Diabetes Mellitus - Symptoms, Types and Diagnosis

Learn how to identify symptoms and what values indicate diabetes. This disease occurs when there is an accumulation of glucose in the blood due to the inability of cells to consume it for energy production.

Diabetes test
Diabetes test
 


Diabetes can occur mainly in 2 ways:

Type 1 diabetes
Type 1 diabetes
 
Type 1 diabetes - occurs when there is the destruction of pancreatic cells which are responsible for production of insulin. This destruction is generally an autoimmune process (i.e., the antibodies act against the body). The result is lack of insulin and high blood glucose, referred to as hyperglycemia. Type 1 diabetes usually occurs in young people and should be treated with insulin replacement. It corresponds to only 10% of cases of diseases.

Type 2 diabetes - occurs when there is a decrease in insulin production, but mainly because of a malfunction. There is insulin but the cells have problems in using it to capture glucose. Type 2 diabetes occurs in adults, usually obese and with a family history. Treatment is carried out with drugs that increase the affinity of the cells by insulin. It corresponds to more than 80% of cases of diseases.

Over time the patient with diabetes also presents two of its damage pancreatic beta cells, and needs insulin. So do not think that you have diabetes 2 only by the necessity of insulin replacement.

There are actually other types of diabetes such as gestational diabetes and diabetes by chronic pancreatitis, but that will be discussed separately.


Diagnosis of diabetes


Type 2 diabetes
The diagnosis of diabetes is normally performed after the second measurement (on different days) of blood glucose (glucose) after 8-12 hours fasting. Values greater than or equal to 126 mg/ml confirmed by two tests indicate diabetes.

The normal value is less than 100 mg / dl. People with blood glucose between 100 and 125 show signs of insulin resistance. This phase is called pre-diabetes. It's time to keep to a diet, lose weight and start exercising to prevent disease progression.

The blood test should preferably be done on fasting, but if the patient shows symptoms of diabetes mellitus, a value above 200mg/dl of glucose, even when performed without fasting, is also indicative of diabetes.

The test for the correct diagnosis is the analysis of blood. The ribbons for evaluation of CBG are used to control diabetics already on treatment and are not intended to establish the diagnosis. Obviously, high values in the ribbons suggest the diagnosis, but should always be confirmed with blood tests.


Risk factors for diabetes

  • Age above 45 years
  • Overweight or obesity (BMI greater than 25 kg/m2)
  • Family history of diabetes
  • Sedentary way of life
  • Hypertension
  • Previous history of gestational diabetes
  • Glucose greater than 100 mg/dl (pre-diabetes)
  • Polycystic ovary
  • Cholesterol
  • Prolonged use of medications such as corticosteroids, tacrolimus, cyclosporine and niacin.
  • Smoking
  • Diet rich in saturated fats and carbohydrates and low in vegetables and fruits


Symptoms of diabetes

Symptoms of diabetes
Symptoms of diabetes
 
Diabetes mellitus in the early stages may be asymptomatic. Its symptoms are usually related to excess blood sugar:

Thirst: Hyperglycemia increases the osmolarity of the blood and triggers the thirst mechanism. The diabetic, especially when blood glucose is too high, drinks plenty of water and is very thirsty.

Excess urine: Normally the kidney does not eliminate glucose in the urine, but in situations of hyperglycemia, it makes it a regulator of the organism, which is excreted in excess. As sugar can not be urinated, glucose needs to be diluted with water, thus, the volume of urine increases. The excess water lost in urine causes dehydration and further contributes to the seat.

Hunger: As the cells fail to capture glucose, the body interprets this as a state of lack of food and causes hunger. As the diabetic drinks a lot of water but it does not kill thirst, the same happens with hunger, eating much does not solve the problem.

Thinning: Diabetes is one of the causes of weight loss without loss of appetite.

Blurred vision: High glucose levels also cause changes in visual acuity, which sometimes can be mistaken by patients with myopia.


Diabetic ketoacidosis

Diabetic ketoacidosis is a complication of type 1 diabetes, due to the absence of insulin. Because the cells do not receive glucose, they must find another source to generate power not to die. The solution is to burn fat. The problem is that besides it does not generate as much energy as glucose, the metabolism of fats generates a tremendous amount of acids (called ketoacids) leading to ketoacidosis. The pH of the blood drops too and can reach levels incompatible with life if not treated quickly. Glucose level is higher than 500 mg/dl.


Hyperosmolar state

The hyperosmolar state is a complication of diabetes analogous to ketoacidosis. Since the problem is not the absence of insulin, there is no production of ketoacids, however, the glucose can exceed 1000 mg / dl. Much glucose leaves the blood thick and with a very high osmolarity can lead to hyperosmolar coma.

Both diabetic ketoacidosis and hyperosmolar state have similar clinical picture. The patient has severe dehydration, altered level of consciousness, rapid breathing and abdominal pain (the latter two are more common in diabetic ketoacidosis).

Both are considered medical emergencies.

They are often triggered by poor adherence to treatment, with uncontrolled blood glucose, but also by infections, drugs, heart attacks, strokes and other stress factors.


Complications of diabetes

Complications of diabetes
Complications of diabetes
 
Excess blood glucose and metabolic changes lead to a state of chronic inflammation, which provides the appearance of all the long-term complications of diabetes:
  • Myocardial infarction
  • CVA / Stroke
  • Renal failure
  • Blindness
  • Arterial insufficiency and limb amputations
  • Involvement of peripheral nerves
  • Ulcers of the skin
  • Carpal tunnel syndrome

The diabetic foot is a common complication of diabetes being harshly treated. The decrease in blood supply and nerve damage (diabetic neuropathy) of the lower limbs, decrease the sensitivity of the feet and legs causing injuries in this region without pain. Pain is one of our major defense mechanisms and indicates that something wrong is happening. Patients with diabetic neuropathy do not notice when something is hurting their feet, so do not take appropriate steps to protect the skin.

It is common to the formation of ulcers and in advanced cases may need limb amputation due to necrosis.

Diabetes is also the main cause of renal failure. You can not only lead the patient to dialysis as well as causing nephrotic syndrome by excessive loss of protein in the urine. The control of proteinuria is a major means of preventing progression of renal disease.

A sad but common image, the patient is blind, with one leg amputated, connected to a hemodialysis machine and, after some years, dies of massive heart attack. Typical epilogue if diabetes is treated badly.

General keywords

User discussion

Philip
22 April 2012
You described the symptoms diabetes, but you did not write the way to treat it. Is it possible to maintain a low blood sugar when diet and exercise do not help? My father had diabetes and you say that family history of diabetes is a risk factor.
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Fedelis
22 June 2012
You have enough stmoypms to justify a visit to a doctor. While we here on answers have all the answers the only one to tell you is a doctor. Low blood sugar in me causes much irritation, very tired and split vision(eyes are not in sinc). High blood sugar(same as untreated diabetic) blurry vision, very tired, sluggish, excessive hunger and extreme thirst(and going to the john too ofter) Hypoglycemia can lead to diabetes. Was this answer helpful?
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