Diabetes Mellitus (D.M.) is a disorder of glucose metabolism which is either due to:
(1) Inability of pancreas to produce sufficient insulin needed for the body or (2) Inability of the body cells to use the insulin available.
If the blood sugar is more than the normal concentration then it is known as hyperglycemia but the blood sugar level is less than the normal concentration then it is known as hypoglycemia. Hyperglycemia is characterized by high concentration of sugar in blood and the presence of sugar in the urine (glucosuria).
The normal blood glucose level ranges from 70-90 mg. per 100 ml. but if fasting blood sugar level increases more than 120mg. per 100ml. then diabetes should be suspected.
Diabetes could be caused not only by deficiency of insulin but also due to the disturbance in the level of other substances like adrenaline, oestrogen, pituitary hormones, Thyroid hormones, corticosteroids, glucagon etc. All these substances produce their effects on blood sugar level so Glucose Tolerance Curve should be determined which will be most useful test for diabetes.
Types of Diabetes
Clinically It is of two types:Medical
(1) Insulin Dependent Diabetes [IDDM]: In this type usually in young age during first 40years of life & has a very rapid onset. In this the pancreas produces very little or no insulin so administration of insulin is required hence it is called Insulin Dependent Diabetes.
(2) Non-insulin Dependent Diabetes [NIDDM]: In this usually after 40years of age or elderly persons who are obese & progresses slowly. In this type, pancreas inadequate amount of insulin. This type of diabetes can be controlled by dietary and light exercise or along with oral drugs.
Symptoms
1. Loss of weight
2. Increased thirst
3. Frequent urination
4. Lack of concentration
5. Irritability
6. General weakness & fatigue
7. Prone to infection
8. Delayed wound healing.
Prevention & Control
Diabetes can’t be cured but can be effectively controlled so that diabetic can enjoy life, feel hale & healthy.
Diabetes can be prevented & controlled by adopting these following measures:
(1) A diabetic should not married to another diabetic otherwise their children will also be diabetic.
(2) The obesity should be reduced by restricting the diet and going for normal physical exercise.
(3) Regular checkup of urine sugar and blood sugar should be done.
(4) Personal hygiene including care of feet and skin should be taken.
(5) The patient should try to avoid emotional and social stress and strain in life which are associated with diabetes.
Treatment
Diet, physical exercise and drugs are recommended for treatment of diabetes. The treatment should be done under the supervision of a qualified diabetologist and supervised by him once in 3 months. The patient should undergo full biochemical tests, eye checkup and obtain advice for foot care at least once a year.
•The commonly used drugs in controlling the diabetes are insulin which is administered by parenteral route in case of insulin dependent diabetes. Example,
1. Inj. Human Mixtard (Mixtard)
2. Inj. Human Actrapid (Human Insulin)
3. Inj. Lantus (Basalog)
4. Inj. Lispro etc.
•For non insulin dependent diabetes various type of oral tablets are available. Example,
1. Tab. Metformin 500mg/850mg
2. Tab. Glimipride 1mg/2mg
3. Tab. Glibenclamide (Daonil)
4. Tab. Vildagliptin (Galvas)
5. Tab. Voglibose etc.
These drugs should be taken as suggested by the physician.
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