Diabetes Mellitus

Manila Bulletin, May 28, 2008 | Go to article overview

Diabetes Mellitus


For this reason, the body strives to maintain blood sugar levels within a narrow range through the coordinated effort of several glands and their hormones. If these control mechanisms are disrupted, diabetes (high blood sugar) or hypoglycemia (low blood sugar) may result. Normally, the body responds to the rise in blood glucose after meals by secreting insulin, a hormone produced by the beta cells of the pancreas.

Diabetes mellitus is a common disorder that occurs when your pancreas either totally stops producing insulin or does not produce enough of the hormone for your body's need. This lack of insulin results in a low absorption of glucose, both by the body's cells, which need it for energy , and by the liver, which stores it and this result in an abnormally high level of glucose in your blood, along with a spillover of some of the excess glucose into the urine.

There are two main forms of Diabetes Mellitus:

1. Type I ( also called juvenile onset or insulin dependent) diabetes -- associated with destruction of the beta cells of the pancreas, which manufacture insulin. This type of diabetes occurs mostly in children and young adults. Recent evidence implicates a viral cause in some cases. Symptoms of type I diabetes include irritability , frequent urination, abnormal thirst, nausea or vomiting, weakness, fatigue, weight loss despite a normal ( or even increased) intake of food, and unusual hunger. In children, frequent bedwetting -- especially by a child who did not previously wet the bed -- is another common sign.

2. Type II (non-insulin dependent or maturity onset) diabetes -In this form of diabetes mellitus, which usually affects people over 40, the insulin-producing cells in your pancreas function, but the output of insulin is not adequate for your body's needs. People who have this form of disorder usually over-eat and are over-- weight. Heredity is also a factor. In most cases, there is a family history of the disorder. Age is also a factor, because the efficiency of your pancreas decreases as you become older. Symptoms include blurred vision, itching, unusual thirst, drowsiness, fatigue, skin infections, slow wound healing, tingling or numbness in the hands and feet, and loss of weight since the fat and muscle are burned up to provide energy. Other symptoms are reduced resistance to infections (boils, urinary tract infections and fungus vaginal infections are sometimes the first signs of diabetes mellitus), impotence in men, and the absence of menstrual period in women. Certain microorganisms (bacteria) are attracted to sugary urine, and these can cause complications, such as bladder infections and other urinary tract problems.

What are the risks?

Diabetes mellitus becomes increasingly common with age. The type II form occurs most often among those who are overweight, especially middle-aged and older women. Most people with type II diabetes have a relative with the disease.

However, even if both your parents have diabetes there is only a 1:20 risk that you will have it.

The effectiveness of today's treatment has changed this disease that once was often fatal into one from which deaths are extremely rare. However, there are still risks. People with type I diabetes mellitus may lead to a life threatening condition called "ketoacidosis" -- when the body is unable to use glucose because of lack of insulin, it is forced to obtain energy from fat. As the fat is burned, ketones (a dangerous chemical substance) are produced.

Other conditions that may affect both types of diabetes usually occur 15 to 20 years after the onset of the disease. Such risks include: "diabetic retinopathy" -- an eye disorder that causes blindness; "peripheral neuropathy" -- a nerve disease and "chronic kidney failure." People with diabetes also run a higher than average risk of developing atherosclerosis, with its risk of stroke, heart attack, and high blood pressure. …

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