Diabetes Mellitus: Causes, Symptoms, and Treatment

Diabetes Mellitus: Causes, Symptoms, and Treatment

 

Causes of Diabetes Mellitus

Diabetes mellitus is a condition characterized by high blood sugar levels resulting from insufficient insulin production by the pancreas or the body's reduced responsiveness to insulin, or both. This inability to properly metabolize carbohydrates leads to elevated blood sugar levels. Diabetes is a common disease, affecting 10.2% of the population aged over 35 years.

 

Diabetes specialists at Vibhavadi Hospital are happy to provide consultation.

 

Self-observation symptoms:

• Frequent thirst
• Frequent urination during the night
• Blurry vision
• Fatigue
• Unexplained weight loss

 

Diabetes can be divided into two types:

Type 1: Insulin-dependent diabetes

This occurs when the pancreas produces insufficient insulin, or in some cases, none at all. It is commonly found in children under 10 years of age, with more severe symptoms.

 

Treatment may involve transplanting pancreatic cells, with further research needed.

 

Type 2: Non-insulin-dependent diabetes

The pancreas of patients with type 2 diabetes produces a relatively large amount of insulin, but the body responds less effectively than normal, leading to insulin resistance. Approximately 90% of diabetic patients have type 2 diabetes.

 

Initially, the pancreas will release more insulin to meet the increased demand. However, eventually, the overworked pancreas will be unable to produce enough insulin to manage high blood sugar levels.

 

In the beginning, treatment may involve controlling diet and medication without needing insulin injections. However, in cases where blood sugar levels are difficult to control, fluctuate rapidly, or are very high, insulin injections may be required occasionally. Insulin injections become necessary when the pancreas can no longer produce insulin.

 

Since diabetes is a chronic disease that cannot be cured, relying solely on medication is not enough to control it. Therefore, controlling diet and making appropriate food choices, in quantities proportional to the body's needs, is another crucial aspect of treatment and prevention of diabetes.

 

Risk factors:

• Obesity
• Age over 40 years
• High blood pressure
• An abnormal glucose tolerance test, with blood sugar levels between 140-199 mg/dL after consuming 75 grams of glucose
• High triglyceride levels and low levels of good cholesterol (HDL-C)
• Fasting blood sugar levels between 100-125 mg/dL after 8 hours of fasting
• Family history of diabetes

 

Indications for diabetes screening in individuals who are unaware of their diabetes and have no symptoms:

 

1. Age over 45 years; if the test results are normal, retest every 3 years.
2. Those who should be screened before the age of 45 or require more frequent testing include individuals with the following risk factors:
   1. Body Mass Index (BMI) > 25 (calculated as {weight(kg) / height²(meters)})
   2. Family history of diabetes, such as having a parent, sibling with diabetes.
   3. History of delivering a baby weighing more than 4 kilograms or having gestational diabetes.
   4. High blood pressure, greater than 140/90 mmHg.
   5. Abnormal blood lipids: HDL < 35 mg/dl, Triglyceride > 250 mg/dl.
   6. Fasting blood sugar > 100 mg/dl after fasting for 8 hours.
   7. Sedentary lifestyle.
   8. Presence of vascular disease.
   1. Polycystic ovarian syndrome (PCOS).

 

Diagnosis:

The diagnostic criterion for diabetes is a blood sugar level equal to or greater than 126 milligrams per deciliter (mg/dl). If found in a person with symptoms, the test must be repeated to confirm the result. Thus, a blood test is always required. For individuals with blood sugar levels between 101 and 125 mg/dl, it is considered abnormal but not yet diabetic. These individuals have a high risk of developing diabetes and are at risk for complications from large blood vessel diseases.

 

1. Fasting blood sugar > 126 mg/dl after refraining from eating or drinking calorie-containing beverages for at least 8 hours.
2. Presence of diabetes symptoms, along with a random blood sugar level at any time of the day, regardless of when the last meal was consumed, > 200 mg/dl. HbA1c is the average blood sugar level over the past 2-3 months. The treatment goal is to control HbA1c levels to < 6.5 or 7 (depending on the type of patient).

 

This value is useful because many patients strictly control their diet for just 1-2 days before seeing their doctor, which can result in good blood sugar levels during testing. However, in reality, they may not have managed their condition well during the past 2-3 months, which would be reflected in a high HbA1c value. This allows the doctor to see the patient's true blood sugar levels, and if the HbA1c is high, it increases the risk of diabetes-related complications.

 

Chronic Complications (or Silent Dangers from Diabetes)

Diabetes is commonly found in people who are obese, have a family history of diabetes, and often have high blood pressure and abnormal blood lipids. The latter two conditions contribute to the development of large blood vessel complications more rapidly. People with high blood sugar levels experience effects on the body's red blood vessels, leading to faster deterioration of various body parts and subsequent complications. Therefore, strict treatment must be carried out alongside controlling blood sugar levels, high blood pressure, and abnormal blood lipids, which are often found in conjunction with diabetes and accelerate the development of large blood vessel complications.

 

1. Coronary arteries: Can lead to ischemic heart disease or myocardial infarction (heart attack).
2. Cerebral arteries: Can result in strokes or transient ischemic attacks (TIAs).
3. Peripheral arteries in the legs: May cause insufficient blood flow to the legs, leg pain while walking, and potentially ulcers on the feet due to poor blood supply.
4. Retina: Patients should have their retinas examined by an ophthalmologist at least once a year, and if abnormalities are detected, laser treatment can be used to prevent vision deterioration and blindness. Learn more about diabetic retinopathy.
5. Kidneys: Early stages may detect protein leakage in the urine, and if not properly managed, it could lead to kidney failure in the future.
6. Nerves: Common symptoms include numbness, stinging or burning pain, severe pain, or a tingling sensation, often starting in the toes and fingertips.

 

To prevent such diabetes-related complications, it is crucial to control blood sugar levels from the moment of diagnosis and to detect and treat any associated risk factors, such as high blood pressure and high blood lipids.

 

Diabetes management tips:

 

1. Control your diet by reducing rice, starch, sugar, and sugar-containing beverages, especially soft drinks, fruit juices, and sour milk.
2. Exercise regularly for 30-60 minutes per session, 3-5 times per week.
3. Refrain from smoking.
4. Take medications or injections as prescribed by your doctor.
5. Treat other risk factors found in conjunction, such as high blood pressure and high blood lipids.
6. If you experience abnormal symptoms, such as severe vomiting or inability to eat, consult a doctor as your blood sugar levels may fluctuate significantly.

Physician

Dr. Waranun Charoenhirunyingyas

Department of Diabetes and Endocrinology