Diabetes : Type,Classification, Prevention, and treatment |an Overview of Diabetes
What is Diabetes?
Definition of diabetes:
it is a clinical condition characterized by persistent hyperglycemia due to absolute or relatives deficiency.
If the pancreas cannot make enough insulin or if the body fails to use the insulin it produces, then the disease that occurs is diabetes. In other words, it is called uncontrolled glucose in the body. All the food we eat is digested by various enzymes and acids. Food is then digested in soft state as it passes through the small intestine and large intestine. This part of digestion is called glucose in simple language. And what is not digested is excreted as dirt or waste – and this is what we call diabetes when insulin is not made properly or becomes uncontrolled to control glucose.
Epidemiology of Diabetes Mellitus : Diabetes patients in Bangladesh have about 8.3 million countrywide, that is the big challenge to the health system of Bangladesh, according to the data of IDF or International diabetes Federation. Diabetes Patients in the world have around 463 million (2019 report).
Sign and symptoms of diabetes :
- Polyuria or increase urination
- Polyphagia or extrem Hunger
- Weight loss
- Ketone body present in urine
- Reoccurrent infection
- Slow-healing ulcer
Type of diabetes:
There are two types of diabetes-
2) diabetes insipidus.
There is also another type of diabetes which is called gastric diabetes. Gastrointestinal diabetes is more common in pregnant mothers.
Diabetes mellitus is a common health condition. The global diabetes patients in2019 is about to be 463 million people (9.3%), rising to 578 million (10.2%) by two thousand thirty and 700 million (10.9%) by two thousand fourty five. The prevalence is higher in urban area 10.8% than rural area 7.2%, and in high-income countries 10.4% than low-income countries 4.0%(Source:Pubmed)
There are 7.1 milion diabetic patients in Bangladesh as per IDF ( International Diabetes Federation) 2015 .
There are 3.6 million people with diabetes in the United Kingdom, 6 out of every 100 people in the hall are always read the situation and we don’t know if he has diabetes, he should be included, this number has risen to 4 million.
Rice, Breeds, potatoes, sweet potatoes and sugar and other Sweet foods converted to glucose by digestion. Glucose Produce into liver by glycogenolysis from glycogen breakdown. And also Glucose Produce from non carbohydrate source is called gluconeugenesis.
Type of diabetes mellitus:
Diabetes mellitus is divided into two categories depending on the treatment or the type of disease
1.Diabetes Mellitus type 1(Insulin dependent diabetes mellitus)
– it is a T cell meditated autoimmune disease involving destruction of the insulin secreting beta cell in Pancreas (Islets of lengarhans cell of pancreas), gradual loss of beta cell function depressed insulin level that produce hyperglycemia. classical symptoms of Diabetics seen When 80-90% beta cell are damaged.This type of diabetics should be seen before the age of 30. Genetic factor also account for devlop type 1 diabetes, inheritance of this is polygenic.There is no single genetic pathway, but cells can be reviewed at any time by a virus or other infection, diseases and chemical. This type of diabetics can occur in specially in young age.It’s common in coccasian people.The pancreas itself becomes diseased and cannot make insulin (Insulin is essential for the life. This is a hormone Secreted by the pancreas, which injects glucose with potassium ion into the cell.) – (beta cells are destroyed) – so you have to go outside with lifelong insulin – but most of the time, it starts in childhood. Is called insulin dependent diabetes. It should be treated by insulin injections and diet and physical exercise regularly.
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2.Diabetes Mellitus type 2(Non-Insulin dependent diabetes mellitus)
The body fails to make enough insulin or insulin cannot work even if it makes enough insulin. It usually affects people over the age of 30 – and is mainly due to heredity – which is still the main cause of the disease – which affects 250 million people worldwide – especially in those who are overweight and do not exercise.commonly seen in South Asian and African-Calabrian places, when it shows people over 25.That’s why insulin is usually not needed in the treatment of insulin-dependent diabetes. In this case, a slight change in eating habits, exercise or walking plays a greater role in the control of diabetes, so the increase or decrease of the disease depends on your wishes. However, when the disease attacks in a severe form, many people can go to type 1.
Type 1 Diabetes VS Type 2 Diabetes
|Points||Type 1 DM||Type 2 DM|
|Insulin deficiency||Absolute deficiency||relative deficiency|
|Age||before 30||after 30|
|Dependency||insulin dependent||Non insulin dependent|
|Family history||less common||more common|
|Prevention||cannot be prevented||prevented by lifestyle modifications|
|Risk factors||family history||Obesity, Hypertension, family history|
|Insulin||c peptide negative||c peptide positive|
|Treatment||insulin (must)||diet, lifestyle modifications, drugs ,insulin|
[See more : Foods Habits of Diabetic Patients
Gestational Diabetes mellitus :
Criteria for diagnosis of DM (Diabetes mellitus) :
- Fasting blood glucose level more than or equal 7 mmol/l, or
- Random glucose blood sugar (RBS) level more than or equal 11.1 mmol/l, (You can check Random blood suger or RBS D in home easily) or
- 2 hours after 75g glucose, blood sugar level more than or equal 11.1 mmol/l.
- HBA1C more than 6.5(48mmol/l)
Aetiological classification of diabetes mellitus :
- Type 1 DM
- Autoimmune mediated
- Type 2 DM or Non insulin dependent Diabetes Mellitus
- Insulin resistance
- Insulin secretory defect
- Gestational Diabetes mellitus
- Secondary diabetes mellitus
- Genetic defect of beta cell function due to gene mutation
- Genetic defect in insulin action
- Pancreatic disease-
- fibrocalculous pancreatopathy etc
- Endrocrinal disease –
- cushing’s syndrome,
- cystic fibrosis, pheochromocytoma,
- hyperthyroidism etc
- Medication and chemical causes DM-
- glucocorticoid ,
- nicotinic acid,
- thyroid hormone,
- beta agonist,
- beta blockers,
- clozapine and
- protease inhibitors
- CRS(congenital rubella syndrom)
- coxasacki virus
- Uncommin Immune mediated diabetes – anti insulin receptors antibody, stiff man syndrome
- Some genetic disorder
- Down syndrome,
- klinefelter syndrome,
- Turner syndrome,
- Friedrich’s ataxia,
- Huntington’s chorea,
- Wolfram’s syndrome
Complications of Diabetes mellitus:
Acute complications :
- DKA or Diabetic ketoacidosis
- Hyperglycaemic hyperosmolar state or hyperosmolar non-ketotic diabetic coma
Chronic complications :
- Diabetic neuropathy : peripherl neuropathy, mono- neuritis complex, autonomic neuropathy, mononeuropathy.
- Diabetic nephropathy(chronic kidney disease)
- Diabetic retinopathy
- Diabetic Foot Ulcers,
- Heart disease
- Cerebral disease
- Peripheral vascular diseases