Diabetes Mellitus is a chronic metabolic disease characterized by elevated levels of blood glucose which leads over time to serious damage to the heart, blood vessels, eyes, kidneys, and nerves.
The most common one is Type 2 diabetes, usually in adults, which -occur when the body becomes resistant to insulin or doesn’t make enough insulin. In the past three decades, the prevalence of Type 2 Diabetes has raised dramatically in countries of all income levels.
Type 1 Diabetes, once known as the juvenile Diabetes or insulin dependent. Diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself.
Epidemiology
About 422 million people world-wide have Diabetes, the majority living in low- and middle-income countries, and 1.5million deaths are directly attributed to Diabetes each year. Both the number of cases and prevalence of Diabetes have been steadily increasing over the past few decades.
World Health Organization agreed target to halt the rise in Diabetes and Obesity in 2025. A national prevalence survey in Uganda estimated 26.5% of adults had Hypertension and 1.4% had Diabetes and the majority of them were unaware of their underlying medical condition; while the proportion of undiagnosed Diabetes in Uganda is as high as 49%: The overall prevalence Diabetes in Uganda is estimated to be at 1.4%.
There are pockets of higher prevalence e.g., Rural Eastern Uganda showed a Diabetic prevalence of 7.4% and pre-diabetes 8.6% (Mayuge ET la 2019).
What goes wrong with individuals having diabetes mellitus
Type 1: It is an autoimmune disease where the body reacts to its own cells, as the reaction being triggered by the environmental factors like viruses in individuals with susceptible genes (HLA, DR4, & DR3). Diseases like Rheumatoid, SLE, Celiac disease, and vitiligo take a similar course.
Type 2: The body is resistant to insulin and with time even the amount of insulin produced becomes inefficient. All these are believed to be secondary to;
Metabolic syndrome which comprises of having;
- Fasting blood sugar >/= 100mg/dl, HDL- Female </=50mg/dl, Body mass index– Female>/=35- Male >/=40, Triglycerides >/=150mg/dl
First degree relative (genetic)
Complications of Diabetes DM affects the body majorly at two levels;
Macroscopic tissue level
Stroke, Coronary artery disease, Peripheral artery disease, microscopic tissue level, Diabetic neuropathy (nerve damage), Diabetic retinopathy (damage to lenses of eyes).
Acute Complications
Diabetic Ketoacidosis (DKA)
Individuals present with confusion, nausea, vomiting, intense abdominal pain and shortness of breath all secondary to high blood sugars due to absence of insulin.
Hyperosmolar Hyperglycemic tate (HSS)-Individuals present with severe dehydration due to excessive osmotic water loss secondary to high sugars.
Signs and Symptoms
Excessive urination (polyuria), Excessive thirst, Excessive hunger, Unexplained weight loss, non-healing wounds, Blurred vision, Numbness.
Diagnosis
In the presence of signs and symptoms;
Fasting glucose >/=126mg/dl, -Random glucose >/=200mg/dl, Two-hour oral glucose per hour>/=200mg/dl, Hemoglobin A 1c >/= 6.5%.
Management
Depends on the type of diabetes.
Type 1-entirely managed by insulin therapy due to inability of the body to produce its own insulin.
Type 2– Both insulin therapy and oral treatment which can increase the sensitivity of the body cells to produce insulin are used.
Prevention of Diabetes Mellitus
Maintain a healthy diet, stay active; avoid sedentary life style, Control alcohol intake and quit smoking, Routine monitoring of your blood sugar levels at least every after 6months, Seek attention to a professional health worker immediately in case of the above symptoms.
This content is published in partnership with Specialist Doctors International, Jinja
