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Diabetes Mellitus

DIABETES MELLITUS:

Diabetes mellitus (pronounced /ˌdaɪ.əˈbiːtiːz/ or /ˌdaɪ.əˈbiːtɨs/; /mɨˈlaɪtəs/ or /ˈmɛlɨtəs/)—often referred to simply as diabetes—is a condition in which the body either does not produce enough, or does not properly respond to, insulin, a hormone produced in the pancreas. Insulin enables cells to absorb glucose in order to turn it into energy. In diabetes, the body either fails to properly respond to its own insulin, does not make enough insulin, or both. This causes glucose to accumulate in the blood, often leading to various complications.[2][3]

Many types of diabetes are recognized:[3] The principal three are:

  • Type 1: Results from the body’s failure to produce insulin. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes. Presently almost all persons with type 1 diabetes must take insulin injections.
  • Type 2: Results from Insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes. Many people destined to develop type 2 diabetes spend many years in a state of Pre-diabetes: Termed “America’s largest healthcare epidemic,”[4]:10-11, pre-diabetes indicates a condition that occurs when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. As of 2009 there are 57 million Americans who have pre-diabetes.[5]
  • Gestational diabetes: Pregnant women who have never had diabetes before but who have high blood sugar (glucose) levels during pregnancy are said to have gestational diabetes. Gestational diabetes affects about 4% of all pregnant women. It may precede development of type 2 (or rarely type 1).
  • Many other forms of diabetes mellitus are categorized separately from these. Examples include congenital diabetes due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes.

All forms of diabetes have been treatable since insulin became medically available in 1921, but there is no cure for the common types except a pancreas transplant, although gestational diabetes usually resolves after delivery.

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Signs and symptoms

The classical symptoms are polyuria and polydipsia which are, respectively, frequent urination and increased thirst and consequent increased fluid intake.

Symptoms may develop quite rapidly (weeks or months) in type 1 diabetes, particularly in children. However, in type 2 diabetes symptoms usually develop much more slowly and may be subtle or completely absent. Type 1 diabetes may also cause a rapid yet significant weight loss (despite normal or even increased eating) and irreduciblemental fatigue.

All of these symptoms except weight loss can also manifest in type 2 diabetes in patients whose diabetes is poorly controlled, although unexplained weight loss may be experienced at the onset of the disease. Final diagnosis is made by measuring the blood glucose concentration.

When the glucose concentration in the blood is raised beyond its renal thresholdreabsorption of glucose in the proximal renal tubuli is incomplete, and part of the glucose remains in the urine (glycosuria). This increases the osmotic pressure of the urine and inhibits reabsorption of water by the kidney, resulting in increased urine production (polyuria) and increased fluid loss. Lost blood volume will be replaced osmotically from water held in body cells and other body compartments, causing dehydration and increased thirst.

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Research

Diabetics are often advised to receive regular consultation from a physician (e.g., at least every three to six months) although research is underway to develop artificial intelligence systems which may reduce the frequency of such visits.[81]

References

  1. ^ “Diabetes Blue Circle Symbol”. International Diabetes Federation. 17 March 2006.
  2. a b c Rother KI (April 2007). “Diabetes treatment—bridging the divide”. The New England Journal of Medicine 356 (15): 1499–501. doi:10.1056/NEJMp078030PMID 17429082.
  3. a b L M Tierney, S J McPhee, M A Papadakis (2002). Current medical Diagnosis & Treatment. International edition. New York: Lange Medical Books/McGraw-Hill. pp. 1203–15. ISBN 0-07-137688-7.
  4. a b c d e Wild S, Roglic G, Green A, Sicree R, King H (May 2004). “Global prevalence of diabetes: estimates for the year 2000 and projections for 2030”. Diabetes Care 27 (5): 1047–53. doi:10.2337/diacare.27.5.1047PMID 15111519.
  5. ^ “Other “types” of diabetes”American Diabetes Association. August 25, 2005.
  6. ^ “Diseases: Johns Hopkins Autoimmune Disease Research Center”. Retrieved 2007-09-23.
  7. ^ Lawrence JM, Contreras R, Chen W, Sacks DA (May 2008). “Trends in the prevalence of preexisting diabetes and gestational diabetes mellitus among a racially/ethnically diverse population of pregnant women, 1999–2005”. Diabetes Care 31 (5): 899–904. doi:10.2337/dc07-2345PMID 18223030.
  8. ^ Handelsman, Yehuda, MD. “A Doctor’s Diagnosis: Prediabetes.” Power of Prevention, Vol 1, Issue 2, 2009.
  9. a b World Health Organisation Department of Noncommunicable Disease Surveillance (1999). “Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications” (PDF).
  10. ^ Cooke DW, Plotnick L (November 2008). “Type 1 diabetes mellitus in pediatrics”. Pediatr Rev 29 (11): 374–84; quiz 385. doi:10.1542/pir.29-11-374PMID 18977856.

January 27, 2010 - Posted by | Blood, Brain, Cells, Kidney, Liver, Muscles, Pancreas

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