What is Diabetes Mellitus?

Diabetes mellitus is a kind of metabolic disease that is brought about by either the insufficient production of insulin or the inability of the body to respond to the insulin formed within the system. Diabetes is a disease in which the body does not make enough insulin or does not use it as it should.

Most of what we eat is broken down into glucose. Glucose is a form of sugar in the blood – it is the principal source of fuel for our bodies. When our food is digested the glucose makes its way into our bloodstream. Our cells use the glucose for energy and growth. However, glucose cannot enter our cells without insulin being present – insulin makes it possible for our cells to take in the glucose.

Insulin is a hormone that is produced by the pancreas. After eating, the pancreas automatically releases an adequate quantity of insulin to move the glucose present in our blood into the cells, and lowers the blood sugar level.

Why is it called Diabetes Mellitus?

Diabetes comes from Greek, and it means a siphon. Aretus the Cappadocian, a Greek physician during the second century A.D., named the condition diabainein. He described patients who were passing too much water (polyuria) – like a siphon. The word became “diabetes” from the English adoption of the Medieval Latin diabetes.

In 1675 Thomas Willis added mellitus to the term, although it is commonly referred to simply as diabetes. Mel in Latin means honey; the urine and blood of people with diabetes has excess glucose, and glucose is sweet like honey. Diabetes mellitus could literally mean “siphoning off sweet water”.

In ancient China people observed that ants would be attracted to some people’s urine, because it was sweet. The term “Sweet Urine Disease” was coined.

Pathophysiology of Diabetes Mellitus

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Risk Factors for Type 1 Diabetes

With type 1 diabetes, which starts in childhood, the pancreas stops producing insulin. Insulin is a hormone your body needs to be able to use the energy — glucose — found in food. The primary risk factor for type 1 diabetes is a family history of this lifelong, chronic disease.

• Genetics and family history. Having family members with diabetes is a major risk factor. The American Diabetes Association recommends that anyone with a first-degree relative with type 1 diabetes — a mother, father, sister, or brother — should get screened for diabetes. A simple blood test can diagnose type 1 diabetes.
• Diseases of the pancreas. Injury or diseases of the pancreas can inhibit its ability to produce insulin and lead to type 1 diabetes.
• Infection or illness. A range of relatively rare infections and illnesses can damage the pancreas and cause type 1 diabetes.

Risk Factors for Type 2 Diabetes

Type 2 diabetes occurs when the body can’t use the insulin that’s produced, a condition called insulin resistance. Though it typically starts in adulthood, type 2 diabetes can begin anytime in life. Because of the current epidemic of obesity among U.S. children, type 2 diabetes is increasingly found in teenagers.

Here are the risk factors for developing type 2 diabetes.

• Obesity or being overweight. Diabetes has long been linked to obesity and being overweight. Research at the Harvard School of Public Health showed that the single best predictor of type 2 diabetes is being obese or overweight.

Obesity and diabetes are both epidemic in the U.S. The most-used measure for obesity is BMI, which stands for body mass index. BMI is a ratio, and can be determined using standard tables of height and weight. A BMI of 25 to 29.9 is considered overweight. A BMI of 30 or higher defines obesity. Here are some examples of how BMI is used:

• A woman who’s 5 feet 5 inches tall and weighs 120 pounds has a BMI of 20.
• A woman who’s 5 feet 5 inches and weighs 180 pounds has a BMI of 30. She would be diagnosed as “obese.”

A woman who’s 5 feet 5 inches tall and weighs 240 pounds has a BMI of 40. She would be diagnosed with “extreme obesity” or as having “clinically severe obesity.”

Risk Factors for Gestational Diabetes

Diabetes affects about 4% of all U.S. pregnancies. Diabetes triggered by pregnancy is called gestational diabetes mellitus or GDM. It’s caused by hormones that are produced by the placenta during pregnancy or by too little insulin. High blood sugar from the mother crosses the placenta, causing high blood sugar in the baby. That can lead to growth and development problems if left untreated. Risk factors for gestational diabetes include the following.

• Obesity or being overweight. Being obese or overweight puts women at risk of gestational diabetes.
• Previous glucose intolerance. A history of glucose intolerance or previous gestational diabetes increases the risk of gestational diabetes in a current pregnancy.
• Family history. A family history of diabetes — a parent or sibling who’s been diagnosed with diabetes — increases the risk of gestational diabetes.
• Age. The older a woman is when she becomes pregnant, the higher her risk of gestational diabetes.

3 P’s of Diabetes

 

 

Polyphagia

(↑ hunger)

 

 

 

Polydipsia

(↑ thirst)

 

 

 

Polyuria

(↑ urination)

 

 

Symptoms

Type 1

• Increased thirst or urination
• Constant hunger
• Weight loss without trying
• Blurred vision
• Extreme fatigue

  Type 2

• Any symptoms of type 1 diabetes
• Sores those are slow to heal
• Dry, itchy skin
• Loss of feeling or tingling in feet
• Infections, such as a yeast infection, that keep coming back

Preventions

• Reaching and keeping a healthy weight.
• Eating healthy, low-fat foods.
• Getting regular exercise.
• Not smoking.
• Checking your feet each day.
• Getting regular health care.
• Keeping your blood glucose level to normal.
• Asking your doctor about thyroid testing.

Complications

• Kidney disease
• Eye problems
• Nerve damage and blood vessel damage
• High blood cholesterol levels
• Certain infections
• Problems in pregnancy
• Thyroid problems

Type 2 diabetes mellitus comprises an array of dysfunctions resulting from the combination of resistance to insulin action and inadequate insulin secretion. It is disorders are characterized by hyperglycemia and associated with microvascular (ie, retinal, renal, possibly neuropathic), macrovascular (ie, coronary, peripheral vascular), and neuropathic (ie, autonomic, peripheral) complications.

Unlike patients with type 1 diabetes mellitus, patients with type 2 are not absolutely dependent upon insulin for life. This distinction was the basis for the older terms for types 1 and 2, insulin dependent and non–insulin dependent diabetes. However, many patients with type 2 diabetes are ultimately treated with insulin. Because they retain the ability to secrete some endogenous insulin, they are considered to require insulin but not to depend on insulin. Nevertheless, given the potential for confusion due to classification based on treatment rather than etiology, these terms have been abandoned.

Another older term for type 2 diabetes mellitus was adult-onset diabetes. Currently, because of the epidemic of obesity and inactivity in children, type 2 diabetes mellitus is occurring at younger and younger ages. Although type 2 diabetes mellitus typically affects individuals older than 40 years, it has been diagnosed in children as young as 2 years of age who have a family history of diabetes.

Diabetes mellitus is a chronic disease that requires long-term medical attention both to limit the development of its devastating complications and to manage them when they do occur. It is a disproportionately expensive disease; in the United States in 2002, the per-capita cost of health care was $13,243 for people with diabetes, while it was $2560 for those without diabetes. The emergency department utilization rate by people with diabetes is twice that of the unaffected population.