Diabetes Mellitus

Diabetes Mellitus

All about Diabetes Mellitus

diabetes checking machine

Introduction

Diabetes Mellitus is a clinical syndrome characterized by an increase in plasma blood glucose level, which is also called as Hyperglycemia

Etiological Classification of Diabetes Mellitus

  1. Type 1 Diabetes (Insulin Dependent Diabetes Meliitus)
    • Immune mediated
    • Idiopathic
  2. Type 2 Diabetes (Insulin Independent Diabetes Mellitus)
  3. Other Specific Types
    • Genetic defect of beta cell function
    • Genetic defect of insulin action
    • Pancreatic disease
    • Excess endogenous production of hormone antagonist to insulin
    • Drug induced
    • Uncommon form of immune mediated diabetes
    • Associated with genetic syndromes
  4. Gestational Diabetes

Symptoms of Hyperglycemia

  1. Thirst
  2. Dry Mouth
  3. Nocturia
  4. Unusual weight loss
  5. Tiredness, Fatigue, Lethargy
  6. Blurring of vision
  7. Nausea
  8. Headache
  9. Hyperphagia - Predilection for sweet foods
  10. Mood change, irritability
  11. Difficulty in concentrating
  12. Apathy
  13. Genital candidiasis - pruritus vulve, balanitis

Diagnosis of Diabetes and Pre-Diabetes

  1. Plasma Glucose level
  2. Plasma Urea, Creatinine, Electrolytes
  3. Liver Function Test
  4. Thyroid Function Test
  5. Urine test for Ketones, protein or microalbuminuria

Management of Diabetes Mellitus

  1. Dietary and lifestyle modification
    • Regular physical activity
    • Healthy diet
    • Limit the sodium intake (less than 6 gm per day)
    • Reducing alcohol consumption
    • Stoppage of smoking
  2. Oral Anti-diabetic drugs
    • Biguanide - Metformin
    • Sulphonylurease
    • Alpha Glucosidase inhibitor
    • Thiazolidinediones
    • Sodium and Glucose Transporter 2 (SGLT2) inhibitor
  3. Injectable Insulin therapy

Complications of Diabetes Mellitus

A) Microvascular / Neuropathic

  1. Retinopathy - Cataract, Impaired vision
  2. Nephropathy - Renal failure
  3. Peripheral Neuropathy - Sensory loss, Pain, Motor weakness
  4. Autonomic Neuropathy - GIT problems, Postural hypotension
  5. Foot Disease - Ulceration, Arthropathy

B) Macrovascular

  1. Coronary Circulation - Myocardial Ischaemia / Infarction
  2. Cerebral Circulation - Transient Ischaemic Attack, Stroke
  3. Peripheral Circulation - Claudication, Ischaemia