diabetes mellitus

Diabetes Mellitus: A Chronic Metabolic Disease

Diabetes mellitus is a group of diseases that affect how the body uses blood sugar (glucose). Glucose is an important source of energy for the body, and it is obtained from the food we eat. In people with diabetes, the body either cannot produce enough insulin (a hormone that regulates glucose levels) or is unable to effectively use the insulin it produces.

Causes and Symptoms

Diabetes mellitus can be caused by a combination of genetic and environmental factors. The symptoms of diabetes include:

• High blood sugar levels
• Increased thirst and urination
• Fatigue
• Blurred vision
• Slow healing of cuts and wounds

Types of Diabetes

There are several types of diabetes, including:

• Type 1 Diabetes: An autoimmune disease in which the body's immune system attacks and destroys the cells in the pancreas that produce insulin.
• Type 2 Diabetes: A condition that develops when the body becomes resistant to insulin, making it harder for glucose to enter the cells.
• Gestational Diabetes: A type of diabetes that develops during pregnancy.

Complications

If left untreated or poorly managed, diabetes can lead to serious complications, including:

• Heart Disease: High blood sugar levels can damage the blood vessels and increase the risk of heart disease.
• Kidney Damage: Prolonged high blood sugar levels can damage the kidneys and increase the risk of kidney failure.
• Nerve Damage: High blood sugar levels can damage the nerves, leading to numbness or tingling in the hands and feet.

References

• [2] Diabetes mellitus refers to a group of diseases that affect how the body uses blood sugar (glucose). Glucose is an important source of energy.
• [3] Diabetes mellitus is a disorder in which the amount of sugar in the blood is elevated. Doctors often use the full name diabetes mellitus, rather than diabetes.
• [4] Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the body's organs and tissues.
• [7] Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces.

Common Signs and Symptoms of Diabetes Mellitus

Diabetes mellitus, also known as diabetes, is a group of diseases that affect how the body uses blood sugar (glucose). The symptoms of diabetes can vary depending on the type of diabetes, but there are some common signs and symptoms that are often experienced by people with diabetes.

Common Symptoms:

• Feeling very thirsty [6]
• Passing urine more often than usual, particularly at night [6]
• Feeling very tired [7]
• Weight loss and loss of muscle mass, even if you're eating enough calories [7][8]
• Increased hunger [9]
• Diminished vision or blurred vision [10]
• General abdominal pain, cramps, or spasms [10]
• Loss of sensations in the hands and feet [11]

Type 1 Diabetes Symptoms:

• Frequent urination
• Eating more but losing weight
• Feeling very thirsty

Type 2 Diabetes Symptoms:

• Increased hunger
• Diminished vision or blurred vision
• General abdominal pain, cramps, or spasms
• Loss of sensations in the hands and feet

Gestational Diabetes Symptoms:

• Increased urination
• Feeling very thirsty
• Weight loss and loss of muscle mass, even if you're eating enough calories

It's essential to note that some people may not experience any symptoms at all, or their symptoms may be mild. If you suspect you have diabetes, it's crucial to consult with a healthcare professional for proper diagnosis and treatment.

References:

[6] Apr 25, 2024 — Symptoms of diabetes [7] by A Ramachandran · 2014 · Cited by 336 — Unexplained weight loss, fatigue and restlessness and body pain are also common signs of undetected diabetes. [8] Symptoms of diabetes may include increased urination and thirst, and people may lose weight even if they are not trying to. [9] Diabetes mellitus refers to a group of diseases that affect how the body uses blood sugar (glucose). [10] Result: frequent or urgent urination | excessive thirst | increased hunger | diminished vision | general abdominal pain, cramps, or spasms | loss of sensations | hazy or clouded vision | back pain, aches, soreness, or discomfort [11] Common symptoms of type diabetes in children include. having to urinate more often; eating more but losing weight; feeling very thirsty;

Diagnosing Diabetes Mellitus: A Comprehensive Overview

Diabetes mellitus, a metabolic disorder characterized by high blood sugar levels, can be diagnosed using various tests. These diagnostic tests help healthcare professionals determine the presence and severity of diabetes in individuals.

Common Diagnostic Tests for Diabetes:

• A1C Test: This blood test measures the average blood glucose level over the past 2-3 months. It's a simple, non-fasting test that can diagnose diabetes and prediabetes.
• Fasting Blood Sugar Test: This test measures blood glucose levels after an overnight fast. It's used to diagnose diabetes and prediabetes in individuals who have not eaten for at least 8 hours.
• Glucose Tolerance Test (GTT): This test measures the body's ability to regulate blood sugar levels after consuming a sugary drink. It's often used to diagnose gestational diabetes in pregnant women.

Other Diagnostic Tests:

• Fasting Plasma Glucose (FPG) Test: This test measures blood glucose levels after an overnight fast.
• Random Plasma Glucose Test: This test measures blood glucose levels at any time of day, regardless of when the individual last ate.
• Oral Glucose Tolerance Test (OGTT): This test measures the body's ability to regulate blood sugar levels after consuming a sugary drink.

Screening for Diabetes:

The U.S. Preventive Services Task Force recommends screening for abnormal blood glucose and type 2 diabetes in adults 40 to 70 years of age who are overweight or obese, have high blood pressure, or have a family history of diabetes [9]. Early detection and diagnosis of diabetes can help prevent complications and improve treatment outcomes.

References:

• [1] - Tests for type 1 diabetes, type 2 diabetes, prediabetes, and gestational diabetes · A1C test · Fasting blood sugar test · Glucose tolerance test.
• [3] - Learn about the diabetes diagnosis criteria and various tests used like A1C, Fasting Plasma Glucose (FPG), Oral Glucose Tolerance Test (OGTT), and Random ...
• [5] - Tests for type 1 and type 2 diabetes and prediabetes. A1C test. This blood test, which doesn't require not eating for a period of time (fasting), shows your ...
• [9] - by K PIPPITT · 2016 · Cited by 259 — The U.S. Preventive Services Task Force recommends screening for abnormal blood glucose and type 2 diabetes in adults 40 to 70 years of age who ...

Overview of Drug Treatment for Diabetes Mellitus

Diabetes mellitus, a chronic metabolic disorder characterized by high blood sugar levels, requires effective management through lifestyle modifications and medication. The primary goal of drug treatment is to lower blood glucose levels, relieve symptoms, and prevent complications.

Types of Oral Medications

Several oral medications are commonly used to treat type 2 diabetes:

• Metformin: Considered the most prescribed oral medication for type 2 diabetes, metformin works by lowering glucose production in the liver [6]. It is often the first-line treatment due to its efficacy and safety profile.
• Sulfonylureas: This class of medications includes glimepiride (Amaryl), glipizide (Glucotrol XL), and glyburide (DiaBeta, Glynase). Sulfonylureas stimulate insulin release from the pancreas [4].
• Other oral medications: Ertugliflozin is a newer medication indicated for improving glycemic control in adults with type 2 diabetes [7]. Metformin (Fortamet, Glumetza) is also commonly prescribed as a first-line treatment [9].

Injectable Medications

In addition to oral medications, injectable treatments are available:

• Insulin: Administered via injection, insulin helps regulate blood sugar levels. It is often used in conjunction with other medications or as a standalone treatment for type 1 diabetes and some cases of type 2 diabetes [5].

Other Treatment Options

ACE inhibitors and ARBs may be recommended for patients with known atherosclerotic cardiovascular disease (ASCVD) for secondary prevention [8]. HMG-CoA reductase inhibitors, angiotensin converting enzyme inhibitors, insulins, sulfonylureas, and other medications are also used to manage diabetes, although their usage varies depending on individual patient needs.

References

[4] Context 4 [5] Context 5 [6] Context 6 [7] Context 7 [8] Context 8 [9] Context 9

Differential Diagnosis of Diabetes Mellitus

Diabetes mellitus, a metabolic disorder characterized by high blood sugar levels, can be challenging to diagnose due to its various presentations and potential differential diagnoses. Here are some conditions that may mimic or coexist with diabetes mellitus:

• Type 1 diabetes: An autoimmune condition where the body's immune system attacks the insulin-producing beta cells in the pancreas, leading to high blood sugar levels.
• Type 2 diabetes: The most common form of diabetes, characterized by insulin resistance and impaired insulin secretion. It often presents with symptoms such as polyuria, polydipsia, and weight loss.
• Ketosis Prone Type 2: A rare variant of type 2 diabetes that is associated with ketosis and may require more aggressive treatment.
• Monoclonal Gammopathies: A group of conditions characterized by the production of abnormal proteins in the blood, which can lead to high blood sugar levels.
• Liver disease: Certain liver conditions, such as cirrhosis or fatty liver disease, can cause high blood sugar levels and mimic diabetes mellitus.
• Cystic fibrosis: A genetic disorder that affects the pancreas and can lead to high blood sugar levels due to impaired insulin production.
• Hereditary hemochromatosis: A genetic disorder that causes excessive iron accumulation in the body, which can lead to high blood sugar levels.
• Pancreatic cancer: Cancer of the pancreas can cause high blood sugar levels due to impaired insulin production.
• Chronic pancreatitis: Inflammation of the pancreas that can lead to high blood sugar levels and mimic diabetes mellitus.

Key Symptoms

Classic symptoms for diabetes mellitus type 2 include:

• Polyuria (frequent urination)
• Polydipsia (increased thirst)
• Polyphagia (increased hunger)
• Blurred vision
• Fatigue
• Weight loss

Other presentations may include:

• Diabetic ketoacidosis (DKA)
• Diabetic nephropathy
• Diabetic foot ulcers
• Insulin resistance

References

1. Table 2Abbreviated Differential Diagnosis of Diabetes [1]
2. Dec 13, 2023 — Differential Diagnoses [3]
3. Differential Diagnosis; Cystic fibrosis. Hereditary hemochromatosis. Pancreatic cancer. Chronic pancreatitis. Hormonal syndromes that can lead to impaired insulin production [4]
4. Classic symptoms for diabetes mellitus type 2 include: Polyuria, polydipsia, polyphagia, blurred vision, fatigue and weight loss. Other presentations include: Diabetic ketoacidosis (DKA), Diabetic nephropathy, Diabetic foot ulcers, Insulin Resistance [5]
5. Differentials; Non-diabetic hyperglycaemia (pre-diabetes) · Diabetes mellitus, type 1 · Latent autoimmune diabetes in adults (LADA) · Monogenic diabetes · Ketosis- prone diabetes [6]