Diabetes: A Brief Look
Diabetes mellitus is described as a group of diseases characterized by abnormally high blood glucose levels. It is characterized by a collection of symptoms commonly known as the three P’s:
- Polyphagia: increased appetite
- Polydipsia: increased thirst
- Polyuria: frequent urination
Diabetes mellitus is caused by inadequate production or action of insulin, the hormone responsible for the ability of the cells of the body to utilize glucose. In turn, the glucose remains in the blood stream, unusable. The longer the glucose remains in the blood stream, the more damage it causes. It increases the risk of heart diseases, damages the blood vessels and can scar and destroy the kidneys.
There are two types of Diabetes mellitus according to whether it is caused by inadequate production or a faulty receptor to insulin.
Also known as insulin-dependent diabetes mellitus or juvenile-onset Diabetes mellitus, this type is caused by an inadequate or complete absence of insulin in the body. The cells responsible for the production of insulin are destroyed by the body’s antibodies. Antibodies are responsible for fighting off infection in the body but in the case of Type I diabetes, it turns on itself and starts attacking the beta cells of the islets of Langerhans in the Pancreas, the cells that produce insulin.
Type I diabetes is also characterized by ketone bodies in the blood. Ketones are the waste product of a body process known as gluconeogenesis where, since the body cannot use the glucose in the blood, it generates glucose through other biomolecules such as fatty acids and amino acids. In rare occasions, a life-threatening condition known as ketoacidosis accompanies a diagnosis of Type I diabetes due to extremely large amounts of ketone bodies in the blood.
Type I Diabetes accounts for 10 to 20% of all causes of diabetes. Type I diabetes usually presents itself in childhood and continues onto adulthood. It is genetic and can be passed on through children. Treatment is primarily regular insulin injections.
Why is glucose important?
Glucose is the body's primary source of energy. We get glucose from food especially those rich in carbohydrates. Our body converts glucose through into ATP through the process of glycolysis and converts the excess glucose into glycogen which is then stored in the liver.
Type II diabetes is also known as Non-insulin dependent diabetes mellitus and adult-onset diabetes. This is caused by the inability of the body to use insulin to regulate blood glucose levels. Unlike Type I diabetes, Type II diabetes patients usually have normal insulin production but develop insulin resistance wherein the body does not respond to the actions of insulin. Patients with Type II diabetes are generally obese, and it is thought to be a primary cause of this kind of diabetes. Since the body is still able to utilize glucose albeit inefficiently, in this type of diabetes, the body does not undergo gluconeogenesis and therefore does not have as much ketone bodies as the Type I diabetes.
While the production of insulin is normal in Type II, it is insufficient and cannot regulate all the excess glucose in the blood. The excess glucose is a product of a sedentary lifestyle as well as an unhealthy diet and true enough, Type II diabetes is also often treated by lifestyle changes. A combination of a healthy diet, exercise and medication is the treatment to Type II diabetes.
Insulin treatment has little to no effect
Presents itself when the patient is young
More frequent in adults around the age of 40
Patients are usually underweight
Patients are usually obese
There is presence of ketones
Usually have no ketones
Requires a regular injection of insulin
Can be treated with lifestyle changes such as exercise
Can benefit from a good healthy diet
Can benefit from a good healthy diet
Did you know?
There is another kind of Diabetes which is unreleated to blood glucose levels. The disease is called Diabetes Insipidus which is cause by the deficiency of the anti-diuretic hormone and is mainly characterized by an increase in urination.
A third type of diabetes is often considered as well. Pregnant woman previously without diabetes develops some insulin resistance which results in gestational diabetes. Patients with gestational diabetes are closely monitored since while the insulin resistance usually returns to normal after pregnancy, some women develop full-fledged Type II diabetes.
Diabetes mellitus can be diagnosed through measuring the glucose in the blood in a variety of examinations.
- Random Blood Sugar – blood collected without fasting, usually done by a finger-prick, can read results almost immediately.
- Fasting Blood Sugar – patient is instructed to fast for 8 to 10 hours and blood is collected through venipuncture. This is one of the more frequent laboratory tests requested by physicians in patients being monitored for Diabetes mellitus.
- 2 hour Post-prandial Blood sugar – this is a test done to monitor how much of the blood sugar remains in the blood after a meal. In a healthy individual, blood glucose returns to normal 2 hours after a meal while a diabetic may still have elevated blood glucose. Blood is collected from a fasting patient. He is then instructed to eat a full meal and come back exactly 2 hours after eating for another blood collection.
- Urine Glucose – this is a part of routine urinalysis although the examination can be requested specifically. Normally, even in diabetic patients, glucose can only be seen in the urine once the blood glucose level goes higher than the renal threshold which is 180mg/dL.
- Oral Glucose Tolerance Test – this is the definitive test for the diagnosis of diabetes, although this test is routinely done in pregnant women. Fasting blood is first collected from the patient. Afterwards, he is told to drink a glucose load. Every hour for two to three hours after the last drop of the glucose load, blood is extracted and measured for the amount of glucose present.
- HBA1C - Hemoglobin A1C, also known as glycated hemoglobin is used to measure the amount of blood glucose over a long period of time and is used to monitor glucose metabolism in diabetes patients.
Criteria for Diabetes
Random Blood Sugar
Fasting Blood Sugar
Oral Glucose Tolerance Test