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HEALTH CONDITIONS
Adult-Onset Diabetes
Overview
Symptoms
Risk Factors
Commonly Prescribed Drugs
Treatment and Management
Doctors to Consult
Overview

Diabetes mellitus or simply diabetes is a metabolic disease characterized by elevation of blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger).

Symptoms
  • Excessive thirst and appetite
  • Frequent urination
  • Unusual weight loss or gain
  • Fatigue
  • Nausea, perhaps vomiting
  • Blurred vision
  • In women, frequent vaginal infections
  • In men and women, yeast infections
  • Dry mouth
  • Slow-healing sores or cuts
  • Itching skin, especially in the groin or vaginal area
  • Breathing more deeply and rapidly than normal -- perhaps with sweet breath that smells like nail polish remover

Long term complications of poorly controlled diabetes includes:

  • Eye complications which may lead to cataracts and blindness

  • Cardiovascular disorders such as hypertension, heart attack, and stroke

  • Poor blood circulation (poorly healing wound, limb amputation)

  • Kidney failure

There are three main types of diabetes mellitus

  • Type 1 DM results from the body's failure to produce insulin, and presently requires the person to inject insulin or wear an insulin pump. This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes".

  • Type 2 DM results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. This form was previously referred to as non insulin-dependent diabetes mellitus (NIDDM) or "adult-onset diabetes".

  • Gestational diabetes occurs when pregnant women without a previous diagnosis of diabetes develop a high blood glucose level. It may precede development of type 2 DM.
Risk Factors
  • Age

  • Genetics and family history

  • Diseases of the pancreas

  • Infection or illness

  • Sedentary lifestyle

  • Smoking

  • Unhealthy eating habits

  • High blood pressure and high cholesterol
Commonly Prescribed Drugs

Insulin may be of human insulin or a synthetic insulin analog. Three types of insulin based on their onset, duration & intensity of action following subcutaneous administration:

  • Short-acting

  • Long-acting

  • Intermediate-acting

Insulin is the primary mainstay therapy for type 1 DM but it may also be given to type 2 DM patients whose condition is not properly controlled by diet, exercise & weight reduction.

Oral hypoglycemics are given to patients with type 2 DM who have not achieved favorable results after about 3 months of dietary control and exercise. They act mainly by improving insulin resistance in order to normalize blood sugar levels.

  • Sulfonylureas stimulate the pancreas to secrete insulin. They also decrease the production of glucose by the liver, potentiate insulin action at target tissues and decrease the level of cholesterol and triglyceride-transporting molecules in the blood.

  • Biguanides decrease the production of glucose by the liver, improve insulin sensitivity & utilization of glucose in peripheral tissues; decrease & delay absorption of glucose from the GIT.

  • Thiazolidinediones do not stimulate insulin secretion but enhances tissue sensitivity to insulin.

  • Meglitinides lower glucose levels by stimulating the release of insulin.

  • Alpha-glucosidase inhibitors act by delaying the absorption of glucose from a carbohydrate load.

  • Dipeptidyl dipeptidase inhibitors inhibit the action of the DPP4 enzyme which breakdown GLP-1, effectively increasing the levels of GLP-1, causes glucose-dependent increase in insulin secretion.
Treatment and Management
  • Diet modifications. Use of alternative sweeteners should be weighed against their safety. Eating a smaller meal more often is recommended because the smaller the meal, the less insulin is needed to handle the glucose influx from each meal. Instead have complex carbohydrates like rice, pasta, cereals and fresh fruits.

  • Exercise. Repetitive, rhythmic movements involving the large muscles (e.g. walking, jogging, swimming, rowing or bicycling) are best for diabetics. Lifting weights or engaging in any activity that involves pushing or pulling weights may cause a raised blood sugar level and blood pressure.
Home Remedies
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