not provide current blood glucose level.In the hospital portable glucose meters are used to check the blood glucose level. This gives more quick results, hence it is most preferably used in the hospitals for diabetes treatment.

5) Pancreas Transplantation for diabetes treatment

: This procedure for diabetes treatment is used as the treatment of the option for patients with types I diabetes mellitus. Who have end-stage renal disease.

Indication for the patients who do not have renal failure : a history of frequent, acute, and severe metabolic complications. Eg- Hypoglycemia, Hyperglycemia, Ketoacidosis.
Clinical and emotional problem with exogenous insulin therapy those are as severe as to be incapacitating.
Consistent failure of insulin-based management to prevent acute complications.