What Is Diabetes?

Diabetes Mellitus is primarily a disease of metabolism. It is caused by the inefficient production of insulin by the beta cells in the pancreas, leading to increased levels of glucose (hyperglycemia) in the blood. This causes increased urinary output (polyuria) and increased thirst (polydipsia). The increase in thirst is due to the dehydration caused by the polyuria.

Two forms of Diabetes:

Diabetes Mellitus (DM): A disorder characterized by excessive urination and extreme thirst.

Type 1: Usually affects the younger generation and is diagnosed before the age of 40.Type 2: Onset mostly begins at middle age and is associated with insulin resistance, as opposed to a lack of insulin in the body. Insulin resistance occurs when the body is not effectively using the insulin being produced.

Diabetes Insipidus: The pituitary gland secretes a hormone that regulates the kidneys called Vasopressin. In decreased levels, Vasopressin causes increased urination of pale, dilute urine. With the increased loss of fluids comes dehydration, followed by excessive thirst. Diabetes Insipidus is the more rare of the two forms.

Signs and Symptoms:

Excessive urination (polyuria) Insatiable thirst (polydipsia)Increased hunger High blood glucose levelFatigueVision impairmentWeight loss Wounds do not heal

Insulin serves to change glucose into energy to be used by the cells and muscles of the body. When insulin is inadequate, the glucose can't be processed into energy and the cells have no fuel. The body then begins to feed on itself looking for the needed fuel to function properly. This leads to a breakdown of fat and muscle, resulting in proteins (ketones) to appear in the urine. Keytones are toxic to the body and cause the blood to become acidic.

Signs of Ketonuria Toxicity:

Dehydration, Nausea/vomitingHeavy breathing Enlarged pupilsConfusionHigh blood sugar levels (DM)

Risk factors for diabetes include:

OverweightSedentary lifestyleHypertensionCardiovascular diseaseHigh serum cholesterol and triglyceride levels

Diabetes is most prevalent in the middle-aged populations, but young people have it as well, including children. Persons with diabetes have an increased risk for cardiovascular disease that is 2 to 4 times higher than for people who do not have diabetes. There are many people who have diabetes but are undiagnosed.

How Is It Diagnosed?

Persons showing signs and symptoms of diabetes mellitus will need diagnostic testing to determine the reason for their symptoms. These tests include:

Fasting Plasma Glucose: Blood is tested after 8 hours of fasting. Oral Glucose Tolerance Test: Testing the blood after 8 hours, then 2 hours after drinking a glucose liquid.Random Plasma Glucose Test: Testing without regard to the time of the last meal.

Treatment:

Treatment for DM involves an adjustment in lifestyle that include diet, exercise, oral or injectable insulin medications. Diabetes can often be controlled with just dietary changes. Blood glucose levels must be monitored daily before meals and at bedtime. If you have insulin dependent diabetes mellitus (IDDM), the results of your daily blood glucose testing determines the amount of insulin to inject.

Insulin comes in several types and each has it's own time of onset, peak, and duration. It can be given orally or by injection into the subcutaneous tissues of the abdomen, arms, and thighs. Injection sites are your doctor will decide which type is best suited for your condition.

Insulin Pump: Insulin pumps deliver a continuous administration of insulin subcutaneously and is used sometimes instead of multiple injections. Although the pump allows for greater freedom for the diabetic, it is more costly than using insulin syringes or pens.

Diet: The diabetic diet takes into consideration the amount of carbohydrates are eaten. Carbohydrates increase blood sugar levels, therefore, daily calories must be counted. Consult with a dietician to develop a meal plan that is beneficial to your health and condition.

Skin Care: Caring for the skin is another very important aspect of diabetic care. Make sure to keep skin clean and dry and use a simple skin lotion. Dry skin thoroughly after showering, especially in skin folds and between the toes. You can use a cornstarch powder under the arms, skin folds, and between toes. This helps to keep skin dry and prevent bacterial and fungal skin infections.

If you or someone you know has diabetes, making changes in your life will reduce your risks and possibly avoid complications. With maintaining blood glucose at appropriate levels, changing your diet, getting proper exercise and rest ensures a great quality of life in spite of the condition.

by Barb Hicks RN/LMT