Diabetes Mellitus

Diabetes is a disease where people do not have enough insulin in their blood, or their body has a problem using the insulin they do have. There are other kinds of diabetes, like diabetes insipidus. However, when people say "diabetes", they usually mean diabetes mellitus. People with diabetes mellitus are called "diabetics".

Glucose is not regular sugar that is available in stores and supermarkets. Glucose is a natural carbohydrate that our bodies use as sources for energy. The kind of sugar sold in supermarkets is called sucrose, and is much different from glucose. High concentrations of glucose can be found in soft drinks and fruits.

Type 1 diabetes mellitus

Type 1 diabetes mellitus happens when the part of the pancreas that makes insulin is destroyed by that person’s own immune system. When a person does not make insulin, glucose – sugar – in the blood cannot get into the parts of the body that need sugar to live. In order to live, a person with Type 1 diabetes must take insulin for the rest of their life. They also need to check the amount of sugar in their blood many times each day. Type 1 diabetes happens most of the time in younger people, however it can occur in adults, although this is much less common. About 1 out of every 10 people with diabetes have Type 1 Diabetes.

Type 2 diabetes mellitus is a very different illness from Type 1 diabetes. In Type 2 diabetes, the person makes insulin, but either the insulin does not work in that person’s body as it should, or they do not make enough to process the glucose. When insulin does not work as it should, glucose (sugar) in the blood cannot get into the parts of the body that need sugar. Type 2 diabetes happens most of the time in an older person who is overweight.

Complications of diabetes

Too high blood glucose is called 'hyperglycemia'. If very high, it can cause acute complications. In Type 1 diabetics, one of these complications is diabetic ketoacidosis which is always a medical emergency and can often be noticed by a kind of fruity smell on the breath. Another acute complication, more common in Type 2 diabetics, is non-ketotic hyperosmolar coma which is also very dangerous.

Too low blood glucose is called hypoglycemia. It can also cause acute complications. If too low, diabetics can have many symptoms such as sweating, trembling, anger (or feeling passive), and possibly even passing out. But diabetics with hypoglycemia may be confused or even unconscious. They may even appear to have had too much alcohol. Severe hypoglycemia is very dangerous and can cause death. The best treatment of hypoglycemia is avoiding it. If it happens, eating a glucose-containing food (for instance, table sugar) usually makes it better, and pretty quickly. Sometimes it is also treated by giving an injection of a medicine called 'glucagon'. Glucagon is a hormone that is also made by the pancreas. It does the opposite of insulin. So giving it will cause the blood glucose to rise by forcing stored glucose into the blood. Hypoglycemia is usually caused by too much diabetic medication, insufficient food, too much exercise, or some combination of these.

Treatment of diabetes

Education is important for both types of diabetes. Diabetics must learn about diet. They learn how to estimate and keep track of how much carbohydrate, protein, and fat are in different foods. They plan their meals to have the right amount of carbohydrates, proteins, and fats. Patients with Type 1 may decide how much insulin to take before a meal based on how much they will eat.

Diabetics must also be careful about exercise. Exercise is important to stay healthy. But too hard or too long exercise may cause hypoglycemia. So diabetics must also carefully plan exercise like they plan meals.

In addition to controlling blood glucose other treatments may be needed. Diabetics often have blood vessel diseases, so it is important to pay attention to other diseases which may affect blood vessels. In people with diabetes, treating high blood pressure (hypertension) and high cholesterol is even more important than usually. Both of these diseases damage blood vessels. The treatment goals can change for diabetics. For instance, in people without diabetes, blood pressure should be 140/90 or less. In diabetics it should be 130/80 or less.