what is it ????
Refers to diabetes mellitus or, less often, to diabetes insipidus. Diabetes mellitus and diabetes insipidus share the name “diabetes” because they are both conditions characterized by excessive urination (polyuria).
The word “diabetes” is borrowed from the Greek word meaning “a siphon.” The 2nd-century A.D. Greek physician, Aretus the Cappadocian, named the condition “diabetes.” He explained that patients with it had polyuria and “passed water like a siphon.”
When “diabetes” is used alone, it refers to diabetes mellitus. The two main types of diabetes mellitus — insulin-requiring type 1 diabetes and adult-onset type 2 diabetes — are distinct and different diseases in themselves.
What are the Types ???
1. Type I
2. Type II
3. Gestational Diabetes Mellitus
4. Others
Type I ????
It is also called Insulin Dependent Diabetes (IDDM) or Juvenile Diabetes.
Although, it may occur at any age, but it usually develops in childhood or adolescence, before the age of 25. Equal incidences are seen in both sexes. But there are increased incidences in white population. This type of diabetes accounts for 10-15% of all cases of Diabetes mellitus. This type of Diabetes is acute in onset and progresses rapidly.
Type 1 Diabetes is caused by complete deficiency of Insulin resulting from Beta cell destruction. It can be explained on the basis of three basic factors:
(i) Genetic susceptibility:
- A family history of Type 1 Diabetes mellitus is often found.
- Moreover, it has been seen in identical turns, that if one twin has Type 1 diabetes, there is 50% chance of the second twin developing diabetes.
- Majority of the cases of Type 1 diabetes has been seen in individuals with HLA-D Phenotypes (HLA-DR3 and HLA-DR4).
(ii) Auto Immunity:
- The islet cell antibodies, sometimes instead of providing immunity to the pancreas, acts against it and destroys the insulin producing Beta cells of Pancreas. Thereby leading to raised glucose level and thus diabetes mellitus.
- There may be Insulitis i.e. infiltration of lymphocytes around the Pancreatic islets further leading to loss of most of the Beta Cells.
- Type 1 Diabetes may also be associated with other autoimmune diseases such as Hashimoto’s thyroiditis. Addison’s disease as pernicious anaemia.
(iii) Environmental Factors:
It may be:
- Viral infections such as –congenital Rubella, Mumps, Measles and coxsackie B virus may lead to the onset of Type 1 Diabetes.
- Exposure to cow’s milk rather then material milk in infancy may lead to development of type 1 DM. It is because the albumin from cow’s milk may react with islet cells of pancreas, leading to their destruction.
- Geography also plays an important role, as the incidences of Type 1 DM are mainly high in Finland and Sardinia
Type II??
This type of Diabetes is also known as Adult onset Diabetes. Non-insulin dependent Diabetes Mellitus (NIDDM), Maturity onset diabetes.
It is more common and constituents 80-90% of all cases of diabetes. It usually occurs in adults over 40 years of age. But now a day few cases are observed in teen years also. Many people with Type 2 diabetes do not known they have it, although it is a serious condition. Generally, when the diagnosis is made, patient is asymptomatic. Routine urine or blood test shows the presence of high glucose levels in the blood or urine. The onset of symptoms in type 2 are slow and does not progresses rapidly.
The main cause of Type 2 Diabetes mellitus is insufficient Insulin secretion by Beta Cells due to their destruction. Due to lack of insulin, there is raised blood sugar level and finally diabetes” type 2 diabetes mellitus also occur due to development of Insulin Resistance where the cells of the body mainly fat and muscle cells does not accept the insulin. The liver of such patients also produces glucose through a process called gluconeogenesis, which further worsens the controlling of glucose level.
Type 2 diabetes is more prevalent because of faulty eating habit, increasing obesity end failure to exercise. There is a direct relationship between the degree of obesity and the risk of developing type 2 diabetes. The chance to become 2 diabetes doubles for every 20% increase form normal body weight. Heredity and Genetic factors play a major role in development of Type-2 Diabetes.
In Europe and North America about 80% of all diabetes have Type-2 Diabetes have Type 2 Diabetes mellitus.
Gestational Diabetes Mellitus (GBM)
Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance, with the onset of pregnancy. Women who develop Type –1 diabetes mellitus during pregnancy and women with undiagnosed a symptomatic type –2 diabetes mellitus that is discovered Gestational Diabetes Mellitus. Women with diabetes mellitus before pregnancy are said to have “Pregestational Diabetes”. Many women who have developed gestational diabetes may have controlled glucose level during the first half of the pregnancy and develop insulin
deficiency during the latter half of the pregnancy, leading to hyper-glycaemia.
Gestational Diabetes Mellitus is a complication in approximately 4% of all pregnancies in the United States. Mother with Gestational diabetes mellitus have increased rate of caesarian delivery and chronic hypertension “High blood Glucose levels in early pregnancy may deprive the embryo of oxygen and lead to Birth Defects, especially of the heart and spinal cord. Maintaining blood glucose control continues to be important throughout the pregnancy, but it is particularly important during the first eight weeks, when an embryo’s organs are farming.
To diagnose GDM, a 50 gm glucose-screening test should be performed at 24-28 weeks of gestation known as Glucose Tolerance Test (GTT). By them, the placenta begins to make the hormones that lead to insulin resistance. The screening test measures the blood sugar response to glucose consumed in a drink. Untreated gestational diabetes can lead to problems for both the mother and the child. It can lead to Fat baby syndrome or Microsomatia, in which the baby’s body produces extra fat.
Others ???
Diabetes mellitus of various known reasons is included in this type. It includes:
- Diabetes may develop in persons with genetic defects such as Down Syndrome, Klinefelter’s syndrome, Turner’s Syndrome, etc.
- Persons with endocrinopathies such as Acromegaly, Cushing’s syndrome, Hyperthyroidism, may develop diabetes.
- Persons with pancreatic dysfunction caused by drugs like Phenytoin, Nicotinic acid, Diaz oxide, may also develop diabetes.
- Malnutrition may also lead to diabetes and it is common in young malnourished individuals in developing countries.
It is also seen during natal and early childhood.
Treatment ???
Controlling your blood sugar is essential to feeling healthy and avoiding long-term complications of diabetes. Some people are able to control their blood sugar with diet and exercise alone. Others may need to use insulin or other medications in addition to lifestyle changes. In either case, monitoring your blood sugar is a key part of your treatment program.
A healthy diet and exercise should be placed as a priority for diabetes treatment. Second, you might also try some of the diabetes treatment using alternative medicine. Third, follow your doctor’s prescriptions. And last, pancreas or islet cell transplantation may be an option for people whose kidneys are failing or who aren’t responding to other treatments.
1. Monitoring Blood Sugar
a. Food
b. Exercise and Physical activity
c. Medications
d. Illness
e. Alcohol
f. Hormonal Imbalance
2. Healthy Diet
3. Healthy Weight
4. Medications
a. Sulphonylurea Drugs
b. Meglitinide
c. Biguanides
d. Apha Glycosidase inhibitors
e. Thiozolidinediones
5. Pancreas transplant
Other Treatment Available !!!
1. Accupunture
2. Biofeedback
3. Chromium
4. Magnesium
5. Vanadium
History, Medicine, Personal, Society, admin, management | drlokku | January 12, 2010 | 
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