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Diabetes Mellitus: Causes, Symptoms, Diagnosis, Treatment, and Prevention

Diabetes mellitus is a chronic condition that affects how the body converts food into energy. Usually, the pancreas produces insulin, a hormone that helps the cells use glucose (sugar) from the food as fuel. Those with diabetes, however, either lack enough insulin or do not respond well to insulin, leading to high blood sugar levels and other health problems as a result of glucose building up in the blood.

Causes of Diabetes Mellitus

There are different types of diabetes, and each one has different causes. The most common types are:

• It is unknown what causes type 1 diabetes, but it may be caused by genetic or environmental factors. Type 1 diabetes occurs when the immune system mistakenly attacks and destroys insulin-producing cells in the pancreas. It usually develops in childhood or adolescence, and requires lifelong insulin injections or pumps to control blood sugar.

• Diabetes type 2 occurs when the pancreas cannot produce enough insulin to overcome the resistance of the cells to insulin. There is no known exact cause for gestational diabetes, but it may be influenced by factors like obesity, physical inactivity, family history, age, ethnicity, or gestational diabetes (diabetes during pregnancy). With lifestyle changes, oral medications, or insulin injections, type 2 diabetes can be managed.

• During pregnancy, the placenta produces hormones that interfere with the action of insulin, causing high blood sugar levels for both the mother and the baby. Although the cause of this condition is unknown, it may be related to factors such as obesity, family history, or previous gestational diabetes. After the baby is born, gestational diabetes usually disappears, but it increases the risk that both the mother and the child will develop type 2 diabetes later in life.

Symptoms of Diabetes Mellitus

The symptoms of diabetes may vary depending on the type and severity of the condition, but some common signs include:

• Increased thirst and urination

• Increased hunger and weight loss

• Fatigue and weakness

• Blurred vision and headaches

• Numbness or tingling in the hands or feet

• Slow healing of wounds or infections

• Dry skin and itching

A person with diabetes may not experience any symptoms at all, or may only experience mild symptoms that are easily missed. For this reason, it's important to get regular blood tests to check for diabetes, especially if you have risk factors or a family history of diabetes.

Diagnosis of Diabetes Mellitus

The diagnosis of diabetes is based on the measurement of blood sugar levels, either fasting (before eating) or after eating. The normal range of blood sugar levels is:

• Fasting: 70 to 99 mg/dL (3.9 to 5.5 mmol/L)

• Two hours after eating: less than 140 mg/dL (7.8 mmol/L)

The criteria for diagnosing diabetes are:

• Fasting: 126 mg/dL (7.0 mmol/L) or higher on two separate occasions

• Two hours after eating: 200 mg/dL (11.1 mmol/L) or higher on two separate occasions

• Random (any time of the day): 200 mg/dL (11.1 mmol/L) or higher with symptoms of diabetes

Also, a blood test called A1C can also be used to diagnose diabetes. This test measures the average blood sugar level over the past two to three months, and reflects how well blood sugar is controlled over time.

• Less than 5.7%

The criteria for diagnosing diabetes with A1C are:

• 6.5% or higher on two separate occasions

Treatment of Diabetes Mellitus

As part of the treatment for diabetes, blood sugar levels are lowered and complications of the condition are prevented or delayed, including heart disease, stroke, kidney disease, nerve damage, eye damage, foot problems, and skin infection. The treatment plan may vary depending on the type and severity of diabetes, but it generally involves:

• Changes in lifestyle include eating well, exercising regularly, maintaining a healthy weight, quitting smoking, and limiting alcohol intake. As a result of these changes, blood sugar can be controlled better, blood pressure and cholesterol can be lowered, and cardiovascular complications can be reduced.

• Oral medications include metformin, sulfonylureas, DPP-4 inhibitors, GLP-1 agonists, SGLT2 inhibitors, and others that help the body use insulin more effectively, stimulate the pancreas to produce more insulin, and reduce glucose absorption by the intestines or kidney excretion. In addition to lowering blood sugar levels, these drugs may also cause side effects, such as nausea, diarrhea, weight gain, hypoglycemia (low blood sugar), or infections. They should be taken as prescribed by the doctor, and their effectiveness and safety should be monitored regularly.

• A synthetic insulin is injected into the body, either with a syringe, a pen, or a pump, to replace insulin that cannot be produced or used by the pancreas. People with type 1 diabetes require insulin therapy, and some people with type 2 diabetes or gestational diabetes may also need insulin therapy if oral medications cannot control their blood sugar adequately. If insulin therapy is not used properly, it can cause hypoglycemia (low blood sugar) or weight gain, and requires careful monitoring, adjustment, and coordination with diet and exercise.

Prevention of Diabetes Mellitus

The prevention of diabetes depends on the type of the condition, but some general strategies include:

• Early detection and treatment of diabetes can help prevent or delay the complications of the disease, and improve quality of life for those with risk factors.

• The first step is to adopt a healthy lifestyle, which includes eating a balanced diet, exercising regularly, maintaining a healthy weight, quitting smoking, and limiting alcohol consumption. By making these changes, type 2 diabetes can be prevented or delayed, or gestational diabetes during pregnancy can be reduced. In addition, they can reduce the risk of cardiovascular and other diseases associated with diabetes.

• Infections, such as influenza, pneumonia, hepatitis B, and COVID-19, can worsen blood sugar control and increase complications in diabetics, so these vaccines are recommended. By protecting the immune system and reducing the severity and duration of infections, vaccination can be helpful.