Diabetes Mellitus

Diabetes mellitus and its different types

Diabetes mellitus and its different types

 

Diabetes Mellitus
Main types of diabetes mellitus

Diabetes is a chronic condition associated with an elevated level of glucose in blood. Insulin is released from pancreas which is a vital organ in the body. It lowers blood glucose in body. Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates, insulin is released from the pancreas to normalize the glucose level by promoting the uptake of glucose into body cells. In patients with diabetes, the absence of insufficient production of or lack of response to insulin causes hyperglycemia. There are three types of diabetes mellitus. Chronic diabetes includes type 1 diabetes mellitus referred to insulin dependent diabetes mellitus, type 2 referred to non-insulin dependent diabetes mellitus and gestational diabetes which comes with pregnancy.

Types of Diabetes Mellitus:

Type 1 Diabetes

 

Diabetes Mellitus Type 1
Diabetes Mellitus Type 1

Type 1 diabetes mellitus is also called insulin dependent diabetes mellitus which is also called juvenile diabetes mellitus as it usually begins in the childhood.

It is an autoimmune condition which happens when your body releases antibodies that attack your pancreas. Therefore, Beta Langerhans cells found in your pancreas are damaged and no longer have the ability to release insulin anymore.

Your genes might cause this type of diabetes. It could also happen because of problems with cells in your pancreas that make insulin. Most of the complications that come with this type of diabetes include diabetic retinopathy which is damage to the blood vessels found in your eyes. Diabetic neuropathy is damage to the nerves that are found all over your body. Diabetic nephropathy is damage to both kidneys. People suffering from diabetes type 1 have a higher risk of suffering from heart diseases and stroke.

Treatment of diabetes mellitus involves injecting insulin into the fatty tissue just under your skin and it’s injected subcutaneously

You might need:

  • Syringes
  • Insulin pens that use prefilled cartridges and a thin needle
  • Jet injectors that use high-pressure air to send a spray of insulin through your skin
  • Pumps that send insulin through a tube to a catheter under the skin of your belly

You need to perform HbA1c test which refers to glycated haemoglobin. It develops when haemoglobin, a protein within red blood cells that carries oxygen throughout your body, joins with glucose in the blood, becoming ‘glycated’. If you have type 1 diabetes, you’ll need to make changes including:

  • Testing your blood glucose frequently
  • Managing your daily caloric intake
  • Physical exercise
  • Taking your insulin or other medications as prescribed.

Type 2 Diabetes

 

Diabetes Mellitus Type 2
Diabetes Mellitus Type 2

 

Type 2 Diabetes mellitus is used to be called non-insulin-dependent or adult-onset diabetes. But it’s become more common in children and teens over the past 20 years; this is because more teens and adolescents are overweight or obese or have BMI of higher than 29.

When you have Type 2 Diabetes mellitus, your pancreas usually releases reduced amount of insulin. But usually it’s not sufficient or your body is not using it properly. insulin resistance occurs when your cells don’t respond to insulin like normal cells usually happens in fat, liver, and muscle cells.

Type 2 diabetes is less dangerous than type 1. But it can still cause critical health complications like retinopathy, nephropathy and neuropathy.

People who are obese have especially high risk of type 2 diabetes and health problems that can follow. Obesity often causes insulin resistance so your pancreas has to work harder to make more insulin. But it’s still not enough to keep your blood sugar levels where they should be.

Treatment of type 2 involves keeping a healthy weight, eating right, and exercising. Some people need medication, too.

Your doctor might do glycated hemoglobin test a few times a year to see how well you’ve been controlling your blood sugar properly.

Gestational Diabetes

 

Gestational Diabetes
Gestational Diabetes

Pregnancy usually causes some form of insulin resistance. If it develops into diabetes then it’s called gestational. Doctors often spot it in middle or late pregnancy. Because a female’s blood glucose travels through her placenta to the fetus, it’s important to control gestational diabetes to protect the baby’s growth and development.

Doctors report gestational diabetes in 2% to 10% of pregnancies. It usually goes away after birth. But up to 10% of women who have gestational diabetes get type 2, weeks or even years later.

Gestational diabetes is more of a risk for the baby than the mother. A baby might have unusual weight gain before birth, trouble breathing at birth, or a higher risk of obesity and diabetes later in life. The mother might need a cesarean section because of an overly large baby, or they might have damage to their heart, kidney, nerves, and eyes.

Gestational Diabetes Management 

  • Careful meal planning to make sure you get enough nutrients without too much fat and calories
  • Daily exercise
  • Keeping weight gain under control
  • Taking insulin to control your blood sugar levels, if needed

Common Signs and symptoms of different types:

  • Excessive eating
  • Fatigue
  • Thirst
  • Xerostomia (dry mouth)
  • Blurred vision
  • Yeast infections
  • Slow healing of cuts and injuries
  • Nausea and vomiting
  • Neuropathic pain
  • Retinopathy
  • Excessive urination
  • Vaginal and skin infections
  • Coordination problems
  • Impotence and erectile dysfunction 

Diabetes Mellitus Guide Plan: 

You need to learn how to monitor your blood glucose at home

Depending on your treatment plan, you may check and record your blood sugar as many as four times a day or more often if you’re taking insulin. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range. Moreover, People with type 2 diabetes who aren’t taking insulin generally check their blood sugar much less frequently.

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 Treating with Insulin

People with type 1 diabetes need insulin therapy to survive. Many people with type two diabetes or gestational diabetes may also need insulin therapy according to their blood tests.

Many types of insulin are available, including short-acting (regular insulin), rapid-acting insulin, and long-acting insulin and intermediate options. Depending on your needs, your doctor may prescribe a mixture of insulin types to use throughout the day and night.

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Insulin can’t be taken orally to lower blood sugar because stomach enzymes interfere with insulin’s action. Often insulin is injected using a fine needle and syringe or an insulin pen a device that looks like a large ink pen.

An insulin pump also may be an option. The pump is a device about the size of a small cellphone worn on the outside of your body. A tube connects the reservoir of insulin to a catheter that’s inserted under the skin of your abdomen.

A tubeless pump that works wirelessly is also now available. You program an insulin pump to dispense specific amounts of insulin. It can be adjusted to deliver more or less insulin depending on meals, activity level and blood sugar level.

An artificial pancreas is also called closed-loop insulin delivery. The implanted device links a continuous glucose monitor, which checks blood sugar levels every five minutes, to an insulin pump. The device automatically delivers the correct amount of insulin when the monitor indicates it’s needed.

  • Oral or other medications.

Sometimes other oral or injected medications are prescribed as well. Some diabetes medications stimulate your pancreas to produce and release more insulin. Others inhibit the production and release of glucose from your liver, which means you need less insulin to transport sugar into your cells.

Still others block the action of stomach or intestinal enzymes that break down carbohydrates or make your tissues more sensitive to insulin. Metformin is generally the first medication prescribed for type 2 diabetes.

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Another class of medication called SGLT2 inhibitors may be used. They work by preventing the kidneys from reabsorbing sugar into the blood. Instead, the sugar is excreted in the urine.

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In some people who have type 1 diabetes, a pancreas transplant may be an option. Islet transplants are being studied as well. With a successful pancreas transplant, you would no longer need insulin therapy.

  • Bariatric surgery.

Although it is not specifically considered a treatment for type two diabetes. People with type 2 diabetes who are obese and have a body mass index higher than 35 may benefit from this type of surgery. People who’ve undergone gastric bypass have seen significant improvements in their blood sugar levels. However, this procedure’s long-term risks and benefits for type 2 diabetes aren’t yet known.

References

Diabetes – Symptoms and causes – Mayo Clinic

Diabetes Mellitus: Types, Risk Factors, Symptoms, Treatments (clevelandclinic.org)

 

 

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