Diabetes Mellitus comprises of a group of metabolic disorders that share the common feature of hyperglycemia (increased sugar level in blood) Diabetes Mellitus (DM) is currently classified on the basis of the pathogenic process that leads to hyperglycemia. Type 1 Diabetes Mellitus is characterized by insulin deficiency and a tendency to develop ketosis (which includes nausea, vomiting, polyuria, thirst, abdominal pain, altered mental functions or frank coma.), whereas Type 2 Diabetes Mellitus (Type 2DM) is a group of disorders characterized by variable degrees of insulin resistance, impaired insulin secretion and excessive production of glucose in liver. Type I Diabetes Mellitus (Type 1DM) results from autoimmune destruction of pancreatic beta cells which produce insulin. It is also known as juvenile- onset diabetes because of its peak prevalence in children and adolescents.
The commonly discussed disease and simply known as diabetes is the Type 2 Diabetes Mellitus (Type 2 DM).
The prevalence of Diabetes Mellitus (DM) is increasing rapidly, Type 2 Diabetes Mellitus frequency in particular is rising in parallel to obesity, which mostly arise out of life-style changes in the society. Between 1985 and 2013 the world- wide prevalence of DM has risen more than 10 fold in spite of the fact that the significant portion of Diabetes Mellitus are undiagnosed. In India more and more people are being diagnosed to be suffering from the disease because of wider net of screening for the same. It is estimated that in less than 3 decades from now our country, India will be labelled as “The world capital of Diabetes”.
The common presenting symptoms of Diabetes Mellitus (DM) include polydipsia (an urge to drink more) polyuria (an urge to urinate more often), weight loss, fatigue, weakness and poor healing of wounds. In early Type 2 Diabetes Mellitus the classical symptoms are either absent or are so subtle that, more often than not, results in delayed diagnosis of the same. Many patients are diagnosed based on screening or during blood test for other reasons.
Diabetes Mellitus (DM) is attended with serious morbidity (state of illness) and mortality. It is the fifth leading cause of death world-wide and hence needs greater attention towards diagnosing the illness as early as possible. Commonest among the investigation are the fasting plasma (blood) Diabetes Mellitus (DM) is attended with serious morbidity (state of illness) and mortality. It is the fifth leading cause of death world-wide and hence needs greater attention towards diagnosing the illness as early as possible. Commonest among the investigation are the fasting plasma (blood)
Sugar level and post- prandial (2 hours after a full meal) plasma/blood sugar level. Screening with a fasting plasma/blood sugar is recommended every 3 years for individuals over the age of 45, as well as younger individuals who are overweight and have one or more additional risk factors (viz First degree relative with diabetes, physical inactivity, hypertension or history of vascular disease etc…) Optimal treatment of Diabetes Mellitus requires more than plasma/blood glucose management. Comprehensive diabetes care should also detect and manage DM– specific complications and modify risk factors of Diabetes– associated diseases. Patients with Type 1 or Type 2 Diabetes Mellitus should educate about nutrition, exercise, care of Diabetes during illness and medications to lower plasma/blood glucose in general. Patients with Type 1 DM require insulin divided into multiple doses, the quantity depending upon the weight of the patient. Patients with Type 2 Diabetes may be managed with diet and exercise alone in borderline cases, or in conjunction with oral glucose lowering agents, insulin or a combination of oral agents and insulin.
Take home message: (a) The importance of diagnosing Diabetes Mellitus et very early stage and manage accordingly.(b) The importance of regular exercises and consumption of healthy food. (c) Avoiding or stopping smoking and pan-chewing completely. There are no known benefits of the same.
Dr. John C.S. D’Costa M.B..B.S.(Bom) Aquem-Alto Margao Goa.