Diabetes Mellitus is a disease in which the pancreas produces little or no insulin, a hormone that helps the body’s tissues absorb glucose (sugar) so that it can be used as a source of energy. The disease can also develop when muscle, fat, and liver cells react badly to insulin. In people with diabetes, glucose levels build up in the blood and urine, leading to excessive urination, thirst, hunger, and problems with fat and protein metabolism. Diabetes mellitus differs from the less common diabetes insipidus, which is caused by a lack of the hormone vasopressin that controls the amount of excreted urine.
Diabetes is most common in adults over 45 years of age; in people who are overweight or physically inactive; in people who have a close relative with diabetes; and in people of African, Hispanic, and Native American descent. The highest rate of diabetes in the world is among Indians. More women than men have been diagnosed with the disease.
There are two types of diabetes. In type 1 diabetes, which usually begins in childhood, the pancreas stops making insulin whole. It is also called insulin-dependent diabetes. In type 2 diabetes, which starts in adulthood (and in some teenagers) the body still makes some insulin. But it doesn’t make enough insulin, or the body can’t use it properly. It is also called non-insulin-dependent diabetes.
Diabetes is detected by measuring the amount of glucose in the blood after an individual has been fasting (abstaining from food) for about eight hours. In some cases, doctors diagnose diabetes by administering an oral glucose tolerance test, which measures glucose levels before and after taking a certain amount of sugar. Another test developed for type 1 diabetes looks for specific antibodies (proteins of the immune system that attack foreign substances) that are only present in people with diabetes. This test can detect type 1 diabetes at an early stage, reducing the risk of complications of the disease.
Once diabetes is diagnosed, the treatment consists of monitoring the amount of glucose in the blood and preventing complications. Depending on the type of diabetes, this can be achieved by regular exercise, a carefully controlled diet and medication.
People with type 1 diabetes need insulin injections, often two to four times a day, to provide the body with the insulin it does not produce. The amount of insulin needed varies from person to person and can be influenced by factors such as a person’s level of physical activity, diet, and the presence of other health problems. Usually, people with type 1 diabetes use a meter several times a day to measure the glucose level in a drop of their blood obtained by puncturing a fingertip. They can then adjust the amount of insulin injected, exercise, or food intake to keep blood sugar levels at normal levels. People with type 1 diabetes should carefully control their diet by distributing meals and snacks throughout the day so that the insulin supply is not exaggerated to help the cells absorb glucose. They should also eat foods that contain complex sugars, which break down slowly and cause a slower rise in blood sugar levels.
For persons with type 2 diabetes, treatment begins with diet control, exercise, and weight reduction, although over time this treatment may not be sufficient. People with Type 2 diabetes usually work with nutritionists to create a diet plan that regulates blood sugar levels so that they don’t rise too quickly after a meal. A recommended meal is usually low in fat (30 percent or less of total calories), provides moderate protein (10 to 20 percent of total calories), and contains a variety of carbohydrates, such as beans, vegetables, and grains. Regular exercise helps cells absorb glucose – even ten minutes of exercise a day can be effective. Dietary control and exercise can also play a role in weight reduction, which seems to partially reverse the body’s inability to use insulin.