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Diabetes mellitus: Treatment, symptoms, advice and help

About diabetes mellitus

Diabetes mellitus is a disorder characterised by the abnormal elevation of blood sugar levels because of either impaired secretion or by the decreased action of a hormone called insulin. It leads to a wide array of complications affecting most of the vital organs.

Diabetes mellitus: Incidence, age and sex

The prevalence of diabetes is 4 percent. It is more commonly seen in people more than 40 years of age. Men and women are equally affected. Certain ethnic groups like Asian Indians and blacks have a higher prevalence.

Signs and symptoms of diabetes mellitus: Diagnosis

The most classical symptoms of diabetes are frequent urination, unusually increased thirst and hunger, weight loss and fatigue. Other features which can point towards a diagnosis are frequent infections, blurred vision, poor wound healing and tingling in the hands and feet. However, many patients do not have any symptoms and are detected on routine screening.

The diagnosis of diabetes is confirmed by finding of raised blood sugar levels. An oral glucose tolerance test may be required. Glycosylated haemoglobin or HbA1c is a measure of average blood glucose levels over the last three months.

Causes and prevention of diabetes mellitus

Diabetes mellitus is caused by either insulin deficiency (type 1 diabetes) or insulin resistance (type 2 diabetes). Insulin is a hormone produced by certain cells called the beta cells of the pancreas which is responsible for glucose regulation. Certain conditions like obesity, sedentary lifestyle, history of diabetes in family increase the likelihood of getting this disease.

Prevention of diabetes mellitus can be achieved by adopting a healthy lifestyle which includes regular physical activity, balanced diet with avoidance of high calorie junk food, avoidance of smoking and maintaining normal body weight. Regular screening with either a fasting blood glucose or oral glucose tolerance test helps in early detection and avoidance of long term complications.

Diabetes mellitus: Complications

Diabetes mellitus affects almost every part of the body. Patients with diabetes have a two to four times higher risk of heart disease and stroke. It is the leading cause of kidney failure as well as blindness. About 2/3rd of patients with diabetes have some form of nerve damage which sometimes leads to lower limb amputations. Other complications associated with this disease are erectile dysfunction, recurrent skin and urinary infections.

A very high blood sugar level can lead to potentially life-threatening acute complications like diabetic ketoacidosis, especially in patients with type 1 diabetes mellitus.

Diabetes mellitus: Treatment

The treatment of diabetes involves essentially three components namely diet, physical exercise and drugs. Eating well balanced meals in correct amounts and at the correct time is of prime importance and a nutritionist’s advice should be taken. Regular physical exercise which involves at least thirty minutes of aerobic exercise is also important. Drugs to treat diabetes include oral agents and insulin. Oral agents work by either increasing insulin secretion from pancreas or making the tissues more sensitive to insulin. A vast majority of patients with type 2 diabetes maintain good control with oral agents. However, some patients with type 2 diabetes and all patients with type 1 diabetes need to take insulin. Insulin is administered by injection given under the skin. There are newer injection devices which make the task of taking insulin simpler, more convenient and almost painless. Insulin pump is also a very convenient device which provides flexibility with meals.

Patients on therapy need to monitor their blood glucose regularly. Self-monitoring of blood glucose with commercially available glucose testing devices is especially important for patients who are on insulin.

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