Diabetes Mellitus is a disease in which blood sugar (glucose) levels are abnormally high because the body does not produce enough of the hormone insulin or the body fails to respond to insulin.
When sugar from food is absorbed into the bloodstream, the pancreas responds by producing insulin. Insulin plays a key role in moving the sugar from the bloodstream into the cells, where it is then converted into energy. The body uses this energy to function; sugar is the fuel on which the body runs. If the body cannot adequately produce or respond to insulin, sugar cannot enter the cells, instead, sugar accumulates in the blood, and the cells must turn to other sources for energy.
Diabetes is extremely common in older people, of whom about 15 to 25% have the disease. Statistically, there are about 500 daily diagnosed cases of diabetes in the Philippines . Diabetes can lead to such complications as chest pain (angina pectoris) and heart attacks, heart failure, stroke, kidney failure, erectile dysfunction, blurred vision and blindness, pain and loss of sensation in the hands and feet, and amputation. Many of these complications arise because elevated blood sugar leads to narrowing and hardening of the blood vessels, which impairs circulation and damages tissues. These complications are even more likely in people who smoke or have high blood pressure and high cholesterol levels, both of which often accompany diabetes. Fortunately, many complications can be prevented by quitting smoking and by taking steps to control blood pressure and cholesterol levels as well as blood sugar levels.
Causes of Diabetes
Diabetes is categorized as Type I or Type II, each with a different cause. Type II diabetes is the main form of diabetes among older people. Obese older people with a family history of diabetes have the highest risk of developing type II diabetes which accounts for 90% of the entire diabetes population worldwide.
In type I diabetes, the type that usually becomes evident in childhood or young adult, the pancreas cannot produce insulin or produce tiny amount of insulin. Symptoms include intense thirst, frequent urination, extreme hunger, and rapid weight loss. It can be controlled by regular lifetime doses of insulin in the proper amounts. Keeping the balance between insulin dose and sugar intake is one of the major challenges faced by people with Type II diabetes, also known as adult-onset diabetes usually doesn’t appear until the early to mid forties. In most cases, the problem is not a simple lack of insulin, but a defect in the receptors for insulin in the cell walls. The body does not respond normally to the insulin produced by the pancreas. Long term complications of Type II diabetes are similar to those of Type I, but include higher incidence of heart disease, high blood pressure, and stroke. So it’s worth it to have blood sugar monitoring regularly.
The main risk factor for Type II diabetes is obesity. Obesity causes insulin resistance, possibly by increasing the blood levels of building blocks of fats and certain proteins that interfere with the action of insulin.
Aging itself puts people at higher risk of developing diabetes. As people age, insulin secretion tends to decrease slightly and insulin resistance tends to increase slightly, even among people without obesity or diabetes.
Heredity is a risk factor as well.
Signs and Symptoms
People with Type II diabetes may have no symptoms for months or even years before the disease is diagnosed. When the blood sugar level raises too high, sugar spills into the urine. The kidneys then must excrete additional water to dilute the sugar. Therefore, a person with high blood sugar urinate large volumes (Polyuria). The loss of water due to excessive urination also creates abnormal thirst (Polydipsia). Also, the body cannot use sugar as energy, a person with diabetes may experience excessive hunger and thus eat more (Polyphagia) and yet still lose weight. Other symptoms include blurred vision, drowsiness, light headedness, irritability, fatigue and weakness, decreased endurance during exercise, numbness in the hands and feet, body itchiness, hard to heal wounds, frequent vaginal discharges, recurring skin infections, hard to maintain or achieve an erection in men.
Diagnosis and Screening
A simple blood test called Fasting Blood Sugar (FBS) or Glucose test is most commonly used to make a diagnosis. The level of sugar (glucose) in the blood is measured, usually after the person has fasted for at least 8 hours. Sometimes the blood sugar level is measured randomly without regard to when the person last ate, but this is not as accurate.
In a person who does not have diabetes, blood sugar levels after fasting range from 70 to 110 milligrams per deciliter (mg/dl) of blood. Diabetes is the likely diagnosis if the blood sugar level is 126 mg/dl or higher if the person fasted before the test or 200 mg/dl or higher if the test was performed at random.
People who have two or more fasting blood sugar levels between 110 to 125 mg/dl (a condition called impaired fasting glucose) should repeat the test yearly.
The diagnosis of diabetes mellitus is confirmed if any one of the following results is obtained:
Two fasting levels are 126 mg/dl or higher
Two random levels are 200 mg/ml or higher
Fasting level of 126 mg/dl or higher and a random level of 200mg dl or higher.
Diabetes often can be prevented. Losing weight through dietary changes, increased physical activity, or both is a very effective measure. Brisk walking for 30 minutes daily is one type of beneficial physical activity.
The goal of treatment is to maintain blood sugar levels within the normal range so as to prevent or control symptoms and reduce the risk of complications. There are maintenance drugs that could help control blood sugar levels but these are not substitute for proper diet, exercise and weight reduction.
Function: Control blood sugar levels in people with Type I diabetes and some Type II diabetes. Side effects: overused can raise cholesterol levels, blood pressure and increase body fat.
Oral Hypoglycemic Drugs (Sulfonylureas)
Function: lower blood sugar levels by stimulating cells in the pancreas to release more insulin. Side effects: with long-term use, increased risk of death from heart attack.
Function: increase insulin’s activity in muscle and fat tissue and prevent the liver from releasing extra glucose into the blood stream. Side effects: nausea, diarrhea, loss of appetite, and abdominal discomfort.
Function: counteract insulin resistance by increasing the activity of receptors in the liver, muscle, and fat cells. Side effect: not common.
Function: prevent blood glucose from rising after ingestion of complex carbohydrate when used with a starchy, high-fiber diet. Side effects: gas, bloating and poor absorption of nutrients.
Interestingly, before the advent of insulin and oral hypoglycemic drugs, herbal medicines were often used to help treat diabetes. There are many safe botanical medicines that are helpful in managing Type I and II diabetes. But it doesn’t mean that you can discontinue insulin or other drugs without consulting your doctor.