What is Diabetes?
In the rural people called Diabetes is more over blood sugar is the blood flow, but in medical term Diabetes is condition associated with abnormality high level of glucose (sugar) in the blood (hyperglycemia).
Normally blood glucose level stay within narrow limit throughout the day was 4 to 7mmol/l before meal and will be increase till to less than 10mmol/l 90 minute after a meal, and around 8mmol/l at the bedtime.
Diabetes mellitus is a chronic hereditary disorder of carbohydrate ,protein, and fat metabolism . It is characterized by lack of insulin activity and the ability to regulate blood glucose level, resulting hyperglycemia and glucosuria. There are two types of Diabetes mellitus:
1. In type 1 diabetes, which usually starts in childhood or adolescence, the pancreas stop making insulin altogether. It is also called Insulin Dependent Diabetes Mellitus(IDDM).
2. In type 2 diabetes, which starts in adulthood (and in some teenagers, mainly after 40 years of age), the body still makes some insulin , but it doesn't make enough insulin,or the body can't use it properly. It also called Non-Insulin Dependent Diabetes Mellitus (NIDDM).
Insulin deficiency may be due to abnormality of beta cell function in the manufacture or release of insulin ,autoimmunity factors ,insensitivity of body cell to insulin or the excessive demands for insulin in obesity ,pregnancy, periods of extreme stressor infection.
Glucose increases in the blood (hyperglycemia) ,because without insulin it can't be converted to glycogen or cross cell membranes. The conversion of fat and protein to glucose energy will occur.
This fault fat metabolism produces ketone bodies ,acetone, and low blood pH (metabolic acidosis). Hyperglycemia in a severe state causes ketoacidosis and diabetic coma.
Symptom and Causes
- Glycosuria (sugar in urine) : Excess glucose in the blood ultimately results in high levels of glucose being present of the urine
- Polyuria (excessive urinary output and dehydration) : This increase of urine output ,which leads to dehydration and increase thirst.
- Polydipsia (excessive thirst ) : to counter of dehydration makes the body need lot of water
- Polyphagia ( excessive hunger) : Loss of calorie (glucose excreted) and cell starvation makes the body need much of energy that supplied by ate over
- Weight loss : Causes by calorie loss via urine (urine glucose),cell starvation, catabolism of stored fat and protein
- Drowsiness,fatigue : Lack of energy from absence of glucose in cell, CNS (Central Nervous System),depression of ketone bodies, metabolism acidosis
- Electrolyte losses : Loss of electrolyte such as NA+,K+,Ca++,CL-,depletion with polyuria and increasing of acidosis
- Acidosis(metabolic) : Causes ketone bodies are acidic. Excessive H+ ions (Low pH) overwhelm and lower HCO3
- Kussmaul breathing (air hunger rapid,deep breathing) : Causes respiratory compensation which lowers carbonic acid "blow off" CO2 in acidosis state ,Acetone odor on breath may be present.
The blood studies measure the body's ability to clear excessive glucose from the blood in the fasting state or after an increased load. Usually test to FBS (Fasting Blood Sugar),2 hour Post Prandial Blood Sugar (PPBS),and also GTT ( Glucose Tolerance Test) should be done.
A key of diabetes treatment is to prevent complications because, over time, diabetes can damage the heart, blood vessels ,eyes, kidneys, and nerves, although the person may not know damage is taking place. Complications are most likely to occur in someone who has had diabetes for many years.
If uncontrolled for many years ,diabetes mellitus can lead to more serious health problems as a below:
- Heart Disease
- Kidney Disease
- Eye Problems
- Diabetic retinopathy
- Legs and Feet
- Other effects of Diabetic Neuropathy
- Skin and Oral Infections
Diabetes also may affect the function of the nerves that control eyesight causing blurred vision. Cataract and glaucoma are eye disease that occur more frequently in the people with diabetes.
Very high glucose levels cause symptom that are hard to ignore . Frequent urination and excessive thirst .However, in someone who is elderly or in poor health these symptoms may go unnoticed. Without treatment a person with high blood glucose level or hyperglycemia can lose fluids ,become weak, confuse and even unconscious . Breathing will be shallow and the pulse rapid. The person's lips and tongue will be dry, and his or her hands and feet will be cool. If the condition is taking place, a doctor should be called immediately.
The opposite of high blood glucose ,very low blood glucose or hypoglycemia ,is also dangerous. Hypoglycemia can occur when someone hasn't eaten enough to balance the effects of insulin or medicine. Prolonged, strenuous exercise in someone taking oral diabetes drugs or insulin also can cause hypoglycemia ,as can alcohol.