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Diabetes Mellitus: Types, causes, and management.

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May 10, 2024

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Diabetes Mellitus: Types, causes, and management.

1. Introduction

The blood glucose level is higher than the normal limit and the body’s inability to control it, and is dangerous because it can lead to complications such as heart disease, kidney failure, blindness, and metabolism of a body in the future. There are currently three types of diabetes mellitus including: type 1, type 2 diabetes mellitus, and pregnancy diabetes. Diabetes, hypertension, high cholesterol cause diseases of the blood vessels. There are two common causes of vascular disease in diabetics. Blood vessels occur more than cholesterol (atherosclerosis) and damage to the blood vessels of the eye. This is an age-related cortical cataract in the earlier ages. Furthermore, to the eye disease, also cause new blood vessels to grow, resulting in bleeding, swelling, and blockage of vision. Also, unwanted to destroy the nerve itself. Early intervention across the disease process of diabetes is important.

Diabetes mellitus is a common disease and its global prevalence rose from 1980 to 2014. The prevalence continues to increase, with a worldwide estimate in 2019 that approached 9.3%. Recently, the global diabetic prevalence has surged due to an expanding elderly population, increased life expectancy, unhealthy diet, and limited physical exercise. A disease caused by defects in insulin secretion, insulin action, or both is divided into two principal categories: reduced insulin action and abnormal insulin secretion. Thus, normal insulin action and normal insulin secretion, such that it is classified into four major groups.

2. Types of Diabetes Mellitus

In the event of an increase in the concentration of sugar in the body, there is a chronic increase in the concentration of blood sugar levels, causing the blood to have an increased opportunity for damage to the internal organs of the body. Elevated blood sugar levels lead to chronic and long-term complications.

The pancreas produces insulin, which is absorbed by the stomach and can be used by the body as a source of glucose. Complex sugars are found in starchy foods such as bread, rice, potatoes, and pasta, as well as glucose and fructose, which are produced in the body and made of simple sugars found in sugary foods. Insulin is produced in the pancreas and can also be used by muscle and fat cells. It is stored in the liver in the form of glycogen or converted to fat and stored in adipose tissue. People with diabetes mellitus may or may not be able to tolerate the metabolism of sugar, and in their case, insulin is not produced, causing the pancreas, muscles, liver, and fat tissue to be ineffective.

In people with this type of diabetes, the pancreas does not effectively produce and release insulin to control blood sugar. People with type 2 diabetes may only have to change to a healthy diet, engage in regular exercise, reduce weight, monitor their condition, and take medication. Some people with this type may have to monitor and take medication or insulin regularly to help control their blood sugar levels for the rest of their lives.

A syndrome occurring in humans and other animals which has high blood sugar or glucose levels – also known as ‘hyperglycemia’ – is called diabetes mellitus. Sugars are the primary energy source for the body’s cells. Insulin, being a hormone, regulates blood sugar and helps in controlling the flow of such sugar from the blood into the body’s cells. The pancreas helps in controlling the production of insulin upon requirements and releases insulin in response to the increase of sugar in the bloodstream.

3. Causes of Diabetes Mellitus

The cause of diabetes is unknown. Diabetes can occur when viral antigens stimulate a person’s immune system to attack and destroy beta cells of the pancreatic islets. Circumstantial evidence suggests that excessive insulin production degenerates beta cells or that chronic exposure to elevated blood glucose weakens insulin secretion or both. Whatever their cause, deficiencies of insulin and glucagon can also impair the secretion of the counterregulatory hormones glucagon, cortisol, epinephrine, and norepinephrine to low blood glucose. Without intervention, ketoacidosis and death can supervene. Insulin reacts with its cellular receptor to allow glucose to pass the plasma membrane. Insulin increases glucose entry into the cells, and thus lowers plasma glucose.

Causes of diabetes mellitus: Diabetes is caused by deficiencies of two hormones: insulin and glucagon. In diabetes, there is too little insulin or seemingly excessive glucagon. Diabetes can occur early in childhood or be acquired. In both forms, there are metabolic disturbances. Diabetic patients lose glucose in the urine, and they fail to metabolize glycogen in the liver and muscle. Their brains are unable to metabolize glucose because the transport of glucose into cells is inhibited; instead, amino acids, lactate, and beta-hydroxybutyrate are used as alternative brain fuels. Amino acids are derived from muscle breakdown; the amino acid alanine is released, converted to glucose, and made available for brain use.

4. Management of Diabetes Mellitus

Alcohol An individual should seek advice from their health team and drink a small amount of alcohol in conjunction with some food. Decide whether the alcohol is safe based on their personal medical history and the medications they are using, and the amount of physical activity they have planned when alcohol is considered. It should be checked with plasma glucose levels, especially at bedtime, and for symptoms of hypo- or hyperglycemia such as sweating, shaking, sleepiness, or intoxication.

Physical Activity The physical activity program should take into account the patient’s prediabetes, age, developmental stage, level of physical fitness, and the duration of diabetes.

Sick Days Make a plan for sick days and include syringe, steroids, and antibiotics. Check insulin and its supply; test urine. Keep up with eating schedules and drink about eight to twelve fluid ounces of sugar-free, non-caffeinated fluids per hour on sick days. A pancreas transplant is considered when a pancreatic gland can be sent from a donor.

Exercise Regularly Regular exercise can improve glucose metabolism and help keep the blood sugar levels of insulin-dependent diabetics closer to normal.

Glucose Control A hemoglobin A1C test needs to be performed every three to four months to help determine the levels of plasma glucose control that have been present over the previous 60 to 90 days.

Regular Glucose Control A fasting blood sugar of a diabetic should be kept between 70 and 130 mg/dL, and two hours after a meal reading should be less than 180 mg/dL but without causing hypoglycemia (dangerously low blood sugar).

Fasting blood glucose levels can be controlled by diet, oral medications, and insulin. The following are pieces of advice for proper care by those with diabetes mellitus: obesity, cholesterol, and lipid levels should be checked. Smoking increases the risk of stroke and heart disease, and adding diabetes increases that risk seven times.

5. Conclusion

Besides, there are currently no prospects for a cure as the etiology underlying this condition remains unresolved, although insulin therapy provides a temporary benefit due to the replacement of the missing hormone. Thus, the proposed prediction, prevention, and sustainable intervention components for the pipeline of T2DM that adheres to the 5Ps of diabetes care. This has highlighted the research gaps related to the diabetes burden in Nepal. Therefore, the worldwide framework for the treatment, care, and support for diabetes mellitus-related needs is envisaged for moving forward for sustainable implementation of diabetes research and resultant coordinated actions.

Diabetes is a challenging management condition, but with effective and well-structured disease management and patient education, this metabolic disease can be managed well in diverse patient populations from low resource to developed country care settings. The aim of the management of diabetes must focus on keeping blood glucose levels near normal. The patient is required to fulfill the complex criteria, which include the correct diet and regular exercise, medical care to learn to adjust the treatment as the condition progresses, blood pressure control, and foot care, etc. The optimal control of blood glucose is achievable with the use of a healthy diet, physical activity, judicious use of medications, and the appropriate self-monitoring of blood glucose.