Diabetes mellitus
From Wikipedia, a free encyclopedia written in simple English for easy reading.
Diabetes means a disease where people have too much sugar in their blood. There are other kinds of diabetes, like diabetes insipidus. But when people say 'diabetes' they usually mean diabetes mellitus.
Diabetes mellitus is a disease where people have high levels of too much glucose (a kind of sugar) in the blood. Glucose level in the blood is controlled by several hormones. Hormones are chemicals in your body that send messages from cells to other cells. Insulin is a hormone made by the pancreas. When you eat, the pancreas makes insulin to send a message to other cells in your body. This insulin tells the cells to take up glucose from the blood. This glucose is used by cells for energy. Extra glucose that is not needed right away is stored in some cells as glycogen. When you are not eating, cells break down glycogen to have glucose to use as energy.
People with diabetes mellitus are sometimes called 'diabetics'.
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[edit] Types of diabetes
Type 1 or Insulin Dependent Diabetes Mellitus (IDDM) is caused by the pancreas not making any insulin. In the past, it was called 'juvenile' diabetes, because it usually is found in children or young adults. Before insulin was discovered, this type of diabetes usually caused death within a year. People with IDDM must take insulin every day. This is usually given by injecting insulin under the skin with a small needle. People with IDDM also have to eat a special diet.
Type 2 or Non-Insulin Dependent Diabetes Mellitus (NIDDM) is the more common form of diabetes mellitus. It can be caused by cells not responding to the message insulin sends. It can also be caused by the pancreas making some insulin, but not enough. Sometimes it is caused by both of those things happening. Many people with this type of diabetes can be treated by eating a better diet, exercise, and losing weight. If their NIDDM cannot be fixed with these things, they may have to take medicine. Most of the time, this means pills. Sometimes they may also need to take insulin.
There are other types of diabetes. Gestational diabetes is when a woman gets high blood glucose when she is pregnant. Usually this gets better after she has her baby. However, it makes her more likely to get NIDDM later in life. It also makes her baby more likely to get some kinds of birth defects.
[edit] Complications of diabetes
"Complications" are problems that happen because of a disease. The complications of diabetes are caused by the blood glucose being too high for many years. High blood glucose is called 'hyperglycemia'.
Hyperglycemia causes damage to blood vessels and nerves. Damage to blood vessels can cause strokes, heart attacks, kidney failure, blindness, skin infections, and even amputations from poor circulation (decreased blood flow). Damage to nerves can make diabetics not feel pain in their feet. This causes them to have more injuries and not realize they have hurt themselves. Damage to nerves can also cause pain. This can be so bad that people need strong pain medicines.
Complications happen from years of elevated blood glucose. But too low blood glucose is also dangerous. If levels are too low, this is called 'hypoglycemia'. Hypoglycemia usually comes from taking too much medicine, or not eating enough food. Hypoglycemia is very dangerous and can cause death. The best treatment of hypoglycemia is avoiding it. If it happens, eating sugar usually makes it better. But diabetics with hypoglycemia may be confused or even unconscious. They may even appear to have had too much alcohol. If they cannot eat, glucose must be given as an injection into the blood. 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 acts opposite of insulin. So giving it will cause the blood glucose to rise.
[edit] Monitoring of diabetes
Because of the damage that is caused by high blood glucose it is important to treat diabetes mellitus. The goal of treatment is to keep the blood glucose normal. The normal range for blood glucose is 60-120 mg/dL (milligrams of glucose per deciliter of blood) or 3.5-7 mmol/l (millimole per liter of blood.)
Diabetics should check their blood glucose often. This is to make sure they do not get hypoglycemia or hyperglycemia. A glucometer is a machine that checks the level of glucose in blood. Diabetics may carry a glucometer with them to check their level several times in a day.
Doctors may also check a blood test called a hemoglobin A1C. This is sometimes written Hgb-A1C. This tells the doctor what the average blood glucose has been for about 6 weeks. If the level is too high, new medicines or better diet may be needed.
Diabetics also must be monitored for the complications of diabetes. They must see an eye doctor to be checked for damage to the blood vessels in the eyes. If this is not found early and treated it can cause blindness. They also may have their urine or blood checked for signs of early kidney damage. They must have their feet checked for nerve damage, circulation, and infections.
[edit] Treatment of diabetes
The most important goal in diabetes is to keep a normal blood glucose level. People with IDDM are treated with insulin. People with NIDDM are treated with pills (and sometimes insulin.)
Education is important for both types of diabetes. Diabetics must learn about diet. They learn 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 IDDM 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 have more blood vessel diseases, so it is important to treat other diseases that damage blood vessels. In people with diabetes, treating high blood pressure (hypertension) and high cholesterol is more important. Both of these diseases damage blood vessels. In people without diabetes, blood pressure should be 140/90 or less. In diabetics it must be 130/80 or less.
