Diabetes Mellitus is an endocrine disorder where your body can’t produce insulin or/and is sensitive to your body. Diabetic is the most common endocrine disorder.
So if you recently diagnosed with diabetes, these are 5 things about diabetics you should know.
- Science about diabetes
- What to eat and what not to eat?
- How much exercise you should do?
- Complications
- Diabetic medication and follow up
You Should Know What Diabetic is
What Is Diabetes Mellitus?
Diabetes mellitus is a group of common metabolic disorders that share the phenotype of hyperglycemia. It classifies two broad categories- type 1 and 2 DM.
How To Differentiate Type 1 and 2 Diabetes Mellitus
Type 1 is immune-mediated beta cell destruction usually leading to absolute insulin deficiency but type 2 ranges from predominantly insulin resistance with relative insulin deficiency to a predominantly insulin secretory defect with insulin resistance. Mostly type 1 diabetic patients need insulin injections to survive. But type 2 can control their blood sugar using PO medication.
Epidemiology
The worldwide prevalence of DM has risen dramatically over the past two decades. There were 30 million diabetic patients in 1985 which increase to 415 million in 2017. Which is expected to be 642 million by the year 2040. The bottom line here is, a diabetic is a fast-growing disease worldwide. And this is due to our lifestyle. Sedentary lifestyle and diet is the most 2 common cause of the increasing prevalence of the disease.
How to Diagnosis Diabetes Mellitus
Glucose intolerance is classified into three categories.
- Normal
- Prediabetic (impaired glucose homeostasis)
- Diabetes Mellitus
Glucose intolerance can be assessed using fasting sugar, oral glucose challenge, and hemoglobin A1c.
Normal define as
- Fasting glucose level <5.6 mmol/L or 100 mg/dL
- A glucose level of <7.9 mmol/L or 140 mg/dL 2 hours after the glucose challenge test
- HA1c <5.7%
An impaired glucose test define as
- Fasting glucose level <5.6-6.9 mmol/L or 100-125 mg/dL
- Glucose level of <7.8-11 mmol/L or 140-199 mg/dL 2 hour after glucose challenge test
- HA1c <5.7-6.4%
Diabetic defined as
- Fasting glucose level >7 mmol/L or >126 mg/dL
- Glucose level of >11.1 mmol/L or >200 mg/dL 2 hour after glucose challenge test
- HA1c >6.5%
- Random plasma glucose of >11.1 mmol/L or >200 mg/dL accompanied by classic symptoms of DM (polyuria – excessive urination, polydipsia – drink excessive water and weight loss)
One time measurement is not sufficient to diagnose diabetic Mellitus. Because many people may fulfill these criteria and are not diabetic. Because any kind of stress can elevate blood glucose. So repeated measurement is needed before diagnosis diabetics.
Sign And Symptoms
Most patients don’t even know they have diabetics because the symptoms are difficult to notice. You might have symptoms of hyperglycemia like drinking too much water, urinate frequently, and eat more than usual. And sometimes patients might have a chronic complication of diabetes without knowing they have it. They may have a foot ulcer, ocular manifestation, stroke, and myocardial infraction even without knowing they have diabetics.
If you have an acute and emergency complication of diabetes called DKA or diabetic ketoacidosis. You might have a worsening of polyuria and polydipsia. You might have abdominal pain, nausea which mimics the surgical cause of the acute abdomen.
What To Eat And What Not To Eat
This is a controversial idea. Some doctors don’t claim to eat some food and avoid others. They argue it should be individualized.
But as a general rule, diabetic patients advice to minimize carbohydrate meals like wheat bread, sugar, rice, potato…. They advise eating high protein food like milk, peanut, barley bread, yogurt….
How Frequent Should You Exercise?
It is recommended to exercise 30 minutes – 1 hour a day for 3 – 5 days a week. The exercise can be just jogging or running.
What Are Complication
There are short and long term complications. Hypoglycemia and DKA are the 2 most common acute complications.
Long term complications further classified into micro and macrovascular.
But for now we will see about hypoglycemia and foot ulcers.
Hypoglycemia Symptoms And Diagnosis
Hypoglycemia is one of the most common acute disorders of diabetics. It occurs when your blood sugar is below 70 in diabetic patients. You might feel dizzy, might have palpitation, sweating, blurred vision…. Whenever you experience these symptoms you should immediately take a sweet drink or candy.
Foot Care
One of the chronic complications of diabetics is a foot ulcer. This is due to neuropathy and microvascular complication which lead to decrease pain sensitivity of the foot. This means you might not notice injury because you didn’t feel pain. So you should check your foot daily. And you should wear comfortable shoes. You should also avoid washing your feet with warm water.
Diabetes Mellitus Medication And Follow Up
There is 2 broad category to treat diabetes.
- Injection
- Po medication
Injectable Medication of Diabetes Mellitus
It can be short-acting or long-acting. Either way, you should be trained to administer the medication yourself. Injection sites are the arm, thigh, abdomen (lateral to umbilicus). And you should slant your needle 45o to administer it to the subcutaneous.
PO Medication of Diabetes Mellitus
There are different types of PO medication to treat diabetic Mellitus. Metformin is the most common one. Usually, type 2 diabetes mellitus treated by PO than injectable unless there are indications.
The other thing is, you should take follow up seriously. Your doctor might change the dose of the medication depending on your glucose control.
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