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diabetes mellitus type 1, and type 2

Diabetes mellitus (DM)is known as diabetes.it is a metabolic disorder where high blood sugar levels for a prolonged period. The common symptoms of high blood pressure are,  frequent urination, increased thirst, increased hunger.


Diabetes is due to the Pancreas is not produced enough insulin or the cells of the body not responding properly to the produced insulin.



Types of diabetes mellitus


Type 1- diabetes mellitus –the pancreas fails to produce enough insulin due to the loss of beta cells. The cause is unknown. it is also known as juvenile diabetes or insulin-dependent diabetes is a chronic condition in which the pancreas produces little or no insulin by itself.




Type 2 diabetes mellitus –a condition where cells fail to respond properly, as the disease progress, lack of insulin develops in the body. this is known as non-insulin-dependent diabetes mellitus ( NIDDM).

The common causes are excessive body weight and lack of exercise. The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin.




Gestational diabetes –When pregnant women without a previous history of diabetes, develop high blood sugar levels.
                          



Another type of diabetes




Prediabetes  -Prediabetes is a condition where blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes mellitus. Many people who later develop type 2 diabetes mellitus spend many years in prediabetes.



Latent autoimmune diabetes of adults (LADA) - is a condition where  type 1 diabetes mellitus develops in adults



Steroid diabetes -a condition where high doses of glucocorticoids drug are introduced.




Symptoms



The symptoms of type 1 diabetes are.

  • Weight loss,
  • Polyuria (increased urination),
  • Polydipsia (increased thirst),
  • Polyphagia (increased hunger),
  • Blurred vision,
  • Headache,
  • Fatigue,
  • Slow healing of cuts and wounds.


Longe term complication is



All the forms of diabetes increased the risk of long term. these develop after many years (10- 20). but 
maybe first symptoms those, who not diagnosed before that time.


  • Damage to blood vessels
  • Cardiovascular disease 
  • Coronary artery disease
  • Macrovascular disease
  • Stroke
  • Peripheral artery disease.
  • Damage to eyes (diabetic retinopathy)
  • Damage to kidney (diabetic nephropathy)
  •  Damage to the nerve (diabetic neuropathy )
  • The symptoms include numbness, tingling, pain, and pain sensation which can lead to damage to the skin.
  • Diabetes-related foot problems  Diabetic foot ulcers may occur and difficult to treat.


Eye


Prolonged high blood glucose absorption, change the shape of the eye lens, resulting in vision change .long term vision loss caused by diabetic retinopathy.



Skin


A number of rashes that can occur in diabetes are known as diabetic dermadromes.



Symptoms may be developed rapidly in type 1 diabetes, while type 2 diabetes symptoms develop slowly or absent.





Causes of diabetes mellitus

  • Some person, are caused by the body's tissue receptors not responding to insulin. this form is very uncommon. 
  • Genetic mutations (mitochondrial) can lead to defects in beta cell function. Abnormal insulin action may also have been genetically determined in some cases.
  •  Any disease that causes extensive damage to the pancreas may lead to diabetes e.g - chronic pancreatitis and cystic fibrosis.
  •  Diseases- associated with excessive secretion, of insulin-antagonistic hormones can cause diabetes. 
  • Many drugs impair, insulin secretion and some toxins damage pancreatic beta cells. 
  • malnutrition-related diabetes mellitus (MRDM or MMDM.



Role of insulin


Insulin is a hormone that regulates glucose in the body. Insulin plays an important role in balancing glucose levels in the body. Insulin is released into the blood by beta cells, found in the islets of Langerhans in the pancreas. Insulin is used by about two-thirds of the body's cells to absorb glucose from the blood for use as fuel, for conversion to other needed molecules, or for storage. Lower glucose levels result in decreased insulin release from the beta cells and decreased breakdown of glycogen to glucose. This process is mainly controlled by the hormone glucagon, which acts in the opposite manner to insulin.

If the amount of insulin available is insufficient, or if cells respond poorly to the effects of insulin (insulin insensitivity or insulin resistance) then glucose will not be absorbed properly by the body cells that require it, and it will not be stored appropriately in the liver and muscles. The net effect is persistently high levels of blood glucose, poor protein synthesis, and other metabolic derangements, such as acidosis. When the glucose concentration in the blood remains, high long time, the kidneys will reach a threshold of reabsorption, and glucose will be excreted in the urine. This increases the osmotic pressure of the urine and inhibits the reabsorption of water by the kidney, resulting in increased, urine production and increased fluid loss. Lost blood volume will be replaced osmotically from water held in body cells and other body compartments, causing dehydration and increased thirst.

diagnose

The following test is used for diagnosed diabetes.

Fasting plasma glucose (FPG) test

The FPG blood test measures, blood glucose levels at a single point in time.  best to have this test in the morning, after fasting for at least 8 hours. Fasting means having nothing to eat or drink except sips of water.

A1C test

The A1C test is a blood test that provides, average levels of blood glucose over the past 3 months. Other names for the A1C test are hemoglobin A1C, HbA1C, glycated hemoglobin, and glycosylated hemoglobin test. You can eat and drink before this test. The A1C test is not accurate in people with anemia.

Random plasma glucose (RPG) test

 The RPG test diagnoses diabetes when diabetes symptoms are present. You do not need to fast overnight for the RPG test. You may have this blood test at any time.

Glucose test

Pregnant women may have, the oral glucose tolerance test, or both. These tests show how well your body handles glucose.

Oral glucose tolerance test (OGTT)

The OGTT measures blood glucose after you fast for at least 8 hours. First,  will draw your blood. Then you will drink the liquid containing glucose. For diagnosing gestational diabetes, you will need your blood drawn every hour for 2 to 3 hours. High blood glucose levels at any two or more blood test times during the OGTT—fasting, 1 hour, 2 hours, or 3 hours—mean you have gestational diabetes.
 The OGTT to used diagnose type 2 diabetes and prediabetes in people who are not pregnant. To diagnose type 2 diabetes and prediabetes, draw your blood 1 hour after you drink the liquid containing glucose and again after 2 hours.
  • If  Fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) it is, Normal Range,
  • If fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) it is considered, prediabetes,
  • If  Fasting blood sugar level 126 mg/dL (7 mmol/L) or higher on two separate tests have diabetes


Fasting blood sugar



Normal for person without diabetes: 70–99 mg/dl (3.9–5.5 mmol/L)

Blood sugar 2 hours after meals



Normal for person without diabetes: Less than 140 mg/dl (7.8 mmol/L)

HbA1c



Normal for person without diabetes: Less than 5.7%
Official ADA recommendation for someone with diabetes: Less than 7.0%.


Manage your Diabetes


Manage your, diabetes and live a long and healthy life by taking care of yourself. Diabetes affects every part of the body. Therefore, you need to manage blood glucose levels, as well as, blood pressure and cholesterol, to help prevent the health problems that can occur when you have diabetes.
  • Make physical activity every day,
  • Take medicine,
  • Check blood glucose levels,
  • Get medical advice,
  • Check blood pressure,
  • Check your cholesterol level,
  • Stop smoke.


Follow a diabetes meal plan


Choose fruits and vegetables, beans, whole grains, chicken or turkey without the skin, fish, lean meats, and nonfat or low-fat milk and cheese. Drink water instead of sugar-sweetened beverages. Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt




also, read hypoglycemia :


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