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An Overview About Diabetes Mellitus

Diabetes Mellitus: Inability of the body to produce enough insulin due to dysfunction of beta cells of pancreas.

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Diabetes Mellitus (DM), usually referred to as diabetes, is a group of metabolic disorders in which there is high blood sugar (blood glucose), either because the body’s cells do not respond properly to insulin or because insulin production is insufficient or both. Symptoms of high blood sugar consist of increased thirst, frequent urination, and increased hunger. If it is untreated, diabetes can cause many complications. Acute complications can include hyperosmolar hyperglycemic state, diabetic ketoacidosis. Serious long-term complications include stroke, cardiovascular disease, foot ulcers, chronic kidney disease and damage to the eyes.

If blood glucose concentration increases (hyper-glycaemia)
FBS – 70 – 110 mg/dl
PP 180 – 200 mg/dl
RBS - 140 mg/dl
IFG – Impaired fasting glucose / impaired glucose tolerance.
If FBS – 100- 125 mg/dl.
Person is considered as diabetic when fasting blood sugar levels are more than 126 mg/dl and post prandial levels are more than 200 mg/dl HbA1C > 6.5%.

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Types of Diabetes Mellitus:
Type 1 DM occurs from the pancreas’s failure to produce enough insulin. This form was formerly referred to as “juvenile diabetes” or “insulin-dependent diabetes mellitus” (IDDM). The cause is unknown.
Gestational diabetes is another main form and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels.

Type 2 DM results from insulin resistance, a state in which cells stop working to respond to insulin properly. As the disease progresses a lack of insulin may also develop. This form was formerly referred to as “adult-onset diabetes” or “Non-Insulin-Dependent Diabetes Mellitus” (NIDDM). The most common cause is not enough exercise and excessive body weight.

Prevention:
There is no identified preventive measure for type 1 diabetes. Type 2 diabetes – which accounts for 85-90% of all cases – can often be delayed or prevented by engaging in physical activity, maintaining a normal body weight and consuming a healthful diet.
The relationship between type 2 diabetes and the main modifiable risk factors (unhealthy diet, excess weight, tobacco use and physical inactivity) is similar in all regions of the world. There is growing evidence that the underlying determinants of diabetes are a reflection of the major forces driving social, economic and cultural change: urbanization, globalization, the general health policy environment and population aging.

Management:
Diabetes mellitus is a chronic disease, for which there is no recognized cure except in very specific situations. This can usually be accomplished with a healthy diet, exercise, weight loss, and use of appropriate medications (insulin in the case of type 1 diabetes; oral medications and possibly insulin, in type 2 diabetes).
The aim of management is to maintain HbA1C level as 6.5%, but should not be lower than that, and may be set higher. Awareness is also paid to other health problems that may accelerate the negative effects of diabetes. These include elevated cholesterol levels, smoking, obesity, lack of regular exercise and high blood pressure.

Pre-Diabetes
When person is fasting blood sugar (FBS) = 100-125 mg/dl and post prandial (pp) = 140 – 200 mg/dl then person is considered as pre diabetes or IGT (Impaired Glucose Tolerance).

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