All You Need To Know About Diabetes Mellitus Treatment

Medically reviewed by David Agugoesi, MD
July 6, 2021

All You Need To Know About Diabetes Mellitus Treatment

Overview

Diabetes mellitus, commonly known as diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces.

Insulin is a pancreatic hormone that regulates the amount of sugar that circulates in the bloodstream and moves sugar from the blood into your cells to be stored or used for energy.

With diabetes, your body either does not make enough insulin or cannot effectively utilize the insulin it makes. This leads to an increase in blood sugar also known as Hyperglycemia. The human body breaks down food into a sugar called glucose which is then released into your bloodstream.

When there is an increase in sugar level, your brain sends a signal to your pancreas to release insulin which controls how much sugar is let in and utilized by your body. However, in diabetes this process becomes ineffective. High blood sugar if untreated could lead to other serious health issues that may affect your nerves, eyes, kidneys, and other organs. Diabetes can be Insipidus or Mellitus, but we will be concentrating on diabetes Mellitus.

Types of Diabetes Mellitus

There are different types of diabetes Mellitus and some scientists believe that there are sub-categories of these types of diabetes.

Type 1 Diabetes

It is an autoimmune disease where the immune system attacks and destroys β-cells of the pancreas, where insulin is made. Scientifically, it is unclear what causes this attack.

Type 2 Diabetes

This occurs when your body becomes resistant to the available insulin, and sugar builds up in your blood.

Gestational diabetes

This type of diabetes is often diagnosed in the second or third trimester of pregnancy. Insulin-blocking hormones produced by the placenta causes this type of diabetes.

Prediabetes

This is not necessarily a type of diabetes and occurs when your blood sugar is higher than normal, but it is not high enough for a diagnosis of type 2 diabetes. Prediabetes does not typically cause symptoms, but without intervention, it can progress to type 2 diabetes.

 

Type 1 Diabetes

Type 1 diabetes also known as Insulin-dependent diabetes or early-onset diabetes [2], is a chronic condition where insufficient or no insulin is produced. This is because of an abnormality where the immune system attacks and destroys insulin-producing cells known as β-cells in the pancreas[3]. Neither the cause of Type 1 diabetes nor the means to prevent it are known.

This condition accounts for only 5–10% of those living with diabetes. Those diagnosed with Type 1 diabetes do not produce insulin and require daily administration of insulin to maintain their blood sugar control and utilize carbohydrates for energy.

The auto-immune disease is not caused by diet and lifestyle habits and it can take months or years for the beta cells to be destroyed before patients begin to exhibit symptoms.

Symptoms include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes, and fatigue. These symptoms may occur suddenly.

 

Type 2 Diabetes

Type 2 Diabetes is a chronic condition where the body is unable to produce enough insulin, or the body is ineffective in utilizing insulin to control the blood glucose (sugar) level. Most people with diabetes have Type 2 Diabetes and, it accounts for approximately 90% to 95% of those living with diabetes.

This type of diabetes is largely the result of excess body weight and physical inactivity [4], making it the most common type. The disease can also be called adult-onset or insulin-resistant diabetes. According to the Journal of Epidemiology and Global health, the global prevalence of Type 2 Diabetes is projected to increase to 7,079 individuals per 100,000 by 2030, reflecting a continued rise across all regions of the world.

In Nigeria, although there are no specific figures to show the exact prevalence of Type 2 Diabetes, research done in 2017 revealed that there is an increasing burden of Type 2 Diabetes in the country with many undiagnosed cases and few known cases being treated.

Risk factors that can lead to diabetes include age, body weight, family history, race, poor lifestyle, and underlying health conditions. Lifestyle modifications can improve blood glucose levels by decreasing insulin resistance.

 

Gestational Diabetes

Gestational diabetes occurs during pregnancy. It presents as elevated blood glucose values above normal but below those diagnosed of diabetes. It occurs because of insulin-resistant hormones produced by the placenta during pregnancy.

Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery. These women and possibly their children are also at increased risk of Type 2 Diabetes in the future.

Changes in diet and exercise help in treating gestational diabetes. Gestational diabetes is diagnosed through prenatal screening, rather than through reported symptoms.

Other types of diabetes Miletus include impaired glucose tolerance and impaired fasting glycaemia. Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) are intermediates between normal blood sugar levels and diabetes. People with IGT or IFG are at a high risk of progressing to Type 2 Diabetes, although this is not inevitable.

 

General Symptoms of Diabetes Mellitus

Diabetes of all types can lead to complications in many parts of the body and can increase the overall risk of premature death. Possible complications include nerve damage, kidney failure, vision loss and leg amputation. Adults with diabetes also have two- to three-times increased risk of heart attacks and strokes. In pregnancy, poorly controlled diabetes increases the risk of fetal death and other related complications. 

The overall symptoms can be summarized as follows:

  • Polyuria, or frequent urination
  • Fatigue
  • Dry skin
  • Unending thirst and constant hunger
  • Poor vision
  • Amnesia
  • Weight loss
  • Infections and sores that heal slowly
  • Nausea, vomiting, stomachache etc.

Other Complications of Diabetes Mellitus include:

  • Nephropathy, or damage to the kidney
  • Hypertension - high blood pressure
  • Heart attack
  • Retinopathy, or damage to the retina of the eye that can lead to vision loss
  • Peripheral arterial disease - a disease that affects the blood vessels in the lower and upper extremities
  • Heart disease
  • Depression
  • Stroke


Prevention of Diabetes Mellitus

Healthy lifestyle measures have been shown to be effective in preventing or delaying the onset of type 2 diabetes. To help prevent type 2 diabetes and its complications, people should:

  • achieve and maintain a healthy body weight.
  • be physically active – doing at least 30 minutes of regular, moderate-intensity activity on most days. For weight control, more
  • activity is required.
  • eat a healthy diet, avoiding sugar and saturated fats; and
  • avoid tobacco use – smoking increases the risk of diabetes and cardiovascular disease.

 

Diagnosis of Diabetes Mellitus

Diabetes mellitus types can be detected early through relatively inexpensive testing of blood sugar. Type I and Type 2 diabetes tests include:

  • Fasting plasma glucose (FPG) test
  • A1C test and Random plasma glucose (RPG) test.

Gestational Diabetes tests include:

  • Glucose Challenge Test
  • Oral Glucose Tolerance Test (OGTT)

It is important to know that diabetes is not age-specific or gender-based. Anyone can come down with it, and while there may be no permanent cure, there are ways to treat and manage diabetes to prevent further complications.

 

Treatment of Diabetes Mellitus

Treatment of diabetes is individualized and involves diet and physical activity along with lowering blood glucose and the levels of other known risk factors that damage blood vessels. The person's medical history, blood sugar control, diet preferences, and goals, will be put into consideration when formulating a treatment plan.

People with Type 1 Diabetes require insulin injections daily, while people with Type 2 Diabetes can be treated with oral medication but may also require insulin. This is followed by blood pressure control and checks.

Other intervention treatments and costs saving includes options include [5]:

  • foot care (maintaining foot hygiene; wearing appropriate footwear; seeking professional care for foot ulcer management, and
  • regular examination of feet by health professionals)
  • screening for early signs of diabetes-related kidney disease and treatment
  • regulation of cholesterol levels
  • screening and treatment for retinopathy

When all fails, bariatric surgery for certain people with Type 1 or Type 2 Diabetes, and an artificial pancreas and pancreatic islet transplantation for some people with type 1 diabetes is carried out.

 

Management of Diabetes Mellitus

Management of diabetes can be challenging especially when accurate information is not provided before treatment begins.
Adherence to your routine medications, exercise, carbohydrate counting, blood sugar testing is necessary for the management of diabetes. Meeting up with appointments with your specialist is very critical.


Maintain a healthy lifestyle by:

  • Eating healthy foods
  • Exercising regularly
  • Avoiding smoking
  • Limiting your alcohol intake.

And if you notice any slight change in your body that resemble symptoms of diabetes, visit a doctor.

 

Response from HealthCabal

Diabetes is not a death sentence, and if managed properly, a patient can live a healthy life. If you suspect that you have diabetes and experiencing the symptoms, an early appointment with your doctor is necessary and can save your life.

Make changes to your lifestyle by limiting alcohol intake, exercise, quit smoking and eat healthy foods.

If your family have a history of Type 2 Diabetes or heart disease, it is important to make changes to your lifestyle and prevent the occurrence of diabetes.

Seek the help of a specialist and adhere to the treatment plan if you have diabetes.

HealthCabal will continue to provide updated information to help patients seeking information or undergoing treatment make an informed decision through their specialist.

 

References

Diabetes Care Journal - Diabetes Care[2][4]

Pancraepedia - Anatomy and Histology of the Pancreas - [3]

WHO - Diabetes Fact Sheet [5]

Further Reading

WebMD - Prediabetes: Definition, Symptoms, Diagnosis, and Treatment

 

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