What is Diabetes?
The medical name for diabetes is diabetes mellitus which has both Greek and Latin roots. Diabetes comes from a Greek word that means to siphon. The most obvious sign of diabetes is excessive urination. Water passes through the body of a person with diabetes as if it were being siphoned from the mouth through the urinary system and out of the body.










Mellitus comes from a Latin word that means sweet like honey. The urine of a person with diabetes contains extra sugar (glucose). In 1679,the physician Thomas Willis, tasted the urine of a person with diabetes and described as ‘wonderfully sweet’ like honey.

A more thorough and in depth definition of diabetes is any disorder characterized by excessive urine excretion. The most common form is diabetes mellitus, a metabolic disorder in which there is an inability to oxidize carbohydrates due to a disturbance in insulin production or function. Diabetes mellitus is characterized by elevated glucose in the plasma and episodic keto-acidosis.

To learn about the history of diabetes click here: file:///N|/My Documents/DM_REAL.html

How does hyperglycemia occur?
To learn how hyperglycemia occurs click here: hyperglycemia.html

Criteria Needed for Diabetes Mellitus Diagnosis:
1) Having a fasting glucose level in excess of 140 mg/dL
2) Or having plasma glucose levels in excess of 200 mg/dL at two time points during a glucose tolerance test (GTT), one of which must be within 2hrs. of ingestion of glucose.

Glucose Tolerance Curve


This is a glucose tolerance curve for a normal person and one with insulin-independent diabetes mellitus.  (This graph compliments of: http://www.bmb.leeds.ac.uk/teaching/icu3/practic/bmb3/)

To learn more about the diagnosis of diabetes click here
 

Pre-Diabetes
    Pre-diabetes is a condition in which blood glucose levels are higher than normal but are not high enough for a diagnosis of diabetes. People with pre-diabetes are at an increased risk for developing type 2 diabetes and for heart disease and stroke.

Symptoms of Diabetes Mellitus:
Frequent urination – the kidney dam
Excessive thirst
Dry Skin
Itchy Skin
Slow healing of cuts
Blurry eyesight
Always feeling hungry
Feeling tired and weak
Weight loss
Skin infections
Numbness of tingling in feet

Why these symptoms occur:
    When blood glucose rises above a certain level, it is removed from the body in urine. A resulting increase in the volume of urine occurs due to the osmotic effect of glucose. Picture the kidney as a dam: when there is too much glucose in the blood, the excess is diluted with water and spills out. The maximum blood glucose level reached before sugar spills out is called the kidney threshold and is usually about 180 mg/ml. This results in two conditions: polyuria or excessive urination and glycosuria or glucose in the urine. The loss of water through urination triggers the brain to send a message of thirst. This results in a condition known as polydipsia or excessive thirst. Excessive urination can also lead to dehydration, which accounts for the dry, itchy skin. The blurred vision can be caused by fluctuations in the amount of glucose and water in the lenses of the eyes. As far as always feeling hungry this is because there is no insulin or the insulin is unable to activate the uptake of glucose into the cells and therefore the cells are starving. This triggers the brain to send a message of hunger, resulting in polyphagia or excessive hunger. The fact that the cells are low on energy also explains why there are feelings of fatigue and weakness. Weight loss may occur in people due to the inability to supply the cells with the needed amount of glucose. The complication of skin infections occurs at times because of the excess glucose in the blood, this excess glucose suppresses natural defense mechanisms such as the activity of white blood cells and the glucose is also an excellent food source for bacteria. And finally, numbness and tingling in the feet and night leg cramps may result from nerve damage due to prolonged high glucose levels that cause changes in the nerves.

Types Of Diabetes:
Most people with diabetes have one of two major types. About 10% have type 1 or insulin dependent diabetes mellitus (IDDM). About 85% suffer from type 2 or non-insulin dependent diabetes mellitus (NIDDM).
 
 
Type 1 (IDDM) Type 2 (NIDDM)
Age of Onset Usually under 40 years Usually over 40 years
Body Weight Thin Usually overweight
Symptoms Appear suddenly Appear slowly
Insulin Produced None Too little, or ineffective
Insulin Required Must take insulin May require insulin
Other Names Juvenile Diabetes Adult onset diabetes

Other types of diabetes:
Impaired glucose tolerance: A condition in which the blood contains more glucose than normal but less than is required for a diagnosis of diabetes (aka pre-diabetes)

Gestational diabetes mellitus: A condition that occurs when the level of blood glucose rises in women as a complication of pregnancy. The blood glucose levels usually return to normal after delivery

Secondary diabetes mellitus: A condition with the same symptoms as diabetes mellitus however it is due to disease of the pancreas or endocrine system, genetic disorders, or exposure to chemical agents.

Insulin-Dependent Diabetes Mellitus (IDDM)
To learn about Insulin-Dependent Diabetes Mellitus click here: type 1.html

Non-Insulin-Dependent Diabetes Mellitus
To learn about Non-Insulin-Dependent Diabetes Mellitus click here: type 2.html

Treating Diabetes:
IDDM:
    It has been determined that hyperglycemia is responsible for the long-term microvascular complications of diabetes. Thus, the therapy for IDDM should try to intensify metabolic control to lower blood glucose levels while avoiding hypoglycemic episodes. Treatments for IDDM include but are not limited to the following:
1) Diet
2) Education
3) Plasma glucose monitoring
a. Glycosylated hemoglobin
b. Fructosamine levels
c. Urine ketone levels
4) Insulin therapy
5) Oral anti-diabetic drugs

To learn more about insulin therapy in the treatment of IDDM click here:

NIDDM:
The treatment for NIDDM is very similar to IDDM with slight variations in oral anti-diabetic drugs. Type 2 diabetes can often be treated with diet and lifestyle changes alone, without the need for medication.

To learn more about the anti-diabetic drugs used to treat NIDDM click here:

To learn more about the overall treatment of diabetes mellitus click here:
 
 
 

 Interesting and educating sites relating to diabetes mellitus:
http://www.medscape.com/viewarticle/445672 - The rise of childhood type 1 diabetes in the 20th century

http://www.medscape.com/viewarticle/450150-Economic costs of diabetes in the US in 2002

http://www.niddk.nih.gov/health/diabetes/pubs/type1-2/what.htm-Your guide to diabetes: Type 1 and
Type 2

http://www.medscape.com/viewarticle/444392-Potential of Surgery for Curing Type 2 Diabetes Mellitus

http://www.medscape.com/viewarticle/444348- Current Approaches to Type 2 Diabetes Mellitus

http://www.medscape.com/viewarticle/449887 - Insulin Therapy in Type 2 Diabetes

http://www.medscape.com/viewarticle/438369 - Perspectives on Islet Transplantation

http://www.medscape.com/viewprogram/1967 - Insulin Replacement/Insulin Technologies