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Diabetes

Diabetes mellitus is a medical disorder characterized by varying or persistent hyperglycemia (high blood sugar levels) resulting from the defective secretion or action of the hormone insulin

Diabetes is a condition that means your body cannot control the level of sugar in the blood effectively. People with diabetes are very susceptible to kidney failure because diabetes affects the blood supply to the kidneys. There are two types of diabetes. Type I  diabetics tend to develop the disease early in life and are unable to control blood sugar levels because their bodies cannot make a special hormone called insulin. Type II diabetics are older and the disease is often associated with obesity.


Insulin  is a polypeptide hormone that regulates carbohydrate metabolism. Apart from being the primary effector in carbohydrate homeostasis, it has effects on fat metabolism. It can change the liver's ability to release fat stores. Insulin's concentration (more or less, presence or absence) has extremely widespread effects throughout the body.

Since insulin is the principal hormone that regulates uptake of glucose into most cells from the blood (primarily muscle and fat cells, but not central nervous system cells), deficiency of insulin or its action plays a central role in all forms of diabetes mellitus.

Types of diabetes

Type 1 diabetes

Type 1 diabetes (formerly known as insulin-dependent diabetes, childhood diabetes, or juvenile-onset diabetes) is most commonly diagnosed in children and adolescents, but can occur in adults, as well. It is characterized by -cell destruction, which usually leads to an absolute deficiency of insulin. Most cases of type 1 diabetes are immune-mediated characterized by autoimmune destruction of the body's -cells in the Islets of Langerhans of the pancreas, destroying them or damaging them sufficiently to reduce insulin production. However, some forms of type 1 diabetes are characterized by loss of the body's -cells without evidence of autoimmunity. Lifestyle does not affect the probability of getting Type 1 diabetes.

Currently, type 1 diabetes is treated with insulin injections, lifestyle adjustments (diet and exercise), and careful monitoring of blood glucose levels using blood testing monitors

Type 2 diabetes

In type 2 diabetes insulin levels are initially normal or even elevated, but peripheral tissues lose responsiveness to insulin (known as "insulin resistance").

Drugs like metformin may be prescribed to decrease inappropriate mobilization of glucose from liver stores. Type 2 diabetes is a more complex problem than type 1 but is often easier to treat, since insulin is still produced, especially in the initial years; insulin levels may drop later in the course. Type 2 diabetes may go unnoticed for years in a patient before diagnosis, since the symptoms are typically milder (no ketoacidosis) and can be sporadic. However, severe complications can result from unnoticed type 2 diabetes, including renal failure and coronary artery disease.

Type 2 diabetes is usually first treated by changes in physical activity (increase), diet (decrease calories and avoid junk foods), and through weight loss. These can restore insulin sensitivity, even when the weight loss is modest, e.g., around 5 kg (10 to 15 lb). The next step, if necessary, is treatment with oral antidiabetic drugs: the sulphonylureas, metformin, or thiazolidinediones or some combination of them. If these fail, insulin therapy will be necessary to maintain normal or near normal glucose levels. A disciplined regimen of blood glucose checks is recommended in most cases, particularly when taking medication.

Gestational diabetes

Gestational diabetes mellitus occurs in about 2%?5% of all pregnancies. It is temporary, and fully treatable, but, if untreated, may cause problems with the pregnancy, including macrosomia (high birth weight) of the child. It requires careful medical supervision during the pregnancy. In addition, about 20%?50% of these women go on to develop type 2 diabetes.

 

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