Understanding Diabetes Mellitus

Overview of Diabetes

• Diabetes mellitus, commonly called diabetes, is a chronic condition affecting approximately 25.8 million people in the U.S.
• It ranks as the seventh leading cause of death in the country.
• The condition involves high blood sugar levels, known as hyperglycemia.

Mechanism of Diabetes

• Food is converted into glucose, which enters the bloodstream, serving as the body’s fuel.
• The pancreas produces insulin, a hormone crucial for transporting glucose into muscle, fat, and liver cells.
• Diabetic individuals struggle with high blood sugar due to insufficient insulin production or insulin resistance in cells.

Types of Diabetes

• Type 1 Diabetes (T1D):

  • Often referred to as juvenile or insulin-dependent diabetes.
  • Can affect both adults and children and occurs when the pancreas fails to produce insulin due to the destruction of beta cells.
  • Affected individuals require daily insulin injections.
  • Causes are not fully understood but involve genetic and environmental factors.

• Type 2 Diabetes (T2D):

  • The most prevalent type, primarily affecting adults but increasingly seen in teens due to obesity and sedentary lifestyles.
  • Characterized by insulin resistance, preventing glucose from entering cells and causing accumulation in the bloodstream.
  • Develops gradually over time.

• Gestational Diabetes:

  • Diagnosed during pregnancy, affecting around 8% of pregnant women in the U.S.
  • Linked to weight gain and hormonal changes during pregnancy, impairing insulin function.
  • Generally resolves after giving birth, but increases the risk of T2D in the future.

Risk Factors for Diabetes

• Type 1 Diabetes:

  • Family history of diabetes.
  • Pancreatic diseases or infections affecting the pancreas.

• Type 2 Diabetes:

  • Obesity and family history.
  • History of gestational diabetes.
  • Higher risk in specific ethnic groups: African Americans, Native Americans, Hispanic Americans, Asian Americans.
  • Older age and hypertension.

• Gestational Diabetes:

  • Family history and pre-pregnancy obesity.
  • Belonging to a high-risk ethnic group.
  • Previous gestational diabetes and having large babies (over 9 pounds).

Symptoms of Diabetes

• Type 1 Diabetes:

  • Rapid onset symptoms: weight loss, frequent urination, extreme thirst and hunger, weakness, fatigue, nausea, and vomiting.

• Type 2 Diabetes:

  • Symptoms develop slowly, often with no noticeable signs: may include symptoms from type 1, along with blurred vision, slow healing of skin, infections, and numbness in extremities.

• Gestational Diabetes:

  • Symptoms can be absent; testing required during pregnancy; symptoms mirror type 2 diabetes.

Complications of Diabetes

• Potential complications include:
  • Kidney disease (diabetic nephropathy).
  • Blindness (diabetic retinopathy).
  • Increased risk of heart disease and stroke (2 to 4 times more likely).
  • Nerve damage.
  • Severe foot sores, potentially leading to amputations.
  • Diabetic coma from critically high blood sugar levels.

Diagnosis of Diabetes

• Fasting Blood Glucose Test:

  • Diagnoses diabetes if levels are 126 mg/dL or higher after an 8-hour fast.
  • Levels between 100-126 mg/dL indicate prediabetes.

• Hemoglobin A1c Test:

  • Measures average blood glucose control over the past 3 months.

• Oral Glucose Tolerance Test (OGTT):

  • Diagnoses diabetes if glucose levels reach 200 mg/dL or higher post-consumption of a glucose solution.

• Screening Recommendations:

  • Overweight children, adults with risk factors, and individuals over 45 should be screened for T2D.

Treatment and Management

• While there is no cure, diabetes management includes lifestyle modifications, monitoring blood sugar, and possibly medication or insulin therapy to maintain proper glucose levels.