Diabetes mellitus

Diabetes mellitus, the most common disorder of the endocrine system, occurs when blood sugar levels in the body consistently stay above normal.

It affects more than 17-million people in the United States alone. The disease is brought on by either too little insulin in the body (type one diabetes) or by the body not responding to the effects of the insulin (type two diabetes). Insulin is the hormone that regulates blood sugar levels and allows the body to use sugar for energy.

Type one diabetes, is the most common form of diabetes in people under age 20, it results from a shortage of insulin. Type two diabetes results from the body's inability to process the hormone effectively. About 90% of all people with diabetes have type two diabetes. In the past, type one was known as insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes and type two used to be called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset or stable diabetes.

The older terms have been abandoned because type two diabetes is now seen in children. In addition, some people with type two diabetes require insulin to keep their blood sugar levels normal. Regardless of what type of diabetes you have, you need to work closely with your doctor to manage your diet, medication and activity on a day-to-day basis. Your ability to oversee your own care makes a huge difference in whether you can control the condition and avoid its potentially serious effects.

The many short-and long-term complications of diabetes can demand as much attention as the disease itself. Just as important as watching out for high blood sugar, you need to watch our blood sugar levels every day to prevent an attack of low hypoglycemia, in which blood sugar levels are too low to fulfill your body's energy needs. Hypoglycemia can be easily remedied once you recognize its symptoms.

In people with type one diabetes, a lack of insulin can bring on a serious condition known as ketoacidosis, in which acid builds up in the blood from the accumulation of toxic by-products called ketones. Ketones are produced as the body breaks down fat for energy. Ketoacidosis occurs:

• In people who have type one diabetes, if they do not receive adequate supplementary insulin and their bodies are starved for energy sources
• If the body comes under sudden physical stress, perhaps from an accident or illness
• In those with type two diabetes
  Note: This is less common

If you have type one diabetes, be alert for the warning signs of ketoacidosis: nausea, excessive thirst, frequent urination, extreme weakness, abdominal pain, rapid deep breathing, loss of appetite, reddened and warm skin, headache, drowsiness, fruity-smelling breath, restlessness and ketones in our urine.

In both types of diabetes, long-term complications of diabetes can damage eyes, nervous system, kidneys, heart and circulatory systems. Cuts and sores heal more slowly for people with diabetes, and they are prone to gum problems, urinary tract infections and mouth infections such as thrush, caused by an overgrowth of yeast organisms. All of these complications are more common in people who are unable to get their blood sugar under control.

Diabetes is the primary cause of adult blindness in the United States. Within ten years of their condition being diagnosed, about half of all people with type one diabetes develop an eye disorder called diabetic retinopathy, which can weaken the capillaries that supply blood to the retina and eventually affect vision. Almost all who have had the disease for at least 30 years, experience some degree of diabetic retinopathy. Staying on top of you blood sugar can help delay or prevent the development of retinopathy. Other common problems in people with diabetes include blurred vision, cataracts and glaucoma.

People with diabetes stand a higher than normal chance of developing heart disease and circulatory problems (i.e., high blood pressure, hardening of the arteries, heart attacks and strokes). Poor circulation increases the risk of developing skin ulcers, cramps and gangrene. Damage to the blood vessels in the kidneys from diabetes may lead to kidney failure.

A number of people with diabetes suffer from a condition known as diabetic neuropathy, which causes damage to one or more nerves. The condition appears to begin early in both types of diabetes and affects nerves that control both muscle function and sensation. As a result, people with diabetes commonly experience a variety of aches and pains. Some develop slowed reflexes, loss of sensation, numbness and tingling in the legs, impotence and circulatory problems.

Causes

In type one diabetes, the pancreas secretes little or no insulin. Unable to use glucose in the blood, the body tries to produce energy by burning fat and muscle. Type one diabetes usually develops before age 20.

Type two diabetes usually develops in people over age 40, and more likely in people who are overweight. Although this particular group of patients have sufficient or even excessive amounts of insulin in their systems, their bodies are unable to use the hormone effectively, called insulin resistance. Excessive food intake boosts blood sugar levels, and the pancreas cannot produce enough insulin to convert the extra sugar into energy. Sometimes a similar form of this disease, called gestational diabetes, occurs as a temporary condition in women who are pregnant.

Risk factors type one

• Family history of type one diabetes
• Being white
• Having islet cell antibodies in the blood

Risk factors type two

• Being overweight
• Family history of diabetes
• Being of Hispanic, African American, Native American or Asian origin
• Being over 40 years of age
• Impaired glucose tolerance - a pre-diabetes condition in which blood sugar levels are too high after eating
• High blood pressure
• Abnormal blood cholesterol levels
• Heavy alcohol use
• Smoking
• History of gestation diabetes
• Women with polycystic ovary syndrome