DIABETIC MELITUS

Diabetes is a condition that impairs the body's ability to process blood glucose, otherwise
known as blood sugar.In the United States, the estimated number of people over 18 years of age
with diagnosed and undiagnosed diabetes is 30.2 million. The figure represents between 27.9 and
32.7 percent of the population.Without ongoing, careful management, diabetes can lead to a
buildup of sugars in the blood, which can increase the risk of dangerous complications, including
stroke and heart disease.Different kinds of diabetes can occur, and managing the condition
depends on the type. Not all forms of diabetes stem from a person being overweight or leading
an inactive lifestyle. In fact, some are present from childhood.

Diabetes is due to either the pancreas not producing enough insulin, or the cells of the body not
responding properly to the insulin produced. There are three main types of diabetes mellitus:

1. Type 1 diabetes results from the pancreas's failure to produce enough insulin due to loss
of beta cells. This form was previously referred to as "insulin-dependent diabetes
mellitus" (IDDM) or "juvenile diabetes". The cause is unknown.
2. Type 2 diabetes begins with insulin resistance, a condition in which cells fail to respond
to insulin properly. As the disease progresses, a lack of insulin may also develop. This
form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM)
or "adult-onset diabetes".The most common cause is a combination of excessive body
weight and insufficient exercise.
3. Gestational diabetes is the third main form, and occurs when pregnant women without a
previous history of diabetes develop high blood sugar levels.

Signs and symptoms:

The classic symptoms of untreated diabetes are :

1. unintended weight loss,

2. polyuria (increased urination),
3. polydipsia (increased thirst),
4. polyphagia (increased hunger)
Symptoms may develop rapidly (weeks or months) in type 1 diabetes, while they usually
develop much more slowly and may be subtle or absent in type 2 diabetes. Other symptoms of
diabetes mellitus include weight loss and tiredness.

Several other signs and symptoms can mark the onset of diabetes although they are not
specific to the disease. In addition to the known ones above, they include blurred vision,
headache, fatigue, slow healing of cuts, and itchy skin. Prolonged high blood glucose can cause
glucose absorption in the lens of the eye, which leads to changes in its shape, resulting in vision
changes. Long-term vision loss can also be caused by diabetic retinopathy. A number of skin
rashes that can occur in diabetes are collectively known as diabetic dermadromes.

WHO diabetes diagnostic criteria

Condition 2-hour Fasting glucose HbA1c
glucose
Unit mmol/l(mg/dl) mmol/l(mg/dl) mmol/mol DCCT %
Normal <7.8 (<140) <6.1 (<110) <42 <6.0
Impaired fasting glycaemia <7.8 (<140) ≥6.1(≥110) & 42-46 6.0–6.4
<7.0(<126)
Impaired glucose tolerance ≥7.8 (≥140) <7.0 (<126) 42-46 6.0–6.4
Diabetes mellitus ≥11.1 (≥200) ≥7.0 (≥126) ≥48 ≥6.5

Diabetes mellitus is characterized by recurrent or persistent high blood sugar, and is diagnosed
by demonstrating any one of the following:

Medications

There are a number of different classes of anti-diabetic medications. Some are available
by mouth, such as metformin, while others are only available by injection such as GLP-1
agonists. Type 1 diabetes can only be treated with insulin, typically with a combination of
regular and NPH insulin, or synthetic insulin analogs.