Diabetes Mellitus (DM) is a cluster of metabolic diseases which is characterized mainly by the unusual blood sugar levels over a sustained time period. The International Diabetes Federation estimates that 1 in every 12 individuals is a sufferer of the condition. The total number of individuals affected by diabetes mellitus globally is more than 350 million. This number is thought to increase by the upcoming decades. The causes of diabetes may be genetic, environmental, physical inactivity or any other auto-immune diseased condition.
Symptoms of Diabetes Mellitus
The major symptoms of the disease include.
- Weight loss
- Frequent urination (polyuria)
- Increased thirst (polydipsia)
- Increased hunger (polyphagia)
- Blurred vision
Some secondary signs are as under
- Diabetic ketoacidosis
- Cardiovascular diseases
- Chronic kidney failure
- Retinopathy (glucose absorption in the eye lens)
- Diabetic dermadromes (skin rashes)
Types of Diabetes Mellitus
Diabetes Mellitus consists of the following three types.
Type 1 Diabetes Mellitus:
Insulin-Dependent Diabetes Mellitus (IDDM) is also known as juvenile diabetes and type 1 Diabetes Mellitus. It is chronic ailment which occurs mainly in children and young adults. The destruction of the insulin producing cells of the pancreas causes this type.
The beta cells of the islets of Langerhans (located in pancreas) are the ones which generate insulin hormone. When autoimmune reactions of the body destroys these cells, it slows down the insulin production.
Due to the lack of insulin, reduces glucose uptakes and thus increases glucose levels. Such a condition is termed as the Insulin-Dependent Diabetes Mellitus (IDDM) or type 1 Diabetes Mellitus.
Type 2 Diabetes Mellitus
In this condition, the manufactured insulin is not utilized efficiently by the body. This condition is referred to as insulin resistance, in which the cells of the body do not respond appropriately to the insulin. With the progression of the type 2 DM, a lack of insulin may develop.
The type 2 diabetes is also known as non insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. The symptoms of this type develop much slower or they may be absent in some cases.
Gestational Diabetes Mellitus (GDM):
This type of diabetes is not as common as the other two types. This condition appears when a pregnant female with negative history acquires diabetes mellitus. It resembles more to the type 2 DM. GDM causes a number of adverse health effects on the affected individual and the infant.
Insulin is a peptide based hormone; composed of about 51 amino acids. It is synthesized in the human body by cells of the pancreas. This hormone is involved in the controlling of the carbohydrates and fats metabolism and it also promotes the uptake of sugars (particularly glucose) from the blood circulation. In this manner, the hormone regulates the levels of sugars within the blood preventing them to fluctuate from normal levels. But in some cases such as diabetes mellitus, metabolic syndrome etc., the levels of insulin is seen to vary from their normal ranges. Insulin also suppresses the glucose synthesizing pathways of the liver.
According to the estimates of the World Health Organization (WHO), insulin-dependent diabetes mellitus is responsible for only 10% of the total cases of diabetes mellitus, i.e.; the number of cases being more than about 20 million worldwide. It has been found out that 1 out of 10 diabetic patients have type 1 DM.
The number of affected youngsters in the US has reached 208,000 in 2015. The number of individuals diagnosed with type 1 DM each year is about 18,000. The incidence is increasing rapidly each year, at the rate of about 3%. It also causes number of deaths.
Considering the type 2 diabetes, it is by far the most prevalent form of diabetes. In the UK, type 2 diabetes makes 90% of all diabetes cases and type 1 diabetes contributes for approximately 10%.
The diagnosis of the can be accomplished via one of the following methods.
- Fasting Plasma Glucose (FPG): The test is used for diagnosing diabetes and pre-diabetes. The plasma glucose is determined after about eight hours of fasting. The levels of fasting glucose should be greater than or equal to 126 mg/dL.
- Oral Glucose Tolerance Test (OGTT): The test is used for diagnosing pre-diabetes, diabetes, insulin resistance and impaired beta cell In the test, standard 75g glucose dose is ingested and the blood sugar levels are determined two hours later. The levels should be greater than or equal to 200 mg/dL.
- Glycated Hemoglobin (HbA1c): It is the glycated form the hemoglobin. The test was identified as another useful test for diabetes diagnosis in 2010 by the American Diabetes Association. HbA1c determines the average concentrations of plasma glucose for over three month period. The levels of HbA1c should be greater than or equal to 48 mmol/mol (≥ 6.5 DCCT%).
By observing several preventive measures, Insulin-Dependent Diabetes Mellitus (IDMM) can be prevented.
- Maintenance of Healthy Lifestyle: The most important measure for the prevention of IDMM is the maintenance of healthy lifestyle. For this purpose, a person should maintain healthy body weight and involve in active physical activities. Avoid tobacco also.
- Diet: Studies indicate that diet and lifestyle may help to prevent insulin-dependent diabetes. Breastfeeding is one such factor which decreases the risk of developing the condition later on in life. Vitamin D administration in childhood also tends to minimize the risk of developing IDMM.
- Immunosuppressive drugs: The use of various immunosuppressive drugs is seen to prevent the risks of Insulin-Dependent Diabetes Mellitus.
The management of diabetes may be achieved by the following ways.
- Lifestyle: Stress is known to pose negative effects on diabetes. So stress and tension should be avoided as much as possible.
- Insulin Therapy: Insulin therapy utilizes the insulin for the management of insulin-dependent diabetes mellitus. This is a very useful management technique as untreated type 1 diabetes could have fatal consequences. Four basic types of insulin are used, i.e.; rapid acting insulin, short acting insulin, intermediate acting insulin, and long acting insulin. Each of these varies in action onset rates. The insulin can be administered either via subcutaneous injection or insulin pump. Along with the insulin therapy, the diet intake should also be monitored. Previously, insulin was isolated from various organisms such as pig, cattle, fish etc. But now a days, commonly used insulin are synthetic in nature which are manufactured by the genetic recombination procedures.
- Pancreas Transplantation: In several cases of type 1 diabetes, the proper restoration of glucose regulation is achieved via the transplantation of pancreas. The difficulties associated with this approach are the accompanying immunosuppression and surgery complications
- Islet Cell Transplantation: Another choice for the management of insulin-dependent diabetes is the Islet cell transplantation. This option is chosen only when insulin therapy is not much effective. Complications associated with this approach are the finding of a compatible donor. As well as, the survival from immune responses and the side effects of the immune suppressing medications.