DIABETES MELLITUS

Description
Diabetes is a chronic disease, which occurs when the pancreas does not
produce enough insulin, or when the body cannot effectively use the insulin it
produces. This leads to an increased concentration of glucose in the blood
(hyperglycaemia).
Type 1 diabetes (previously known as insulin-dependent or childhood-onset
diabetes) is characterized by a lack of insulin production.
Type 2 diabetes (formerly called non-insulin-dependent or adult-onset
diabetes) is caused by the body’s ineffective use of insulin. It often results from
excess body weight and physical inactivity.
Gestational diabetes is hyperglycaemia that is first recognized during
pregnancy.

CAUSES
Diabetes mellitus occurs when the pancreas doesn't make enough or any of
the hormone insulin, or when the insulin produced doesn't work effectively. In
diabetes, this causes the level of glucose in the blood to be too high.

In Type 1 diabetes the cells in the pancreas that make insulin are destroyed,
causing a severe lack of insulin. This is thought to be the result of the body
attacking and destroying its own cells in the pancreas - known as an autoimmune
reaction.
It's not clear why this happens, but a number of explanations and possible
triggers of this reaction have been proposed. These include:

* infection with a specific virus or bacteria;

* exposure to food-borne chemical toxins; and
* exposure as a very young infant to cow's milk, where an as yet unidentified
component of this triggers the autoimmune reaction in the body.

Type 2 diabetes is believed to develop when:

* the receptors on cells in the body that normally respond to the action of
insulin fail to be stimulated by it - this is known as insulin resistance. In response
to this more insulin may be produced, and this over-production exhausts the
insulin-manufacturing cells in the pancreas;
* there is simply insufficient insulin available; and
* the insulin that is available may be abnormal and therefore doesn't work
properly.

The following risk factors increase the chances of someone developing Type 2
diabetes:

* Increasing age;
 * obesity; and
* physical inactivity.

Rarer causes of diabetes include:

* Certain medicines;
* pregnancy (gestational diabetes); and
* any illness or disease that damages the pancreas and affects its ability to
produce insulin e.g. pancreatitis.

Signs and Symptoms

High blood levels of glucose can cause several problems, including frequent
urination, excessive thirst, hunger, fatigue, weight loss, and blurry vision.
However, because type 2 diabetes develops slowly, some people with high blood
sugar experience no symptoms at all.

Symptoms of type 1 diabetes:

* Increased thirst
* Increased urination
* Weight loss in spite of increased appetite
* Fatigue
* Nausea
* Vomiting

Patients with type 1 diabetes usually develop symptoms over a short period of
time, and the condition is often diagnosed in an emergency setting.

Symptoms of type 2 diabetes:

* Increased thirst
* Increased urination
* Increased appetite
* Fatigue
* Blurred vision
* Slow-healing infections
* Impotence in men

Treatment
There is no cure for diabetes. Treatment involves medicines, diet, and exercise
to control blood sugar and prevent symptoms and complications.

LEARN THESE SKILLS

Basic diabetes management skills will help prevent the need for emergency care.
These skills include:

* How to recognize and treat low blood sugar (hypoglycemia) and high blood
sugar (hyperglycemia)
* What to eat and when
* How to take insulin or oral medication
* How to test and record blood glucose
* How to test urine for ketones (type 1 diabetes only)
* How to adjust insulin or food intake when changing exercise and eating
habits
* How to handle sick days
* Where to buy diabetes supplies and how to store them

After you learn the basics of diabetes care, learn how the disease can cause
long-term health problems and the best ways to prevent these problems. People
with diabetes need to review and update their knowledge, because new research
and improved ways to treat diabetes are constantly being developed.