Mid-week Medical: Diabetes Mellitus (DM)
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If you’ve missed our Chief Medical Officer on his weekly slot on Wednesday afternoon on FM100, don’t worry because we’ve got the highlights for you right here.
What is DM?
Diabetes Mellitus (DM) or more commonly known as Diabetes is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period.
Diabetes is due either to the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced.
There are three main types of Diabetes:
- Type 1 DM results from the pancreas not producing enough insulin. Previously referred to as IDDM or juvenile diabetes. (Cause unknown)
- Type 2 DM begins with insulin resistance. As the disease progresses a lack of insulin may also develop. Previously referred to as NIDDM or adult onset diabetes. (causes include excessive body weight and lack of exercise)
- Gestational diabetes occurs when pregnant women without a previous history of DM develop high blood sugar levels. (Usually resolves after birth of the baby
- as of 2014 an estimated 387 million people or 8.3% of the total adult population had diabetes.
- Type 2 making up 90% of the cases.
- 1.5 – 4.9 million deaths (DM doubles a person’s risk of death).
- global cost of DM estimated at US$ 612 billion.
Signs and symptoms
- classic symptoms of untreated DM are weight loss, polyuria (increased urination), polydipsia (increased thirst) and polyphagia (increased hunger). Symptoms develop rapidly (weeks or months) in Type 1 and much more slowly and maybe subtle or absent in Type 2.
- non-specific signs and symptoms include blurry vision, vision changes, headache, fatigue, slow healing of cuts, skin rashes, itchy skin and vomiting and stomach pain.
The WHO Diabetes diagnostic criteria are based on three different blood tests namely:
- 2 hour GTT
- Fasting blood glucose
- HbA1c (Glycated Hb)
People with DM have an increased risk of developing a number of serious health problems. In addition people with DM also have a higher risk of developing infections.
- affects the heart and blood vessels
- coronary artery disease – heart attack and stroke
- cardio-vascular disease is the most common cause of death in people with DM.
Kidney disease (Diabetic nephropathy):
- damage to small blood vessels in the kidneys
- diminished function leading to kidney failure
Nerve disease (Diabetic neuropathy):
- damage to nerves throughout the body with high blood glucose and high blood pressure
- most common areas are the feet – nerve damage in these areas is called peripheral neuropathy
- pain, tingling and loss of feeling
- increased risk of infection
- Risk of amputation is 25 times higher.
Eye disease (Diabetic retinopathy):
- reduced vision
- still being researched.
- having a family member with Type 1 increases the risk of developing the disease.
- family history of DM
- unhealthy diet
- physical inactivity
- Increasing age
- high blood pressure.
- at present Type 1 cannot be prevented.
- lifestyle changes i.e. healthy body weight and moderate physical activity. Smoking cessation.
- can only be treated with insulin (Sub-cutaneous injections).
- oral medication. Oral medication is sometimes supplemented with insulin.