Diabetes melitus, or diabetes, is a disease of abnormal carbohydrate metabolism. Diabetes affects the storage of glucose in the liver and has an influence on fat metabolism. Types 1 and 2 vary in causative factors, but early detection and control are important for both to achieve a favorable prognosis. According to the National Diabetes Education Program, diabetes is the seventh-leading cause of death in the United States, where more than 23 million people have the disease. Control of blood sugar depends on patient compliance with diet and exercise as well as taking prescribed medications.
Hyperglycemia
In Type 1 diabetes, groups of cells in the pancreas do not secrete enough of the hormone insulin. In Type 2 diabetes, there may enough insulin, but it cannot work properly. In both types, hyperglycemia, or high blood sugar, is the result.
Too much sugar in the blood produces abnormal levels in the urine, or glycosuria, as it spills into the kidneys. A fasting blood sugar is obtained by taking a blood sample before breakfast. Recently, doctors have found that a marker in the blood, the hemoglobin A1C, is the most accurate test. It provides an average of blood glucose levels over the previous three months.
Hyperglycemia damages blood vessels, nerves, organs and the body's ability to heal. Poorly controlled blood sugar leads to complications, including blindness, kidney failure, heart disease, nerve pain and lower limb amputations from infections and gangrene. NDEP reports that diabetics have double the risk of heart attack or stroke compared to non-diabetics.
Fluid Imbalance
Frequent and excessive urination, or polyuria, is a classic sign of diabetes, along with excessive thirst, or polydipsia. These symptoms and an excessive appetite are the body's attempts to rid the bloodstream of unused sugar and to get nutrients to starving cells. Untreated Type 1 diabetics may eventually develop metabolic acidosis, a life-threatening condition characterized by a fruity breath odor, abdominal pain, vomiting, rapid respirations, weakness, confusion and coma.
Physical Changes
Impotence, fatigue, unexplained weight loss (Type 1), night sweats, tremors and blurred vision are signs of diabetes that compel people to seek help from a doctor. Obesity, high blood pressure and elevated cholesterol levels are risk factors for Type 2 diabetes. It is called a "silent disease," however, because serious complications can result before symptoms become apparent. The only way to diagnose diabetes is through blood tests. Having regular check-ups makes it more likely that diabetes will be detected early. New prevention programs target pre-diabetes, aiming to delay or prevent the development of Type 2 diabetes. NDEP reports that 90 percent of diabetics are Type 2.
