Health Talk With Dr. Wrinkle : All You Need To Know About Diabetes Mellitus

Diabetes mellitus has been known as a long standing enemy of man, amidst different technologies, therapies and drugs it remains one of the incurable diseases in our planet.

Killing many ranging from the youngest of age to the oldest, often time we call it the 'plaque of the modern world'.
My colleague in the university once said 'the easiest way to kill a man, is to pray he goes down with diabetes mellitus'. Do you know why ?
Soon you will.

Introduction : What Is Diabetes Mellitus

It is mostly abbreviated as diabetes, and it is a Greek word which was translated diabetes (siphon) and melittus (sugar). It was first diagnosed in Egypt and since then is noticed in all of the world. In the early days it was known as 'the pissing evil'.

It is a family of metabolic disorders which is characterized by an increase in blood sugar level above normal due to a decrease, shortage or inability of the body to respond to insulin secretion.
Insulin is an hormone secreted by the beta cells of the pancreas, which helps in the regulation of blood sugar (blood glucose) into cells to be used for energy. When this natural process is altered, it will result in the inability of the body to process blood glucose and so leading to an increase in the sugar level in the blood. Which is the golden signal of the disease.

Diabetes Incipidus vs Diabetes Melittus

Both diseases are of caused by hormonal imbalance but they are not the same.  Diabetes incipidus is a condition caused by a defect in the production of Anti-diuretic Hormone or Vasopressin, resulting in the excretion of large quantity of fluid. It could also be caused by the malfunctioning of the kidney.
While diabetes mellitus is characterized by high level of blood glucose as a result of defect of the pancreas to secrete insulin.  Though both are characterized by passage of large quantity of urine, continual thirst, the key difference is, in diabetes mellitus, the urine passed has a sweet taste while in incipidus there is passage of dilute urine.

What Causes Diabetes Melittus

Diabetes mellitus occurs when there is a high increase in blood glucose level, as a result of, impaired secretion, lack of secretion or resistance to the secretion of insulin by the pancreas.
When this happens, an individual is bound to develop diabetes.

DM - Diabetes melittus

Are they any type of Diabetes ?

Yes! We have 3 types of diabetes mellitus and all of them is related to the functionality of the insulin.

I) Type 1 Diabetes : This is an autoimmune condition in which the antibodies of an an individual, attacks the beta cells of the pancreas which produces insulin. By this action, they will be a decrease in the number of beta cells and also in the production of insulin.
Type 1 DM is caused by genetic, environmental and immunologic factors. It occurs mostly in young people and could also affect newborn. It forms 10% of the total population of people with Diabetes. The most trigger of type 1 DM is environmental factor, which means that an individual could be a genetic carrier of type 1 DM but without environmental factors (viral infections, exposure to casein, toxins) they will be no clinical manifestation of the disease.
This explains the fact why a set of twins may not have DM at the same time, if they are in different locations.

2) Type 2 DM : It is a metabolic disorder caused by inability of the body to use insulin. Could be as a result of impaired secretion, insulin resistance, excess production of glucose by the liver or even abnormal fat metabolism. The common cause I'd insulin resistance is obesity especially central obesity (protruded tummy) .
This type of DM is seen in about 80-90% of the population, and is caused by Age, Family history sedentary lifestyle and  obesity .
Age : the risk of having type 2 DM increases with age. This means that a man in his 40's is more likely to have DM than a teenager, although studies has shown teenagers also going down with type 2 Dm but it is in rare cases.
Family History : Any individual from a family wit history of DM, is likely to have DM.
Sedentary lifestyle:  Staying in a particular spot all day without enough exercise, or expending of energy is a key factor in the cause of obesity, which we all know, obesity is a predisposing factor to type 2 DM .

Excuse me Doctor, What Is Obesity ?

Obesity is a condition in which there is excessive accumulation of fat in the body. It occurs when the body mass index is 30 and above.
The body mass index (BMI) is calculated by dividing your weight in kilograms (kg) by your height in meters (m) squared.

BMI                      Weight status

Below 18.5.          Underweight
18.5 - 24.9             Normal
25.0 - 29.9          Overweight
30.0 - 34.9                 Obese (Class I)
35.0 - 39.9            Obese (Class II)
40.0 and higher     Extreme obesity (Class III)

Obesity is not just a predisposing factor to diabetes but to other diseases like Cardiovascular diseases, breathing diseases, stroke and cancer.

3) Gestational Diabetes : A woman that is pregnant may experience a surge in blood glucose level, resulting from hormonal imbalance. This is known as gestational diabetes and in most cases, after child birth her glucose level returns to normal, that is for a woman whose blood glucose level rose during pregnancy. But a diabetic woman who becomes pregnant will still maintain her blood glucose level with prescribed medications.
Reason for the high surge in glucose level in normal pregnant woman is as a result of the effect of the anti-hormone (oestrogen, prolactin, progesterone) secreted by the placenta exceeds pancreatic function. Babies born in this condition are often large and sometimes delivered through caserean section. They do have birth defects like respiratory distress syndrome, brain damage etc.

How Do I Test For Diabetes Mellitus ?

Test for DM is easily conducted using gluconometer either at home or in the hospital, though it is used in checking for fasting venous plasma glucose level.

According to the World Health Organization and American Diabetics Association, the recommended test to confirm you status include  ;
A person is diabetic if
a) Fasting venous plasma glucose is greater or equal  to 126mg/dl (7mmol/L) on more than one occasion or once in the presence of diabetic symptoms.
b) Random plasma glucose is greater or equal to 200mg/dl (11.1mmol/L) with symptoms of DM.
c) Two hour plasma glucose is greater or equal to 200mg/dl (11.1mmol/L) following 75g of glucose during an oral glucose tolerance test (OGTT).
d) Glycated HbA1c greater or equal to 6.5% (48mmol/mol) by American Diabetic Association or greater or equal to 7% by World Health Organization. The preferred test is always fasting venous plasma glucose level.

Abbreviation
mmol/dl - Millimole per decilitre
mmol/L - Millimole per Litre

Plasma is the liquid part of the blood and it forms a large part of the blood.

Doc, How Do I Know Am Diabetic?

The most common acronym to remember the signs and symptoms of DM is 3P L.
i) Polydipsia : Continual thirst
ii) Polyuria : Continual passage of large quantity of urine.
iii) Polyphagia : Continual hunger for food, as you body is not able to absorb digested food for use, so the brain receives a wrong signal of you being hungry, even when you just finished eating not quite long. It is called starving in the midst of plenty.
iv) Loss of weight.

Doc, You Mentioned If You Want To Kill Someone Slowly, Pray They Have Diabetes Why?

Chuckles! I was only trying to tell you how creepy the disease called diabetes is, it is a slow killing disease. An increase in blood sugar over time without being maintained with prescribed drugs, will result in both short term and long term complications which in most cases could be life threatening, here are a list of complications associated with an unmanaged diabetic condition ;
i) Cardiovascular diseases like the coronary artery disease.
ii) Kidney Failure (Nephropathy)
iii) Brain Damage (neuropathy)
iv) Eye defects such as cataract and glaucoma
V) Leg ulcers: if not properly taken care of will result to the amputation of affected leg.
vi) Skin infections ( fungal infections)
vii) Alzheimer's disease
viii) Excessive growth of babies born under gestational diabetes condition.
ix) Low insulin level in the new born baby.

What Drugs Should I Take?

It is against ethics to prescribe drugs over the phone or without physical contact, I will advice you visit a hospital to see an Endocrinologist (A doctor who specializes on diseases of the endocrine gland and their secretions).
And when once, drugs are prescibed to you, take them religiously without missing a day, dose or time. With proper management, a diabetic patient life span could exceed 100 years and still counting.

Common Myths Of Diabetes Mellitus

Drinking Of Bitter Juice Helps In Treatment Of Diabetes

Hell no! Diabetes is never a nutritional problem but an endocrine issue, so drinking bitter juice everyday has no effect on your pancreas, neither will it boast your insulin level, so if the proper medications are not taken, diabetes will never be control.

Diabetes Leads To Blindness And Amputation

Not in all cases, unless the patient isn't placed on any medication for over a long period of time. And in such case, it will result in eye defects and also, loss of sensation to the foot.
In the loss of sensation to the foot, a patient might pick up nails, or bruise the leg without feeling pains but then the wound has lost its healing ability, due to the excess blood glucose, which will now encourage the growth of microorganisms which affects wound healing.

Diabetes Can Be Passed Through Physical Contact

Chuckles! No way could that happen. Diabetics isn't caused by any microorganisms, neither are there any vectors for diabetes. So it is never a communicable disease.

How Do  I Avoid Diabetes Mellitus ?

This is a tough question because different factors leads to different type of diabetes, it is always advisable you stay off sugary food, avoid sedentary lifestyle, exercise always and also carry out a regular plasma glucose level test.
And if you are diabetic, make sure you take all your drugs correctly and accordingly.

Words On Marble

Health is wealth,  treasure your health.

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