RECOGNIZE YOUR EARLY DIABETES

Inner health is a very important subject because 95% of life threatening diseases starts inside our bodies where we can't see what is happening. By ignoring symptoms we often allow the problem to increase until treatment become difficult or, in the worst cases, impossible. It is also true that one hour of prevention is far better than one year of treatment, therefore recognize your self when getting any abnormal condition especially to the Diabetes Mellitus.

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).
Etiology
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.

Pathophysiology
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.

Diagnosis test
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.

Diabetes Complication
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:

1. Heart Disease
   
Heart disease is the most common life-threatening disease linked to diabetes, and experts say diabetes doubles a person's risk of developing heart disease .In heart disease ,deposit of fat and cholesterol build-up in the arteries that supply the heart with blood. If this build-up blocks blood from getting to the heart a potentially fatal heart attack can occur.


2. Kidney Disease
   
People with diabetes are also more likely to develop kidney disease (nephropathy) or kidney failure than the other people.


3. Eye Problems
   
Diabetes can effect the eyes in several ways. Frequently, the effect are temporary and can be corrected with better diabetes control. However, long-term diabetes can cause changes in the eyes that threaten vision as cause by the blood vessel damage whitin the eyes (retinopathy).
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.



4. Diabetic retinopathy
   
Retinopathy a disease of retina, the light sensing tissue at the back of the eye, is a common concern among people with diabetes. Diabetes retinopathy damages the tiny vessels that supply the retina with blood.


5. Legs and Feet
   
Leg and foot problems can arise in the people with diabetes due to changes in blood vessel and nerves in these areas. Peripheral vascular disease is condition in the which blood vessel become narrowed by fatty deposits ,reducing blood supply to the legs and feet. Diabetes also can dull the sensitivity of nerves . Someone with this condition, called peripheral neuropathy ,might not notice a sore spot caused by tight shoes or pressure from walking. If ignored, the sore can become infected, and because circulation blood is poor, may be affect to slow healing ability even can makes gangrene if there is no good treatment will be go to amputation.


6. Other effects of Diabetic Neuropathy
   
Someone who has had diabetes for some years and has other complications, may find that spells of indigestion or diarrhea are common. Diabetes also can affect the nerves that control penile erection in the men ,which can cause impotence that show up gradually ,without any loss of desire for sex.


7. Skin and Oral Infections
   
People with diabetes are more likely to develop infections, like boils and ulcers, than the average person. Women with diabetes may develop vaginal infection more often then the other women.


8. Emergencies

Someone whose blood glucose has become too low may feel nervous, shaky, and weak. The person may sweat, feel hungry, and have a headache. Severe hypoglycemia can cause loss of consciousness .A person with hypoglycemia who begins too feel weak and shaky should eat or drink something with sugar in immediately, like orange juice . If the person is unconscious, he or she should be taken to a hospital emergency room right way.

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.