2008/08/10

Diabetes Mellitus

By: dr rony

Diabetes mellitus frequently referred to simply as diabetes (Greek: διαβήτης), is in fact a syndrome characterized by disordered metabolism and abnormally high blood sugar (hyperglycaemia) resulting from the insufficient levels of the hormone insulin.[2] The characteristic symptoms are as excessive urine production (polyuria) due to high blood glucose levels, excessive thirst and increased fluid intake (polydipsia) those attempting to compensate for increased urination, blurred vision due to the high blood glucose effects on the eye's optics, unexplained weight loss, and lethargy. These symptoms are most likely to be less apparent if the blood sugar is only mildly elevated. [edit] Other types

There are several rare causes of the diabetes mellitus that do not fit into type 1, type 2, or gestational diabetes; attempts to classify all them remain controversial. Some cases of diabetes are actually caused by the body's tissue receptors not responding to the insulin (even when insulin levels are normal, which is what separates it from the type 2 diabetes); this form is very uncommon. Genetic mutations (autosomal or mitochondrial) can lead to others defects in beta cell function. Abnormal insulin action may also have been hereditarily determined in some cases. Any disease that causes extensive damage to the pancreas may also lead to diabetes (for example, chronic pancreatitis and cystic fibrosis). Diseases associated with the excessive secretion of insulin-antagonistic hormones can basically cause diabetes (which is typically resolved once the hormone excess is removed). Many drugs impaired by insulin secretion and some toxins damage pancreatic beta cells. The ICD-10 (1992) diagnostic entity, malnutrition-related diabetes mellitus (MRDM or MMDM, ICD-10 code E12), was then deprecated by the World Health Organization when the current taxonomy was introduced in 1999.[3] [edit] Signs and symptoms

The classical triad of diabetes symptoms just these is polyuria, polydipsia and polyphagia, which are, correspondingly, frequent urination; increased thirst and consequent increased fluid intake; and increased appetite. Symptoms may get develop quite rapidly (weeks or months) in type 1 diabetes, particularly in children. However, in type 2 diabetes the symptoms also develop much more slowly and may be subtle or completely absent. Type 1 diabetes may also get cause a rapid yet significant weight loss (despite normal or even increased eating) and irreducible fatigue. All of these symptoms get except weight loss can also manifest in the type 2 diabetes in patients whose diabetes is poorly controlled.

When the glucose concentration in the blood is raised just beyond the renal threshold, reabsorption of glucose in the proximal renal tubuli is incomplete, and part of the glucose remains here in the urine (glycosuria). This increases the osmotic pressure level of the urine and inhibits the reabsorption of water by the kidney, resulting in increased urine production (polyuria) and increased fluid loss. Lost blood volume will also be replaced somatically from water held in body cells, causing dehydration and increased thirst. A rarer but evenly severe possibility is hyperosmolar nonketotic state, which is more general in type 2 diabetes and is mainly the result of dehydration due to loss of body water. frequently, the patient has been drinking extreme amounts of sugar-containing drinks, leading to the a vicious circle in regard to the water loss.


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