Diabetes Mellitus-Types Causes and treatment

Diabetes Mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia (high blood glucose levels) resulting from defects in insulin secretion, insulin action, or both. It is a major public health problem affecting millions of people worldwide, with increasing prevalence and incidence in both developed and developing countries. We will discuss the different types of DM, its causes, symptoms, diagnosis, and management.

Types of Diabetes:

There are three types of diabetes:

Type 1 Diabetes:

Type 1 diabetes, also known as insulin-dependent diabetes mellitus (IDDM), is an autoimmune disorder that results from the body's immune system attacking and destroying the beta cells in the pancreas. These cells are responsible for producing insulin, a hormone that regulates blood sugar levels.

People with type 1 diabetes require insulin injections to survive since their bodies do not produce insulin. The condition usually occurs in children and young adults but can occur at any age.

Type 2 Diabetes:

Type 2 diabetes, also known as non-insulin-dependent diabetes mellitus (NIDDM), is a condition that develops when the body becomes resistant to insulin or does not produce enough insulin to regulate blood sugar levels adequately.

Type 2 diabetes is the most common form of diabetes and can be managed with lifestyle changes, medication, or insulin therapy. The condition is usually diagnosed in adults but can occur in children and teenagers.

Gestational Diabetes:

Gestational diabetes is a type of diabetes that occurs during pregnancy. It usually develops in the second or third trimester and goes away after delivery. Women who develop gestational diabetes have an increased risk of developing type 2 diabetes later in life.

Blood Glucose Chart

Mg/DL	Fasting	After Eating	2-3 hours After Eating
Normal	80 -100	170 - 200	120 -140
Impaired  Glucose	101 -125	190 - 230	140 -160
Diabetic	126+	220 - 300	200+

Symptoms of Diabetes:

The symptoms of diabetes vary depending on the type of diabetes. However, some of the common symptoms of diabetes include:

• Frequent urination:  Increased urination can be a result of the body's attempt to eliminate excess sugar in the blood.
• Increased thirst:  As a result of the increased urination, your body may lose more fluids, causing you to feel thirsty more often.
• Increased hunger:  Since glucose is not properly utilized by the body in diabetes, you may feel hungry more often.
• Fatigue: Diabetes can cause fatigue because the body cannot use glucose effectively for energy.
• Blurred vision: High blood sugar can cause the lens of the eye to swell, resulting in blurred vision.
• Slow healing of cuts and wounds: High blood sugar levels can affect blood flow, which can slow down the healing process.
• Numbness or tingling in the hands and feet: This is known as neuropathy and can occur when high blood sugar levels damage the nerves.

Causes of Diabetes:

CAUSES OF TYPE 1 DIABETES MELLITUS.

Genetic Factors:

Type 1 Diabetes Mellitus is strongly associated with genetic factors. Individuals with a family history of the disease are more likely to develop it. The risk of developing Type 1 Diabetes Mellitus increases by 10 to 20 times if a first-degree relative (parent or sibling) has the disease.

Environmental Factors:

Environmental factors can trigger the autoimmune response that leads to the destruction of the insulin-producing beta cells in the pancreas. 

Viral Infections: 

Viral infections such as Coxsackie virus, Rotavirus, and Cytomegalovirus have been linked to the development of Type 1 Diabetes Mellitus. It is believed that the viruses trigger an autoimmune response in genetically susceptible individuals.

 Diet:

The development of Type 1 Diabetes Mellitus has been linked to the introduction of cow's milk protein, gluten, and cereal protein in the diet before the age of 3. Breastfeeding for a longer duration has been associated with a reduced risk of developing the disease.

Chemicals: 

Exposure to certain chemicals, such as nitrosamines and phthalates, has been linked to an increased risk of developing Type 1 Diabetes Mellitus.

CAUSES OF TYPE 2 DIABETES MELLITUS:

The following are the causes of Type 2 Diabetes Mellitus:

Genetic Factors:

Type 2 Diabetes Mellitus is strongly associated with genetic factors. The risk of developing the disease increases with a family history of the disease. More than 100 genes have been associated with an increased risk of developing Type 2 Diabetes Mellitus.

Lifestyle Factors:

Lifestyle factors, such as poor diet and lack of physical activity, play a significant role in the development of Type 2 Diabetes Mellitus. The following lifestyle factors have been associated with an increased risk of developing the disease:

Frequently Asked Question:

1- How is diabetes diagnosed ?

Diabetes is typically diagnosed through blood tests that measure the level of glucose (sugar) in the blood. The most commonly used tests to diagnose diabetes are:

• Fasting plasma glucose test (FPG): This test measures blood glucose levels after an overnight fast (at least 8 hours). A glucose level of 126 milligrams per deciliter (mg/dL) or higher on two separate occasions indicates diabetes.
• Hemoglobin A1c (HbA1c) test: This test measures the average blood glucose level over the past two to three months. An HbA1c level of 6.5% or higher on two separate occasions indicates diabetes.
• Oral glucose tolerance test (OGTT): This test involves drinking a sugary solution, then      measuring blood glucose levels two hours later. A blood glucose level of 200 mg/dL or higher indicates diabetes.

2- How can diabetes be treated?                                   

There are several ways to manage diabetes, and the treatment approach may vary depending on the type and severity of diabetes. Here are some general treatment options for diabetes:

• Lifestyle Changes: This includes adopting a healthy diet, engaging in regular physical activity, quitting smoking (if applicable), and managing stress.
• Medications: Depending on the type of diabetes, medications such as insulin, oral hypoglycemic agents, and other glucose-lowering medications may be prescribed to help manage blood sugar levels Ex-Metformin.
• Monitoring Blood Sugar: This can be done through self-monitoring using a blood glucose meter or continuous glucose monitoring (CGM) devices.
• Managing Complications: Diabetes can lead to several complications such as nerve damage, kidney damage, and eye problems. Proper management of these complications is essential to prevent further damage and improve overall health.
• Surgery: In some cases, weight loss surgery may be recommended for people with type 2 diabetes who are severely overweight or obese. 

 3- What is the HBA1C?

HbA1c (sometimes abbreviated as Hb1c) is a blood test that measures the average blood sugar level over the past two to three months. It is used to diagnose and monitor diabetes, a condition in which the body is unable to properly regulate blood sugar levels. 

                                                   

HbA1c stands for Hemoglobin A1c, which is a protein found in red blood cells that carries oxygen. When blood sugar levels are high, some of the sugar molecules attach themselves to hemoglobin, forming a molecule called glycated hemoglobin. The more glucose in the blood, the more glycated hemoglobin is formed.

4- What is the normal glucose level?

The normal range for fasting blood glucose (glucose level after not eating for at least 8 hours) is typically between 70 and 100 mg/dL (3.9 to 5.6 mmol/L).

5- Which hormone is responsible for diabetes?

The hormone responsible for diabetes is insulin. Diabetes is a metabolic disorder characterized by high blood sugar levels due to the body's inability to produce or effectively use insulin. Insulin is a hormone produced by the pancreas that regulates the metabolism of carbohydrates and fats in the body.

6- Who is the discover of insulin?

 Insulin was discovered by Canadian scientists Sir Frederick Banting and Charles Best in 1921. Their discovery revolutionized the treatment of diabetes and earned them the Nobel Prize in Physiology or Medicine in 1923.                                                                                                                                                  

7- Which country has most diabetes?

According to the International Diabetes Federation (IDF) Diabetes Atlas 2021, the country with the highest prevalence of diabetes among adults aged 20-79 years is currently the island nation of Nauru, with an estimated diabetes prevalence of 31.3%.

Other countries with high prevalence rates of diabetes include:

• India (10.8%)
• China (10.4%)
• Indonesia (6.9%)
• United States (14.3%)
• Brazil (8.4%)
• Mexico (13.4%)
• Egypt (15.1%)
• Saudi Arabia (17.6%)

8- What is the "3Ps" in diabetic mellitus ?                                                                                                The "3Ps" in diabetes mellitus refer to the three classic symptoms of hyperglycemia (high blood sugar):

Polyuria: This refers to increased urination. High blood sugar causes the kidneys to filter and excrete more glucose, which leads to increased urine production.
Polydipsia: This refers to increased thirst. When the body loses more fluid through urine due to polyuria, it triggers a thirst response to replenish the fluid loss.                                                      Polyphagia: This refers to increased hunger. In diabetes, the body is not able to effectively use glucose for energy, so it relies on stored fat for energy. This leads to increased hunger as the body tries to replenish its energy store.

                                                                                                                              

9- Which type of diabetes is genetic? 

Both Type 1 and Type 2 diabetes can have a genetic component, but Type 1 diabetes is generally considered to have a stronger genetic link.

Type 1 diabetes is an autoimmune disease in which the immune system attacks and destroys the insulin-producing cells in the pancreas. 

There are several genes that have been identified as playing a role in the development of Type 1 diabetes, including the HLA (human leukocyte antigen) genes.                                                                  Type 2 diabetes is also influenced by genetics, but lifestyle and environmental factors, such as obesity and lack of physical activity, play a more significant role in its development.          

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