Diabetes Basics
Posted on 11/18/2011
Diabetes mellitus is a metabolic disease characterized by hyperglycemia that results from defects in insulin secretion, insulin action, or both. Important abnormalities in fat and protein metabolism are also present. Nonetheless, the diagnosis still rests upon demonstrating elevated plasma glucose levels. The chronic hyperglycemia of diabetes mellitus is specifically associated with long-term damage, dysfunction, and failure of various organs, especially the retina and lens of the eye, the kidneys, and both somatic and autonomic nervous systems. The heart, arterial system, and microcirculation are also adversely affected.
Type 1 diabetes mellitus
is characterized by absolute insulin deficiency, making patients dependent on exogenous insulin replacement for survival. Insulin deficiency results from destruction or disappearance of the insulin-producing beta cells. When 90% of the beta cells have been eliminated, clinical diabetes occurs
Type 2 diabetes mellitus
This is known as insulin resistance.. Approximately nine out of every ten people living with diabetes have type 2 diabetes.
The pathogenesis of type 2 diabetes mellitus is even more complex than that of type 1 diabetes mellitus. occurs when your body makes insulin, but your cells cannot use it properly. When you are first diagnosed, you may even be over-producing insulin. However, over time your body’s ability to make insulin decreases. Insulin resistance plays a major role in generating hyperglycemia. In addition, some degree of functional insulin deficiency exists. Furthermore, insulin resistance may cause secondary insulin deficiency, and insulin deficiency tends to lead to insulin resistance.
Gestational diabetes mellitus (GDM)
The Gastational diabetes mellitus (GDM) constitutes a separate category for cases of diabetes first detected during pregnancy.3When diabetes is detected early in pregnancy, it is likely to be type 1 or type 2 diabetes mellitus that is presenting symptomatically and was probably precipitated or worsened by the pregnant state. Diabetes is commonly detected in the second and third trimester (i.e., in 4% of pregnant women) and is likely to be specific for the pregnant state, to be transient, and to reverse to normal glucose tolerance or to IGT on follow-up oral glucose tolerance testing 6 weeks after delivery. However, GDM is associated with a high risk of future diabetes, especially in women who have IGT post partum or who remains obese.3Permanent diabetes will develop in approximately 50% of patients within 10 years of GDM. The greatest importance of any single episode of GDM lies in the risks it poses to the fetus. These risks include intrauterine mortality, neonatal mortality, respiratory distress syndrome, hypoglycemia, hypocalcemia, jaundice, and macrosomia, which can cause trauma such as shoulder dystocia during passage through the birth canal.
Managing diabetes is a great balancing act. You need to balance your food, medication and exercise to keep blood glucose levels as close to normal as possible. It takes a great deal of work, but it can be done. The key to successful diabetes management is education.
See the sections below for more information.
· Physical activity and diabetes
