Mellitus refers to the sweetness of honey. People with diabetes urinated more often than normal and their urine was found to be sweet. The condition became known as diabetes mellitus.
While the symptoms remain the same, we now know much more about diabetes. This group of disorders has one feature in common – an unusual amount of sugar (glucose) in the blood.
Glucose, the main sugar in the blood, is necessary for cells of the body to work properly. It is the main source of fuel for all cells and the only fuel for some. For instance, it is the only nutrient the brain can use as fuel. Glucose is supplied both by food that we eat and by the liver, which serves as a factory to manufacture it. Once in the blood, it can be carried to tissues and used by all cells for energy.
Insulin is a hormone produced in the pancreas. Certain cells of the body, especially muscle, need insulin in order to use glucose. Without insulin, glucose accumulates in the blood. When the level of glucose gets too high, diabetes results.
Insufficient insulin use can come from having too little available insulin in the blood or a lack (or reduction) of insulin activity at the cell. Lower insulin activity at the cell is called insulin resistance. In this case the body resists the work of insulin, so more is needed to do the same job.
Type 1 diabetes, once called insulin-dependent diabetes, involves an absolute lack of insulin. Since insulin is essential for life, someone with type 1 diabetes will not survive unless it is replaced.
People with type 2 diabetes produce insulin but not enough to meet their needs. They are almost certainly insulin resistant, and require therapy that improves insulin’s action, makes more insulin available, or both.
You do not get diabetes from eating too much sugar!
The tendency toward it is inherited, meaning you are born with genes linked to the condition. We are not certain which factors cause type 1 diabetes in someone carrying the genes. In certain circumstances, a virus may be the cause.
With type 2, a high-fat diet or simply being overweight often combines with genetic factors to produce diabetes.
Classic symptoms of high blood glucose include tiredness, thirst, increased urination during the day and having to get up more often to do so at night. Other possible symptoms include vaginal yeast infections, muscle cramps, and a 'pins and needles' sensation in the feet. Many people with diabetes do not have symptoms. The diagnosis is made based on the results of a blood test during a routine physical exam.
Untreated diabetes is dangerous. High blood sugars increase the risk of blindness, kidney disease requiring dialysis or transplant, foot infections and amputations, and other disabilities. Diabetes is also a major risk factor for heart attack and stroke.
With treatment, complications are much less likely and you have a better chance to live a long, healthy life. The closer to normal the glucose level is maintained, the lower the risk of having problems.
A low-fat diet with the proper number of calories is best.
It is much easier for your body to keep blood glucose controlled if calories are spread evenly through the day.
Exercise helps lower blood sugar during and for several hours after exercise. A program of regular exercise is recommended for anyone with diabetes. Before starting any new exercise program, visit your doctor who can assess your present level of health and advise how your medical condition might influence the type of activity you choose.
If diet and exercise are not enough, pills can help treat type 2 diabetes (see sidebar). Insulin is required for everyone with type 1 diabetes and for those with type 2 who are not completely controlled on other medications. Injection is the only way to deliver insulin to the bloodstream at present, since the stomach would digest the insulin molecule if swallowed.
Thanks to research, we are entering another era of diabetes treatment. New pills are becoming available with novel mechanisms of action. New insulins are available and more are on the way. With newer insulins, better delivery devices, and more accurate blood glucose monitors, it is easier to keep blood sugars controlled.
Complications are being found and treated earlier. Drugs are becoming available to prevent complications or stop them from progressing. Our understanding of both types of diabetes is advancing dramatically. Several studies attempting to prevent these illnesses are now underway. A cure will be next.
The future looks hopeful for diabetes treatment. In the meantime, follow the recommended diet, get regular exercise and take medications exactly as prescribed. Learn as much as you can by attending diabetes education programs and public forums. Join a support group and read as much as you can about the disease. You can take control and manage your diabetes.