09/02/2024
{Diabetes Mellitus}
1 Definition
- **Diabetes Mellitus** is a group of metabolic disorders characterized by **persistent hyperglycemia** (elevated blood sugar levels).
- It results from defects in **insulin secretion**, **insulin action**, or both.
- Chronic hyperglycemia can lead to complications affecting various organs and systems.
2. Types:
- There are several types of diabetes, but the two main ones are:
- Type 1 Diabetes (T1DM):
- Also known as **insulin-dependent diabetes** or **juvenile diabetes**.
- Results from **autoimmune destruction** of pancreatic beta cells, leading to **absolute insulin deficiency**.
- Typically diagnosed in childhood or adolescence.
- **Type 2 Diabetes (T2DM)**:
- Most common form.
- Involves **insulin resistance** (cells don't respond effectively to insulin) and **relative insulin deficiency**.
- Often associated with lifestyle factors (obesity, sedentary lifestyle, poor diet).
3. Etiology:
- **Type 1 Diabetes**:
- **Autoimmune process**: Immune system attacks and destroys beta cells.
- Genetic predisposition.
- Environmental triggers (viral infections, toxins).
- **Type 2 Diabetes**:
- **Insulin resistance**: Cells become less responsive to insulin.
- Genetic factors.
- Lifestyle (obesity, physical inactivity, unhealthy diet).
4. Pathophysiology:
- **Type 1**:
- Beta cell destruction → **absolute insulin deficiency**.
- Hyperglycemia results from reduced glucose uptake by cells.
- **Type 2**:
- Insulin resistance → increased insulin production.
- Over time, beta cells may fail → relative insulin deficiency.
- Hyperglycemia due to impaired glucose utilization.
5. Clinical Features:
- **Common Symptoms**:
- **Polyuria**: Frequent urination due to excess glucose in urine.
- **Polydipsia**: Excessive thirst.
- **Polyphagia**: Increased hunger.
- **Weight loss** (especially in T1DM).
- **Complications**:
- **Neuropathy**, **retinopathy**, **nephropathy**, cardiovascular issues.
6. Diagnosis:
- **Fasting blood glucose** test.
- **Oral glucose tolerance test**.
- **Hemoglobin A1c** (reflects average blood sugar over 2-3 months).
7. Non-Pharmacological Management:
- **Lifestyle Modifications**:
- **Diet**: Carbohydrate counting, balanced meals.
- **Exercise**: Regular physical activity.
- **Blood sugar monitoring**.
- **Stress management**.
- **Avoidance of to***co and alcohol**.
8. Pharmacological Management:
- **Type 1**:
- **Insulin replacement therapy**: Multiple daily injections or insulin pump.
- **Type 2**:
- **Oral antidiabetic medications**: Metformin, sulfonylureas, etc.
- **Injectable medications**: GLP-1 receptor agonists, SGLT-2 inhibitors.
- **Insulin** (if needed).
👉Remember, diabetes management involves a holistic approach, including medical care, lifestyle adjustments, and ongoing monitoring. Regular follow-up with healthcare professionals is crucial for optimal control and prevention of complications.
Dr Abdisamed Ali
