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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.

Hypoglycaemia

Hypoglycaemia is a condition where a person has low blood glucose. The level of glucose in the blood drops below 2.5mmol/l. Insulin produced in the pancreas helps in aborption of glucose from the blood. When the levels of insulin in the blood is high, it can result in extremely low levels of blood sugar or a condition of Hypoglycaemia. Hypoglycaemia can result on account of excessive consumption of refined sugar and carbohydrates, soft drinks or caffeine. Hypoglycaemia is sometimes noticed in persons on medications such as quinine, salicylates for rheumatic disease and propranolol for hypertension. Other causes include:
Missing or skipping meals
Strenuous exercise
Excessive alcohol consumptions
Tumor in the pancreas
Weakened pituatary gland
Reduced liver function
Overdose of insulin or diabetic tablets

A person suffering from hypoglycaemia will notice symptoms such as rapid heartbeat, agitation and trembling. There is difficulty in concentration and sometimes temporary loss of consciousness. Hypoglycaemia can cause double vision, temporary paralysis and seizures and abnormal behavior. The person suffering from hypoglycaemia feels hungry and starts sweating profusely. Ignoring this condition can lead to hypoglycaemic coma. It is essential to avoid repeated attacks of hypoglycaemia since it can lead to fatal brain damage. An attack of hypoglycaemia during driving or swimming can be disastrous. Night time hypoglycaemia is characterized by sweating at night and headache on waking up.

Hypoglycaemia is diagnosed by measuring the blood glucose levels. If there is any tumor in the pancreas, it is usually removed. Treatment for weakened pituatary and adrenal glands include suitable medication. To handle reactive hypoglycaemia, it is essential to eat smaller meals spread out during the day. This can prevent large fluctuations in insulin secretion levels. Try and include complex carbohydrates in the diet. Never overload your body with very heavy large meals. Spacing out the meals allows better digestion and absorption. Smaller meals also helps keep weight in check and keeps acidity at bay. Snack on high-fiber food as it slows down the rise in blood sugar levels. Include fresh vegetables, fruits and wholegrain cereal foods. Make lean proteins and reduced fat a part of your diet. Drink plenty of water.