Diabetes Mellitus is a chronic disorder in which the blood sugar levels are very high due to inadequate production of insulin by the pancreas (insulin deficiency) or resistance to the action of insulin (insulin resistance).
There are 2 major types of Diabetes – Type 1 and Type 2 Diabetes
In Type 1 Diabetes there is absolute insulin deficiency whereas in Type 2 diabetes there is a dual defect of insulin deficiency as well as insulin resistance as described above.
Type 1 Diabetes / Insulin Dependent Diabetes / Juvenile Diabetes is usually seen in children, adolescents, and young adults, though it is also seen in the very elderly population. It is an autoimmune disorder in which the immune system of the body perceives the beta cells of the pancreas (that produce insulin) as alien and mount an attack by producing antibodies against them and destroying them. This leads to an absolute insulin deficiency in the body. These patients need insulin for treatment and survival, else they can go into a coma and can even die.
Genetic factors determine which patient gets Type 1 diabetes – these genetic markers are located on chromosome 6 (HLA complex). Children of parents with Type 1 Diabetes and siblings of patients with Type 1 Diabetes are more susceptible to developing the disorder. Other risk factors for Type 1 Diabetes include certain viral infections, race/ethnicity, geographical factors (northern climates), early exposure to cow milk and other autoimmune disorders like Graves’ disease, pernicious anemia etc.
Type 2 Diabetes / Noninsulin-dependent diabetes is commonly seen in the middle-aged and elderly population though it is now commonly also seen in children, adolescents, and young adults.
Type 2 Diabetes is a lifestyle disorder wherein the hereditary factors, as well as environmental factors, play an important role in its etiology. A strong family history is invariably seen in Type 2 Diabetes. Sedentary lifestyle along with physical inactivity, compounded by stress lead to obesity, which in turn leads to diabetes. Type 2 diabetes is also commonly associated with hypertension and hyperlipidemia.
The most common presentation of diabetes, whether type 1 or type 2, is that it can be asymptomatic (without any symptoms). These are incidentally detected when investigated for other unrelated problems. At times the complications of diabetes like neuropathy, retinopathy or nephropathy could itself be its presenting feature.
However, the most common symptoms of severely uncontrolled diabetes are excessive thirst, excessive hunger, excessive urination (especially during the night time), bedwetting in children, unexplained weight loss, easy fatigability, blurry vision, dizziness, delayed wound healing and fungal infections of the genitals.
Dr. Prakash Pania
Aster Clinic, Bur Dubai (AJMC)