Definition
Diabetes mellitus is the metabolic dysfunctional disorder, which causes elevated blood sugar level.
Insulin is secreted from the tail of pancreatic cells , which is responsible for storage and usage of sugar. Sugar accumulation and utilization are disrupted when pancreatic cell function is impaired.
Diabetes mellitus results due to:
- Insulin production is insufficient
- No insulin production or
- Insulin production is adequate but body is unable to use it effectively
Types
a) Type 1: It is autoimmune condition. Beta cells of pancreas are destroyed (which produces insulin hormone). This is insulin dependent type. Mostly young people <20 years of age develop type 1 diabetes or juvenile diabetes.
b) Type 2: Insulin synthesis is insufficient or body is not able to utilize hormone properly, resulting in elevated blood sugar level. The majority of those affected are adults.
c) Pre-diabetic: When your sugar level is elevated, but not high enough to be graded as diabetic.
d) Gestational diabetes mellitus (GDM): GDM affects about 4% of pregnant women. The placenta releases insulin blocking hormone during pregnancy.
Diabetes insipidus is different condition compared to diabetes mellitus, it causes the kidneys to excrete a large volume of urine.
Causes
Type 1:
- Genetic: Abnormal genes are inherited, which is linked to diabetes mellitus and causes autoimmune destruction of the cells.
Type 2:
- Overweight
- Above the age of 45 years
- Family history
- A sedentary life
- History of GDM
- Hypertension (High blood pressure)
- A high level of cholesterol
Gestational diabetes mellitus:
- Being overweight
- above the age of 25 years
- A history of gestational diabetes mellitus (GDM) during prior pregnancies
- Polycystic ovarian syndrome
- Family history
- Baby's weight higher than 9 pounds
Signs and Symptoms
- Increased hunger
- Increased thirst
- Frequent urination
- Distorted vision
- Extreme fatigue
- Erectile dysfunction in men
- Recurrent urinary tract infection in women
- Yeast infection
- Dry and itchy skin
- Kussmaul's respiration (Heavy breathing)
- Loss of consciousness (rare)
- Weight loss
- On physical examination: poor skin turgor due to dehydration and fruity odor breath.
Complication
- Heart attack: Diabetes is silent killer. Due to diabetic neuropathy, one may not be able to sense the pain which are usually felt during attack due to damaged nerves.
- Brain stroke
- Diabetic neuropathy: Peripheral nerve sensations are lost at first. When diabetic patient takes a normal walk, he/she may not be able to fell pain due to nail prick.
- Diabetic foot: Loss of sensation, unless and until doctor/ relative do not observe the foot injury of the patient, patient won't be able to complain as he do not feel any pain.
- Non healing ulcer
- Recurrent fungal infection
- Depression
- Dementia
- Vision loos or retinopathy
- Baby with extra pounds
- Premature delivery
- Chances of DM increases in later life
- Still birth
- Jaundice
Treatment
Insulin is the first line therapy for juvenile diabetes.
- Rapid acting
- Short acting
- Intermediate acting
- Long acting
Type 2:
- Life style changes
- Alpha glucosides inhibitors: Sugar and starchy breakdown decreases. Eg.: Acarbose
- Biguanides: Reduces amount of glucose. Eg.: Metformin
- DPP-4 inhibitors: Avoids sudden drop of sugar level. Eg.: Linagliptin
- Glucagon like peptide: Eg.: Dulaglutide
- Meglitinides: Stimulates pancreatic cells to increase production of insulin. Eg.: Nateglinide
- SGL T2 inhibitors: Increases glucose excretion in urine. Eg.: Canagliflozin
- Sulfonylureas: Increases insulin production. Eg.: Glimepiride, glipizide
- Thiazolidinedione: Increase efficiency of insulin hormone. Eg.: Pioglitazone, rosiglitazone
Alternative therapy
Homeopathy and diabetes
As homeopathy is based on "Similia Similibus Curantur", law of minimum and law of simplex; so the medicine which is selected should be prescribed as per suggested by Dr Hahnemann.
Management:
- Eat healthy and sugar free.
- Be active enough to burn your body fat.
- Have low amount of carbs in your diet.
- Replace your diet with whole grain.
- Have green leafy vegetables.
- Well balanced diet should be taken.
Diagnosis
- Fasting blood sugar (Normal
- Post prandial blood sugar
- HbA1c
- Oral glucose tolerance test is done at 24th and 28th weeks of pregnancy.
Prevention
- Go for cycling, aerobics or regular work out.
- Intake of carbohydrates, sugar and fat should be limited.
- Have well balanced diet.
- If you are overweight, then loose weight.
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