diabetes a metabolic disease of blood sugar

diabetesDr. Iakovos Theodosiou MD.DipU
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Diabetes or diabetes mellitus (DM), describes a group of metabolic diseases or disorder in which the person has high blood glucose (blood sugar), caused either because insulin production is inadequate, or because the body’s cells do not respond properly to insulin, or both. Patients with high blood sugar will typically experience polyuria, polydipsia and polyphagia.

Ιs classed as a metabolism disorder, where Metabolism refers to the way our bodies use digested food for energy and growth. Most of what we eat is broken down into glucose. Glucose is a form of sugar in the blood – it is the principal source of fuel for our bodies.

When our food is digested, the glucose makes its way into our bloodstream. Our cells use the glucose for energy and growth. However, glucose cannot enter our cells without insulin being present – insulin makes it possible for our cells to take in the glucose.

Insulin is a hormone that is produced by the pancreas. After eating, the pancreas automatically releases an adequate quantity of insulin to move the glucose present in our blood into the cells, as soon as glucose enters the cells blood-glucose levels drop.

A person with DM has a condition in which the quantity of glucose in the blood is too elevated (hyperglycemia). This is because the body either does not produce enough insulin, produces no insulin, or has cells that do not respond properly to the insulin the pancreas produces. This results in too much glucose building up in the blood. This excess blood glucose eventually passes out of the body in urine. So, even though the blood has plenty of glucose, the cells are not getting it for their essential energy and growth requirements.

DIABETES Type 1 (DM-1)
The body does not produce insulin. Μay refering as insulin-dependent diabetes, juvenile diabetes, or early-onset diabetes. People usually develop type 1 diabetes before their 40th year, often in early adulthood or teenage years.
Patients with type 1 diabetes will need to take exogenic insulin for the rest of their life. They must also ensure proper blood-glucose levels by carrying out regular blood tests and following a special diet.

DIABETES Type 2 (DM-1)
The body does not produce enough insulin for proper function, or the cells in the body do not react to insulin (insulin resistance).

Approximately 90% of all cases of diabetes worldwide are type 2 (DM-2).
Some people may be able to control their DM-2 symptoms by losing weight, following a healthy diet, doing plenty of exercise, and monitoring their blood glucose levels. However, DM-2 is typically a progressive disease – it gradually gets worse – and the patient will probably end up have to take exogenous insulin.

Overweight and obese people have a much higher risk of developing the DM-2 compared to those with a healthy body weight. People with a lot of visceral fat, also known as central obesity, belly fat, or abdominal obesity, are especially at risk.
Overweight people or physically inactive and eating the wrong foods is in risk of developing DM-2.

The risk of developing the disease is also greater as we get older. Those with a close relatives with type 2 diabetes, are in higher risk of developing the disease.

Men whose testosterone levels are low have been found to have a higher risk of developing DM-2. Researchers from the University of Edinburgh (Scotland) say that low testosterone levels are linked to insulin resistance.

This type affects females during pregnancy. Some women have very high levels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, resulting in progressively rising levels of glucose.
Diagnosis of gestational diabetes is made during pregnancy.

The majority of GD patients can control their diabetes with exercise and diet. Between 10% to 20% of them will need to take some kind of blood-glucose-controlling medications. Undiagnosed or uncontrolled GD can raise the risk of complications during childbirth and the baby may be overweight.

The vast majority of patients with DM-2 initially had prediabetes. Their blood glucose levels where higher than normal, but not high enough to merit a diabetes diagnosis. The cells in the body are becoming resistant to insulin.

Studies have indicated that even at the prediabetes stage, some damage to the circulatory system and the heart may already have occurred.


Doctors can determine whether a patient has a normal metabolism, prediabetes or diabetes in one of three different ways – there are three possible tests:

A1C test
– at least 6.5% means diabetes
– between 5.7% and 5.99% means prediabetes
– less than 5.7% means normal

FPG (fasting plasma glucose) test
– at least 126 mg/dl means diabetes
– between 100 mg/dl and 125.99 mg/dl means prediabetes
– less than 100 mg/dl means normal

OGTT (oral glucose tolerance test)
– at least 200 mg/dl means diabetes
– between 140 and 199.9 mg/dl means prediabetes
– less than 140 mg/dl means normal
An abnormal reading following the OGTT means the patient has impaired glucose tolerance (IGT)

All types of diabetes are treatable. DM-1 lasts a lifetime, there is no known cure. Exogenus insulin must be used forever and a diet to adjust the relation blood glucose/insuline.
Type 2 usually lasts a lifetime, however, some people have managed to get rid of their symptoms without medication, through a combination of exercise, diet and body weight control.
Patients with DM-1 are treated with regular insulin injections, as well as a special diet and exercise.
Patients with DM-2 are usually treated with tablets, exercise and a special diet, but sometimes insulin injections are also required.
If diabetes is not adequately controlled the patient has a significantly higher risk of developing complications.

Below is a list of possible complications that can be caused by badly controlled diabetes:

Eye complications – glaucoma, cataracts, diabetic retinopathy, and some others.
Foot complications – neuropathy, ulcers, and sometimes gangrene which may require that the foot be amputated
Skin complications – people with diabetes are more susceptible to skin infections and skin disorders
Heart problems – such as ischemic heart disease, when the blood supply to the heart muscle is diminished
Hypertension – common in people with diabetes, which can raise the risk of kidney disease, eye problems, heart attack and stroke
Mental health – uncontrolled diabetes raises the risk of suffering from depression, anxiety and some other mental disorders
Hearing loss – diabetes patients have a higher risk of developing hearing problems
Gum disease – there is a much higher prevalence of gum disease among diabetes patients
Gastroparesis – the muscles of the stomach stop working properly
Ketoacidosis – a combination of ketosis and acidosis; accumulation of ketone bodies and acidity in the blood.
Neuropathy – diabetic neuropathy is a type of nerve damage which can lead to several different problems.
HHNS (Hyperosmolar Hyperglycemic Nonketotic Syndrome) – blood glucose levels shoot up too high, and there are no ketones present in the blood or urine. It is an emergency condition.
Nephropathy – uncontrolled blood pressure can lead to kidney disease
PAD (peripheral arterial disease) – symptoms may include pain in the leg, tingling and sometimes problems walking properly
Stroke – if blood pressure, cholesterol levels, and blood glucose levels are not controlled, the risk of stroke increases significantly
Erectile dysfunction – male impotence.
Infections – people with badly controlled diabetes are much more susceptible to infections
Healing of wounds – cuts and lesions take much longer to heal