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Diabetes Mellitus : Type 1 and Type 2

Diabetes Mellitus : Type 1 and Type 2

Diabetes can manifest itself in two different forms and severities. When there is an occurence of diabetes due to an inadequate production of insulin by the pancreas, it is a condition of Diabetes mellitus. Insulin is a hormone which regulates the level of glucose (sugar) in the blood stream. Glucose serves as a vital source of energy for all organs in the body and is the only source of energy that can be utilized by the brain. But insulin is needed to control the glucose levels in the blood so that the body can effectively use it for regulation of metabolism. Insulin is critical in the transport of glucose to the cells for energy metabolism.

The two forms of diabetes are discussed below:

TYPE 1 Diabetes: Diabetes of this kind usually manifests in childhood or adolescence. Patients suffering from this type of diabetes are dependent on insulin injections to maintain normal body chemistry. This type of diabetes can be inherited. If this is not tackled with insulin, diabetic ketoacidosis and death can result. Type 1 Diabetes is referred to as insulin dependent diabetes.

TYPE 2 Diabetes: Usually, middle aged and overweight people suffer from this type of diabetes when their blood sugar is higher than normal. This manifestation of diabetes is also known as adult onset diabetes. Insulin injections are not needed to conrol this form of diabetes but a suitable diabetes diet and weight reduction can help. But this form of diabetes can lead to long term diabetic complications.

Complications arising out of long-term diabetes
1. Diabetic Retinopathy: There is damage to the retina (perceptive structural tissue of the eye). This condition results in decreased vision and sometimes leads to blindness.
2. Kidney Disease: Impaired kidney function can be a resultant of long term diabetes. It can even lead to overt kidney failure.
3. Stroke: Diabetics have an increased risk of stroke.
4. Heart Disease: Increased risk of myocardial infarction (heart attack).
5. Peripheral Vascular Disease
6. Poor Wound Healing: Ulcers and foot problems are common
7. Decreased immunity to infection
8. Peripheral Neuropathy: Patients suffering from Diabetes face damage to the peripheral nerves and altered sensation. It is also accompanied by numbness, tingling and/or burning pain to the extremeties.
9. Females who are diabetic need to be carefully monitored during pregnancy

Type I Diabetes manifests itself in symptoms such as increased frequency of urination, increased thirst and hunger. Type I Diabetic patients also experience weight loss and increased fatigue. Read up the symptoms of diabetic ketoacidosis

Type II Diabetes is characterized by increased hunger and thirst and increased fatigue. Persons suffering from this form of diabetes face numbness or tingling in the hands and feet as well as frequent infections along with slow healing of cuts, ulcers and sores. Impotence is yet another resultant condition.

Random and fasting blood sugar testing can help in revealing any indications of diabetes. Examining the medical history combined with a physical examination is also done by a physician. To confirm the diagnosis, a Glucose tolerance testing is also done. Blood tests for kidney profile and blood counts are also done. Urinalysis will show the excess presence of glucose.

Treating Diabetes
1. Controlling the symptoms of diabetes.
2. Achieving and maintaining a desirable weight.
3. Achieving and maintaining a healthy level of physical activity.
4. Achieving and maintaining a nearly-normal blood glucose level (between 70 mg/dl and 140 mg/dl).

Treatment of type 1 diabetes requires adherence to a strict diabetes diet and regular doses of insulin. Failure to take care of the diabetic condition can lead to potentially serious outcomes. Blood glucose levels must be monitored so that complications are avoided. Diabetics must be trained to check their own blood and urine glucose levels. They can use the newer forms of ambulatory glucose monitors that can give you automatic readings and help in diabetes management. Avoiding sweets is an elementary precaution that needs to be followed. Many a time, oral hypoglycaemic agents (Orinase, Glucatrol) may be used for regulating blood sugar levels. Find out more on a diabetes diet (in total calories). You can seek help from an Internist or Endocrinologist

Use of Steroid medications (i.e. Prednisone and Medrone) can increase blood sugar levels. They can affect the control and treatment of diabetes. Beta-blocker antihypertensive medications are yet another set of medicines that can cause serious complications for the diabetic patient and should be avoided.

ANA blood test

Antinuclear antibodies (ANA) refer to the unusual antibodies that are detectable in the blood. ANA are gamma-globulins type of antibodies that are found in patients with certain autoimmune diseases. ANA are directed against certain components found in the nucleus of a cell in the body. These antibodies have the capacity of binding certain structures within the nucleus of the cells. The ANA test was first designed by Dr.George Friou in 1957. The laboratory blood test exposes the antibodies in the serum of the blood to cells. It is then determined whether or not antibodies are present that react to various parts of the nucleus of cells. Hence the term 'anti-nuclear' antibody is used. Fluorescence techniques are adopted to detect the ANA antibodies in the cells. Thus ANA testing is sometimes referred to as fluorescent antinuclear antibody test (FANA). Nowadays, a method to detect antinuclear antibodies called enzyme linked immunosorbent assay (ELISA) is replacing the previous method of immunofluorescent assay technique. The ELISA method is less likely to produce false positive ANA result than the previous method.

Patterns also give doctors a clue as to the type of illness to look for while evaluating a patient. For instance, the disease Scleroderma shows in nucleolar pattern. If a person does not have any autoimmune disease, it is defined in speckled pattern. An ANA blood test is used in patients who might be suffering from Sjogren's syndrome, rheumatoid arthritis, polymyositis, scleroderma, Hashimoto's thyroiditis, juvenile diabetes mellitus, Addison's disease, vitiligo, pernicious anemia, glomerulonephritis and pulmonary fibrosis. ANA can also be found in patients with conditions that are not considered autoimmune diseases such as chronic infections and cancer. The result of ANA test is expressed in titers. A titer of 1 to 80 (1:80) means that antibodies could be last detected when 1 part of the blood sample was diluted by 80 parts of another liquid. Usually this other liquid is a diluted salt solution. A larger second number indicates that the antibodies are present in greater concentration. Therefore a titer of 1 to 320 indicated higher concentration of antibodies in the blood than a titer of 1 to 80. The normal values of ANA blood test is : Titer below 1: 20 or 1:40 depending on the test method used.

Positive ANA test result is suggestive of autoimmune disease. It can also mean that the patient has drug induced lupus. Some drugs and infections can also induce false positive ANA test results. Steroids can cause a false-negative result. Medications, especially antibiotics such as isoniazid, penicillin, and tetracycline, birth control pills, lithium and some diuretics such as chlorthalidone can interfere with the test and affect the accuracy of the ANA test result.

Nephrologist

Nephrologists are specialists who specialize in diagnosing and treating diseases related to the kidney. They are trained to mange kidney disorders too. Pediatric nephrologists treat the same conditions in infants, children, and young adults. Nephrologists should complete medical school and then complete three years in internal medicine and further specialize for two years in the field of nephrology. Pediatric nephrologists have to further take special certification to qualify as pediatric nephrologists. Nephrologists also termed as renal physicians treat diseases related to the kidney, any malfunctioning in the kidney can affect other organs of the body.

Conditions that can lead to kidney disorders such as hypertension and diabetes mellitus.

Check the functioning of the kidney.

They treat polycystic kidney diseases.

Prescribe medications for kidney disorders.

Support kidney transplantation.

Treat patients who have kidney failure also called as renal failure / uremia.

Treat patients with kidney stones.

Removes sample from the tissues of the kidney for biopsy purposes.