Home Doctor: Practical Medicine for Every Household
Diabetes Mellitus (DM) Diabetes is a disease in which the patient has increased levels of glucose (blood sugar) over a long period of time. There are two types: type 1, or juvenile, diabetes, in which the pancreatic cells do not produce insulin, and type 2 diabetes, in which the tissues lose their affinity for insulin. The symptoms of diabetes are increased thirst (polydipsia), increased hunger (polyphagia), and increased urination. In addition, patients suffering from this condition have progressive damage to the kidneys, eyes, and sensitive nerves of the hands and feet. The patient with diabetes loses sensitivity in their hands and feet (“glove-and-stocking anesthesia”), so it is common to have wounds in these places that later become ulcers that are very difficult to heal because diabetes affects the scarring process. Type 1 diabetes is an autoimmune disorder in which the immune system attacks the cells that produce insulin by destroying them. Its symptoms occur acutely, usually in adolescence or youth. It is also called “insulin-dependent diabetes” because there is no other way to treat it but with insulin. Type 2 diabetes develops over time. It starts with a condition called insulin resistance, which is reversible with lifestyle changes. At first it can be treated with oral medication, but if the process continues to progress, insulin will eventually need to be prescribed.
a) Diagnosis The diagnosis is made by measuring blood glucose. The normal value is 80 to 110 mg/dL. A person with a value greater than 126 mg/dL after an eight-hour fast, or greater than 200 mg/dL at any time, is considered diabetic. The measurement can be made with a small device called a glucometer. To use it, a blood sample is taken from the fingertip and placed on a special glucose measuring tape. This tape is inserted into the glucometer to give the result.
Omstaal, Own work, CC BY-SA 4.0
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