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diabetes mellitus (Diabetes) : Symptoms, Causes, Diagnosis and Treatment

What is diabetes mellitus?

Meaning of 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 insipidus is a rare disorder that occurs when a person's kidneys pass an abnormally large volume of urine that is insipid?dilute and odorless. In most people, the kidneys pass about 1 to 2 quarts of urine a day. In people with diabetes insipidus, the kidneys can pass 3 to 20 quarts of urine a day. As a result, a person with diabetes insipidus may feel the need to drink large amounts of liquids.

Diabetes insipidus and diabetes mellitus?which includes both type 1 diabetes and type 2 diabetes?are unrelated, although both conditions cause frequent urination and constant thirst. Diabetes mellitus causes high blood glucose, or blood sugar, resulting from the body's inability to use blood glucose for energy. People with diabetes insipidus have normal blood glucose levels; however, their kidneys cannot balance fluid in the body.

Diabetes mellitus, commonly known as diabetes, is a metabolic disease that causes high blood sugar. The hormone insulin moves sugar from the blood into your cells to be stored or used for energy. With diabetes, your body either doesn?t make enough insulin or can?t effectively use the insulin it does make.

Untreated high blood sugar from diabetes can damage your nerves, eyes, kidneys, and other organs.

There are a few different types of diabetes:

  • Type 1 diabetes is an autoimmune disease. The immune system attacks and destroys cells in the pancreas, where insulin is made. It?s unclear what causes this attack. About 10 percent of people with diabetes have this type.
  • Type 2 diabetes occurs when your body becomes resistant to insulin, and sugar builds up in your blood.
  • Prediabetes occurs when your blood sugar is higher than normal, but it?s not high enough for a diagnosis of type 2 diabetes.
  • Gestational diabetes is high blood sugar during pregnancy. Insulin-blocking hormones produced by the placenta cause this type of diabetes.

A rare condition called diabetes insipidus is not related to diabetes mellitus, although it has a similar name. It?s a different condition in which your kidneys remove too much fluid from your body.

Each type of diabetes has unique symptoms, causes, and treatments. Learn more about how these types differ from one another.

diabetes mellitus is also known as Diabetes. diabetes mellitus belongs under the category of Sugar disease. Type 1 diabetes, Type 2 diabetes, Prediabetes, Gestational diabetes (GDM) are some common types of diabetes mellitus. Generally Male, Female are the victim of the diabetes mellitus. Seriousness of this disease is Medium.

Symptoms of diabetes mellitus are :

  • Vision problems, such as blurred vision, double vision or loss of peripheral vision
  • Double vision is the perception of two images of a single object seen adjacent to each other (horizontally, vertically, or obliquely) or overlapping. Diplopia is the medical term for double vision. Polyplopia is the perception of three or more images of a single object overlapping each other.

    Double vision is called "monocular" when the double image is perceived by an eye that is tested alone. In "binocular" double vision, each eye sees a single image when tested alone, but a double image is present when both eyes are open.

  • hunger
  • tingling or numbness in the feet
  • tingling or numbness in the hands
  • pain, numbness in hand and fingure
  • Frequent urination
  • Extreme thirst
  • sore throat
  • A sore throat is a painful, dry, or scratchy feeling in the throat.

    Pain in the throat is one of the most common symptoms. It accounts for more than 13 million visits to doctor?s offices each year (1Trusted Source).

    Most sore throats are caused by infections, or by environmental factors like dry air. Although a sore throat can be uncomfortable, it?ll usually go away on its own.

    Sore throats are divided into types, based on the part of the throat they affect:

    • Pharyngitis affects the area right behind the mouth.
    • Tonsillitis is swelling and redness of the tonsils, the soft tissue in the back of the mouth.
    • Laryngitis is swelling and redness of the voice box, or larynx.
  • Weight loss
  • Sudden, noticeable weight loss can happen after a stressful event, although it can also be a sign of a serious illness.

    It's normal to lose a noticeable amount of weight after the stress of changing jobs, divorce, redundancy or bereavement.

    Weight often returns to normal when you start to feel happier, after you've had time to grieve or get used to the change. Counselling and support may be needed to help you get to this stage.

    Significant weight loss can also be the result of an eating disorder, such as anorexia or bulimia. If you think you have an eating disorder, talk to someone you trust and consider speaking to your GP. There are also several organisations that can provide you with information and advice, such as the eating disorders charity Beat.

    If your weight loss wasn't due to one of the causes mentioned, and you didn't lose weight through dieting or exercising, see your GP, as you may have an illness that needs treating.

  • Fatigue/weakness
  • Weakness

    Weakness is when strength is decreased and extra effort is needed to move a certain part of the body or the entire body. Weakness is due to loss of muscle strength. Weakness can be a big part of why cancer patients feel fatigue.

    Fatigue

    Fatigue is an extreme feeling of tiredness or lack of energy, often described as being exhausted. Fatigue is something that lasts even when a person seems to be getting enough sleep. It can have many causes, including working too much, having disturbed sleep, stress and worry, not having enough physical activity, and going through an illness and its treatment.

    Causes

    diabetes mellitus can be caused due to:

    To understand diabetes, first you must understand how glucose is normally processed in the body.

    How insulin works

    Insulin is a hormone that comes from a gland situated behind and below the stomach (pancreas).

    • The pancreas secretes insulin into the bloodstream.
    • The insulin circulates, enabling sugar to enter your cells.
    • Insulin lowers the amount of sugar in your bloodstream.
    • As your blood sugar level drops, so does the secretion of insulin from your pancreas.

    The role of glucose

    Glucose ? a sugar ? is a source of energy for the cells that make up muscles and other tissues.

    • Glucose comes from two major sources: food and your liver.
    • Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin.
    • Your liver stores and makes glucose.
    • When your glucose levels are low, such as when you haven't eaten in a while, the liver breaks down stored glycogen into glucose to keep your glucose level within a normal range.

    Causes of type 1 diabetes

    The exact cause of type 1 diabetes is unknown. What is known is that your immune system ? which normally fights harmful bacteria or viruses ? attacks and destroys your insulin-producing cells in the pancreas. This leaves you with little or no insulin. Instead of being transported into your cells, sugar builds up in your bloodstream.

    Type 1 is thought to be diabetes is caused by a combination of genetic susceptibility and environmental factors, though exactly what those factors are is still unclear. Weight is not believed to be a factor in type 1 diabetes.

    Causes of prediabetes and type 2 diabetes

    In prediabetes ? which can lead to type 2 diabetes ? and in type 2 diabetes, your cells become resistant to the action of insulin, and your pancreas is unable to make enough insulin to overcome this resistance. Instead of moving into your cells where it's needed for energy, sugar builds up in your bloodstream.

    Exactly why this happens is uncertain, although it's believed that genetic and environmental factors play a role in the development of type 2 diabetes too. Being overweight is strongly linked to the development of type 2 diabetes, but not everyone with type 2 is overweight.

    Causes of gestational diabetes

    During pregnancy, the placenta produces hormones to sustain your pregnancy. These hormones make your cells more resistant to insulin.

    Normally, your pancreas responds by producing enough extra insulin to overcome this resistance. But sometimes your pancreas can't keep up. When this happens, too little glucose gets into your cells and too much stays in your blood, resulting in gestational diabetes.

    What kind of precaution should be taken in diabetes mellitus?

    Type 1 diabetes can't be prevented. However, the same healthy lifestyle choices that help treat prediabetes, type 2 diabetes and gestational diabetes can also help prevent them:

    • Eat healthy foods. Choose foods lower in fat and calories and higher in fiber. Focus on fruits, vegetables and whole grains. Strive for variety to prevent boredom.

    • Get more physical activity. Aim for 30 minutes of moderate physical activity a day. Take a brisk daily walk. Ride your bike. Swim laps. If you can't fit in a long workout, break it up into smaller sessions spread throughout the day.

    • Lose excess pounds. If you're overweight, losing even 7 percent of your body weight ? for example, 14 pounds (6.4 kilograms) if you weigh 200 pounds (90.7 kilograms) ? can reduce the risk of diabetes.

      Don't try to lose weight during pregnancy, however. Talk to your doctor about how much weight is healthy for you to gain during pregnancy.

      To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem.

    Sometimes medication is an option as well. Oral diabetes drugs such as metformin (Glucophage, Glumetza, others) may reduce the risk of type 2 diabetes ? but healthy lifestyle choices remain essential. Have your blood sugar checked at least once a year to check that you haven't developed type 2 diabetes.

    Treatment for the diabetes mellitus

    Before diagnosing the diabetes, we should know that what is the Normal range of blood sugar for the diabetes:

    Diabetes normal sugar level range:

    • Random blood sugar test. A blood sample will be taken at a random time. Regardless of when you last ate, a blood sugar level of 200 milligrams per deciliter (mg/dL) ? 11.1 millimoles per liter (mmol/L) ? or higher suggests diabetes.
    • Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes.
    • Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours.

    A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal. A reading of more than 200 mg/dL (11.1 mmol/L) after two hours indicates diabetes. A reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes.

    Diagnosis:

    Anyone who has symptoms of diabetes or is at risk for the disease should be tested. Women are routinely tested for gestational diabetes during their second or third trimesters of pregnancy.

    Doctors use these blood tests to diagnose prediabetes and diabetes:

    • The fasting plasma glucose (FPG) test measures your blood sugar after you?ve fasted for 8 hours.
    • The A1C test provides a snapshot of your blood sugar levels over the previous 3 months.

    To diagnose gestational diabetes, your doctor will test your blood sugar levels between the 24th and 28th weeks of your pregnancy.

    • During the glucose challenge test, your blood sugar is checked an hour after you drink a sugary liquid.
    • During the 3 hour glucose tolerance test, your blood sugar is checked after you fast overnight and then drink a sugary liquid.

    The earlier you get diagnosed with diabetes, the sooner you can start treatment. Find out whether you should get tested, and get more information on tests your doctor might perform.

    Other test for diagnosing diabetes:

    Treatment of diabetes:

    Depending on what type of diabetes you have, blood sugar monitoring, insulin and oral medications may play a role in your treatment. Eating a healthy diet, maintaining a healthy weight and participating in regular activity also are important factors in managing diabetes.

    Treatments for all types of diabetes

    An important part of managing diabetes ? as well as your overall health ? is maintaining a healthy weight through a healthy diet and exercise plan:

    • Healthy eating. Contrary to popular perception, there's no specific diabetes diet. You'll need to center your diet on more fruits, vegetables, lean proteins and whole grains ? foods that are high in nutrition and fiber and low in fat and calories ? and cut down on saturated fats, refined carbohydrates and sweets. In fact, it's the best eating plan for the entire family. Sugary foods are OK once in a while, as long as they're counted as part of your meal plan.

    Yet understanding what and how much to eat can be a challenge. A registered dietitian can help you create a meal plan that fits your health goals, food preferences and lifestyle. This will likely include carbohydrate counting, especially if you have type 1 diabetes.

    • Physical activity. Everyone needs regular aerobic exercise, and people who have diabetes are no exception. Exercise lowers your blood sugar level by moving sugar into your cells, where it's used for energy. Exercise also increases your sensitivity to insulin, which means your body needs less insulin to transport sugar to your cells.

    Get your doctor's OK to exercise. Then choose activities you enjoy, such as walking, swimming or biking. What's most important is making physical activity part of your daily routine.

    Aim for at least 30 minutes or more of aerobic exercise most days of the week. Bouts of activity can be as brief as 10 minutes, three times a day. If you haven't been active for a while, start slowly and build up gradually.

    Treatments for type 1 diabetes and type 2 diabetes

    Treatment for type 1 diabetes involves insulin injections or the use of an insulin pump, frequent blood sugar checks, and carbohydrate counting. Treatment of type 2 diabetes primarily involves lifestyle changes, monitoring of your blood sugar, along with diabetes medications, insulin or both.

    • Monitoring your blood sugar. Depending on your treatment plan, you may check and record your blood sugar as many as four times a day or more often if you're taking insulin. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range. People with type 2 diabetes who aren't taking insulin generally check their blood sugar much less frequently.

    People who receive insulin therapy also may choose to monitor their blood sugar levels with a continuous glucose monitor. Although this technology hasn't yet completely replaced the glucose meter, it can significantly reduce the number of fingersticks necessary to check blood sugar and provide important information about trends in blood sugar levels.

    Even with careful management, blood sugar levels can sometimes change unpredictably. With help from your diabetes treatment team, you'll learn how your blood sugar level changes in response to food, physical activity, medications, illness, alcohol, stress ? and for women, fluctuations in hormone levels.

    In addition to daily blood sugar monitoring, your doctor will likely recommend regular A1C testing to measure your average blood sugar level for the past two to three months.

    Compared with repeated daily blood sugar tests, A1C testing better indicates how well your diabetes treatment plan is working overall. An elevated A1C level may signal the need for a change in your oral medication, insulin regimen or meal plan.

    Your target A1C goal may vary depending on your age and various other factors, such as other medical conditions you may have. However, for most people with diabetes, the American Diabetes Association recommends an A1C of below 7 percent. Ask your doctor what your A1C target is.

    • Insulin. People with type 1 diabetes need insulin therapy to survive. Many people with type 2 diabetes or gestational diabetes also need insulin therapy.

    Many types of insulin are available, including rapid-acting insulin, long-acting insulin and intermediate options. Depending on your needs, your doctor may prescribe a mixture of insulin types to use throughout the day and night.

    Insulin can't be taken orally to lower blood sugar because stomach enzymes interfere with insulin's action. Often insulin is injected using a fine needle and syringe or an insulin pen ? a device that looks like a large ink pen.

    An insulin pump also may be an option. The pump is a device about the size of a cellphone worn on the outside of your body. A tube connects the reservoir of insulin to a catheter that's inserted under the skin of your abdomen.

    A tubeless pump that works wirelessly also is now available. You program an insulin pump to dispense specific amounts of insulin. It can be adjusted to deliver more or less insulin depending on meals, activity level and blood sugar level.

    An emerging treatment approach, not yet available, is closed loop insulin delivery, also known as the artificial pancreas. It links a continuous glucose monitor to an insulin pump, and automatically delivers the correct amount of insulin when needed.

    There are a number of versions of the artificial pancreas, and clinical trials have had encouraging results. More research needs to be done before a fully functional artificial pancreas receives regulatory approval.

    However, progress has been made toward an artificial pancreas. In 2016, an insulin pump combined with a continuous glucose monitor and a computer algorithm was approved by the Food and Drug Administration. However, the user still needs to tell the machine how many carbohydrates will be eaten.

    • Oral or other medications. Sometimes other oral or injected medications are prescribed as well. Some diabetes medications stimulate your pancreas to produce and release more insulin. Others inhibit the production and release of glucose from your liver, which means you need less insulin to transport sugar into your cells.

    Still others block the action of stomach or intestinal enzymes that break down carbohydrates or make your tissues more sensitive to insulin. Metformin (Glucophage, Glumetza, others) is generally the first medication prescribed for type 2 diabetes.

    • Transplantation. In some people who have type 1 diabetes, a pancreas transplant may be an option. Islet transplants are being studied as well. With a successful pancreas transplant, you would no longer need insulin therapy.

    But transplants aren't always successful ? and these procedures pose serious risks. You need a lifetime of immune-suppressing drugs to prevent organ rejection. These drugs can have serious side effects, which is why transplants are usually reserved for people whose diabetes can't be controlled or those who also need a kidney transplant.

    • Bariatric surgery. Although it is not specifically considered a treatment for type 2 diabetes, people with type 2 diabetes who are obese and have a body mass index higher than 35 may benefit from this type of surgery. People who've undergone gastric bypass have seen significant improvements in their blood sugar levels. However, this procedure's long-term risks and benefits for type 2 diabetes aren't yet known.

    Treatment for gestational diabetes

    Controlling your blood sugar level is essential to keeping your baby healthy and avoiding complications during delivery. In addition to maintaining a healthy diet and exercising, your treatment plan may include monitoring your blood sugar and, in some cases, using insulin or oral medications.

    Your doctor also will monitor your blood sugar level during labor. If your blood sugar rises, your baby may release high levels of insulin ? which can lead to low blood sugar right after birth.

    Treatment for prediabetes

    If you have prediabetes, healthy lifestyle choices can help you bring your blood sugar level back to normal or at least keep it from rising toward the levels seen in type 2 diabetes. Maintaining a healthy weight through exercise and healthy eating can help. Exercising at least 150 minutes a week and losing about 7 percent of your body weight may prevent or delay type 2 diabetes.

    Sometimes medications ? such as metformin (Glucophage, Glumetza, others) ? also are an option if you're at high risk of diabetes, including when your prediabetes is worsening or if you have cardiovascular disease, fatty liver disease or polycystic ovary syndrome.

    In other cases, medications to control cholesterol ? statins, in particular ? and high blood pressure medications are needed. Your doctor might prescribe low-dose aspirin therapy to help prevent cardiovascular disease if you're at high risk. However, healthy lifestyle choices remain key.

    Possible complication with diabetes mellitus

    People with diabetes have an increased risk of developing a number of serious health problems. Consistently high blood glucose levels can lead to serious diseases affecting the heart and blood vessels, eyes, kidneys, nerves and teeth. In addition, people with diabetes also have a higher risk of developing infections. In almost all high-income countries, diabetes is a leading cause of cardiovascular disease, blindness, kidney failure, and lower limb amputation.

    Maintaining blood glucose levels, blood pressure, and cholesterol at or close to normal can help delay or prevent diabetes complications. Therefore people with diabetes need regular monitoring.

    Cardiovascular disease: affects the heart and blood vessels and may cause fatal complications such as coronary artery disease (leading to heart attack) and stroke. Cardiovascular disease is the most common cause of death in people with diabetes. High blood pressure, high cholesterol, high blood glucose and other risk factors contribute to increasing the risk of cardiovascular complications. Learn more about diabetes and CVD.

    Kidney disease (diabetic nephropathy): caused by damage to small blood vessels in the kidneys leading to the kidneys becoming less efficient or to fail altogether. Kidney disease is much more common in people with diabetes than in those without diabetes. Maintaining near normal levels of blood glucose and blood pressure can greatly reduce the risk of kidney disease. Learn more about diabetes and the kidneys.

    Nerve disease (diabetic neuropathy): diabetes can cause damage to the nerves throughout the body when blood glucose and blood pressure are too high. This can lead to problems with digestion, erectile dysfunction, and many other functions. Among the most commonly affected areas are the extremities, in particular the feet. Nerve damage in these areas is called peripheral neuropathy, and can lead to pain, tingling, and loss of feeling. Loss of feeling is particularly important because it can allow injuries to go unnoticed, leading to serious infections and possible amputations. People with diabetes carry a risk of amputation that may be more than 25 times greater than that of people without diabetes. However, with comprehensive management, a large proportion of amputations related to diabetes can be prevented. Even when amputation takes place, the remaining leg and the person?s life can be saved by good follow-up care from a multidisciplinary foot team. People with diabetes should regularly examine their feet. Learn more about the diabetic foot.

    Eye disease (diabetic retinopathy): most people with diabetes will develop some form of eye disease (retinopathy) causing reduced vision or blindness. Consistently high levels of blood glucose, together with high blood pressure and high cholesterol, are the main causes of retinopathy. It can be managed through regular eye checks and keeping glucose and lipid levels at or close to normal. Learn more about diabetes and the eye.

    Pregnancy complications: Women with any type of diabetes during pregnancy risk a number of complications if they do not carefully monitor and manage their condition. To prevent possible organ damage to the fetus, women with type 1 diabetes or type 2 diabetes should achieve target glucose levels before conception. All women with diabetes during pregnancy, type 1, type 2 or gestational should strive for target blood glucose levels throughout to minimize complications. High blood glucose during pregnancy can lead to the foetus putting on excess weight. This can lead to problems in delivery, trauma to the child and mother, and a sudden drop in blood glucose for the child after birth. Children who are exposed for a long time to high blood glucose in the womb are at higher risk of developing diabetes in the future. Learn more about diabetes in pregnancy.

    Oral complications: People with diabetes have an increased risk of inflammation of the gums (periodontitis) if blood glucose is not properly managed. Periodontitis is a major cause of tooth loss and is associated with an increased risk of cardiovascular disease (CVD). Regular oral check-ups should be established to ensure early diagnosis, particularly among people with previously undiagnosed diabetes and prompt management of any oral complications in people with diabetes. Annual visits are recommended for symptoms of gum disease such as bleeding when brushing teeth or swollen gums.

    References:

    1 https://www.idf.org/aboutdiabetes/what-is-diabetes.html
    2 https://www.healthline.com/health/diabetes#diet
    3 https://www.medicalnewstoday.com/articles/323627
    4 https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes
    5 https://www.medicinenet.com/diabetes_mellitus/article.htm
    6 https://www.webmd.com/diabetes/default.htm
    7 https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
    8 https://medlineplus.gov/diabetes.html
    9 https://www.who.int/news-room/fact-sheets/detail/diabetes
    10 https://www.diabetes.org/diabetes
    11 https://www.cdc.gov/diabetes/basics/diabetes.html

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