About Diabetes Mellitus

Overview

Diabetes mellitus is a disease that affects how the body uses blood sugar. The disease gets its name from its primary symptom, frequent urination. The word "diabetes" comes from the Greek word for urine and "mellitus" means honey or sweet. There are two major forms of diabetes mellitus: type 1 and type 2. While all types of diabetes mellitus affect sugar metabolism, they do so in different ways. With type 1 diabetes, the body does not make the hormone insulin. With type 2 diabetes, the body makes insulin but is unable to use it properly. Insulin makes it possible for blood sugar to enter the cells, where it is converted into energy. In diabetics, the sugar never gets into the cells and remains in the blood stream.

Causes

With type 1 diabetes, the immune system attacks the insulin-producing cells in the pancreas. It is not clear what causes the immune system to attack its own cells but Nora Sarvetnick of the Scripps Research Institute believes that a virus may be the cause.

With type 2 diabetes the cells become resistant to insulin. As a result, the pancreas has to work harder and make more insulin to overcome this resistance. In later stages of type 2 diabetes, the pancreas "burns out" and stops producing insulin entirely.

Risk Factors

Type 1 diabetes is an autoimmune disease and, while heredity may be a factor, there are no known risk factors.

In the case of type 2 diabetes, obesity and heredity are both major risk factors. According to the American Diabetic Association, African-Americans are disproportionately affected by diabetes. Approximately, 14.7 percent of all African-Americans over the age of 20 have diabetes, versus 9.8 percent of whites. People over the age of 45 are also at greater risk for diabetes. Poor diet and a sedentary lifestyle, in addition to hypercholesterolemia and hypertension are also contributing factors.

Symptoms

The most common symptom is frequent urination coupled with increased thirst. Diabetics may also experience unexplained weight loss or weight gain--depending on how the body deals with the excess sugar in the blood. In some cases, the excess is stored as fat. In other cases, the body breaks down fat in an effort to get enough energy for fuel. Because the body is not able to effectively use blood sugar, many diabetics experience extreme hunger as the body tries to get more fuel to make up for the shortfall. Sores often heal slowly and diabetics are prone to frequent infections including yeast infections and bladder infections.

Complications

Type 1 and type 2 diabetes both have a long list of long-term and short-term complications. The kidneys have to work harder to filter the sugar out of the blood, which can lead to kidney damage and kidney failure. Blood sugar causes minute tears in the walls of blood vessels, causing clots to form. These clots can block smaller vessels and reduce, or completely stop, blood flow. In the extremities, this causes poor circulation and poor wound healing. In the organs, such as the heart, it can cause damage by blocking crucial blood flow. Sugar also damages the nerves, resulting in numbness in the extremities and even blindness. The combination of reduced blood flow, poor wound healing and numbness in the extremities makes diabetics at high risk for gangrene and amputation. In the short-term, diabetics are prone to hypoglycemia--a sudden drop in blood sugar. This often results from administering too much insulin or not eating enough to accommodate the amount of insulin injected. Ketones are a by-product of breaking down fats. In diabetics, the body can break down fat too fast, resulting in ketoacidosis--toxic levels of ketones in the blood.

Treatments

With type 1 diabetes, insulin injections are the only treatment. Type 1 diabetics need to closely monitor their blood sugar and often need to take several readings each day. Type 1 diabetics also need to administer insulin several times a day as blood sugar levels fluctuate with diet and activity levels.
Type 2 diabetics have slightly different treatments. As with type 1, type 2 patients need to monitor their blood sugar. However, in the early stages of the disease, the body still produces insulin. A doctor may prescribe drugs that help the cells respond to insulin, or he may instruct the patient to control his condition with diet and exercise. Often the treatment plan includes a combination of drugs and lifestyle changes. In some cases, a type 2 diabetic can keep his condition under control without having to use insulin. If the pancreas stops making insulin, the patient will then need to take insulin injections.

Prevention/Solution

Type 1 diabetes is not preventable, while type 2 diabetes is. Maintain a healthy diet and focus on fruits, vegetables and whole grains. Engage in physical activities, like walking and, if you are overweight, lose excess pounds.