Diabetes Mellitus: A short review

Dr. Ashok Kumar, Dean, Faculty of Pharmacy, Kalinga University
Diabetes is also called juvenile or insulin-dependent diabetes. Insulin is the hormone produced by Beta cells of the pancreas. It is responsible for sending glucose (sugar) to cells for energy production and eventually reduces the sugar concentration in the bloodstream. Type-1 diabetes usually appears in childhood or adolescence and sometimes in adulthood. The root cause of this type of diabetes is unknown. It may be due to a weak immune system or either genetic or it may be a virus. The main symptoms of this type of diabetes are feeling thirstier, tiredness, weight loss, more urination, blurry vision, irritability, hunger, etc.
Type-1 diabetes causes many complications in the major organs. Some of them are kidneys, eyes, heart, nerves, etc. It is a life-threatening disease. It causes coronary artery complications and reduces the artery diameter (contraction of the artery), which causes chest pain i.e. angina pectoris, and eventually increases the risk of heart attack.
High blood sugar level affects the wall of blood capillaries that supply the blood to the nerves. It affects the nerve badly (neuropathy) and causes numbness, and tingling at the tips of fingers and toes in the starting and spreads upward over time. The digestive system is affected because of neuropathy and it causes nausea, vomiting, constipation, diarrhea, etc.
Type-1 diabetes causes kidney damage (nephropathy). Blood vessels that are present in the kidney help to keep away the waste from the bloodstream. However, damage to these blood vessels because of high sugar levels causes severe damage to the kidney leading to kidney failure. At this stage only kidney dialysis or kidney transplant is the option.
Diabetic retinopathy is one of the major chronic effects of high blood sugar levels. It also increases the risk of cataracts and glaucoma besides blurred vision and blindness. During pregnancy, high blood sugar levels may cause miscarriage, stillbirth, etc.
Yet now there is no prevention of juvenile diabetes. We have to control the blood sugar level within the limit. During fasting it should be between 80-130 mg/dl. Two hours after meal it should not be more than 180 mg/dl. To maintain this blood sugar level the patient can take insulin, do more physical work, and eat healthy food with less carbohydrate. Continuous blood sugar monitoring is required for the Type-1 diabetes patient. The patients may also take blood pressure-lowering medicine, blood thinners like aspirin, and cholesterol-lowering medicines.