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ng depekto sa pankreas. Kinakikitaan ang taong may ganitong sakit ng kakulangan sa insulina, hindi mapakinabangang mga karbohidrato sa katawan, labis na asukal sa dugo at ihi. Mayroon ding sobrang pagkauhaw, pagkagutom at pag-iihi, pamamayat, at asidosis. Kapag hindi mareremedyuhan ng insulina, maaaaring mamatay ang isang tao. Ito ang uri ng diyabetes na mas kalimitang natatawag lamang bilang diabetes. Ang World Diabetes Day ay ipinagdiriwang taon-taon tuwing Nobyembre 14. Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). There are three main types of diabetes:
Type 1 diabetes: results from the body's failure to produce insulin, and presently requires the person to inject insulin. (Also referred to as insulin-dependent diabetes mellitus, IDDM for short, and juvenile diabetes.) Type 2 diabetes: results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. (Formerly referred to as non-insulin-dependent diabetes mellitus, NIDDM for short, and adult-onset diabetes.) Gestational diabetes: is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy. It may precede development of type 2 DM.
Other forms of diabetes mellitus include congenital diabetes, which is due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes. All forms of diabetes have been treatable since insulin became available in 1921, and type 2 diabetes may be controlled with medications. Both type 1 and 2 are chronic conditions that usually cannot be cured. Pancreas transplants have been tried with limited success in type 1 DM; gastric bypass surgeryhas been successful in many with morbid obesity and type 2 DM. Gestational diabetes usually resolves after delivery. Diabetes without proper treatments can cause many complications. Acute complications include hypoglycemia, diabetic ketoacidosis, or nonketotic hyperosmolar coma. Serious long-term complications include cardiovascular disease, chronic renal failure, retinal damage. Adequate treatment of diabetes is thus important, as well as blood pressure control and lifestyle factors such as smoking cessation and maintaining a healthy body weight. As of 2000 at least 171 million people worldwide have diabetes, or 2.8% of the population. Type 2 diabetes is by far the most common, affecting 90 to 95% of the U.S. diabetes population.
obesity-related diabetes. Beyond these Ketoacidosis Common Rare two types. Feature Type 1 diabetes Type 2 diabetes including childhood-onset diabetes. the term "type 2 diabetes" has Any age Age at onset Mostly in adults replaced several former terms. where beta cell loss is a T-cell mediated autoimmune attack. Likewise.90 to 95% of Less prevalent Type 1 diabetes U. but without disturbances in the sugar metabolism (insipidus meaning "without taste" in Latin). This type of diabetes can be further classified as immune-mediated or idiopathic.Most cases of diabetes mellitus fall into three broad categories: type 1. (mostly young) including adult-onset diabetes. decreased diabetes. The rare disease diabetes insipidus has similar symptoms as diabetes mellitus. and latent autoimmune diabetes of adults (or LADA or More prevalent "type 1. without qualification. which causes approximately 10% of . There is no known preventive measure against type 1 diabetes. and gestational diabetes. there is no agreedupon standard nomenclature. The term diabetes. The majority of type 1 diabetes is of the immunemediated nature.S. Prevalence . type 2 diabetes which has Concordance progressed to require injected 50% 90% in identical twins insulin.5" diabetes). juvenile diabetes. diabetics Main article: Diabetes mellitus type 1 Type 1 diabetes mellitus is characterized by loss of the insulin-producing beta cells of the islets of Langerhans in the pancreas leading to insulin deficiency. type 2. and insulin-dependent diabetes Onset Sudden Gradual mellitus (IDDM). and nonBody habitus Thin or normal Often obese insulin-dependent diabetes mellitus (NIDDM). Autoantibodies Usually present Absent Various sources have defined "type 3 diabetes" as: gestational Normal. A few other types are described. usually refers to diabetes mellitus. Comparison of type 1 and 2 diabetes The term "type 1 diabetes" has replaced several former terms. insulin-resistant type 1 Endogenous insulin Low or absent or increased diabetes (or "double diabetes").
Even though it may be transient. However. Sensitivity and responsiveness to insulin are usually normal. including an impaired counterregulatory response to hypoglycemia. About 20%– 50% of affected women develop type 2 diabetes later in life. and skeletal muscle malformations. Addison's disease).diabetes mellitus cases in North America and Europe. Gestational diabetes Main article: Gestational diabetes Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several respects. The defective responsiveness of body tissues to insulin is believed to involve the insulin receptor. untreated gestational diabetes can damage the health of the fetus or mother. Diabetes mellitus due to a known defect are classified separately. This term. most commonly as a result of poor placental perfusion due to vascular impairment. In severe cases. such as shoulder dystocia. It occurs in about 2%–5% of all pregnancies and may improve or disappear after delivery. Most affected people are otherwise healthy and of a healthy weight when onset occurs. There are many different reasons for type 1 diabetes to be accompanied by irregular and unpredictable hyperglycemias. and sometimes serious hypoglycemias. often occurring for no apparent reason in insulin-dependent diabetes. especially in the early stages. A cesarean section may be performed if there is marked fetal distress or an increased risk of injury associated with macrosomia. frequently with ketosis. These phenomena are believed to occur no more frequently than in 1% to 2% of persons with type 1 diabetes. also known as unstable diabetes or labile diabetes. "Brittle" diabetes. the predominant abnormality is reduced insulin sensitivity. congenital cardiac and central nervous system anomalies. has no biologic basis and should not be used. the specific defects are not known. Increased fetal insulin may inhibit fetal surfactant production and cause respiratory distress syndrome. and endocrinopathies (eg. Gestational diabetes is fully treatable but requires careful medical supervision throughout the pregnancy. Labor induction may be indicated with decreased placental function. In the early stage of type 2 diabetes. Hyperbilirubinemia may result from red blood cell destruction. involving a combination of relatively inadequate insulin secretion and responsiveness. Type 2 diabetes is the most common type. Risks to the baby include macrosomia (high birth weight). Type 2 diabetes Main article: Diabetes mellitus type 2 Type 2 diabetes mellitus is characterized by insulin resistance which may be combined with relatively reduced insulin secretion. Type 1 diabetes can affect children or adults but was traditionally termed "juvenile diabetes" because it represents a majority of the diabetes cases in children. perinatal death may occur. is a term that was traditionally used to describe to dramatic and recurrent swings in glucose levels. . At this stage hyperglycemia can be reversed by a variety of measures and medications that improve insulin sensitivity or reduce glucose production by the liver. gastroparesis (which leads to erratic absorption of dietary carbohydrates). however. occult infection.
Some cases of diabetes are caused by the body's tissue receptors not responding to insulin (even when insulin levels are normal. chronic pancreatitis and cystic fibrosis). Symptoms may develop rapidly (weeks or months) in type 1 diabetes while in type 2 diabetes they usually develop much more slowly and may be subtle or absent. type 1 should always be suspected in cases of rapid vision change. resulting in vision changes. malnutrition-related diabetes mellitus (MRDM or MMDM. Blurred vision is a common complaint leading to a diabetes diagnosis. Genetic mutations (autosomal or mitochondrial) can lead to defects in beta cell function. which is what separates it from type 2 diabetes). whereas with type 2 change is generally more gradual. Many drugs impair insulin secretion and some toxins damage pancreatic beta cells. In fact the rate of diabetes in expectant mothers has more than doubled in the past 6 years. Any disease that causes extensive damage to the pancreas may lead to diabetes (for example. Diseases associated with excessive secretion of insulin-antagonistichormones can cause diabetes (which is typically resolved once the hormone excess is removed). deep breathing known . a rapid. Prolonged high blood glucose causes glucose absorption. Diabetic emergencies People (usually with type 1 diabetes) may also present with diabetic ketoacidosis. Adults with LADA are frequently initially misdiagnosed as having Type 2 diabetes. ICD-10 code E12).A 2008 study completed in the U. Many people destined to develop type 2 diabetes spend many years in a state of pre-diabetes which has been termed "America's largest healthcare epidemic. but should still be suspected. sustained sensible glucose control usually returns the lens to its original shape. polydipsia (increased thirst) and polyphagia (increased hunger). was deprecated by the World Health Organization when the current taxonomy was introduced in 1999. The ICD-10 (1992) diagnostic entity. This is particularly problematic as diabetes raises the risk of complications during pregnancy. SIGNS ANDSYMPTOMS Hyperglycemia and osmosis The classical symptoms of diabetes are polyuria (frequent urination).S. Abnormal insulin action may also have been genetically determined in some cases. based on age rather than etiology. which leads to changes in the shape of the lenses of the eyes. Other types Pre-diabetes indicates a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. a state of metabolic dysregulation characterized by the smell of acetone. this form is very uncommon. as well as increasing the potential that the children of diabetic mothers will also become diabetic in the future.":10–11 Latent autoimmune diabetes of adults is a condition in which Type 1 diabetes develops in adults. found that the number of American women entering pregnancy with preexisting diabetes is increasing.
reduced vision. which is more common in type 2 diabetes and is mainly the result of dehydration. the genetic "self" identifiers relied upon by the immune system). Often. The cause of diabetes depends on the type. Together with vascular disease in the legs. Diabetes also causes "microvascular" complications—damage to the small blood vessels. the patient has been drinking extreme amounts of sugar-containing drinks. The main "macrovascular" diseases (related to atherosclerosis of larger arteries) are ischemic heart disease (angina and myocardial infarction). tingling and pain in the feet and also increasing the risk of skin damage due to altered sensation. A rarer but equally severe possibility is hyperosmolar nonketotic state. and eventually chronic kidney disease requiring dialysis. and altered states of consciousness. most commonly causing numbness. Type 2 diabetes is due primarily to lifestyle factors and genetics. but may be the first symptom in those who have otherwise not received a diagnosis before that time.e. These typically develop after many years (10–20). Following is a comprehensive list of other causes of diabetes: Genetic defects of β-cell Function Maturity onset diabetes of the young (MODY) .. can lead to scarring changes in the kidney tissue. Diabetic neuropathy is the impact of diabetes on the nervous system. nausea. Diabetic retinopathy. which affects blood vessel formation in the retina of the eye. type 1 diabetes mellitus seems to require an environmental trigger. Diabetes doubles the risk of cardiovascular disease. loss of small or progressivelylarger amounts of protein in the urine. leading to a vicious circle in regard to the water loss.stroke and peripheral vascular disease. and potentially blindness. even in those who have inherited the susceptibility. The major long-term complications relate to damage to blood vessels. with some evidence pointing at Coxsackie B4 virus. can lead to visual symptoms. neuropathy contributes to the risk of diabetes-related foot problems (such as diabetic foot ulcers) that can be difficult to treat and occasionally require amputation. Complications Main article: Complications of diabetes mellitus All forms of diabetes increase the risk of long-term complications. Diabetic nephropathy. Type 1 diabetes is partly inherited and then triggered by certain infections. vomiting and abdominal pain. the impact of diabetes on the kidneys. There is a genetic element in individual susceptibility to some of these triggers which has been traced to particular HLA genotypes (i. Other problems A number of skin rashes can occur in diabetes that are collectively known as diabetic dermadromes. However.as Kussmaul breathing.
the principal carbohydrate energy source used by the body. The rest are passed on for processing by gut flora largely in the colon. Therefore deficiency of insulin or the insensitivity of its receptors plays a central role in all forms of diabetes mellitus. are converted within a few hours to simpler forms most notably the monosaccharide glucose. Mitochondrial DNA mutations Genetic defects in insulin processing or insulin action Defects in proinsulin conversion Insulin gene mutations Insulin receptor mutations Exocrine Pancreatic Defects Chronic pancreatitis Pancreatectomy Pancreatic neoplasia Cystic fibrosis Hemochromatosis Fibrocalculous pancreatopathy Endocrinopathies Growth hormone excess (acromegaly) Cushing syndrome Hyperthyroidism Pheochromocytoma Glucagonoma Infections Cytomegalovirus infection Coxsackievirus B Drugs Glucocorticoids Thyroid hormone β-adrenergic agonists Insulin is the principal hormone that regulates uptake of glucose from the blood into most cells (primarily muscle and fat cells. and some disaccharides such as sucrose. found in the Islets of Langerhans in the . Insulin is released into the blood by beta cells (β-cells). Humans are capable of digesting some carbohydrates. starch. but not central nervous system cells). in particular those most common in food.
Normally liver cells do this when the level of insulin is low (which normally correlates with low levels of blood glucose). then glucose will not have its usual effect so that glucose will not be absorbed properly by those body cells that require it nor will it be stored appropriately in the liver and muscles. 2006 WHO Diabetes criteria edit Condition 2 hour glucose Fasting glucose mmol/l(mg/dl) mmol/l(mg/dl) Normal <7. and part of the glucose remains in the urine (glycosuria).8 (<140) <6. or for storage. and fat storage. reabsorption of glucose in the proximal renal tubuli is incomplete. or if the insulin itself is defective. resulting in increased urine production (polyuria) and increased fluid loss. such as acidosis. If the amount of insulin available is insufficient. Lost blood volume will be replaced osmotically from water held in body cells and other body compartments. The net effect is persistent high levels of blood glucose. and other metabolic derangements. Lowered glucose levels result both in the reduced release of insulin from the beta cells and in the reverse conversion of glycogen to glucose when glucose levels fall. such as pregnancy). typically after eating. This increases theosmotic pressure of the urine and inhibits reabsorption of water by the kidney. for conversion to other needed molecules. and vice versa. Insulin is used by about two-thirds of the body's cells to absorb glucose from the blood for use as fuel. causing dehydration and increased thirst. if cells respond poorly to the effects of insulin (insulin insensitivity or resistance). protein synthesis. Insulin (or its lack) is the principal signal in converting many of the bidirectional processes of metabolism from a catabolic to an anabolic direction. poor protein synthesis. a low insulin level is the trigger for entering or leaving ketosis (the fat burning metabolic phase). In particular. Higher insulin levels increase some anabolic ("building up") processes such as cell growth and duplication. in response to rising levels of blood glucose. When the glucose concentration in the blood is raised beyond its renal threshold (about 10 mmol/L. Insulin is also the principal control signal for conversion of glucose to glycogen for internal storage in liver and muscle cells. This is mainly controlled by the hormone glucagon which acts in the opposite manner to insulin.pancreas.1 (<110) . although this may be altered in certain conditions. Glucose thus forcibly produced from internal liver cell stores (as glycogen) re-enters the bloodstream. muscle cells lack the necessary export mechanism.
understanding. dietetic support.0 (<126) Diabetes mellitus ≥11. Management concentrates on keeping blood sugar levels as close to normal ("euglycemia") as possible.0 (≥126) Main article: Diabetes management Diabetes mellitus is a chronic disease which cannot be cured except in very specific situations. The goal of treatment is an HbA1C level of 6. but should not be lower than that. sensible exercise. without causing hypoglycemia. with the goal of keeping both short-term and long-term blood glucose levels within acceptable bounds. This can usually be accomplished with diet. and may be set higher. obesity. elevated cholesterol levels. In addition. Medications Oral medications Main article: Anti-diabetic medication Metformin is generally recommended as a first line treatment for type 2 diabetes as there is good evidence that it decreases mortality. given the associated higher risks of cardiovascular disease. oral medications as well as possibly insulin in type 2 diabetes).8 (<140) ≥ 6. Routine use of aspirin however has not been found to improve outcomes in uncomplicated diabetes.5%.Impaired fasting glycaemia <7. Attention is also paid to other health problems that may accelerate the deleterious effects of diabetes. high blood pressure. Insulin Main article: Insulin therapy . Lifestyle See also: Diabetic diet There are roles for patient education. and participation is vital since the complications of diabetes are far less common and less severe in people who have well-managed blood sugar levels.0(<126) Impaired glucose tolerance ≥7. These include smoking. exercise. and use of appropriate medications (insulin in the case of type 1 diabetes.8 (≥140) <7. and lack of regular exercise.1(≥110) & <7. lifestyle modifications are recommended to control blood pressure. Patient education.1 (≥200) ≥7.
physiotherapists. In other circumstances. Support In countries using a general practitioner system. When insulin is used in type 2 diabetes. may jointly provide multidisciplinary expertise. nursing specialists (e. care may take place mainly outside hospitals. difficult blood sugar control. or research projects. DSNs (Diabetic Specialist Nurse)). such as the United Kingdom.Type 1 diabetes is typically treated with a combinations of regular and NPH insulin. or synthetic insulin analogs.. . nurse practitioners. Optometrists. a long-acting formulation is usually added initially. general practitioners and specialists share care of a patient in a team approach. while continuing oral medications. Doses of insulin are then increased to effect. podiatrists/chiropodists.g.dietitians. or certified diabetes educators. with hospital-based specialist care used only in case of complications.
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