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Diabetes Mellitus

Overview of Diabetes Mellitus type 2 and Diabetes Mellitus type 1

houston diabetes endocrine jogi endocrinologist
In order to understand diabetes mellitus, the normal processing of glucose needs to be be understood. This section will give an overview. Diabetes mellitus type 1 and type 2 are the two most common forms of diabetes. All forms of diabetes mellitus result in elevated blood sugar concentrations.  Let the endocrinologists at Houston Thyroid and Endocrine help you control your blood sugars. Diabetes is a disease characterized by the build-up of sugar in the blood. In people without diabetes, sugar (or glucose) is able to move out of the blood and into the cells of the body where it can then be used for energy. This is made possible by a hormone called insulin which acts as a key allowing glucose into the cells. We can think of diabetes as a condition in which these keys are either missing or not fitting into their locks properly.

Scope of the problem
The incidence of diabetes mellitus has dramatically increased worldwide since the 1970s.  According to the Centers for Disease Control and Prevetion in 2008 there were approximately 20 million patients with type 2 diabetes mellitus in the United States and an additional 4-5 million individuals with with undiagnosed diabetes mellitus. There is also a concurrent epidemic of obesity which seems to be driving the surge in type 2 diabetes mellitus. Every day there are 4000 new cases of diabetes diagnosed daily, 800 daily deaths from type 2 diabetes, 200 daily amputations, and 50 daily cases of blindness due to diabetes. (1)

Complications

complications of diabetes mellitus

It is important for patients to recognize that long-term hyperglycemia can cause significant damage to blood vessels, leading to complications such as nerve damage, blindness and kidney failure, as well as increased risk of a heart attack or stroke. The many symptoms of diabetes mellitus are categorized as short-term and long-term side-effects to the body from having uncontrolled blood sugars. The long-term side-effects are called microvascular (small blood vessel) and macrovascular (large blood vessel) complications. 

The microvascular diseases that are directly related to the degree and duration of blood sugar elevation include retinopathy (leads to blindness), nephropathy (leads to kidney failure), and neuropathy (leads to amputations, gastroparesis). 

Patients with diabetes mellitus also have a much increased risk of macrovascular diseases such as of blockages of coronary arteries, heart attacks, peripheral vascular disease, and stroke. 

Causes of Diabetes 

There are a number of causes of diabetes mellitus, There are two basic reasons for why blood sugars rise in type 2 diabetes: Insulin resistance and then with eventual insulin deficiency over time. Most patients with type  2 diabetes have already lost over half of the cells that make insulin (pancreatic beta cells) by the time their diabetes is diagnosed. "Pre-Diabetes" is a term applied to patients with mild elevation in their blood sugars who are at very high risk of developing diabetes type 2. 

Type 1 diabetic patients and those with primary pancreatic disease, the problem is mainly a lack of insulin production which occurs suddenly in childhood usually. 

Treatments for diabetes 

Fortunately, the complications of diabetes can be avoided by treatment with insulin, other injectable medications, or oral medications. Mindful meal-planning and regular exercise can also go a long way in successfully managing diabetes and avoiding these complications. With diabetes education it is the goal of our clinic to empower each and every one of our diabetes patients with the knowledge and skill-set to successfully manage their own blood sugar levels with the support of one of our board-certified endocrinologists. If lifestyle and diet changes do not improve blood sugars then anti-hyperglycemic medications are necessary to prevent the microvascular and macrovascular complications of diabetes mellitus.  The goal of treatment is to reduce the likelihood of diabetes-related-complications. There are many tools to manage blood sugars including continuous glucose monitoring systems.



References
2. National institute of diabetes and digestive and kidney diseases. 2008


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Updated 10-2014 Dr. Jogi and Katie Spence