Diabetes Mellitus : Symptoms, Types, Cause, Treatment, And Medications

The word Diabetes comes from Ancient Greek "diabetes" that means a passer through and the word Mellitus comes from Latin "mellitus" that means honey or sweetness.Diabetes Mellitus is a designation for the disease in which the urine of a diabetic has a sweet taste.People with diabetes mellitus have high blood sugar levels over a prolonged period.

The Symptoms of Diabetes Mellitus

• Excessive thirst
• Increased urination
• Unexplained weight loss
• Extreme hunger
• Very dry skin
• Fatigue
• Irritability
• Tingling or numbness in the hands or feet
• More infections than usual
• Slow healing for sores or wounds
• Blurry vision

The Types of Diabetes Mellitus

• Type 1 Diabetes Mellitus results from the pancreas's failure to produce enough insulin.

• Type 2 Diabetes Mellitus begins with insulin resistance, a condition in which cells fail to respond to insulin properly.

• Gestational Diabetes is the third main form and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels.

• Prediabetes indicates a condition that occurs what a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes mellitus.

The Causes of Diabetes Mellitus

• Family history
• Genetic background
• Obesity
• High blood pressure
• High blood triglyceride levels
• Aging
• Dietary factor
• High alcohol intake
• Sedentary lifestyle

A Comprehensive list of other causes of diabetes :

1. Genetic defects of beta-cell functions.

• Maturity onset diabetes of the young
• Mitochondrial DNA mutation

2. Genetic defects in insulin processing or insulin action.

• Defects in proinsulin conversation
• Insulin gene mutations
• Insulin receptor mutations

3. Exocrine pancreatic defects

• Chronic pancreatitis
• Pancreatectomy
• Pancreatic neoplasia
• Cystic fibrosis
• Hemochromatosis
• Fibrocalculous pancreatopathy
• Endocrinopathies

4. Growth hormone excess (acromegaly)

• Cushing syndrome
• Hyperthyroidism
• Pheochromocytoma
• Glucagonoma

5. Infections

• Cytomegalovirus infection
• Coxsackievirus B

6. Drugs

• Glucocorticoids
• Thyroid hormone
• Beta-adrenergic agonists
• Statins

Diagnosis

Diabetes mellitus is diagnosed by any one of the following :

• Plasma glucose : >11.1 mmol/I (200 mg/dl) two hours after a 75 g oral glucose load as in a glucose tolerance test.
• Fasting plasma glucose level : >7.0 mmol/I (126 mg/dl).
• Symptoms of high blood sugar and casual plasma glucose : > 11.1 mmol /I (200 mg/dl).
• Glycated hemoglobin : > 48 mmol/mol (>6.5 DCCT%).

The Treatments of Diabetes mellitus

• People with type 1 diabetes involve insulin injection daily that is a combination short-acting insulin with long-acting insulin.Insulin is usually given in two or three injections per day.
• People with type 2 diabetes take a combination of oral medication and insulin injections to control blood sugar levels.
• People who are obese should lose their weight and begin an exercise program.

Medications of Diabetes Mellitus

There are many types of medications to lower blood sugar levels in people with type 2 diabetes :

• Biguanides decrease the amount of glucose produced by the liver.
• Sulfonylureas stimutate the pancreas to make more insulin
• Meglitinides stimulate the pancreas to make more insulin.
• Thiazolidinediones increase sensitivity to insulin.
• Alpha-glucosidase inhibitors slow absorption of the starches a person eats.This slows down glucose production.
• D-Phenylalanine Derivatives stimulate the pancreas to produce more insulin more quickly.
• Amylin Synthetic Derivatives.Amelyn is a naturally occurring hormone secreted by the pancreas along with insulin.
• Sodium-glucose co-transporter 1 (SGLT2) increase glucose excretion and reduction of blood sugar levels.
• Incretin mimetics promote insulin secretion by the pancreas and mimics other blood sugar level lower actions that naturally occur in the body.Exenatide (Byetta) was the first incretin mimetic agent approved in the United States.
• Insulins customize treatment for an individual based on the goal of providing optimal blood sugar control.Insulin is the principal hormone that regulates the uptake of glucose from the blood into most cells of the body, especially liver, muscle, and adipose tissue.

Different types of insulin based on the times of action onset and duration as the following :

• Rapid-acting insulins : regular insulin (humulin R, novolin R),  insulin lispro (humalog), insulin aspart (novolog), insulin glulisine (apidra).
• Intermediate-acting insulin : insulin zinc (lente), isophane insulin, neutral protamine hagedorn (NPH) (humulin N, novolin N).
• Long-acting insulin : insulin glargine (lantus), insulin detemir (lavemir), ultralente.