Diabetes Mellitus: Ultimate Guide to this very preventable illness

Types of Diabetes Mellitus

  • Type 1 Diabetes

      • An autoimmune disease where the immune system attacks and destroys insulin-producing cells in the pancreas.
      • Primarily diagnosed in children and is typically congenital.
  • Type 2 Diabetes

      • Occurs when the body does not produce enough insulin or when insulin receptors become less responsive, leading to insulin resistance.
      • The most common type of diabetes.
  • Pre-diabetes

      • A stage where blood glucose levels are higher than normal but not yet high enough to be diagnosed as type 2 diabetes.
  • Gestational Diabetes

      • Develops during pregnancy and usually resolves after childbirth.
      • Increases the risk of developing type 2 diabetes later in life.
  • Type 3c Diabetes

      • Results from damage to the pancreas due to conditions such as pancreatitis, pancreatic cancer, cystic fibrosis, or hemochromatosis.
  • Latent Autoimmune Diabetes in Adults (LADA)

      • A condition similar to type 1 diabetes caused by an autoimmune disorder but develops more slowly in adulthood, typically after age 30.
  • Maturity Onset Diabetes of the Young (MODY)

      • A form of monogenic diabetes caused by inherited genetic mutations that affect insulin production and utilization.
      • There are around 10 different types, and it tends to run in families.
  • Neonatal Diabetes

      • A rare form of diabetes that occurs in infants within the first 6 months of life.
      • This condition may either persist throughout life or disappear and reappear later.
  • Brittle Diabetes

    • A severe form of type 1 diabetes with frequent episodes of high and low blood sugar levels, often requiring hospitalization.

Causes

Diabetes mellitus results from elevated glucose levels in the blood and can be caused by:

  • Decreased insulin receptor sensitivity (insulin resistance)
  • Insufficient insulin production
  • Congenital factors
  • Autoimmune disorders
  • Genetic mutations
  • Pancreatic damage
  • Hormonal diseases (e.g., Cushing’s syndrome, pheochromocytoma, acromegaly)
  • Prolonged use of medications, such as HIV drugs and corticosteroids
  • Drug-induced resistance (e.g., phenytoin, estrogen, glucocorticoids)
  • A sedentary lifestyle

Symptoms and Features

Common symptoms of diabetes include:

  • Fatigue
  • Blurred vision
  • Unexplained weight loss
  • Increased thirst (polydipsia)
  • Slower healing
  • Frequent urination
  • Numbness in extremities
  • Vaginal yeast infections

Long-term diabetes can lead to complications such as:

  • Heart attack
  • Stroke
  • Atherosclerosis
  • Neuropathy
  • Retinopathy
  • Amputations
  • Erectile dysfunction
  • Vaginal dryness
  • Hearing loss
  • Periodontal disease
  • Depression

Diagnosis and Tests

  • Fasting Blood Glucose Test
    • Normal: <100 mg/dL
    • Pre-diabetes: 100–125 mg/dL
    • Diabetes: >126 mg/dL
    • Hypoglycemia: <70 mg/dL
  • HbA1c Test
    • Normal: <5.7%
    • Pre-diabetes: 5.7%–6.4%
    • Diabetes: >6.5%
  • Other tests may include:
    • Random blood glucose test
    • Oral glucose tolerance test
    • Oral glucose challenge test

Treatment

  • Oral Medications
    • Metformin (typically prescribed for type 2 diabetes and pre-diabetes)
  • Insulin Injections
  • Lifestyle Changes
    • A balanced diet
    • Regular physical activity

Prevention

  • Regular blood sugar monitoring
  • Maintaining a healthy diet
  • Controlling cholesterol levels
  • Keeping blood pressure within the recommended range
  • Maintaining a healthy weight
  • Adopting a Mediterranean diet
  • Stress management
  • Getting adequate sleep
  • Quitting smoking and alcohol use

Additional Information

  • Type 1 Diabetes may lead to Diabetic Ketoacidosis (DKA).
  • Acanthosis Nigricans is a common sign seen in individuals with pre-diabetes, marked by darkened skin.
  • People with type 2 diabetes are at higher risk for Hyperosmolar Hyperglycemic State (HHS).