Diabetes Mellitus

Cause

Blood sugar level (blood glucose) is a measure of the amount of sugar (glucose), which is dissolved in the blood. Insulin lowers blood sugar level and is produced in the pancreas. There are various types of diabetes. The most common are type 1 and type 2 diabetes.
In people with type 1 diabetes, an autoimmune disease, the pancreas doesn’t produce insulin by itself anymore. The immune system destroys the cells that produce insulin. Risk factors for the development of type 1 diabetes are hardly known yet, but likely viruses, environmental factors and food intolerance play a role. Heredity plays a very limited role.
In people with type 2 diabetes, the pancreas produces too little insulin or the insulin cannot do its job. Risk factors for developing type 2 diabetes are genetic predisposition, overweight, bad fat distribution, lack of physical activity, smoking and unhealthy diet. Especially people who eat too much saturated fat and too little unsaturated fat and food fiber, run a higher risk of type 2 diabetes. The increase in the number of people with type 2 diabetes is mainly caused by overweight. Type 2 is increasingly becoming a lifestyle disease.
Some women develop gestational diabetes from week 24 of pregnancy, but immediately after childbirth it’s over again.

Symptoms

People with diabetes generally experience the following signs and symptoms:

• Often thirsty and peeing a lot.
• Severe fatigue.
• Eye problems, such as red and burning eyes, blurred vision, double vision or poor vision.

People with type 1 diabetes, who are not getting treatment yet, often feel ill. When blood glucose is really very high, it can cause fainting or even coma. People with type 1 diabetes suffer from weight loss without reason, are very hungry or just not at all and are nauseous or have to vomit.
Type 2 diabetes begins so slowly that it's hardly noticable. Many symptoms are so vague that people don’t go to the general practitioner. So it may happen that a person walks around for years with diabetes without knowing it. Type 2 diabetes can often be identified by one or more of these symptoms: poor healing of wounds, shortness of breath, pain in the legs while walking and infections that often recur, such as bladder infection.

Diagnosis

The general practitioner can confirm the diagnosis of diabetes fairly quickly by taking a drop of blood from the finger. With the aid of a blood glucose meter, the doctor determines the level of blood sugar. When there is doubt, the blood is tested in a laboratory.

Treatment

Diabetes does not pass, but can fortunately be properly treated. The treatment of diabetes is aimed at regulating the blood glucose. In practice, this treatment will be needed life-long. The type of treatment depends on the type of diabetes. Type 1 diabetes is treated with insulin injections and type 2 diabetes usually only with antidiabetic drugs. A combination of medications, insulin and adjustment of lifestyle also occurs.
People can do a lot themselves in the treatment of diabetes. If a patient learns to control and regulate blood sugar, the symptoms subside. Regular contact with the practitioner can help. In the treatment of type 2 diabetes, weight reduction is a major focus. Whoever loses weight, might not need to use drugs anymore.

Prognosis

For now, diabetes can only be treated and not be cured. Diabetes can lead to all kinds of complications, for example feet problems, decreased kidney function, damaged nerves, eye problems and increased susceptibility to infection. In addition, a person with diabetes can get hypoglycemia (hypo) or hyperglycemia (hyper). A hypo is a sharp drop in blood sugar and a hyper is just a surge. It’s important that the environment of the patient is aware of this and can recognize the symptoms. When a hyper lasts very long, or when a hypo is severe, it may lead to coma.

Considerations

In a large number of cases, type 2 diabetes can be prevented or postponed by living a healthy life:

• Ensure sufficient exercise.
• Quit smoking.
• Make wise choices with food and alcohol. Take care of the amount of carbohydrate in the diet.
• Keep weight under control.
• Try to keep blood glucose stable.
• Check your feet daily (possibly with a mirror or assistance).
• Make sure to get the necessary checks in time.

Facts

• The Greek doctor Apollonius of Memphis introduced the name ‘diabetes’ in the third century BC.
• The term ‘diabetes mellitus’ is derived from the Greek words dia and betes (flow) and the Latin word mellitus (honey-sweet).
• The prevalence of diabetes mellitus is about 3%. Nine out of ten people with diabetes have type 2 diabetes.
• The condition is most common in people aged 75 to 85 years.
• Men and women are about equally likely to have diabetes.
• In the past, type 2 diabetes was called age sugar, but nowadays it’s also increasingly common in younger people.