Diabetes Mellitus

-

Diabetes Mellitus

Diabetes is a condition where a person either does not produce required amounts of insulin or is unable to utilise insulin appropriately. It is a common (about 10% of the population), complex disease. It can cause complications if not treated and controlled well.

Types of Diabetes:

There are 2 common types of diabetes Type I and Type II. There are other rare varieties due to pancreatic diseases, hormonal disorders, in pregnancy, after drugs and even rarer genetic disorders.
Type I is the cause in about 10 % of cases, onset is in childhood or young age and insulin is required for treatment.
Type II is the common variety, onset is usually around 50 Yrs of age, often associated with overweight and the risk is high if one parent is diabetic (30 %) and if both parents are diabetic (50 %). During initial stages, diet modification and oral drugs may control sugars but later insulin may be required.

Symptoms:

Classically symptoms in diabetes are polyuria (more urine), polydypsia (more thirst ) and polyphagia ( more eating). In children very high sugars may develop suddenly and patient may become unconscious at the onset (DKA etc). Infections both recurrent and difficult to treat may occur. However in a large no the disease remains without many symptoms and found out accidentally or when complecations arise.
Signs are seen only in advanced and long standing diseases. These are few and may include eye, heart, nerve changes, dehydration and very rapid breathing due to acid accumulation in the body.

Diagnosis of diabetes:

Diabetes is diagnosed by blood glucose testing or glycated hemoglobin levels.
Normal Plasma glucose level after 8 hrs of fasting is < 100 mg/dl. Normal 2 hrs after breakfast (called PP) or after 75 gms of glucose orally is <140 mg.   Diabetes is diagnosed if either fasting plasma glucose is >126 or PP or oral GTT (after 75 gms of glucose is >200 mg/dl.
If fasting value is 100 -125 it is called impaired fasting glucose and if PP or Oral GTT is between 140 and 199 mg/dl it is called impaired glucose tolerance( IGT).
In a person with symptoms of diabetes a random value of plasma sugar >200 mg /dl or fasing plasma sugar >126 mg/dl qualifies for diagnosis of diabetes.

Lab tests for diabetes  

For common types of diabetes the following tests may be required at the time of initial diagnosis.
Complete blood counts, Blood sugar, kidney and liver function tests, urine routine and urine for microalbumin, lipid profile, Chest X Ray, ECG. Ultrasonography of abdomen, fundus examination, foot examination and blood pressure is noted.
In Type I cases or where genetic, pancreatic or hormonal disorders are suspected, tests for these are carried out as appropriate.
This is a chronic disease and lifelong follow up and treatment are required.




Coming next ~
Complications of diabetes
Treatment of diabetes.

Comments

Post a Comment

Popular posts from this blog

Urinary Tract Infections : Women

-
Image
U TI in short, is a common illness in a woman, especially during the reproductive period. The incidence in western countries is .5/woman /year. It is commoner in women compared to men due to their shorter urethra (Tube from the lower end of the bladder to opening for urine). Bacteria from large intestines contaminate the skin around the anus, migrate to the vaginal opening and may ascend through the urethra to the bladder and sometimes via ureter to the kidneys. Infections of the bladder are called cystitis, infections of urethra urethritis and that of kidneys pyelonephritis. Symptoms of UTI In cases of urethritis, pain while passing urine (dysuria), more frequency, pus discharge from urine opening may occur. In cases of cystitis, dysuria, frequency, urgency (inability to hold urine), lower abdominal pain or discomfort and sometimes blood in urine may occur. In pyelonephritis, the symptoms usually are fever (temp above 38 °  C ), flank pain or discomfort, tenderne
Read more

Fats in the Diet

-
Image
Each gram of fat provides 9 kcal of energy. Fats are essential for the human body as these make up the important part of all tissues and cells. The cell membrane is rich in lipids and brain is full of fat. In combination with proteins and phosphates, fats (lipids) for many important molecules. Linoleic and a-linolenic acids are essential fatty acids. Trans fats are usually of animal origin or provided by hydrogenation of oils. These are harmful for the body. Poly-unsaturated fats and Mono-unsaturated fats are associated with less risk to heart and brain compared to saturated fats. Fats of animal origin are more harmful compared to fats from vegetable sources. In terms of health benefits, olive oil, soya oil, sunflower and safflower oils rank high. In the body, lipids are measured in blood by the test of lipid profile (best done after 8-10 hrs of fasting). It measures S cholesterol (HDL or high density, LDL or low density and VLDL and IDL very low and intermediate respec
Read more

Water Soluble Vitamins

-
Image
Thiamine B eriBeri was known to the Chinese 5000 years back. However the fact that it was due to Vitamin B 1  deficiency was only known in 1926. This vitamin is found in nuts, legumes, yeast and rice (unpolished). It is not found in fruits, milk or vegetables. The meagre quantities found in these can be destroyed by cooking as well. This vitamin is required for the metabolism of carbohydrates and proteins in the body. It forms part of a chemical required for enzymatic activity. The requirement for man and woman is slightly more than 1 mg /day. A pregnant woman may require about one and half times of this. Severe deficiency of this vitamin can cause the following diseases: Infantile beriberi Adult beriberi Wernicke-Korsakoff syndrome Leigh disease Infantile beriberi occurs in infants less than 6 months fed exclusively on formula feeds not having thiamine. It is now rare. Adult Beriberi: Dry beriberi usually causes nervous system disorder. Wet beriberi causes swel
Read more