DIABETES MELLITUS
Diabetes Mellitus is a syndrome characterized by presence of glucose higher than the normal value in blood. Normal value of glucose in blood ranges from 7.8mg/dl to 140mg/dl. Diabetes classically is recognized by symptoms of polyuria, polydipsia and polyphagia. It is known as syndrome rather than a disease because in Diabetes, if glucose level is not controlled, many complications are associated. Some of them are; retinopathy, nephropathy, neuropathy, diabetic foot and gangrene.
There are many predisposing factors those may contribute in diabetes. For example, obesity, age, poor life style, imbalance diet and genetics.
TYPES:
There are three main types of diabetes:
1-TYPE -1 DIABETES MELLITUS
2-TYPE -2 DIABETES MELLITUS
3-GESTATIONAL DIABETES
In type-1 Diabetes mellitus also known there is a loss of B-Cells of Islets of Langerhans of pancreas due to autoimmune attack. This autoimmune attack is mediated by T-cells. Currently no specific reason for this autoimmune attack is known, so scientists are still unable to find a way to prevent from Type-1 Diabetes. It is also known as juvenile or insulin dependent diabetes mellitus because it usually affects children and young adults and in this type of diabetes, insulin is not produced within the body. So it is injected externally to treat insulin’s deficiency.
In type-2 diabetes mellitus insulin id produced by B-cells of pancreas but either it is produced in less quantity or cells responsible to respond insulin become senseless; means not able to respond properly. This type of diabetes is also known as No- insulin dependent diabetes mellitus because direct insulin is not necessary, although sometimes it is used in combinations with other medications. This type of diabetes usually affects people after 40y.
Third type of diabetes mellitus is gestational diabetes. It affects fetus or mother during gestation period due to hyperglycemia of pregnant mother. If corrective measures do not take, then it may affect fetal respiratory system, central nervous system and in severe cases it may cause fetal death due to vascular anomalies. In this situation C-section is recommended.
SIGNS AND SYMPTOMS:
Classical symptoms of diabetes mellitus include:
Polyuria
Polydipsia
Polyphagia
In later stages, complications may be developed. For example:
Blurred vision due to retinopathy
Loss of kidney’ functions due to nephropathy
Numbness and tingling sensation in muscles of legs back and arms due to neuropathy.
Ketoacidosis, a rare but very dangerous complication that is due to metabolic abnormality. It is characterized by presence of ketene bodies. It may cause loss of consciousness and even death.
A common complication in diabetes is diabetic foot. Diabetic foot means development of ulcers on any part if the skin particularly on foot. These ulcers are difficult to treat if glucose level is not controlled. High glucose level causes hindrance in healing of wound. Drainage of wound is made and strong antibiotics are given to the patient. If it is not treated, then debridement is necessary to protect whole body from damage.
PATHOPHYSIOLOGY/METABOLISM OF CARBOHYDRATES
When we take carbohydrates, they are converted into simple sugar within the body. This simple sugar is known as glucose. As for as glucose level touches its threshold in blood, insulin is secreted into blood from B-cells of Islets of Langerhans. In diabetes either insulin secretion is reduced due to malfunction of B-cells of Islets of Langerhans or sensitivity of insulin’s receptors is diminished and thus glucose level is increased in blood. Normally excessive glucose is converted into glycogen (a complex form of carbohydrate or complex form of sugar) and this glycogen is stored into liver and muscles. Whenever our body needs energy level, this complex sugar, glycogen is secreted from its storage areas and is again converted into simplest form of sugar that is glucose. This process is known as glycogenolysis. During this conversion energy is generated in the form of ATPs (adenosine triphosphate) and this energy is used by the body.
TREATMENT
Different strategies are used to control blood sugar. Neither technique alone is good enough to treat this syndrome. These strategies are discussed one by one:
1-LIFE STYLE:
Life style plays a vital role to control blood sugar. Brisk walk on daily basis for 30 minutes to 1 hour is proved to be effective in reducing glucose level. Researchers have proved that brisk walk produces insulin receptors by up regulation. It also increases sensitivity of existing insulin receptors.
2-WEIGHT REDUCTION:
A very important strategy to reduce glucose level is weight reduction. An ideal weight according to BMI scale is considered if BMI Of a person is less than 25 and greater than 20.A person having BMI greater than 30 is considered to be obese. Brisk walk with reduced calories intake is a good way to control body weight. Gastric bypass is a modern surgical technique also used to treat obesity.
3-MEDICINES
Different group of medicines are used to control glucose level in blood. These include
A-Sulfonylurea
b-Biguanides
c-Thiazolidinediones
d-Meglitinides
5-Insulins
These groups are used as per situation of a patient. These medicines work in different ways. They increase insulin receptors sensitivity. They also increase the process of conversion of glucose into glycogen. They also slow down the process of gluconeogenesis.
External insulin is injected to correct the glucose level in blood. Insulin is divided into short acting, intermediate acting and long acting on the basis of their onset of action.
Like other inherent diseases it goes with the life of a man and accompanies till last breath. The best thing to do is to compromise with it. Once you know that you are a patient of diabetes, simpler it will be for you to perform your common tasks.
In other case you may be obsessed with it and may be under a psychological stress which is more difficult to cope with and a man goes under self pity. Therefore all practitioners suggest patients to live a normal life without taking the disease on nerves and include daily light activities in life that are really helpful. Especially stress free conditions help people to recover and to remain normal.
By: Ammarah Khan
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