Diabetes Mellitus

(Type 1 and Type 2)

Diabetes is a general term that describes two different forms and severities of this disease.
 
Diabetes mellitus occurs secondarily to an inadequate production of insulin by the pancreas, or from an ineffective utilization of the insulin in the body. Insulin is a hormone which regulates the level of glucose (sugar) in the blood stream. Glucose is a critical source of energy utilized by every organ in the body and is the ONLY energy source utilized by the brain. Without insulin, the glucose level rises in the bloodstream, but the body is unable to effectively use it for the regulation of metabolism. Insulin is the necessary link that enables the body to transport glucose into the cells for energy metabolism.

Type 1 Diabetes

This refers to the form of diabetes that has its onset in childhood or adolescence. This can be an inherited disease. These patients are dependent on insulin injections to maintain normal body chemistry. Without insulin, they can be subject to diabetic ketoacidosis and death. Patients with type 1 diabetes are also commonly referred to as insulin dependent diabetics, because without it, death can result.

Type 2 Diabetes

This form of diabetes most commonly occurs in middle aged, overweight people whose blood sugar is higher than normal. Type 2 diabetes is also referred to as adult onset diabetes. In most cases, these patients do not require insulin injections to control their diabetes, but can control the condition with a diabetes diet and weight reduction. These patients are usually not subject to the same severe chemical imbalances as the type 1 diabetics, but they can contract the same long term diabetic complications.

Complications of Long Term Diabetes

  • Diabetic Retinopathy — Damage to the retina (perceptive structural tissue of the eye) resulting in decreased vision and, possibly blindness.
  • Kidney Disease — The long term effects of diabetes can result in a steady decline in kidney function, or kidney failure.
  • Stroke — Diabetics have an increased risk of stroke. 
  • Heart Disease — Increased risk of myocardial infarction (heart attack). 
  • Peripheral Vascular Disease
  • Decreased Immunity to Infection
  • Peripheral Neuropathy — Damage to the peripheral nerves and altered sensation. Patients may complain of numbness, tingling, and/or burning pain to the extremities, hands, and feet.
  • High Risk Pregnancy (in the female diabetic) 

Diagnosis

Evaluation will include patient medical history and physical examination. The physical examination may reveal clues that indicate long standing diabetes is present. Random and fasting blood sugar testing is also be required. Glucose tolerance testing can help confirm this diagnosis. Blood tests for kidney profile and blood counts are also done. Urinalysis will show the excess presence of glucose.