Diabetes mellitus
From Simple English Wikipedia, the free encyclopedia
Diabetes means a disease where people have too much sugar in their blood. There are other kinds of diabetes, like diabetes insipidus. But when people say 'diabetes' they usually mean diabetes mellitus.
Diabetes mellitus is a disease where people have too much glucose (a kind of sugar) in the blood. Glucose level in the blood is controlled by several hormones. Hormones are chemicals in your body that send messages from cells to other cells. Insulin is a hormone made by the pancreas. When you eat, the pancreas makes insulin to send a message to other cells in your body. This insulin tells the cells to take up glucose from the blood. This glucose is used by cells for energy. Extra glucose that is not needed right away is stored in some cells as glycogen. When you are not eating, cells break down glycogen to have glucose to use as energy.
People with diabetes mellitus are sometimes called 'diabetics'.
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[edit] Types of diabetes
Type 1 diabetes has had several names. It used to be called Insulin Dependent Diabetes Mellitus (IDDM), or juvenile diabetes because it requires insulin. In the past, it was called 'juvenile' diabetes, because it usually is found in children or young adults. It is caused by the pancreas stopping making insulin. Before insulin was discovered, this type of diabetes usually caused death within a year. People with Type 1 must take insulin every day. This is usually given by injecting insulin under the skin with a small needle. People with IDDM also have to eat a special diet.
[edit] Complications of diabetes
"Complications" are problems that happen because of a disease. In the case of diabetes, there are two kinds of complications. The first kind happens quickly and can be dealt with quickly. They're called the acute complications. The other kind are caused by the blood glucose being too high for many years, and they're called chronic complications or long-term complications.
Too high blood glucose is called 'hyperglycemia'. If very high, it can cause acute complications. In Type 1 diabetics, one of these is diabetic ketoacidosis which is always a medical emergency, and can often be noticed by a kind of fruity smell on the breath. Another acute complication, more common in Type 2 diabetics, is non-ketotic hyperosmolar coma which is also very dangerous.
Too low blood glucose is called hypoglycemia. It can also cause acute complications. If too low, diabetics can have many symptoms such as sweating, trembling, anger (or feeling passive), etc. Possibly even passing out. But diabetics with hypoglycemia may be confused or even unconscious. They may even appear to have had too much alcohol. Severe hypoglycemia is very dangerous and can cause death. The best treatment of hypoglycemia is avoiding it. If it happens, eating a glucose containing food (for instance, table sugar) usually makes it better, and pretty quickly. Sometimes it is also treated by giving an injection of a medicine called 'glucagon'. Glucagon is a hormone that is also made by the pancreas. It acts opposite of insulin. So giving it will cause the blood glucose to rise by forcing stored glucose into the blood. It's usually caused by too much diabetic medication or insufficient food, or too much exercise, or some combination.
Chronic complications are mostly caused by hyperglycemia (but not high enough to always cause acute complications). It causes damage to blood vessels and nerves. Damage to blood vessels can eventually cause strokes, heart attacks, kidney failure, blindness, slow healing of skin breaks, and so more infections, and even amputations from poor circulation (decreased blood flow, usually to the feet and toes). Damage to nerves can make diabetics not feel pain, also usually in their feet. This causes them to have more injuries and not realize they have hurt themselves. Damage to nerves can also cause pain even when there's no real injury. It's a kind of phantom pain or ghost pain. This can be so bad that people need strong pain medicines.
[edit] Monitoring of diabetes
Because of the damage that is caused by high blood glucose it is important to treat diabetes mellitus. The goal of treatment is to keep the blood glucose normal. The normal range for blood glucose is 60-120 mg/dL (milligrams of glucose per deciliter of blood) or 3.5-7 mmol/l (millimole per liter of blood.) These are different ways of saying the same thing, very much like yards and meters are different ways of measuring distance.
Diabetics should check their blood glucose often. This is to make sure they do not get hypoglycemia or hyperglycemia. A glucometer is a battery powered measuring machine that checks the level of glucose in blood. Diabetics often carry a glucometer with them to check their level several times in a day.
Doctors may also use a blood test called a hemoglobin A1C. This is sometimes written Hgb-A1C or several other ways; there's no standard name. This tells the doctor what the average blood glucose has been for about the past 90 days. If the level has been too high, it may be that new medicines, or different doses, or better diet may be needed.
Diabetics also must be monitored for signs of the complications of diabetes. They should see an eye doctor regularly to be checked for damage to the blood vessels in the eyes. If this is not found early and treated it can cause blindness. They also should have their urine or blood checked regularly for signs of kidney damage. And they must check their feet for cuts, bruises, blisters, and so on at least every day. And they should have their feet checked regularly for nerve damage, circulation, and infections.
[edit] Treatment of diabetes
The most important goal in diabetes is to keep blood glucose as normal as possible. Since it usually goes up after eating, and down after exercise, coping with it sensibly is often complex, and usually takes care and thought. And treatement differs between Type 1 and Type 2. People with Type 1 are treated with insulin. People with Type 2 usually begin with diet, exercise, and weight loss, perhaps moving to pills (and sometimes insulin.)
Education is important for both types of diabetes. Diabetics must learn about diet. They learn how to estimate and keep track of how much carbohydrate, protein, and fat are in different foods. They plan their meals to have the right amount of carbohydrates, proteins, and fats. Patients with Type 1 may decide how much insulin to take before a meal based on how much they will eat.
Diabetics must also be careful about exercise. Exercise is important to stay healthy. But too hard or too long exercise may cause hypoglycemia. So diabetics must also carefully plan exercise like they plan meals.
In addition to controlling blood glucose other treatments may be needed. Diabetics often have blood vessel diseases, so it is important to pay attention to other diseases which may affect blood vessels. In people with diabetes, treating high blood pressure (hypertension) and high cholesterol is even more important than usually. Both of these diseases damage blood vessels. The treatment goals can change for diabetics. For instance, in people without diabetes, blood pressure should be 140/90 or less. In diabetics it should be 130/80 or less.
