Diabetes mellitus

Diabetes Mellitus refers to three types of a highly variable disorders with abnormalities in the ability to make and/or use the hormone insulin resulting in hyperglycemia and other metabolic derangements involving fat and protein. The three principle forms of the disease are Diabetes Mellitus Type I, formally known as Insulin Dependent Diabetes Mellitus, type II, formally known as Non-Insulin Dependent Diabetes Mellitus, and type III (termed gestational diabetes), a form of the disease that arises during pregnancy. Diabetes mellitus is not to be confused with Diabetes Insipidus, which does not involve insulin or glucose.

Pathophysiology

• Diabetes Mellitus Type I - Autoimmune destruction of either insulin itself, or more commonly the insulin secreting cells of the pancreas (beta cells). Patients require intramuscular injections of purified insulin.
• Diabetes Mellitus Type II - The cells of the body are rendered unresponsive to normal insulin, either at the level of the receptor or downstream signaling events within the cell. This is also referred to as "insulin resistance" and is highly correlated to obesity.

Treatment

Initial treatment for mild cases of Type II my include diet and exercise. More severe cases may require drugs such as Metformin and glipizide which are used to either assist in creating more insulin, or to aid the body in using the insulin present. There is a large range of drugs used to treat diabetes.

Extreme cases, where drugs are insufficient, may require injections of insulin. Insulin may also be used in cases where very accurate control of blood glucose levels are desired, such as when a diabetic requires an operation or treatment of an injury.

Type I diabetes is far more serious than its counterpart. Formerly known as juvenile diabetes (because it afflicted primarily children and young adults), it is an autoimmune disease that is not preventable. At present time, the disease cannot be cured, though the field of stem cell research holds potential, according to the scientific consensus.

In March of 2008, 11-year-old Madeline Neumann died of complications from untreated Type I diabetes. The disease is easily manageable, requiring regular blood sugar checks and insulin injections. However, her parents declined such treatment, instead believing God would save their daughter by praying. By the time an aunt called an ambulance, it was too late to save Madeline. There is debate as to whether the parents should be charged with manslaughter, though their actions, according to the law, are to be considered second-degree murder. You bastards have this child's blood on your hands.

Cautions

A diabetic may lose feeling in hands and feet because of nerve damage.

It is very important that feet be inspected and any cuts, scrapes or sores are treated promptly. Amputation of the foot is not uncommon where damage has occurred.

A Doctor or Nurse should do an inspection and test of the feet to see how much loss of feeling has occurred.

Diabetics also suffer from vision loss, as well as a unique degeneration known as diabetic retinopathy. A regular appointment with an Opthamologist is recommended.

Careful attention to blood glucose control is essential to continued good health.

Portion control and choice of foods to reduce spikes in blood glucose levels is desired. A blood test (A1C) is useful every 6 months to check on blood glucose control.