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Diabetes Mellitus



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What is Diabetes Mellitus?    

  
Diabetes mellitus is a disorder of carbohydrate metabolism. There are 2 types of diabetes:

  1. Type 1 Diabetes - where the body is unable to produce insulin. Type 1 diabetes occurs when the pancreas is no longer able to produce insulin. The pancreas produces insulin in response to an increased concentration of glucose in the blood, and it is vital in controlling blood glucose levels. When a person has diabetes their body cannot control their blood glucose, so they become hyperglycaemic – they have abnormally high blood glucose.
  2. Type 2 Diabetes - more common that type 1, where the body becomes resistant to insulin. Type 2 diabetes happens when the body effectively becomes resistant to insulin. The first thing that tends to happen is that the person will have impaired tolerance to glucose. Later, high blood glucose levels may be detected after eating and eventually even when fasting.
Some Type 2 diabetes patients remain relatively sensitive to insulin, while others have little or no insulin sensitivity at all. This difference affects treatment of the disease. Usually it is the Type 2 diabetics who are not obese that retain some sensitivity to insulin.

Symptoms and Signs of Type 1 Diabetes?

Characteristic symptoms of Type 1 Diabetes are:

  1. Excessive thirst
  2. Weight loss
  3. Excessive urination
  4. Tiredness
Symptoms may develop very quickly, over a period of a few days.

Unfortunately, the first sign of Type 1 diabetes can be acidote coma, or near coma, as a result of exceptionally high levels of glucose in the blood. This is a life-threatening state where due to a lack of insulin the glucose in the blood cannot enter the cells where it is desperately needed.

At this stage lipids are metabolized to ketones to prevent starvation and cell death. Ketones can be used as food by cells, even in the absence of insulin, the problem is that they are acidic in nature and can cause an acidosis. The a consequence of this condition is that the blood and the tissues are more acidic than normal, this may also lead to malfunctioning of some organs. A person with ketoacidosis would initially compensate by deep breathing, but after a while even this mechanism cannot cope. Patients tend to feel ill, complain of nausea and vomiting and have no interest in food. There is increased urine production and over a period of time, if the condition is not treated, drowsiness and eventually coma sets in.

Diabetic ketoacidosis can be detected because of the presence of ketones in the urine. Blood insulin levels in the blood may be low or unmeasurable.

Treatment of Type 1 diabetes

Key to treatment is the injection of insulin to maintain tightly controlled glucose levels at all times. Tight control is necessary for prevention of long term complications such as blindness and renal failure.

Signs and Symptoms of Type 2 Diabetes

The main features and symptoms of Type 2 diabetes are:
  1. Overweight
  2. Excessive thirst
  3. Excessive urination
  4. Loss of weight
Unfortunately these are signs only occur when the person is already seriously hyperglycaemic. Earlier on there are more subtle signs such as fatigue, susceptibility to illness and poor wound healing.

Candida infection with erectile dysfunction or candida infection of the tip of the penis in men as well as persistent vaginal candida in women may be an early sign of Type 2 diabetes.

Treatment of Type 2 diabetes

The most important aspect of treatment in Type 2 diabetes is lifestyle change – weight loss, exercise and a low fat diet with plenty of fruit and vegetables is imperative. Consultation with a dietician early on, will assist in working out the correct diet for their lifestyle. Smoking is also very detrimental to the health of type 2 diabetics and they are warned to stop or at least reduce the habit to an absolute minimum.

Recent research has shown however that even the correct diet along with exercise will seldom be sufficient to control their blood glucose long term and drugs and/or insulin usually have to be used at some stage.

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