Diabetes Mellitus

DIABETES MELLITUS

  In simple word diabets mellitus is mean as condition in which high blood sugar levels caused by the body's inability to produce or use insulin hormones. 

Insulin itself is a hormone produced by the pancreas gland body. Insulin process sugar so it can be used by the body's cells for energy and stored if the excess.

The simple case of diabets means that there has been a breakdown in the mechanism of blood sugar, can damage the insulin production of the pancreas gland or damage to the body's cells can not use insulin.

Diabets is divided into two, namely diabets type 1 and type 2 diabets.
Diabets type 1 diabets is due to damage to the production of insulin by the pancreas.
Treatment is necessary only with the administration of insulin by injection or orally.   While in type 2 diabets the pancreas is usually still in production, but cells the body does not use insulin so that it appears "the impression of lack of insulin" because high blood sugar. 

Causes of Diabets

The exact cause of diabets is still a mystery that continues examined by experts in various countries in the world. Some experts have reported that there are several factors associated with the occurrence inferred diabets mellitus among them are:

• Genetics, there was family history of diabets,
• Overweight or obesity,
•  Abnormalities of the pancreas,
• Autoimmune response to insulin,
• Pregnancy (Gestational) usually recover after childbirth,
• Consuming certain drugs,
• Infectious diseases,

Symptoms of Diabets,

Diabets can be established by measuring blood sugar levels with a blood sugar test, which is now widely available. Examination is usually performed during fasting.

The criteria commonly used in the diagnosis of diabets if blood sugar levels are found (mg / dl) were as follows:                 

Normal            Prediabet        Diabet

With Diet        <110                110 - 125         > 125

On time           <110                110 - 200         > 200

WHO Recommendation 2011

HbA1c can be used as a diagnostic test for diabetes providing that stringent quality assurance tests are in place and assays are standardised to criteria aligned to the international reference values, and there are no conditions present which preclude its accurate measurement.
An HbA1c of 48 mmol/mol (6.5%) is recommended as the cut point for diagnosing diabetes. A value of less than 48 mmol/mol (6.5%) does not exclude diabetes diagnosed using glucose tests.
The following is practical guidance in order to help implement WHO guidance in the UK. Final guidance will be produced by the Association for Clinical Biochemistry:

• Finger-prick HbA1c should not be used unless the methodology and the healthcare staff and facility using it can demonstrate within the national quality assurance scheme that they match the quality assurance results found in laboratories. Finger prick tests must be confirmed by laboratory venous HbA1c in all patients.
• In patients without symptoms of diabetes repeat the laboratory venous HbA1c. If the second sample is <48 mmol/mol (6.5%) treat as high diabetes risk and repeat the test in 6 months or sooner if symptoms develop.

Situations where HbA1c is not appropriate for diagnosis of diabetes:

• ALL children and young people
• Patients of any age suspected of having Type 1 diabetes
• Patients with symptoms of diabetes for less than 2 months
• Patients at high diabetes risk who are acutely ill (e.g. those requiring hospital admission)
• Patients taking medication that may cause rapid glucose rise e.g. steroids, antipsychotics
• Patients with acute pancreatic damage, including pancreatic surgery
• In pregnancy
• Presence of genetic, haematologic and illness-related factors that influence HbA1c and its measurement - see Annex 1 from WHO report 

Patients whose HbA1c is under 48 mmol/mol (6.5%)

• These patients may still fulfil WHO glucose criteria for the diagnosis of diabetes.
• Use WHO glucose testing in patients with symptoms of diabetes or clinically at very high risk of diabetes.
• The use of such glucose tests is not recommended routinely in this situation.

The following is recommended for those at high risk of developing diabetes:

• High diabetes risk HbA1c 42-47 mmol/mol (6.0 – 6.4%)
• Provide intensive lifestyle advice
• Warn patients to report symptoms of diabetes
• Monitor HbA1c annually
• HbA1c under 42 mmol/mol (6.0%)
• These patients may still have high diabetes risk.
• Review the patient’s personal risk and treat as “high diabetes risk” as clinically indicated.

Common symptoms that often appear as a marker of diabets known as 3P is

• Polydipsia (much to drink) often feel thirsty,
• Polyfagia (many Meals) often feel hungry,
• Polyuria (lots of urine), especially from sleeping at night,
• Drastic weight loss,
• Besides easily tired, weakness and drowsiness in fact even in the morning.

Complications of Diabets

Complications are the effects of damage to various organs of the body as a direct and indirect manifestations of uncontrolled blood sugar, usually occurs in the long term will lead to other diseases.
Other diseases will emerge as a result of damage to these organs is greatly feared because it can beakibat death.
This causes diabets is also referred to as "the silent killer". The mechanism of high blood sugar and diabets complications on the organs of the body can be described as follows:

• Blood cells diabetic people will increase blood viscosity (viscosity) and increased cohesion of blood cells that cause blood to clot easily (aggregation),
• Thickening of blood vessels due to the inclusion of complex substances in blood sugar mengkibatkan decrease the elasticity of blood vessels, especially the skin and nervous system,
• Uncontrolled blood sugar will also cause more easy accumulation of fat in the blood vessels (plaque) is called atherosclerosis.
• Atherosclerosis increased 2-6 times in people with diabets and worsen blood circulation,
• Poor blood circulation that occurs in large blood vessels (macro) can cause damage to the liver (hepatitis), brain (stroke) and cardiovascular (hypertension and heart attack). This condition is called makroangiopati.
• Poor circulation in small blood vessels / peripheral (Micro) will cause damage to the eyes (retinopathy), kidney (nephropathy) and skin tissue SHG will easily happen that are difficult to heal ulcers.

Treatment of Diabets

Unlikely infectious diseases that require antibiotikm on diabets disease obatpun that no one can completely treat and cure complications. Diabets is often referred to as a disease that can not be fully recovered back as usual just as hard with our changing diet, healthy life style and behavior.

Targeted treatment of diabets mellitus is to be able to control blood sugar levels within the limits of not damaging other organs.

The first and major step in the treatment of diabets is lifestyle modification (Modified Lifestyle). Lifestyle modification has been agreed many national and international experts and has been included in the approved standard therapy in various scientific journals.

• Lifestyle modification in question is changing habits and healthy lifestyle behaviors multiply physical activity (eg movement of 10,000 Steps to Prevent diabets),
• Routine and regular exercise,
• Reduce your intake of sugars (including carbohydrates) through food and drink,
• Avoid of stress,
• Lose weight, some experts report as it can lower the risk of diabets.

If exercise and lifestyle modification fails and the blood sugar remains high, please consult your doctor. Step two drugs that lower blood sugar are now many different types and it works even to insulin injections, if needed. There is a lot of work mechanism of oral diabetic medications ranging from working as a carb blocker that works to reduce the intake of glucose decreased the absorption of carbohydrates to which work by increasing insulin production by the pancreas.

Various efforts that are keeping the blood sugar at normal levels is a key target for treatment of diabets as well. In addition to keeping the plant insulin (pancreas) such efforts can be taken in two ways, namely reducing the intake of carbohydrates and glucose include or improve blood glucose burning through regular physical activity and measurable.

During the treatment, monitoring of blood sugar levels periodically and regularly in need as an absolute indicator of treatment success. Obedience and discipline to take medication for the patient as well as maintain the discipline required to absolute dietary and lifestyle modifications are recommended. The third step is the refrain of the excessive stress due to stress assessed will disrupt the balance of hormones in the body.

If you have not experienced the symptoms of a diet, it is very important check of blood sugar and regular periodic basis such as when a birthday today, especially if you or your parents over 35 years old.

So this is all I can share about diabets and treatment of diabets, hopefully by knowing information and tips on handling diabets, we can avoid the diseases and problems that plagues most of the world's population.