Diabetes Milletus, Its Complications and Preventions

 

Diabetes Milletus 

Introduction:

Millions of individuals throughout the world suffer with diabetes, also known as diabetes mellitus, which is a chronic metabolic illness. It happens when the body is unable to properly control blood glucose levels. In-depth information about diabetes mellitus, including its definition, causes, types, stages, symptoms, diagnostic standards, research, and treatment choices, will be provided in this blog.

Definition of Diabetes Mellitus:

Diabetes Mellitus is a condition characterized by high blood sugar levels resulting from inadequate insulin production, impaired insulin action, or both. Insulin is a hormone produced by the pancreas that regulates the absorption and utilization of glucose in the body.

Causes of Diabetes Mellitus:

The emergence of diabetes mellitus is influenced by a number of factors, including:

In Type 1 Diabetes: This is an autoimmune disease in which the immune system unintentionally targets and kills the pancreatic cells that make insulin.

In Type 2 Diabetes: This kind often consists of both decreased insulin production and insulin resistance (cells that are less sensitive to insulin).

In Gestational Diabetes: This condition develops during pregnancy as a result of hormonal changes that impair insulin function and raise blood sugar levels.

Various drugs, endocrine abnormalities, genetic illnesses, pancreatic diseases, and other less frequent reasons are also possible.

Types of Diabetes Mellitus:

1. Type 1 Diabetes: This type requires lifelong insulin therapy since the pancreas generates little or no insulin. This type is typically discovered in infancy or adolescence.
2. Type 2 Diabetes: This kind makes up the majority of cases of diabetes and is typically brought on by lifestyle choices like obesity, inactivity, and poor eating patterns.
3. Gestational Diabetes, which normally goes away after childbirth and develops throughout pregnancy. However, women who have gestational diabetes are more likely to go on to acquire type 2 diabetes in the future.

Stages of Diabetes Mellitus:

Diabetes mellitus can progress through various stages:

1. Pre-diabetes: Blood sugar levels are above average but not high enough to be classified as diabetes. Without treatment, type 2 diabetes can develop from pre-diabetes.
2. Early-stage diabetes: Although there are elevated blood sugar levels at this stage, there may be minimal or no symptoms.
3. Advanced-stage diabetes: If blood sugar levels are not controlled, symptoms worsen and blood sugar levels stay continuously high.

Signs & Symptoms of Diabetes Mellitus:

Common signs and symptoms of diabetes mellitus include:

• Increased thirst and frequent urination
• Unexplained weight loss or weight gain
• Fatigue and weakness
• Blurred vision
• Slow wound healing
• Recurring infections, particularly urinary and skin infections

Types of complications of diabetes mellitus

Numerous problems that impact numerous human organs and systems might result from diabetes mellitus. There are two basic categories of problems:

1. Acute Complications:

• Diabetic Ketoacidosis (DKA): People with type 1 diabetes are more likely to experience this potentially fatal disease when there is a severe insulin shortage. It causes a buildup of ketones in the blood, which makes the environment more acidic.
• Hyperosmolar Hyperglycemic State (HHS): People with type 2 diabetes are frequently affected by this ailment, which is typically brought on by persistently high blood sugar levels. High blood osmolality and severe dehydration are the results.

2. Chronic Complications:

• Cardiovascular Complications: This covers peripheral artery disease, heart attack, coronary artery disease, and stroke.
• Neuropathy: Peripheral neuropathy (affects the feet and legs), autonomic neuropathy (affects internal organs and automatic activities), and focal neuropathy (affects specific nerves, frequently producing acute pain or paralysis) can all result from diabetes-related nerve damage.
• Nephropathy: It is a chronic disorder that can result in kidney failure and is also referred to as diabetic kidney disease.
• Retinopathy: Diabetic retinopathy, which can damage retinal blood vessels as a result of diabetes and cause blindness, can impair vision.
• Foot Complications: Diabetes can increase the risk of foot ulcers, infections, and amputation by causing poor circulation and nerve damage in the feet.
• Skin Complications: Dryness, itching, bacterial and fungal infections, and sluggish wound healing are among side effects of diabetes that can damage the skin.
• Sexual Dysfunction: Diabetes can be a factor in both male and female sexual dysfunction, including erectile dysfunction in males and decreased arousal and lubrication in women.
• Dental Complications: Diabetes can increase the risk of oral health problems such tooth decay and gum disease.
• Gastroparesis: Due to nerve injury, this illness results in a delayed stomach emptying, which causes digestive issues.
• Increased Susceptibility to Infections: Diabetes can impair immune function, increasing vulnerability to infections, including skin, fungal, and urinary tract infections.

It's crucial to remember that not everyone with diabetes will develop every one of these issues. Complication risk and severity might vary depending on things including blood sugar control, how long a person has had diabetes, general health, and lifestyle choices. Effectively controlling diabetes and upholding a healthy lifestyle can help lower the risk and postpone the onset of these problems. Diabetes-related problems must be prevented and managed through proactive blood pressure, cholesterol, and blood sugar management.

 

Diagnostic Criteria for Diabetes Mellitus:

The following criteria are used to determine a diabetes mellitus diagnosis:

1. Fasting Plasma Glucose (FPG) Test: a blood test that examines blood glucose levels after an overnight fast.
2. Oral Glucose Tolerance Test (OGTT): In this test, blood glucose levels are measured both before and after eating a beverage high in glucose.
3. Glycated Hemoglobin (A1C) Test: An average blood glucose level over the previous few months is provided by this test.

Investigations for Diabetes Mellitus:

To evaluate the general state of health and diabetes-related problems, additional research might be done, including:

• Lipid profile: to assess triglyceride and cholesterol levels.
• Kidney function tests: evaluating kidney health and identifying any harm.
• Eye examination: to identify any diabetic retinopathy or other issues relating to the eyes.

Treatment of Diabetes Mellitus:

The goal of diabetes treatment is to control blood sugar levels and avoid complications. Typically, it entails:

1. Lifestyle Modifications: A balanced diet, consistent exercise, weight management, and stress management are all part of this.
2. Oral Medications: Oral medicines may be administered for people with type 2 diabetes to improve insulin action or boost insulin synthesis.
3. Insulin Therapy: Some people with type 2 diabetes and those with type 1 may need to use an insulin pump or receive insulin injections.
4. Continuous Glucose Monitoring (CGM): Real-time glucose readings from Continuous Glucose Monitoring (CGM) devices enable people to successfully monitor and control their blood sugar levels.

Preventions Of Diabetes mellitus

A combination of risk factor control and lifestyle changes can prevent diabetes mellitus. While some forms of diabetes, such as Type 1 diabetes, cannot be prevented, practising the following techniques can frequently delay or prevent Type 2 diabetes:

Healthy Eating:

• Pick a diet that is well-balanced and full of fresh produce, whole grains, lean meats, and healthy fats.
• Limit your intake of processed foods, foods heavy in saturated and trans fats, and sugary foods and drinks.
• Limit your portion sizes and eat mindfully.

Regular Physical Activity:

• Regularly work out, aiming for 150 minutes or more of aerobic activity at a moderate intensity per week.
• Include weight-lifting activities to increase your muscular mass.
• Integrate movement into daily activities to stay active all day long.

Weight Management:

• By reaching and keeping a Body Mass Index (BMI) within the normal range (18.5 – 24.0), one can maintain a healthy body weight.
• If you are overweight or obese, try to lose weight gradually by reducing your calorie intake, getting more exercise, and altering your behaviour..

Avoid Sedentary Lifestyle:

• Limit sedentary activities like extended periods of sitting or screen usage.
• Every 30 minutes, take a break from sitting and engage in some light exercise.

Blood Pressure Management:

• Regularly check your blood pressure and make an effort to keep it within a healthy range (normally less than 120/80 mmHg).
• Reduce alcohol consumption, eat low in salt, and get regular exercise to control blood pressure.

Healthy Blood Lipid Levels:

• Keep an eye on your triglyceride and cholesterol levels in the blood.
• Eat a diet that is high in unsaturated fats and low in saturated and trans fats.
• To control lipid levels, exercise frequently and keep a healthy weight.

Avoid Tobacco Use:

• Use no tobacco products or smoke.
• If you are already a smoker, seek out assistance and tools to stop.

Moderate Alcohol Consumption:

• Drink alcohol sparingly if you do.
• Limit your alcohol consumption to moderate levels (one drink for women and two for males per day).

Regular Health Check-ups:

• Plan routine medical exams to keep an eye on your blood pressure, blood sugar levels, and general wellness.
• Observe your doctor's recommendations for diabetes prevention and screening.

Stress Management:

• Take up stress-reduction practices like mindfulness, meditation, yoga, or relax-promoting pastimes and occupations.

Although these preventive actions can dramatically lower the risk of Type 2 diabetes, some people may still get the disease owing to a genetic predisposition or other uncontrollable circumstances. To receive individualised advise and perform risk assessment, regular medical examinations and meetings with healthcare specialists are needed.

Conclusion:

Diabetes mellitus is a chronic disease that needs constant attention. For people with diabetes and medical experts, it's critical to comprehend the reasons, varieties, phases, symptoms, diagnostic standards, tests, and available treatments. People with diabetes can live long, productive lives and reduce their risk of complications by managing their illness properly and taking a proactive attitude.

 

Dr.Muhammad Arsalan Khan
MBBS, DHHM, 
MSc (Diabetes & Endocrinology)
CCD-BMJ-AKU-RCP (London)