Diabetes

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
If left unchecked, it damages multiple organs, including eyes, kidneys and nerves.

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.

If high blood sugar level (Diabetes mellitus), has not been managed for long time then one have develop severe complication, i.e. Diabetic Ketoacidosis in which acid builds up in the blood. It is clinically presented as; Kussmaul's breathing, nausea and vomiting.

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
GDM

  • Baby with extra pounds
  • Premature delivery
  • Chances of DM increases in later life
  • Still birth
  • Jaundice

Treatment

Type 1:

Insulin is the first line therapy for juvenile diabetes.

There are 4 types of insulin:
  • 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

Syzygium Jambolanum: 
This medicine is effective enough to decrease thirst amount, urine frequency and in non healing ulcer.

Uranium Nitricum:
Treat excessive micturition, inflammation and burning micturition. 

Conium Maculatum:
For diabetic nephropathy

Plumbum Metallicum:
Gives better result in case of numbness in hands and feet, tinnitus and neurological pain.

Calendula:
For infected ulcer.

Phosphoric Acid:
For memory loss, confusion, hair loss, erectile dysfunction and increased micturition at night. 

Candida: 
For yeast infection.

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.
Keywords: high sugar level, definition, symptoms, types

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