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Diabetes Mellitus

What is diabetes mellitus

Diabetes is a metabolic disease or an autoimmune disease depending on the type. They cause high blood sugar because insulin, a hormone that help moves sugar to cell, are not enough or not effectively used in our body.

Leaving diabetes untreated and constantly elevated in your blood can cause severe damage to your nerves, eyes, kidneys, and other vital organs. Diabetes is usually accompanied by other diseases such as hypertension, hyperlipidemia, and kidney failure (depends on severity).

There are different types of diabetes:

  1. Type 1 diabetes is an autoimmune disease where your body’s immune system attacks and kills pancreas and is unable to produce insulin. The cause of this remains unclear however, it is believe it could be hereditary.
  2. Type 2 diabetes is when your body becomes resistant to insulin and causes sugar to build up in your blood- Not enough insulin is produce or they are unable to move sugar into cells effectively.
  3. Prediabetes is when you have elevated blood sugar than normal but not high enough to be diagnosed as type 2 diabetes. This is the best stage to control and prevent it from progressing.
  4. Gestational diabetes is when you have elevated blood sugar during pregnancy and you may not have diabetes prior to pregnancy. This is because placenta can produce insulin-blocking hormones. Usually will return to normal after birth but they are at higher risk of developing type 2 diabetes.

What are the symptoms of diabetes

Symptoms of diabetes usually appear when you have elevated high blood sugar or too low of blood sugar. 

When blood sugar are high:

  • Increased in thirst
  • Dry mouth (xerostomia)
  • Frequent urination
  • Nausea and vomiting
  • Fatigue
  • Rapid heartbeat
  • Fruity breath odor (ketones build up in blood, extremely dangerous)

When blood sugar are low:

  • Shakiness or nervousness
  • Anxiety
  • Fatigue or feeling weak
  • Sweating
  • Hunger
  • Difficult to speak
  • Confusion
  • Sleepy or fainting

How to manage diabetes

Diabetes management may vary according to type of diabetes.

For Type 1 diabetes, the main treatment is insulin injection. There a variety of insulin injection types as well:

  • Rapid-acting insulin (works within 15 minutes and last 3-4 hours)
  • Short-acting insulin (works within 30 minutes and last 6-8 hours)
  • Intermediate-acting insulin (works within 1-2 hours and last 12-18 hours)
  • Long-acting insulin (works after few hours and last 24 hours)

Insulin injection usually combines various types depending on your lifestyle and doctors usually would prescribe according to your activity accompanied with food intake adjustments.

For Type 2 diabetes, dietary changes and exercise are often used as management aside from medications:

  • Monitoring carbohydrate intake as well as sugar intake to avoid getting hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar), increase fibre intake
  • Exercises that are not extreme to avoid hypoglycemia, or at least prepared with glucose supplements to replenish
  • Alpha-glucosidase inhibitors (breakdown carbohydrates and slow down absorption of sugar into blood)
  • Sulfonylureas (stimulate pancreas and b-cells to produce more insulin)
  • Biguanides (increase insulin sensitivity and reduce production of sugar from liver)
  • Dipeptidyl peptidase-4 (DPP-4) inhibitors (stimulate production of insulin)
  • Meglitinides (stimulate production of insulin, not for everyone as it causes hypoglycemia)
  • Sodium-glucose transporter (SGLT) 2 inhibitors (inhibit kidney upholding sugar, excreted in urine instead)

For Gestational diabetes, mothers are advised to consume a well-balanced meal and limit sugar and salt intake. It is highly encouraged to have dietary changes and implement physical activity instead of medications. Considering a dietitian or nutritionist in management for more effective control in gestational diabetes.

These management methods require a thorough diagnosis from a doctor to determine which is best for you according to your co-morbidities, age, family history, and lifestyle.

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