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What Are Diabetes Mellitus

Diabetes Mellitus: Management Of Microvascular And Macrovascular Complications

Diabetes Mellitus: Management Of Microvascular And Macrovascular Complications

The management of type 1 and 2 diabetes mellitus (DM) requires addressing multiple goals, with the primary goal being glycemic control. Maintaining glycemic control in patients with diabetes prevents many of the microvascular and macrovascular complications associated with diabetes. This chapter presents a review of the prevalence, screening, diagnosis, and management of these complications. Definitions Microvascular complications of diabetes are those long-term complications that affect small blood vessels. These typically include retinopathy, nephropathy, and neuropathy. Retinopathy is divided into two main categories: Nonproliferative retinopathy and proliferative retinopathy. Nonproliferative retinopathy is the development of microaneurysms, venous loops, retinal hemorrhages, hard exudates, and soft exudates. Proliferative retinopathy is the presence of new blood vessels, with or without vitreous hemorrhage. It is a progression of nonproliferative retinopathy. Diabetic nephropathy is defined as persistent proteinuria. It can progress to overt nephropathy, which is characterized by progressive decline in renal function resulting in end-stage renal disease. Neuropathy is a heterogeneous condition associated with nerve pathology. The condition is classified according to the nerves affected and includes focal, diffuse, sensory, motor, and autonomic neuropathy. Macrovascular complications of diabetes are primarily diseases of the coronary arteries, peripheral arteries, and cerebrovasculature. Early macrovascular disease is associated with atherosclerotic plaque in the vasculature supplying blood to the heart, brain, limbs, and other organs. Late stages of macrovascular disease involve complete obstruction of these vessels, which can increase the risks of myocardial infar Continue reading >>

What Is Diabetes Mellitus?

What Is Diabetes Mellitus?

Too much sugar in your blood stream. If you don’t have enough insulin, sugar accumulates in your blood stream and you have diabetes. To put it simply, you have Diabetes Mellitus when too much sugar is circulating in your blood stream. Sugar, also known as glucose, is an important and necessary fuel for our bodies. So necessary, that both the liver and the kidneys produce it naturally; however, we get the most sugar from the foods we eat. Blood sugar levels normally stay in a certain range. In other words, your body has a system that regulates how much sugar is circulating in your blood stream. That system centers on a hormone called insulin, which is released from cells located in the pancreas. Insulin speeds up the transfer of sugar from your blood and delivers it into your muscle, liver and fat tissues where it is used as fuel or stored for your body to use later. If you don’t have enough insulin, sugar accumulates in your blood stream and you have diabetes. There are different factors that determine why you don’t have enough insulin, and those factors determine if you have type 1, type 2, gestational diabetes or other types of diabetes. Self-assessment Quiz Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about Facts about Diabetes, take our self assessment quiz when you have completed this section. The quiz is multiple choice. Please choose the single best answer to each question. At the end of the quiz, your score will display. If your score is over 70% correct, you are doing very well. If your score is less than 70%, you can return to this section and review the information. Common questions about type 2 diabetes: How do you treat type 2 diabetes? When you have type 2 diabetes, you first need to Continue reading >>

What Are The Side Effects Of Diabetes Mellitus Type 2?

What Are The Side Effects Of Diabetes Mellitus Type 2?

With Diabetes, there are short- and long-term side effects to deal with, if you don’t work hard to keep your blood glucose level under control. However, by watching the amount and types of food you eat (your meal plan), exercising, and taking any necessary medications, you may be able to prevent these complications. Heart disease and stroke If you have diabetes, you're up to five times more likely to develop heart disease or have a stroke. Prolonged, poorly controlled blood glucose levels increase the likelihood of atherosclerosis, where the blood vessels become clogged up and narrowed by fatty substances. Nerve damage High blood glucose levels can damage the tiny blood vessels in your nerves. This can cause a tingling or burning pain that spreads from your fingers and toes up through your limbs. It can also cause numbness, which can lead to ulceration of the feet. Diabetic retinopathy Diabetic retinopathy is when the retina, the light-sensitive layer of tissue at the back of the eye, becomes damaged. Blood vessels in the retina can become blocked or leaky, or can grow haphazardly. This prevents light fully passing through to your retina. If it isn't treated, it can damage your vision. Kidney disease If the small blood vessels of your kidney become blocked and leaky, your kidneys will work less efficiently. It's usually associated with high blood pressure, and treating this is a key part of management. Foot problems Damage to the nerves of the foot can mean small nicks and cuts aren't noticed and this, in combination with poor circulation, can lead to a foot ulcer. About 1 in 10 people with diabetes get a foot ulcer, which can cause a serious infection. Sexual dysfunction In men with diabetes, particularly those who smoke, nerve and blood vessel damage can lead to ere Continue reading >>

Diabetes Mellitus

Diabetes Mellitus

Diabetes Mellitus Definition Diabetes mellitus is a condition in which the pancreas no longer produces enough insulin or cells stop responding to the insulin that is produced, so that glucose in the blood cannot be absorbed into the cells of the body. Symptoms include frequent urination, lethargy, excessive thirst, and hunger. The treatment includes changes in diet, oral medications, and in some cases, daily injections of insulin. Description Diabetes mellitus is a chronic disease that causes serious health complications including renal (kidney) failure, heart disease, stroke, and blindness. Approximately 17 million Americans have diabetes. Unfortunately, as many as one-half are unaware they have it. Every cell in the human body needs energy in order to function. The body's primary energy source is glucose, a simple sugar resulting from the digestion of foods containing carbohydrates (sugars and starches). Glucose from the digested food circulates in the blood as a ready energy source for any cells that need it. Insulin is a hormone or chemical produced by cells in the pancreas, an organ located behind the stomach. Insulin bonds to a receptor site on the outside of cell and acts like a key to open a doorway into the cell through which glucose can enter. Some of the glucose can be converted to concentrated energy sources like glycogen or fatty acids and saved for later use. When there is not enough insulin produced or when the doorway no longer recognizes the insulin key, glucose stays in the blood rather entering the cells. The body will attempt to dilute the high level of glucose in the blood, a condition called hyperglycemia, by drawing water out of the cells and into the bloodstream in an effort to dilute the sugar and excrete it in the urine. It is not unusual for p Continue reading >>

What Are Some Pitfalls In Diagnosing Diabetes Mellitus?

What Are Some Pitfalls In Diagnosing Diabetes Mellitus?

Many people with diabetes do not come with specific symptoms, unlike say a urinary tract infection. They may be feeling lethargic, or feel thirsty often, or have been losing weight over the last few months. Or just been having some intermittent giddiness. As medical professionals often it is easy to dismiss these symptoms as they can be attributed to many other causes eg exercise, work stress, not enough sleep. Sometimes the diagnosis can be missed for several months, until the patient comes in with severely elevated blood sugar levels, or with a complication like diabetic ketoacidosis. The doctor needs to always keep diabetes in the back of his/her mind, and order a simple fasting blood test when appropriate. Continue reading >>

Diabetes Mellitus

Diabetes Mellitus

Diabetes mellitus is a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas, or by the ineffectiveness of the insulin produced. Such a deficiency results in increased concentrations of glucose in the blood, which in turn damage many of the body's systems, in particular the blood vessels and nerves. There are two principle forms of diabetes: Type 1 diabetes (formerly known as insulin-dependent) in which the pancreas fails to produce the insulin which is essential for survival. This form develops most frequently in children and adolescents, but is being increasingly noted later in life. Type 2 diabetes (formerly named non-insulin-dependent) which results from the body's inability to respond properly to the action of insulin produced by the pancreas. Type 2 diabetes is much more common and accounts for around 90% of all diabetes cases worldwide. It occurs most frequently in adults, but is being noted increasingly in adolescents as well. Certain genetic markers have been shown to increase the risk of developing Type 1 diabetes. Type 2 diabetes is strongly familial, but it is only recently that some genes have been consistently associated with increased risk for Type 2 diabetes in certain populations. Both types of diabetes are complex diseases caused by mutations in more than one gene, as well as by environmental factors. Diabetes in pregnancy may give rise to several adverse outcomes, including congenital malformations, increased birth weight and an elevated risk of perinatal mortality. Strict metabolic control may reduce these risks to the level of those of non-diabetic expectant mothers. Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) refer to levels of blood glucose concentration above the normal r Continue reading >>

Diabetes Mellitus In Dogs - Overview

Diabetes Mellitus In Dogs - Overview

This handout provides general information about diabetes mellitus in dogs. For information about its treatment, see the fact sheets "Diabetes Mellitus - Principles of Treatment" and "Diabetes Mellitus - Insulin Treatment". What is diabetes mellitus? Diabetes mellitus is a disease of the pancreas, a small but vital organ located near the stomach. The pancreas has two significant types of cells. One group of cells produces the enzymes necessary for proper digestion. The other group, called beta cells, produces the hormone insulin. Insulin regulates the level of glucose (sugar) in the bloodstream and controls the delivery of glucose to the tissues of the body. In simple terms, diabetes mellitus is caused by the failure of the pancreas to regulate blood sugar. The clinical signs of diabetes mellitus are related to elevated concentrations of blood glucose and the inability of the body to use glucose as an energy source. What are the clinical signs of diabetes and why do they occur? The four main symptoms of uncomplicated diabetes mellitus are increased thirst, increased urination, weight loss, and increased appetite. Glucose is a vital substance that provides much of the energy needed by cells, but it must first be absorbed by the cells. Insulin attaches to receptors on the surface of cells and opens "pores" in the cell wall that allow glucose molecules to leave the bloodstream and enter the cell's interior. Without an adequate amount of insulin to "open the door," glucose is unable to get into the cells, so it accumulates in the blood, setting in motion a series of events that result in diabetes mellitus. "When there isn't enough insulin, the cells of the body become starved for their promary source of energy - glucose." When there isn't enough insulin, the cells of the bod Continue reading >>

Diabetes Mellitus

Diabetes Mellitus

Poorly controlled diabetic patients are at risk for numerous oral complications such as periodontal disease, salivary gland dysfunction, infection, neuropathy, and poor healing. Diabetes mellitus (diabetes) is a common chronic disease of abnormal carbohydrate, fat, and protein metabolism that affects an estimated 20 million people in the United States, of whom about one third are undiagnosed. There are two major forms recognized, type-1 and type-2. Both are characterized by inappropriately high blood sugar levels (hyperglycemia). In type-1 diabetes the patient can not produce the hormone insulin, while in type-2 diabetes the patient produces insulin, but it is not used properly. An estimated 90% of diabetic patients suffer from type-2 disease. The causes of diabetes are multiple and both genetic and environmental factors contribute to its development. The genetic predisposition for type-2 diabetes is very strong and numerous environmental factors such as diet, lack of exercise, and being overweight are known to also increase one’s risk for diabetes. Diabetes is a dangerous disease which affects the entire body and diabetic patients are at increased risk for heart disease, hypertension, stroke, kidney failure, blindness, neuropathy, and infection when compared to nondiabetic patients. Diabetic patients also have impaired healing when compared to healthy individuals. This is in part due to the dysfunction of certain white blood cells that fight infection. The most common test used to diagnose diabetes is the fasting blood glucose. This test measures the glucose levels at a specific moment in time (normal is 80-110 mg/dl). In managing diabetes, the goal is to normalize blood glucose levels. It is generally accepted that by maintaining normalized blood glucose levels, one Continue reading >>

Diabetes Mellitus

Diabetes Mellitus

"Diabetes" redirects here. For other uses, see Diabetes (disambiguation). Diabetes mellitus (DM), commonly referred to as diabetes, is a group of metabolic disorders in which there are high blood sugar levels over a prolonged period.[7] Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger.[2] If left untreated, diabetes can cause many complications.[2] Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death.[3] Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes.[2] Diabetes is due to either the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced.[8] There are three main types of diabetes mellitus:[2] Type 1 DM results from the pancreas's failure to produce enough insulin.[2] This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes".[2] The cause is unknown.[2] Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly.[2] As the disease progresses a lack of insulin may also develop.[9] This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes".[2] The most common cause is excessive body weight and insufficient exercise.[2] Gestational diabetes is the third main form, and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels.[2] Prevention and treatment involve maintaining a healthy diet, regular physical exercise, a normal body weight, and avoiding use of tobacco.[2] Control of blood pressure and maintaining proper foot care are important for people with t Continue reading >>

Diabetes - A Major Risk Factor For Kidney Disease

Diabetes - A Major Risk Factor For Kidney Disease

Diabetes mellitus, usually called diabetes, is a disease in which your body does not make enough insulin or cannot use normal amounts of insulin properly. Insulin is a hormone that regulates the amount of sugar in your blood. A high blood sugar level can cause problems in many parts of your body. The most common ones are Type 1 and Type 2. Type 1 diabetes usually occurs in children. It is also called juvenile onset diabetes mellitus or insulin-dependent diabetes mellitus. In this type, your pancreas does not make enough insulin and you have to take insulin injections for the rest of your life. Type 2 diabetes, which is more common, usually occurs in people over 40 and is called adult onset diabetes mellitus. It is also called non insulin-dependent diabetes mellitus. In Type 2, your pancreas makes insulin, but your body does not use it properly. The high blood sugar level often can be controlled by following a diet and/or taking medication, although some patients must take insulin. Type 2 diabetes is particularly prevalent among African Americans, American Indians, Latin Americans and Asian Americans. With diabetes, the small blood vessels in the body are injured. When the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, which can result in weight gain and ankle swelling. You may have protein in your urine. Also, waste materials will build up in your blood. Diabetes also may cause damage to nerves in your body. This can cause difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. Also, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in urine that h Continue reading >>

Diabetes Mellitus

Diabetes Mellitus

Overview: Types of Diabetes Mellitus Diabetes mellitus (DM) is a common disease in which the blood sugar (glucose) is abnormally elevated. Normally, the body obtains glucose from food, and additional glucose is made in the liver. The pancreas produces insulin, which enables glucose to enter cells and serve as fuel for the body. In patients with diabetes, glucose accumulates in the blood instead of being properly transported into cells. Excess blood sugar is a serious problem that may damage the blood vessels, heart, kidneys, and other organs. About 5-10% of patients with diabetes are diagnosed with type 1 diabetes mellitus, an autoimmune disorder in which the immune system mistakenly attacks the insulin-producing beta cells in the pancreas, causing the organ to no longer produce insulin. Type 1 DM most commonly occurs in children or young adults, and the incidence of new cases is increasing. Approximately 90-95% of people with diabetes have type 2 diabetes mellitus, which occurs when the body becomes unable to use the insulin produced by the pancreas. This condition is also called insulin resistance. The prevalence of type 2 DM is increasing dramatically worldwide. In the past, type 2 DM was associated with adulthood; however, it is rapidly increasing in children because of the rise in childhood obesity. Gestational diabetes mellitus (GDM) occurs during pregnancy. This form of diabetes usually resolves after delivery, but patients with GDM have an increased risk of developing type 2 DM later in life. Causes and Risk Factors Type 1 DM is an autoimmune disorder and the exact cause is unknown. Causes may include genetic factors, environmental factors, and viruses. For type 2 DM, the major risk factors include a family history of type 2 DM, increased age, obesity, and a sed Continue reading >>

Type 2 Diabetes Mellitus

Type 2 Diabetes Mellitus

Practice Essentials Type 2 diabetes mellitus consists of an array of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. See the image below. See Clinical Findings in Diabetes Mellitus, a Critical Images slideshow, to help identify various cutaneous, ophthalmologic, vascular, and neurologic manifestations of DM. Signs and symptoms Many patients with type 2 diabetes are asymptomatic. Clinical manifestations include the following: See Presentation for more detail. Diagnosis Diagnostic criteria by the American Diabetes Association (ADA) include the following [1] : Whether a hemoglobin A1c (HbA1c) level of 6.5% or higher should be a primary diagnostic criterion or an optional criterion remains a point of controversy. Indications for diabetes screening in asymptomatic adults includes the following [2, 3] : Overweight and 1 or more other risk factors for diabetes (eg, first-degree relative with diabetes, BP >140/90 mm Hg, and HDL < 35 mg/dL and/or triglyceride level >250 mg/dL) See Workup for more detail. Management Goals of treatment are as follows: Microvascular (ie, eye and kidney disease) risk reduction through control of glycemia and blood pressure Macrovascular (ie, coronary, cerebrovascular, peripheral vascular) risk reduction through control of lipids and hypertension, smoking cessation Recommendations for the treatment of type 2 diabetes mellitus from the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) place the patient's condition, desires, abilities, and tolerances at the center of the decision-making process. [4, 5, 6] The EASD/ADA position statement contains 7 key points: Ind Continue reading >>

What Is The Cure Of Diabetes Mellitus?

What Is The Cure Of Diabetes Mellitus?

Diabetes and its complications can be cured without taking any drugs. There are Natural cures for diabetes available. There are three basic Natural cures for Diabetes available, 1. Diet 2. Exercise 3. Nutritional Supplements Diet Diet is the first and the best natural cures for diabetes patients. A proper diabetic diet menu must have a low glycemic index which means the food containing low level of carbohydrates, moderate protein and high fiber. It will also help to reduce weight, reduce blood pressure; this cures the diabetes and supports body's overall health and energy. Eating a handful of groundnuts everyday will helps the diabetic patients and taking honey daily basis also will help them to reduce diabetes. Juices of tomato, Rose apple, Lemon, Cucumber, Bitter gour, Spinach, Carrot, and Cabbage are helpful to cures the diabetes in natural way. Exercise Many studies have proven that exercises are great benefit to diabetics and can significantly cures them. A daily walking in the morning or little jogging can also helps to cures diabetics.Game like badminton also helps reduce the level of sugar in the blood. Nutritional Supplements There are many of nutritional supplements that every diabetic should be taking on a daily basis in order to cure diabetes in natural method. These supplements are very good and that really helps to lower blood sugar levels and insulin levels, lower cholesterol levels, reduce blood pressure, improve energy, and lower the risk of heart disease. There are thousands of published studies proving the beneficial effects these supplements have on diabetic patients. Amazingly enough, despite the overwhelming evidence, most of the medical advisors do not recommend nutritional supplements to their diabetes patients. Best Treatment Found to Reverse Di Continue reading >>

Classification, Pathophysiology, Diagnosis And Management Of Diabetes Mellitus

Classification, Pathophysiology, Diagnosis And Management Of Diabetes Mellitus

University of Gondar, Ethopia *Corresponding Author: Habtamu Wondifraw Baynes Lecturer Clinical Chemistry University of Gondar, Gondar Amhara 196, Ethiopia Tel: +251910818289 E-mail: [email protected] Citation: Baynes HW (2015) Classification, Pathophysiology, Diagnosis and Management of Diabetes Mellitus. J Diabetes Metab 6:541. doi:10.4172/2155-6156.1000541 Copyright: © 2015 Baynes HW. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Abstract Diabetes Mellitus (DM) is a metabolic disorder characterized by the presence of chronic hyperglycemia either immune-mediated (Type 1 diabetes), insulin resistance (Type 2), gestational or others (environment, genetic defects, infections, and certain drugs). According to International Diabetes Federation Report of 2011 an estimated 366 million people had DM, by 2030 this number is estimated to almost around 552 million. There are different approaches to diagnose diabetes among individuals, The 1997 ADA recommendations for diagnosis of DM focus on fasting Plasma Glucose (FPG), while WHO focuses on Oral Glucose Tolerance Test (OGTT). This is importance for regular follow-up of diabetic patients with the health care provider is of great significance in averting any long term complications. Keywords Diabetes mellitus; Epidemiology; Diagnosis; Glycemic management Abbreviations DM: Diabetes Mellitus; FPG: Fasting Plasma Glucose; GAD: Glutamic Acid Decarboxylase; GDM: Gestational Diabetes Mellitus; HDL-cholesterol: High Density Lipoprotein cholesterol; HLA: Human Leucoid Antigen; IDD Continue reading >>

Overview Of Diabetes Mellitus

Overview Of Diabetes Mellitus

What is diabetes mellitus? Diabetes is a condition in which sufficient amounts of insulin are either not produced, or the body is unable to use the insulin that is produced. Diabetes can be defined as a metabolic disorder because the disease affects the way the body uses food to make glucose, the main source of fuel for the body. The three main types of diabetes include: Type 1 diabetes. Type 1 diabetes is an autoimmune disease in which the body's immune system attacks the cells that produce insulin, resulting in either no insulin or a low amount of insulin. People with type 1 diabetes must take insulin daily in order to live. Type 2 diabetes. Type 2 diabetes is a result of the body's inability to make enough, or to properly use, insulin. Type 2 diabetes may be controlled with diet, exercise, and weight loss, but it may also require oral or injected medication and/or insulin injections. Gestational diabetes. Gestational diabetes is a condition in which the glucose level is elevated and other diabetic symptoms appear during pregnancy when the woman has not previously been diagnosed with diabetes. In many cases of gestational diabetes, all diabetic symptoms disappear following delivery, but the woman is at risk for future diabetes. What is prediabetes? Type 2 diabetes is commonly preceded by prediabetes. In prediabetes, blood glucose levels are higher than normal but not high enough to be defined as diabetes. However, many people with prediabetes develop type 2 diabetes within 10 years, states the National Institute of Diabetes and Digestive and Kidney Diseases. Prediabetes also increases the risk of heart disease and stroke. With modest weight loss and moderate physical activity, people with prediabetes can delay or prevent type 2 diabetes. How does diabetes affect blood Continue reading >>

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