Diabetes Mellitus

Diabetes mellitus stands as a chronic medical condition characterised by heightened levels of blood glucose (hyperglycaemia) stemming from deficiencies in insulin secretion, insulin action, or a confluence of both factors. Insulin, a hormone manufactured by the pancreas, assumes a pivotal role in regulating blood sugar levels. Diabetes may precipitate various complications that impact diverse organ systems. Effective management involves lifestyle modifications, pharmaceutical interventions, and, in certain instances, insulin therapy.

Classification

Type 1 Diabetes:

• Autoimmune Pathogenesis: The immune system orchestrates an assault on and subsequent destruction of insulin-producing beta cells within the pancreas.
• Insulin Dependency: Those afflicted with type 1 diabetes necessitate insulin for subsistence.
• Onset: Typically diagnosed during childhood or adolescence.

Type 2 Diabetes:

• Insulin Resistance: Cells acquire resistance to insulin, while the pancreas may falter in producing an adequate insulin supply.
• Lifestyle Correlates: Obesity, sedentary habits, and genetic predisposition contribute to type 2 diabetes.
• Onset in Adulthood: Frequently diagnosed in adults, though an escalating incidence is observable in the youthful demographic.

Gestational Diabetes:

• Pregnancy-Related Morbidity: Manifests during pregnancy and heightens the risk of later-life type 2 diabetes.
• Glucose Intolerance: Elevation in blood glucose levels during gestation.

Symptoms

• Polyuria: Augmented frequency of urination.
• Polydipsia: Inordinate thirst.
• Polyphagia: Excessive hunger.
• Unexplained Weight Loss: Persists despite an increased appetite.

Diagnosis

• Fasting Blood Glucose Test: Measures blood glucose levels following an overnight fasting period.
• Oral Glucose Tolerance Test (OGTT): Assesses the body's capacity to manage a glucose load.
• Haemoglobin A1c Test: Reflects mean blood glucose levels over the preceding 2-3 months.

Complications

Short-Term Complications:

• Hypoglycaemia: Reduced blood sugar levels, precipitating symptoms like dizziness and cognitive confusion.
• Hyperglycaemia: Elevated blood sugar levels, potentially instigating diabetic ketoacidosis (DKA).

Long-Term Complications:

• Cardiovascular Morbidity: Escalates susceptibility to cardiovascular maladies and cerebrovascular incidents.
• Nephropathy: Induces kidney impairment.
• Retinopathy: Provokes ocular impairment, possibly culminating in blindness.
• Neuropathy: Incites nerve damage, signifying symptoms of paraesthesia.
• Foot Complications: Impaired circulation and neural damage amplify the vulnerability to infections and amputation risks.

Management

• Lifestyle Interventions: Adoption of a wholesome diet, regular physical activity, and weight vigilance.
• Pharmacological Modalities: Administration of oral hypoglycaemic agents or insulin therapy as deemed clinically appropriate.