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Diabetes

Diabetes is a disease of disordered metabolism, usually due to a combination of hereditary and environmental causes, resulting in unusually high blood sugar levels, also known as hyperglycemia.

Blood glucose levels are regulated by the hormone insulin made by the beta cells of the pancreas. The two most common forms of diabetes are due to either a reduced production of insulin (type 1), or weak response by the body to insulin (type 2 and gestational).

Both types of diabetes lead to hyperglycemia, which mainly causes the acute signs of diabetes: excessive urine production, which consequently results in increased thirst and fluid intake, blurred vision, unexplained weight loss, lethargy, and changes in energy metabolism.

Type 1 Diabetes

Type 1 diabetes can only be treated with injected insulin. Most doctors will also strongly recommend dietary and other lifestyle adjustments as part of the treatment.

Type 2 Diabetes

Type 2 is usually controlled with a combination of dietary treatment, tablets, and frequently, insulin supplementation. Insulin can also be delivered continuously by a specialized pump which provides insulin under the skin through a temporary catheter.

If it is not controlled, diabetes and its treatments can cause many severe side effects such as, hypoglycemia, ketoacidosis, or nonketotic hyperosmolar coma.

Serious long-term complications include:

• Doubled risk of cardiovascular disease
• Chronic renal failure
• Retinal damage (which can lead to blindness)
• Nerve damage (of several kinds)
• Microvascular damage, which may cause impotence and poor wound healing

Poor healing of wounds, particularly of the feet, can lead to gangrene, and possibly to amputation.

Adequate treatment of diabetes, as well as an increased emphasis on blood pressure control and lifestyle factors (such as not smoking and maintaining a healthy body weight), may improve the risk profile of most of the chronic complications.

Diabetes is the most significant cause of adult blindness in the non-elderly and the leading cause of non-traumatic amputation in adults, and diabetic nephropathy is the main illness requiring renal dialysis in the United States.

Specialist

Endocrinologist

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