This document provides information on diabetes mellitus (DM), including its definition, symptoms, treatment, management, prevention, and references. DM is a group of metabolic diseases characterized by high blood sugar. There are three main types: type 1 results from failure to produce insulin; type 2 results from insulin resistance and sometimes insulin deficiency; and gestational diabetes occurs in pregnant women. Symptoms include frequent urination, increased thirst and hunger. Complications are both acute, like diabetic ketoacidosis, and long-term, affecting organs like the eyes, kidneys, and heart. Treatment focuses on controlling blood sugar through diet, exercise and medication. Management concentrates on keeping blood sugar levels close to normal through lifestyle changes. Prevention of
This document provides information on diabetes mellitus (DM), including its definition, symptoms, treatment, management, prevention, and references. DM is a group of metabolic diseases characterized by high blood sugar. There are three main types: type 1 results from failure to produce insulin; type 2 results from insulin resistance and sometimes insulin deficiency; and gestational diabetes occurs in pregnant women. Symptoms include frequent urination, increased thirst and hunger. Complications are both acute, like diabetic ketoacidosis, and long-term, affecting organs like the eyes, kidneys, and heart. Treatment focuses on controlling blood sugar through diet, exercise and medication. Management concentrates on keeping blood sugar levels close to normal through lifestyle changes. Prevention of
This document provides information on diabetes mellitus (DM), including its definition, symptoms, treatment, management, prevention, and references. DM is a group of metabolic diseases characterized by high blood sugar. There are three main types: type 1 results from failure to produce insulin; type 2 results from insulin resistance and sometimes insulin deficiency; and gestational diabetes occurs in pregnant women. Symptoms include frequent urination, increased thirst and hunger. Complications are both acute, like diabetic ketoacidosis, and long-term, affecting organs like the eyes, kidneys, and heart. Treatment focuses on controlling blood sugar through diet, exercise and medication. Management concentrates on keeping blood sugar levels close to normal through lifestyle changes. Prevention of
Contents Definition Symptoms Treatment Management Prevention References Definition Diabetes mellitus (DM) or simply diabetes is a group of metaolic diseases in which a person has high lood sugar! This high lood sugar produces the symptoms of fre"uent urination# increased thirst# and increased hunger! $ntreated# diaetes can cause many complications! Acute complications include diaetic %etoacidosis and non%etotic hyperosmolar coma! Serious long-term complications include heart disease# %idney failure# and damage to the eyes! Diaetes is due to either the pancreas not producing enough insulin# or ecause cells of the ody do not respond properly to the insulin that is produced! There are three main types of diaetes mellitus& Type ' DM results from the ody(s failure to produce insulin! This form was previously referred to as )insulin-dependent diaetes mellitus) (*DDM) or )+uvenile diaetes)! Type , DM results from insulin resistance# a condition in which cells fail to use insulin properly# sometimes also with an asolute insulin deficiency! This form was previously referred to as non insulin-dependent diaetes mellitus (-*DDM) or )adult-onset diaetes)! .estational diaetes# is the third main form and occurs when pregnant women without a previous diagnosis of diaetes develop a high lood glucose level! Symptoms The classic symptoms of untreated diaetes are weight loss# polyuria (fre"uent urination)# polydipsia (increased thirst)# and polyphagia (increased hunger)!Symptoms may develop rapidly (wee%s or months) in type ' diaetes# while they usually develop much more slowly and may e sutle or asent in type , diaetes! Prolonged high lood glucose can cause glucose asorption in the lens of the eye# which leads to changes in its shape# resulting in vision changes! /lurred vision is a common complaint leading to a diaetes diagnosis! A numer of s%in rashes that can occur in diaetes are collectively %nown as diaetic dermadromes! Diabetic emergencies People (usually with type ' diaetes) may also e0perience episodes of diaetic %etoacidosis# a type of metaolic prolems characteri1ed y nausea# vomiting and adominal pain# the smell of acetone on the reath# deep reathing %nown as 2ussmaul reathing# and in severe cases a decreased level of consciousness! 3 A rare ut e"ually severe possiility is hyperosmolar non%etotic state# which is more common in type , diaetes and is mainly the result of dehydration! Complications All forms of diaetes increase the ris% of long-term complications! These typically develop after many years ('45,4)# ut may e the first symptom in those who have otherwise not received a diagnosis efore that time! The ma+or long-term complications relate to damage to lood vessels! Diaetes doules the ris% of cardiovascular disease and aout 678 of deaths in diaetics are due to coronary artery disease! 9ther )macrovascular) diseases are stro%e# and peripheral vascular disease! The primary microvascular complications of diaetes include damage to the eyes# %idneys# and nerves! Damage to the eyes# %nown as diaetic retinopathy# is caused y damage to the lood vessels in the retina of the eye# and can result in gradual vision loss and potentially lindness! Damage to the %idneys# %nown as diaetic nephropathy# can lead to tissue scarring# urine protein loss# and eventually chronic %idney disease# sometimes re"uiring dialysis or %idney transplant! Damage to the nerves of the ody# %nown as diaetic neuropathy# is the most common complication of diaetes!The symptoms can include numness# tingling# pain# and altered pain sensation# which can lead to damage to the s%in! Diaetes-related foot prolems (such as diaetic foot ulcers) may occur# and can e difficult to treat# occasionally re"uiring amputation! Additionally# pro0imal diaetic neuropathy causes painful muscle wasting and wea%ness! Treatment :ith type , diaetes# the disease may e reversed with lifestyle changes# especially losing weight through e0ercising and eating healthier foods! Also# some cases of type , diaetes can e improved with weight-loss surgery! There is no cure for type ' diaetes! Treating oth type ' diaetes and type , diaetes involves medicines# diet# and e0ercise to control lood sugar level! .etting etter control over your lood sugar# cholesterol# and lood pressure levels helps reduce the ris% of %idney disease# eye disease# nervous system disease# heart attac%# and stro%e! To prevent diaetes complications# visit your health care provider at least two to four times a year! Tal% aout any prolems you are having! ;ollow your health care provider(s instructions on managing your diaetes! Management Diaetes mellitus is a chronic disease# for which there is no %nown cure e0cept in very specific situations! Management concentrates on %eeping lood sugar levels as close to normal ()euglycemia)) as possile# without causing hypoglycemia! This can usually e accomplished with diet# e0ercise# and use of appropriate medications (insulin in the case of type ' diaetes< oral medications# as well as possily insulin# in type , diaetes)! =earning aout the disease and actively participating in the treatment is vital for people with diaetes# since the complications of diaetes are far less common and less severe in people who have well-managed lood sugar levels! The goal of treatment is an >A'? level of @!78# ut should not e lower than that# and may e set higher!
Attention is also paid to other health prolems that may accelerate the deleterious effects of diaetes! These include smo%ing# elevated cholesterol levels# oesity# high lood pressure# and lac% of regular e0ercise! Specialised footwear is widely used to reduce the ris% of ulceration# or re-ulceration# in at-ris% diaetic feet! Avidence for the efficacy of this remains e"uivocal# however! Prevention There is no %nown preventive measure for type ' diaetes! Type , diaetes can often e prevented y a person eing a normal ody weight# physical e0ercise# and following a healthy diet!
Dietary changes %nown to e effective in helping to prevent diaetes include a diet rich in whole grains and fier# and choosing good fats# such as polyunsaturated fats found in nuts# vegetale oils# and fish! =imiting sugary everages and eating less red meat and other sources of saturated fat can also help in the prevention of diaetes!
Active smo%ing is also associated with an increased ris% of diaetes# so smo%ing cessation can e an important preventive measure as well! References Alem1adeh R# Ali 9! Diaetes mellitus! *n& 2liegman RM# ed! Kliegman: Nelson Textbook of Pediatrics ! 'Bth ed! Philadelphia# Pa!& Alsevier Saunders< ,4''&chap 7CD! Amorosa =;# =ee AE# Swee DA! Diaetes mellitus! *n& Ra%el RA# Ra%el DP# eds! Textbook of Family Medicine ! Cth ed! Philadelphia# Pa!& Alsevier Saunders< ,4''&chap DF! American Diaetes Association! Standards of medical care in diaetes -- ,4'D! Diabetes Care ! ,4'D< Ean<DD Suppl '&S''-S@'! Aisenarth .S# Polons%y 2S# /use E/! Type ' Diaetes Mellitus! *n& 2ronenerg >M# Melmed S# Polons%y 2S# =arsen PR! Kronenberg: Williams Textbook of Endocrinology ! ''th ed! Philadelphia# Pa& Saunders Alsevier< ,44C&chap D'!
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