Diabetes = “excessive urine‟ Mellitus = “honey sweet‟
DM is a group of disorders characterised by hyperglycaemia
▫ Hyper = too much ▫ Glycaemia = “sugar in the blood‟
- DM is a disorder of metabolism
- Most of the food people eat is broken down into glucose, the form of sugar in the blood
- After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy
- Insulin is a hormone produced by the pancreas, a large gland behind the stomach
- For glucose to get into cells, insulin must be present
- When people eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into the cells
- In DM, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced
- Glucose builds up in the blood, overflows into the urine, and passes out of the body in the urine
Types of DM-T1 and T2
T1DM is caused by the destruction or dysfunction of insulin-producing beta cells by the cells of the immune system
In T2DM, beta cells decline gradually over time, and insulin resistance plays a role in the disease – More common (90-95%) of all cases (US/UK)
Pathophysiology of T2DM
- Family history
- Gestational DM
- Increasing age
- Sedentary lifestyle
- (BP and high cholesterol)
Obesity & T2 DM
• Up to 80% of all cases of T2DM would not exist if there were no obesity
• Obesity is associated with insulin resistance
-Blood sugar levels often normalise with weight loss
▫ Even 5-10% reduction in weight has a significant effect
• Note that it is possible for T2DM to exist in normal weight individuals, but this is rare
Signs and Symptoms
The classic triad-
• Polydipsia = excessive thirst • Polyuria = excessive urination • Polyphagia = excessive hunger
6. Recent weight loss
7. Recurrent infections
8. Others, depending on the organ/s involved
In addition to above, commonly seen symptoms by doctors: Obesity , Evidence of micro- or macrovascular complications , Evidence of neuropathy, Recurrent infections (e.g. thrush)
How is it diagnosed?
- History and examination
- Fasting blood glucose
- Glucose tolerance test (GTT)
- Autoimmune markers
DM may be present for years in the absence of symptoms or signs. Up to 50% of diabetes cases goes undiagnosed, especially in developing countries
In the period prior to diagnosis, significant and potentially irreversible end-organ damage may occur. Prevention and early recognition are important to minimise the impact of complications
Eat well : Around 80% of people with Type 2 diabetes are overweight when diagnosed. Eating a healthy diet that is low in salt, sugar and fat with lots of fruit and veg is a simple way to prevent diabetes.
Be physically active: Apart from making you feel good, getting regular exercise can reduce your risk of developing Type 2 diabetes by up to 64%.
Stop smoking: Smoking’s not just bad for your lungs. It can also lead to high blood pressure which causes heart disease, and this is a major risk factor for developing Type 2 diabetes. The risk of dying from heart attack is 5 times higher in folks with diabetes.
Watch your waist: Putting on the pounds round your midriff increases your risk. If you’re a man and your waist is 37 inches or more, or you’re a woman and your waist is over 31.5 inches, then you could be at risk of Type 2 diabetes.
Get checked out: Type 2 diabetes can lay undetected for up to 12 years, which means that 50% of people already have serious complications by the time they’re diagnosed. If you have a large waist, are over 40 and a close member of your family has diabetes, you should get a diabetes test.
I have deliberately omitted the section on treatment. I am not qualified to dispense medical treatment advice, kindly consult your doctor. Kindly note that none of the above constitutes medical advice; it is only shared as public health information. Always speak to a qualified medical practitioner