types signs and symptoms of diabetes mellitus

types signs and symptoms of diabetes mellitus


What is diabetes?

If you have diabetes, your body cannot effectively digest and use glucose obtained from the diet. There are several varieties of diabetes, each with its own set of reasons, but they all have one thing in common: too much glucose in the bloodstream. Medications or insulins are used as treatments. Adopting a healthy lifestyle may help avoid certain kinds of diabetes.

What exactly is diabetes?

Diabetes develops when your body's cells cannot absorb sugar (glucose) and utilise it for energy. Extra sugar builds up in your system as a consequence of this.


Diabetes that is not well managed may have catastrophic effects, including damage to various organs and tissues in your body, including your heart, kidneys, eyes, and nerves.


What is causing my blood glucose level to be so high? What causes this to happen?

Breaking down the food you consume into multiple nutritional sources is part of the digestive process. When you consume carbs (such as bread, rice, or pasta), your body converts them to sugar (glucose). When glucose enters your circulation, it requires assistance – a "key" – to reach its eventual destination, which is within your body's cells (cells make up your tissues and organs). Insulin is the "helper" or "key."


Insulin is a hormone produced by the pancreas, which is positioned beneath the stomach. Insulin is released into your bloodstream by your pancreas. Insulin is the "key" that unlocks the "door" in the cell wall that allows glucose to enter your body's cells. Glucose is the "fuel" or energy that tissues and organs require to function correctly.


If you have diabetes, you should:


Your pancreas does not produce enough or any insulin.

Or your pancreas produces insulin, but your body's cells do not respond to it and cannot use it properly.

If glucose cannot enter your body's cells, it remains in your bloodstream, raising your blood glucose level.


What are the various kinds of diabetes?

The following are the different types of diabetes:


Type 1 diabetes is an autoimmune disease, which means your body is attacking itself. The insulin-producing cells in your pancreas are destroyed in this case. Type 1 diabetes affects up to 10% of people with diabetes. It's most often seen in children and young adults (but can develop at any age). It used to be called "juvenile" diabetes. People with Type 1 diabetes must take insulin daily. It's also known as insulin-dependent diabetes because of this.

 

Type 2 diabetes occurs when your body either does not produce enough insulin or when your cells do not react to insulin appropriately. Diabetes mellitus is the most frequent form of the disease. Type 2 diabetes affects up to 95% of people with diabetes. It mainly affects persons in their forties and fifties. Type 2 diabetes is also known as adult-onset diabetes or insulin-resistant diabetes. It was probably referred to as "having a bit of sugar" by your parents or grandparents.

 

Prediabetes is the period before Type 2 diabetes develops. Your blood glucose levels are higher than usual but not high enough for Type 2 diabetes to be diagnosed.

Gestational diabetes is a kind of diabetes that develops in certain women during pregnancy. Gestational diabetes disappears typically following the birth of a child. If you have gestational diabetes, though, you're more likely to acquire Type 2 diabetes later in life.

Types of diabetes that are less frequent include:


Monogenic diabetes syndromes are uncommon hereditary types of diabetes that account for 4% of all occurrences. Neonatal diabetes and young-onset diabetes are two such examples.

Cystic fibrosis-related diabetes is a kind of diabetes that only affects persons who have the condition.

Drug- or chemical induced diabetes: This kind of diabetes may occur after an organ transplant, as a result of HIV/AIDS therapy, or due to glucocorticoid steroid usage.

Diabetes insipidus is an uncommon disease in which your kidneys create an excessive quantity of urine.


What is the prevalence of diabetes?

In the United States, 34.2 million individuals of all ages – around one in ten – have diabetes. 7.3 million persons aged 18 and above (about 1 in 5) have no idea they have diabetes (just under 3 per cent of all U.S. adults). The number of persons diagnosed with diabetes rises as they become older. Diabetes affects more than 26% of persons aged 65 and over (about 1 in 4).


Who is at risk of developing diabetes? What are the elements that put you at risk?

The factors that raise your risk vary depending on the form of diabetes you get.


The following are some of the risk factors for Type 1 diabetes:


Type 1 diabetes runs in the family (parents or siblings).

Pancreatitis is a condition in which the pancreas is injured (such as by infection, tumour, surgery or accident).

Autoantibodies (antibodies that erroneously target your tissues or organs) are present.

Stress on the body (such as surgery or illness).

Viruses may cause sickness if you are exposed to them.

The following are risk factors for prediabetes and Type 2 diabetes:


Prediabetes or Type 2 diabetes in the family (parent or sibling).

It is of African, Hispanic, Native American, Asian, or Pacific Islander ancestry.

Being overweight is a problem.

High blood pressure is a condition in which one's blood pressure is abnormally high.

We have a high triglyceride level and a low HDL cholesterol (the "good" cholesterol).

Inactivity in the physical sense.

They are being 45 years old or older.

We are having gestational diabetes or having a kid that weighs more than 9 pounds.

Polycystic ovarian syndrome (PCOS).

Having had a heart attack or stroke in the past.

You are being a cigarette smoker.

The following are some of the risk factors for gestational diabetes:


Prediabetes or Type 2 diabetes in the family (parent or sibling).

Being African-American, Hispanic, Native American, or Asian-American has its advantages and disadvantages.

It is being overweight before conception.

It is above the age of 25.

 

CAUSES AND SYMPTOMS

What are the causes of diabetes?

Having too much glucose flowing in your circulation is the cause of diabetes, regardless of the type. However, the explanation for your elevated blood glucose levels varies depending on the kind of diabetes you have.


An immune system disorder causes type 1 diabetes. Insulin-producing cells in your pancreas are attacked and destroyed by your body. Glucose builds up in your bloodstream if you don't have enough insulin to let glucose into your cells. In certain instances, genes may also play a role. A virus may also cause an immune system assault.

The following factors cause type 2 diabetes and prediabetes. Insulin doesn't perform as well as it should in allowing glucose into your body's cells. Insulin resistance has developed in your body's cells. Your pancreas can't keep up with the demand for insulin and can't produce enough to overcome the resistance. Glucose levels in the bloodstream grow.

 

Diabetes during pregnancy: During pregnancy, hormones generated by the placenta make your body's cells more resistant to insulin. Your pancreas is unable to produce sufficient insulin to overcome this resistance. There is an excessive amount of glucose in your bloodstream.

What are some of the signs and symptoms of diabetes?

Diabetic symptoms include:


Thirst has increased.

I'm feeling weak and exhausted.

Vision is hazy.

Hands and feet are numb or tingling.

Sores or cuts that take a long time to heal.

Unintentional weight loss.

Urination regularly.

Infections that don't seem to go away.

You have a dry mouth.

Other signs and symptoms


Dry, itchy skin in women, as well as yeast infections or urinary tract infections regularly.

Reduced sex desire, erectile problems, and physical strength in males.

Symptoms of type 1 diabetes include: Symptoms might appear suddenly for a few weeks or months. Symptoms first appear whether you're a youngster, a teen, or a young adult. Nausea, vomiting, stomach aches, and yeast infections or urinary tract infections are other symptoms.


Symptoms of type 2 diabetes and prediabetes: Because type 2 diabetes and prediabetes develop slowly over many years, you may not notice any symptoms at all. Although symptoms commonly appear in adults, prediabetes and Type 2 diabetes are increasing in people of all ages.


Symptoms of gestational diabetes are usually not noticeable. Between 24 and 28 weeks of pregnancy, your obstetrician will test you for gestational diabetes.


What are the diabetic complications?

Your body's tissues and organs might be badly harmed if your blood glucose level stays high for an extended length of time. Over time, specific issues might become life-threatening.


The following are some of the complications:


Coronary artery disease, chest discomfort, heart attack, stroke, high blood pressure, high cholesterol, and atherosclerosis are all cardiovascular concerns (narrowing of the arteries).

Nerve injury (neuropathy) produces numbness and tingling in the toes and fingers, which eventually spreads.

Nephropathy is kidney deterioration that may lead to renal failure, dialysis, or transplantation.

Cataracts and glaucoma are examples of eye deterioration (retinopathy) that may lead to blindness.

Nerve damage, poor blood flow, and slow healing of wounds and sores are all examples of a foot injury.

Infections of the skin

Erectile dysfunction is a condition that affects men.

Hearing loss is a common problem.

Depression.

Dementia.

Problems with the teeth.

Gestational diabetes complications include:


Preeclampsia (high blood pressure, excess protein in urine, leg/foot oedema) in the mother and the risk of gestational diabetes in subsequent pregnancies and diabetes later in life.


High-than-normal birth weight, low blood sugar (hypoglycemia), increased chance of developing Type 2 diabetes over time, and mortality soon after delivery in newborns.

 

What is the best way to control diabetes?

Diabetes affects every part of your body. To effectively manage diabetes, you'll need to take actions to keep your risk factors in check and within normal limits, such as:


Follow a food plan, take recommended medicine, and increase your exercise level to keep your blood glucose levels as close to normal as possible.

Maintain as close to normal blood cholesterol (HDL and LDL levels) and triglyceride levels as feasible.

Maintain a healthy blood pressure level. Blood pressure shouldn't be more than 140/90 mmHg.

You have the power to control your diabetes if you:


Following a healthy meal plan and planning what you eat. Follow a Mediterranean diet (vegetables, whole grains, beans, fruits, healthy fats, low sugar) or the Dash diet (vegetables, whole grains, beans, fruits, healthy fats, low sugar). These diets are rich in fibre and nutrients yet soft in fats and calories. For assistance with nutrition and meal planning, see a qualified dietitian.

Exercising regularly. On most days of the week, try to exercise for at least 30 minutes. Take a walk, swim, or engage in another activity that you like.

If you are overweight, you must lose weight. Develop a weight-loss strategy with the help of your healthcare team.

Take medicine and insulin as recommended and according to the instructions on how and when to take them.

At home, keep track of your blood glucose and blood pressure.

You are maintaining regular contact with your healthcare professionals and completing laboratory testing as directed by your doctor.

Smoking cessation (if you smoke).

You have a lot of power over how you manage your diabetes daily!


What is the best way to monitor my blood glucose level? What is the significance of this?

Checking your blood glucose level is crucial because the findings may help you decide what to eat, how much exercise you should do, and whether or not you need to alter or add insulin.


A blood glucose meter is the most popular approach to monitor your blood glucose level. This test requires you to prick the side of your finger, put a drop of blood to the test strip, insert the strip into the meter, and the meter will display your current glucose level. Your healthcare professional will advise you on how often you should test your glucose level.


What is continuous glucose monitoring, and how does it work?

Technology has provided us with a new approach to check glucose levels. A tiny sensor is implanted under your skin for continuous glucose monitoring. It's not necessary to prick your finger. Instead, the sensor monitors your blood sugar levels and displays the information at any time of day or night. To check whether continuous glucose monitors are a good fit for you, talk to your doctor about it.


What is the ideal blood glucose level for me?

Inquire with your doctor about the ideal blood glucose level for you. They could have a target range in mind for you. Most individuals, on the other hand, attempt to maintain their blood glucose levels within these ranges:


Between 80 and 130 mg/dL before a meal.

Less than 180 mg/dL two hours after the commencement of a meal.

What happens if I have a low blood glucose level?

Hypoglycemia is defined as a blood glucose level that is lower than the normal range (typically less than 70 mg/dL). This is a signal from your body that you need sugar.


Hypoglycemia may cause a variety of symptoms, including:


Weakness or tremors.

Sweating and moist skin.

The heart is racing.

Dizziness.

Hunger strikes unexpectedly.

Confusion.

Skin that is light in colour.

Numbness in the tongue or mouth.

Nervousness and irritability.

Unsteadiness.

Nightmares, terrible dreams, and disturbed sleep are all common occurrences.

Vision is hazy.

Seizures and headaches.

If your hypoglycemia is not treated, you may pass out.


What happens if I have a high blood glucose level?

Hyperglycemia is a condition in which your blood contains too much glucose. Hyperglycemia is characterized as the following:


When fasting, a blood glucose level of more than 125 mg/dL is present (nothing to eat or drink for at least eight hours).

or


One to two hours after eating, a blood glucose level of more than 180 mg/dL.

What is the treatment for diabetes?

Diabetes treatment is determined by the kind of diabetes you have, how well your blood glucose level is managed, and any other medical issues you may have.


Type 1 diabetes necessitates the use of insulin daily. Your pancreas no longer produces insulin.

If you have type 2 diabetes, your treatments may include drugs (both for diabetes and for diseases that are risk factors for diabetes), insulin, and lifestyle modifications such as decreasing weight, eating healthier and exercising more.

 

Prediabetes: If you have prediabetes, your objective is to avoid becoming diabetic. Treatments are centred on reversible risk factors, such as decreasing weight with a healthy diet (such as the Mediterranean diet) and regular exercise (at least five days a week for 30 minutes). Many diabetes preventive measures are also advised for diabetic treatment (see prevention section of this article).

 

If you have gestational diabetes and your blood sugar level isn't too high, your first line of defence may be to regularly change your diet and exercise. Your healthcare provider may prescribe medicine or insulin if the target goal is not attained or your glucose level is too high.

Oral medicines and insulin are used to treat diabetes in one of the following ways:


It stimulates your pancreas to produce and release more insulin.

Reduces the glucose release rate from your liver (extra glucose is stored in your liver).

It blocks the digestion of carbohydrates in your stomach or intestines, allowing your tissues to respond to insulin more quickly.

Increased urination aids in the removal of glucose from the body.

Who should get a diabetes test?

 

If you have diabetic symptoms or risk factors, you should get tested. The sooner diabetes is detected, the sooner treatment may begin, and complications can be reduced or avoided. Suppose a blood test reveals that you have prediabetes. In that case, you and your healthcare provider may work together to adopt lifestyle changes (such as weight reduction, exercise, and a nutritious diet) that can help you avoid or postpone the onset of Type 2 diabetes.


Additional testing recommendations based on risk factors:


Children and young adults with a family history of diabetes should be tested for Type 1 diabetes. Older persons are less likely to acquire Type 1 diabetes. As a result, testing in adults who arrive at the hospital and are diagnosed with diabetic ketoacidosis is critical. Ketoacidosis is a potentially fatal complication in persons with Type 1 diabetes.

Diabetic type 2 testing: Adults aged 45 and above, those aged 19 to 44 who are overweight and have one or more risk factors, women who have had gestational diabetes, and children aged 10 to 18 who are overweight and have at least two types 2 diabetes risk factors should be tested.

Diabetes during pregnancy: All pregnant women who have been diagnosed with diabetes should be tested. Between weeks 24 and 28, all pregnant women should be tested. Your obstetrician may try you early if you have additional risk factors for gestational diabetes.

 

According to a paper issued by Swedish researchers, we need to rethink diabetes diagnosis and make it more exact to individualize therapy better. The research excludes type 1 diabetes, the most common autoimmune condition among children and young people. The pancreas generates little or no insulin. Therefore people with it must take it every day for the rest of their lives. In type 2 diabetes, the body produces insulin but cannot use it efficiently, and it may ultimately cease producing insulin altogether.

Swedish researchers categorized into five groups type 2 diabetes based on factors such as the age at which they identified it, BMI, the presence or absence of insulin antibodies, and the risk of complications. They looked examined data from 8,980 persons diagnosed with diabetes who were part of a Swedish registry. They then double-checked their findings by looking at data from 5,795 diabetic people in Sweden and Finland.

They classified three of the five diabetes subtypes discovered as severe, while the other two were moderate.

They diagnose one severe kind parallels type 1 diabetes in that individuals, while relatively young, are not overweight and have an immune system issue that prevents insulin production.

Another severe subtype affects relatively young persons who are not overweight at diagnosis and generate little insulin for unknown reasons. Diabetic eye damage is a typical consequence of "severe insulin-deficient diabetes," according to the experts.

The third severe subtype affects overweight persons who produce adequate insulin but do not react to it. We know the condition as "severe insulin resistance and diabetes." Complications such as liver disease and chronic renal disease are more likely to occur in these people.

A fourth kind, known as "moderate obesity-related diabetes," is far less severe than the other three and affects overweight persons.

The fifth and most frequent diabetes afflicted 40% of individuals whose cases they examined in the research. It's called "mild age-related diabetes" since it only affects the elderly.

Lifestyle adjustments and metformin, a medicine often used to reduce high blood sugar, may treat both mild subtypes.

These discoveries might lead to more accurate diabetes therapy, but the Swedish researchers cautioned that there is still more to learn, such as whether patient classifications can alter.

Source: DOI:  doi.org/10.1016/S2213-8587(18)30051-2

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