Diabetes mellitus is a metabolic syndrome characterized by chronic hyperglycemia and disturbances of carbohydrates, fat and protein metabolism associated with absolute or relative deficiency in insulin secretion/action.
The typical signs of diabetes, such as polyuria (excessive urination), polydipsia (excessive thirst), and polyphagia (excessive hunger), are frequently present in both type 2 and type 1 diabetes, which both have extremely high levels of hyperglycemia. Type1 diabetes or long-term type 2 diabetes non-detection are associated with severe weight loss.2
After China, India is the country with the second-highest prevalence of diabetes, estimated to impact 77 million people (1 in 11 Indians). In addition, 700,000 Indians passed away in 2020 from diabetes-related complications such hyperglycemia, kidney disease, or other conditions. 3
The causative factors of diabetes mellitus are obesity, physical inactivity, insulin resistance, Genes and family history, genetic mutations, hormonal disorders, few medicines [drug induced hyperglycemia]4
Types of Diabetes
1. Type 1 diabetes
A. Auto immune
B. Idiopathic
2. Type 2 Diabetes
3. Other specific types of diabetes
A. Defects in 𝛃-cell function: Secondary Type of Diabetes
MODY [Maturity Onset Diabetes of The Young]
It is an uncommon form of diabetes that results from mutations in just one gene.
MODY 1: Due to single gene mutation in the chromosome 20, Hepatocyte Nuclear factor [HNF]- 4α
MODY 2: Due to single gene mutation in the chromosome 7 on glucokinase gene
MODY 3: Due to single gene mutation in the chromosome 12, HNF-1
MODY 4: Due to single gene mutation in the Chromosome 13, insulin promoter factor-1
MODY 6: Due to single gene mutation in the Chromosome 2
MODY 7: Due to single gene mutation in the Chromosome 9
B. Neonatal Diabetes
C. Exocrine pancreatic disease: chronic pancreatitis, postpancreatectomy
D. Endocrinopathies: Cushing's syndrome, acromegaly, thyrotoxicosis, aldosteronoma
E. Genetic syndromes: LMB, Turner syndrome
F. Drug induced diabetes mellitus.
4. Gestational diabetes mellitus [GDM]
Other some non-common specific diabetes includes:
Wolfram Syndrome. 5a
Alstrom syndrome. 5b
Cystic fibrosis syndrome. 5c
Drug induced diabetes. 5d
Symptoms of diabetes include:
- increased thirst and urination
- increased hunger
- fatigue
- blurred vision.
- numbness or tingling in the feet or hands.
- sores that do not heal
- unexplained weight loss [2]
RISK FACTORS AND COMPLICATIONS
The risk factors of diabetes mellitus include:
- An history prediabetes [have ever had gestational diabetes]
- Physical inactivity [more than 3 weeks]
- Age 35 or greater
- Obesity
- A family history of diabetes
- Sedentary lifestyle [5]
Complications of diabetes mellitus includes:
- Microvascular complications [neuropathy, nephropathy, and retinopathy]
- Macrovascular complications [cardiovascular disease, stroke, and peripheral artery disease (PAD)]
- Miscellaneous complications [6]
See a Diabetologist if aforementioned symptoms persist, the diagnosed individuals of diabetes should attend regular health checkup [frequent intervals such as 3 months once] HbA1C test, Blood test consisting of RBS, FBS, Oral Glucose Tolerance Tests are performed for screening and confirming diabetes.
TREATMENT
The therapeutic repertoire for diabetes includes an array of medications designed to mitigate symptoms and regulate blood glucose levels:
1. Regular Insulin:
Categorized by duration of action.
2. Glucagon-like Peptides 1 (GLP-1) Agonists:
Enhancing insulin secretion and reducing hepatic glucose production
3. Sulfonylureas:
Stimulating pancreatic insulin secretion
4. Meglitinides:
Exerting hypoglycemic action akin to sulfonylureas
5. Biguanides:
Enhancing insulin sensitivity in hepatic and peripheral tissues
6. Thiazolidinediones:
Indirectly enhancing insulin sensitivity in muscle, liver, and fat tissues
7. Alpha-Glucosidase Inhibitors:
Preventing breakdown of complex carbohydrates
8. Dipeptidyl Peptidase 4 Inhibitors (DPP-4 Inhibitors):
Reducing elevated postprandial glucose
