Info on Diabetes

Diabetes Mellitus is a cronic desease, self imune or of unknown causes, resulting of an
insuline production deficiency at the pancreas. Its immediate consequence is the maintenance
of inappropriately high glicemia levels (hyperglicemia) or low levels of glicemia (hypoglicemia).

Classification of Diabetes Mellitus

There are several types of Diabetes Mellitus:
1- Diabetes Mellitus
    a - Diabetes Type I - The person is Insuline Dependant;
    b - Diabetes Type II - Non Insuline Dependant. This type of diabetes can be controled with oral medication;
    c - Diabetes related with bad nutrition;
    d - Secundary Diabetes;
2 - Decreased Glucose tolerance;
3 - Gestational Diabetes Mellitus.

Type I Diabetes - Characteristics:

Usally the cause is unknown. There is already an history of Type 1 diabetes in the family.
at the time diagnosis was made, the individuals are usually thin. It can appear in any age,
although, it is more frequent in individuals less than 30 years. They are dependant on
Insuline shots.

Type II Diabetes - Characterisitics:

In this type of Diabetes, an insuline production deficiency can occur, but what usually
occurs is a resistence to the insuline action in the tissues (generally speaking).
It is common on individuals with 40 years old, with progressive beginning. At the time of diagnotic, several years may have passed since the beginning of the desease. The individuals
are usually fat, or with excessive weight.

There was already an history of diabetes in the family. normally, insuline is not required
in type II diabetes. Normally a diet and physical exercise is enough to control this type of
diabetes. When it is not possible, a treatment with oral Anti Diabetic medication is used.

Symptoms of pre diabetes

Sometimes i see people talking about symptoms of pre diabetes. That it is not the correct
way to aboard te matter, but it is valid.
What we should go after is Diagnosis Criteria of Diabetes Mellitus.
When we do a test, and the test reveals that there is glicemia level of 150mg/dl, and the
person is fasting then there is probably a problem if it is associated with the classic symptons of Diabetes.

Classic Diabetes Symptons - Major

- Polyuria (increased urine production);
- Polydipsia (the person is thirsty all the time);
- Polyphagia (hungry all the time);
- Weight loss;

These are the symptons that require atention from us. There are also other symptons of
Diabetes such as:

- Family history;
- Obesity;
- rapid weight loss/gain;
- Cardivascular desease in individual with < 40 years old;
- Balanitis (a penis infection);
- And several others symptons;

There are several Diabetes complications and it can be divided in two sections (Acute and
Cronic)

Acute Complications:

1 - Hypoglicemia;
2 - Ketoacidosis;
3 - Somogyi Phenomenon;

Cronic Complications (late complications):

4 - Vascular Complications;
5 - Nerves complications;
6 - Infections;

Hypoglicemia:

Hypoglicemia happens when the blood sugar levels are below 60mg/dl, and it can happen for
several reasons (mistake on the insuline dosage, or wrong time frame, too much time without
eating, alcohol, physical activity in excess...)
A diabetic should be able to recognise when his glicemia levels are falling into dangerous
levels.

Hypoglicemia Symptons

The most common symptons are:
- cold sweats;
- nervousness;
- sudden hunger;
- asthenia (tiredness);
- weakness;
- trembling;
- palpitations;

If the diabetic fails to recognise these symptons or didn't act imeddiatly to correct his
sugar levels, then more serious symptons can appear:

- Headache;
- Speech alterations;
- Agressiveness, irritability;
- Blurred vision;
- Tachycardia;
- Tongue numbness;
- Mental confusion;
- Convulsions;
- loss of consciousness
and ultimately: COMA

Ketoacidosis

When there isn't enough insuline to make the sugar enter the cells, fat is the main energy source.
But in the energy production process from fat, some of it is degraded in to ketones,
increasing the ketones level on the blood circulation. This can cause ketoacidosis,
manifested by nausea and vomiting, thirst, dry, warm and red skin, ketone odor, ketonuria.

Vascular complications

Diabetes in the long term can cause Vision problems, kidney problems, strokes, angina
pectoris, thrombosis;

Nerves Complications

The diabetic loses sensitivity in the extremities, which increases the chance of developing
ulcers (example: Diabetic foot).
 I am a nurse and during my work i treated many many wounds, ulcers from diabetics because
they didn't feel any pain, and when they realized something was wrong it was too late, the
ulcer was already there. This can bring serious complications to the diabetic, Amputaion is on of them.
It can also, cause sexual impotence, muscular pain, intestinal alterations, amonsgt other
complications.

Infeccions:

Poorly controlled diabetes can lead to infeccions. Amongst the most common diabetic
infections are furuncles, athlete's foot and Vulvar infections. The last one is common
because the sugar present is loved by bacteria!
Another important complication of diabets is the longer Healing process.

Diabetes Treatment

First of all, let me say you this. There is no Cure for Diabetes at the present. This is an
aspect, that I, as a nurse need to tell to every new Diabetic that comes to me. However, it
is important to say that Diabetes can be controled, and there a breakthroughs in research
every year, so we should not lose confidence on a cure for diabetes.

The treatment of Diabetes can be called as a Terapeutic triade:

- Diet;
- Physical Exercise;
- Anti Diabetic Medication.

These topics will be covered on a next hub.

Read the first part about Diabetes Information