Diabetes mellitus is a condition characterized by a disturbance of insulin secretion in the pancreas and resistance of peripheral cells to its action, metabolic disorders that lead to hyperglycemia.
How the condition manifests itself
What is the treatment for diabetes
What is diabetes?
Diabetes mellitus is a condition characterized by a disturbance of insulin secretion in the pancreas and resistance of peripheral cells to its action, metabolic disorders that lead to hyperglycemia.
The main types of diabetes are represented by:
- Type 1 insulin-dependent diabetes is due to total destruction of the insulin-producing pancreatic beta islets; more commonly found in young people under 30, patients require insulin treatment for the rest of their lives
- Type 2 diabetes is characterized by the association of insulin deficiency with increased peripheral cellular resistance to the action of the hormone
- Gestational diabetes – specific to the pregnancy period
What causes diabetes
The factors involved in the development of type 1 (juvenile) diabetes are of 2 types: genetic (inherited) and environmental, represented by viral infections (produced in childhood or adolescence that induce destruction of the Langerhans islands) and diet.
Type 2 diabetes is the most common form of the disease and is frequently associated with obesity, central obesity (waist fat). Risk factors involved in the development of this form of the disease are poor diet, lack of physical activity, chronic alcohol consumption and old age.
Gestational diabetes is due to pregnancy-specific hormonal changes that prevent insulin from regulating glucose metabolism, leading to insulin resistance. The condition appears de novo during pregnancy (in women who have no previous diagnosis of diabetes) and usually disappears after birth.
How the condition manifests itself
The 2 types of diabetes show similar symptoms due to the increased amount of glucose in the blood and are represented by:
- Polyuria – frequent urination with increased urine output
- Polydipsia – intense thirst
- Vision disorders
- Nausea and vomiting
- Polyphagia – increased appetite
- Fatigue
- Recurrent skin and urinary tract infections
- Tingling and numbness in the lower limbs
Type 1 diabetes often has a sudden onset, manifested as diabetic ketoacidosis – in the absence of insulin, the body cannot use glucose as a form of energy, instead metabolizing fats with the production of ketones which cause acidification of the blood.
Type 2 diabetes comprises gradually developing manifestations, the disease is discovered by chance in ophthalmology (diabetic retinopathy), nephrology (diabetic renal failure), neurology (diabetic neuropathy), dermatology, vascular surgery (diabetic arteriopathy) or cardiology. This is due to the multi-organ damage caused by hyperglycaemia and long-term complications of diabetes throughout the body.
How to diagnose the disease
The diagnosis of diabetes mellitus is clinical and paraclinical, the laboratory tests used to detect the condition are:
- Determination of fasting blood glucose (on an empty stomach) which in the case of diabetes mellitus is ≥ 126mg/dl
- Determination of a blood glucose level at any time of the day ≥ 200mg/dl
- Glycosylated haemoglobin (by HPLC method – according to the international standard) ≥ 6.6% – is used as an indicator of blood glucose variation in the last 3 months
- Glucose tolerance test performed 2 hours after ingestion of 75g of glucose > 200 mg/dl
- Glycosuria (urinary glucose) occurs in serum glucose values exceeding 180mg/dl – the renal glucose threshold is an important indicator of the condition
It is important to know that each laboratory reports to its own set of calibrated normal values for serum and urinary glucose.
What is the treatment for diabetes
In type 1 diabetes, insulin is the first line of treatment and is given for life, with the dose and interval of administration being determined in consultation with the diabetologist.
The treatment of type 2 diabetes consists of adopting a healthy lifestyle including regular daily activity and a healthy diet to maintain normal blood glucose levels for as long as possible. In the advanced stages of the disease, patients benefit from hypoglycaemic drug treatment or daily insulin administration to normalize blood glucose values.
In the case of gestational diabetes, an appropriate diet is recommended together with the nutritionist and a special exercise program for the pregnancy period (if there are no contraindications from the obstetrician). Insulin therapy in pregnancy is recommended in situations where normal glycemic values are not reached after the adoption of the measures mentioned above.
Learn More:
- Students with Diabetes – https://fhidd10.tripod.com/HTMLobj-130/ChildrenWithDiabetesOverview.pdf
- Screening for Diabetes – https://care.diabetesjournals.org/content/25/suppl_1/s21.short
- Gestational Diabetes Mellitus – https://www.proquest.com/openview/c54e23eb2d94920c97b3b7bd436be072/1?pq-origsite=gscholar&cbl=47715
