When most people think of diabetes, they think of Diabetes Mellitus. Millions of people are affected by Diabetes Mellitus (DM). DM affects multiple organ systems, and, untreated, has many consequences. The focus of the medical community has been both prevention and treatment. New, innovative, treatment options are in the development stage.
What is diabetes mellitus?
There are multiple times of diabetes. The word ‘diabetes’ comes from Ancient Greek. It means “to pass through” or “siphon.” There is Diabetes Insipidus, Diabetes Mellitus Type 1 and Diabetes Mellitus Type 2.
Diabetes Mellitus is a disorder of the pancreas and insulin. Both types of Diabetes Mellitus are an issue of too much sugar, called glucose, in the blood. Mellitus means “sweet”. Supposedly, Chinese and Japanese physicians noticed that the urine of people with Diabetes Mellitus was sweet because of the extra sugar in their blood, and therefore named the condition Diabetes Mellitus.
Diabetes Insipidus is an issue related to the pituitary and the kidneys. Insipidus is a Latin word meaning “tasteless”. It refers to the fact that urine of those with Diabetes Insipidus is not sweet, in contrast to those with Diabetes Mellitus.
When most people discuss diabetes, they are referring to Diabetes Mellitus.
Diabetes Mellitus Type I (DMI)
Diabetes Mellitus Type I, more commonly referred to as Type I Diabetes, is an autoimmune disease. The body’s immune system destroys special cells in the pancreas called beta cells. The beta cells are important because they produce insulin. Normally, insulin is necessary to move glucose from the blood and into the cells that need it. Without insulin, like in Type 1 diabetes, too much glucose builds up in the blood and does not get to the organs and cells that need it for energy.
Because DMI is an autoimmune disease, it is associated with other autoimmune diseases. These include Hashimoto Thyroiditis, Celiac Disease, and Primary Adrenal Insufficiency. People with DMI may have a family history of DMI or these other autoimmune diseases.
Diabetes Mellitus Type 2 (DMII)
Diabetes Mellitus Type II, more commonly referred to as Type II Diabetes, is caused by insulin resistance. Type II Diabetics make insulin and have functioning pancreases. The body continues to make more insulin, but the cells do not respond to insulin like they are designed to. Insulin then cannot transport glucose into the cells, so glucose builds up in the blood, causing harm.
Because DMII is caused by insulin resistance, it is associated with conditions that cause elevated blood sugar. These include obesity, physical inactivity, high blood pressure, and a history of gestational diabetes. Some races and ethnicities are more at risk for DMII, particularly Hispanic, Black, Indigenous, Asian, and Pacific Islander patients.
What are the symptoms?
Each of these disorders presents with different symptoms, often at different ages in patients’ lives.
DMI
DMI first presents most often in childhood, with a peak between 4-6 years of age and 10-14 years old. It most often occurs in non-Hispanic white people. The first presentation is often sudden. A typical story is that a patient feels fatigued, are very thirsty, urinate frequently, may have cramping, and may even have visual disturbances. These patients are often, but not always, thin.
DMII
One of the biggest issues with DMII is that many people may not notice their symptoms. Unlike DMI, the symptoms of DMII are gradual, not sudden. They may not even notice, but some patients may also feel thirstier than normal and urinate more frequently. They may notice darker pigmentation around their neck, a sign of insulin resistance called acanthosis nigricans. People with diabetes are at greater risk for various infections. Patients may actually notice some of the illnesses that are associated with later stages of diabetes. These include yeast infections, urinary tract infections, superficial skin infections, pneumonia, and more. Many people are diagnosed with diabetes through routine testing from their primary doctor.
How is it diagnosed?
DM is diagnosed by checking the blood glucose at certain time points. The preferred method is checking a Hemoglobin A1C level. The A1C indicates the average blood glucose level of the previous 3 months. An A1C equal or greater than 6.5 indicates DM. An A1C including 5.8 and up to and including 6.4 indicates pre-diabetes. An A1C 5.7 and below is normal and healthy. Patients are suspected to have DMI may undergo specific testing. These tests can look for certain auto-antibodies that are often present in DMI. Depending on the patient, the physician may look for other diseases associated with DMI or DMII.
Conclusion
Diabetes Mellitus is an umbrella term for DMI and DMII. Both are complicated conditions with long-lasting complications if left untreated. The next article will outline treatment options and new research. Contact us today to learn more about Diabetes Mellitus and to determine which options best meet your health goals.
