Diabetes Definition, Cause, Symptoms,treatment, Complication Diabetes Definition, Cause, Symptoms,treatment, Complication Doctors media

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Diabetes Definition, Cause, Symptoms,treatment, Complication

 
Diabetes: Definition, Cause, Symptoms,treatment, Complication

Diabetes mellitus 

Diabetes is a major burden on healthcare facilities in all countries. Globally, in 2015, diabetes caused 5  million deaths in those aged 20–79  years.

Diabetes Definition:

Diabetes mellitus is a clinical syndrome characterized by an increase in plasma blood glucose (hyperglycemia). 
It has many causes .most commonly Type 1 diabetes or type 2 diabetes. 

Symptoms of Diabetes 

   Thirst, dry mouth
   Polyuria 
   Nocturia
   Tiredness, fatigue, lethargy
   Change in weight (usually weight loss)
   Blurring of vision
   Pruritus vulvae, balanitis (genital candidiasis) 
   Nausea 
   Headache 

Diabetes is diagnosed with 

either  plasma glucose in the random sample or 2 hrs after a 75 g glucose load  ≥ 11.1 mmol/L (200 mg/dL)  or 
  fasting plasma glucose  ≥ 7.0 mmol/L (126      mg/dL)  or 
 HbA1c  ≥ 48  mmol/mol

Read about hypoglycemia

Causes of  diabetes mellitus 

 Type 1 diabetes 
 Type 2 diabetes 
 Genetic defects of  β-cell function 
  Pancreatic disease:
 Pancreatitis,
 Pancreatectomy,
 Neoplastic disease, 
 Cystic fibrosis,
 Haemochromatosis,
 Fibrocalculous pancreatopathy

 Excess endogenous production of hormonal antagonists of insulin, e.g.: 

Growth hormone – acromegaly
 Glucocorticoids – Cushing’s syndrome
 Glucagon – glucagonoma 
Catecholamines – phaeochromocytoma 
Thyroid hormones – thyrotoxicosis 

Drug-induced : 

Glucocorticoids, 
Thiazide diuretics, 
Phenytoin

  Associated with genetic syndromes Down’s syndrome, 

Klinefelter’s syndrome, 
Turner’s syndrome,
 DIDMOAD (Wolfram’s syndrome),
 Friedreich’s ataxia, 
Myotonic dystrophy) 

Management of Diabetes 

Treatment of Diabetes

Dietary management of diabetes:
Dietary constituents and recommended % of energy intake 
   Carbohydrate:  50%: Sucrose: up to 10% 
   Fat  (total):  < 35%: n-6 Polyunsaturated:  < 10% n-3 Polyunsaturated: eat 1 portion (140 g) oily fish     once or twice weekly Monounsaturated: 10–20% Saturated:  < 10%
   Protein: 10–15% (do not exceed 1 g/kg body weight/day)
   Fruit/vegetables: 5 portions daily

Drug management 

Insulin 
Sulphonylureas 
Meglitinides 
Metformin 
 Thiazolidinediones (glitazones) 
DPP-4 inhibitors (gliptins) 
GLP-1 receptor agonists 
SGLT2 inhibitors

Complications of diabetes 

Microvascular

 Retinopathy, cataract
 Impaired  vision Nephropathy 
 Renal  failure 
 Peripheral neuropathy
 Sensory  loss
  Pain
 Autonomic neuropathy 
 Gastrointestinal  problems (gastroparesis; altered bowel habit)
 Foot disease •  Ulceration •  Motor  weakness •  Postural  hypotension •  Arthropathy 

Macrovascular 

Coronary circulation 
         Myocardial  ischemia/infarction
Cerebral circulation 
         Transient  ischemic  attack, stroke
Peripheral circulation 
         Claudication
        Ischemia
Read more 

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