Diabetes Mellitus

Eva Jessee

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Diabetes Mellitus

Diabetes Mellitus is a condition where the body cannot manage to maintain

or control the amount of sugar in the blood at a constant, normal level. As an
individual eats food, it is broken down into sugar within the body. Once food has
been broken down, it enters into the blood stream. Insulin, a hormone produced in
the pancreas, plays a foremost role in the amount of sugar that is in the human
body at all times. It is also very important in the regulation of blood sugar levels.
Without the presence of insulin, blood sugar levels would skyrocket. Insulin helps to
move the sugar from the bloodstream into the cells so the body can use it as fuel.
There are 2 different types of Diabetes Mellitus. They are called Type 1, or
Juvenile Diabetes, and Type 2, or non-insulin-dependent diabetes. An article written
by the National Diabetes Information Clearinghouse (NDIC) states that diabetes is
a complex group of diseases with a variety of causes. Scientists believe that genes
and environmental factors interact to cause diabetes in most cases (NDIC).
With type 1 diabetes the body produces little to no insulin on its own. It is
the least common of the 2 disorders and typically onsets prior to the age of 20. It is
commonly referred to as Juvenile Diabetes. Approximately 15% of diabetic patients
are Type 1. This type of diabetes is considered an auto-immune disorder because
essentially what occurs is that the individuals immune system attacks the
pancreatic beta cells called Islet cells. This attack ends up destroying the beta cells
leaving them with an inability to secrete insulin and it also destroys them. Despite
the fact that this type of diabetes can start early, we are presently seeing an
increase of incidence of this condition later in life for some cases. Because the body
cannot produce insulin, there is a decrease of glucose into the adipose tissue and

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muscle. The end result will be that blood sugar levels will rise which is commonly
referred to as hyperglycemia. Excess blood glucose concentrations then cause the
kidney to start to spill glucose. If not treated, this will lead to severe dehydration as
well as an increased desire to consume more fluids. Once this process has started,
it is not long before a patient will begin to sweat, throw up and go into metabolic
acidosis due to a low pH level in the body. Essentially, as the body is starved for
glucose it will begin protein synthesis. This will result in a loss of weight and can
also make it hard for the body to heal from a wound or from a trauma. Fat
catabolism increases the amount of ketones in the body and that results in the
lower pH of the body. This drastic event can result in coma or death within minutes
to hours. The person becomes increasingly disoriented, agitated and begins to
have horrible muscle spasms.
Type 2 diabetes, or non-insulin-dependent diabetes, occurs over a longer
period of time. Type 2 diabetes usually onsets in individuals who are over the age of
40 years old. It is caused due to the receptor, beta cells losing their ability to
function and receive stimuli. As these receptors ago or become overused, they
tend to not respond to insulin as well. Also with insulin resistance the tissues of the
body often become resistant to the effects of insulin. This causes the body to being
to try to produce much more insulin. The pancreas cannot keep up with the
increased bodily demand for insulin and the increase in blood sugar can actually
begin to damage the Islet cells causing increased damage. Type 2 diabetes is
usually the product of obesity and unhealthy dietary habits. This particular form of
diabetes is prevalent. Due to the growing incidences of obesity, it continues to be
on the rise.

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Symptoms of Diabetes Mellitus tend to be very similar in both types. It is
important to note though that the symptoms of a Type 1 diabetic tend to be more
rapid in their progression and are often more severe. Patients with this condition
typically complain of an extreme thirst and frequent trips to the bathroom. They
will often have unexplained weight loss, fatigue, weakness, blurred vision as well as
have some signs of dehydration. Their ability to fight infections is often impaired so
it is common to see them on antibiotics for extended periods of time as they strive
to control and fight an infection. It is not uncommon to see type 2 diabetics who
appear completely normal and are asymptomatic. These are the patients that you
will often note as being pre-diabetic.
In order to test for Diabetes Mellitus, most doctors will primarily begin testing
with a urine sample to see if they can detect sugar in the urine. A glucose tolerance
test may also be administered. To prepare for this test, a patient will go without
food or drink for 8 hours then come in for an immediately blood draw to see where
blood sugar levels are. Once the initial blood draw is done, a patient is given a very
sugary drink and approximately two hours later a blood draw is done to recheck the
glucose level in the blood. The best test that can be done is called an A1C. This is
a test where a patient will go without food or drink for at least 8 hours and then
have their blood drawn. It will give the physician a rough indication of where the
patients blood sugar levels have rested for the past 90 days. If the labs come back
with a fasting blood sugar of 7mmol/litre or higher, the patient is then diagnosed as
being diabetic.
Complications with Diabetes Mellitus may include kidney damage,
neuropathy, heart damage as well as circulatory problems to the legs and feet.

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Patients are also at increased risk for myocardial infarctions, hypertension and are
more prone to tooth and gun disorders.
Treatment for Type 1 Diabetes Mellitus focuses on insulin replacement and
diet therapy. This can be accomplished through a variety of methods of insulin
replacement such as needles, insulin pumps, aerosols and transplantation of new
pancreatic islets. With type 2 diabetes, there is a greater emphasis placed on diet
and exercise because a reduction of weight can often reverse the condition. Along
with behavior modifications, physicians will often prescribe Metformin or other oral
drugs. It is important to note though that if the pills do not work, type 2 patients
must resort to the same insulin replacement treatments as type 1 patients. For
both conditions the doctor is going to recommend a diet that is high in fiber, low in
sugar with limited fat and salt intake. Most patients are unaware that alcohol can
contain high amounts of sugar so it is important to counsel them on this. Smoking
cessation is also a key point to make when discussing treatment options. New
Medical Information and Health Information (NMIHI) states for this reason it is
particularly important that diabetics do not smoke, since this multiplies these risks
still further (NMIHI). Moderation with food and alcohol is the key to maintaining a
healthy body weight. Counseling on hypoglycemia must also take place so that
patients know what to do to avoid a low blood sugar and how to get it back up
quickly if it occurs. Glucagon tablets are often prescribed for patients that
experience frequent low blood sugars. These tablets contain a high level of sugar
that is concentrated. When taken, they quickly raise blood sugar back to a safe
level. Frequent glucose monitoring at home and in a professional setting is required
to maintain optimum health. Testing urine for ketones at home can also be
recommended on a case by case basis by the prescribing physician.

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Works Cited
Diabetes Info. National Diabetes Information Clearinghouse. n.p. 27 Aug 2014.
Web. Accessed 28 Nov 2014. http://diabetes.niddk.nih.gov/dm/pubs/causes/#Points
Diabetes Mellitus. New Medical Information and Health Information. n.p. 17 Jun
2011. Web. Accessed 28 Nov 2014. http://www.nmihi.com/d/diabetes-mellitus.htm