Things to know about DIABETES

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When blood glucose (sugar) level is higher than normal (5.5 mmol/L (100 mg/dL) then the condition is called diabetes. There are two type of diabetes. 1) Diabetes mellitus (DM) and 2) Diabetes insipidus (DI). In general, when we talk about diabetes we refer to diabetes mellitus (DM). DM is subdivided into two types, Type 1 DM and Type 2 DM. Among those people who have diabetes, about 10% have Type 1 DM and about 90% have Type 2 DM. DM occurs when there is a mismatch balance between blood glucose level and blood insulin (a hormone which regulates blood glucose). According to WHO, more than 422 million people have DM worldwide and it has been observed that it is raising more rapidly in middle and low income countries. Long term DM can affect the eyes, brain, heart, and kidneys. Among other serious complications, severe diabetes can also lead to death. 

Risk factors:
1.         Obesity (Over weight)
2.         Hypertension (High blood pressure)
3.         Tobacco use (Smoking)
4.         Hereditary (Family history)
5.         Unhealthy diet (Food with high sugar and fat)
6.         Lake of exercise (Less physical activities)    

Causes:
1.         Type 1 DM: Also known as insulin dependent or Juvenile or childhood onset diabetes. It occurs when body does not produce enough insulin to reduce the blood glucose level to normal. Genetic abnormality causes the loss of self tolerance of T-cell that attacks Beta cell of the pancreas resulting in the decrease production of insulin.

2.         Type 2 DM: Also known as insulin independent or adult onset diabetes. In this case, there is enough insulin in the body but DM occurs when cells become insulin resistant meaning, body does not response to insulin therefore cells can not take glucose inside of them leaving high level of glucose in the circulation.

Symptoms:
1.         Polydipsia (Too much thirst)
2.         Polyphagia (Too much hunger or increased appetite)
3.         Polyuria (Too much urination)  
4.         Glycosuria (Too much glucose in urine)

Diagnosis:
1.         Fasting glucose level: if it is100 to 125mg/dl then consider it to be pre-diabetes and if it is more than 126mg/dl then consider it to be diabetes.
2.         Non-fasting glucose level: if more than 200mg/dl consider diabetes.
3.         HbA1c: if 5.7 to 6.4% consider pre diabetes and more than 6.5% consider diabetes.

Complication:
1.         Vasculopathy can lead to heart attack and stroke.
2.         Retinopathy can lead to blindness.
3.         Nephropathy can lead to kidney failure.
4.         Neuropathy can lead to decrease sensation of hand and feet.

Prevention:
1.         Life style change- eat healthy diet with low sugar and fat and daily at least 30-minute mild to moderate exercise or physical activities.
2.         Weight control.
3.         Avoid tobacco use (stop smoking).

Treatment:
1.         Type 1 DM: Diet and exercise, insulin.
2.         Type 2 DM: Diet and exercise, oral hypoglycemic drugs and insulin if needed. 


Writer- Maruful Bhuiyan 
            MD candidate, Chicago. IL. 
Editor- Fariha Ahmed
            Student at City University of New York. 


*Any suggestion, correction or comment will be highly appreciated.  

References

WHO-Diabetes mellitus

CDC-About Diabetes

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