Diabetes Mellitus

What is Diabetes Mellitus?

Diabetes Mellitus (DM) is a condition characterized by a disorder of carbohydrate metabolism or, more simply, the body's inability to use them, resulting in an increase in blood glucose. Despite its name, this disorder does not only concern the metabolism of carbohydrates but also of the other basic components of food, fats and proteins. At the root of this problem is the deficiency of a pancreatic hormone, insulin. This deficiency concerns either reduced production of the hormone, or increased needs of the body to which the pancreas cannot respond.

Classification of Diabetes Mellitus

Depending on the insulin disorder, DM is classified into the following types:

• Type I or juvenile or insulin-dependent DM. In this type, the pancreatic cells that produce insulin are destroyed by an autoimmune mechanism (that is, by antibodies produced by the body itself). It mainly concerns young people, insulin is completely missing and the patient needs insulin treatment from the beginning.

• Type II or adult-type DM. It is characterized by an increased resistance of the body to insulin, with the result that the insulin produced is not sufficient to cover the body's metabolic needs. Insulin levels may be normal or even elevated in the initial stages of the disease and the patient is treated with antidiabetic tablets. In advanced stages, however, the pancreatic cells are insufficient and it becomes necessary to administer insulin as a treatment. This type of diabetes is characterized by heredity. Type II DM constitutes the vast majority encountered in daily medical practice.

• Gestational diabetes. It is the DM that first appears during pregnancy. It is treated with diet and insulin.

• Other special types of SD. There are various types of DM caused by drugs, hormonal disorders, pancreatic diseases, genetic syndromes.

Symptoms of Diabetes Mellitus

In its initial stages, the disease can be completely asymptomatic and therefore the patient may not know that he is suffering. Nevertheless, the complications of diabetes develop from these stages and are often the first manifestations of the disease. Symptoms of DM related to elevated blood sugar levels are:

• Polyuria

• Polydipsia

• Dry mouth

• Binge eating

• Weight loss

• Blurred vision

• Fatigue

Diagnosis of Diabetes Mellitus

In addition to regular monitoring, early diagnosis of diabetes is also important. Early interventions have been shown to reduce the risk of developing complications and improve patients' quality of life.

A diagnosis of DM is made when:

• The patient has symptoms (polyuria, polydipsia, weight loss) and a blood sugar value equal to or greater than 200 mg/dl

• Blood sugar after 8 hours of fasting equal to or greater than 126 mg/dl or

• Blood sugar 2 hours after taking 75g of glucose (sugar curve) equal to or greater than 200 mg/dl

• In recent years, the measurement of glycated hemoglobin has been used abroad in the diagnosis of DM. Thus values ​​greater than 6.5 are considered diagnostic of the disease. In the guidelines of the Greek diabetes society, this test is not included in the diagnostic criteria for diabetes, so it can only be used as an indication.

Treatment of Diabetes Mellitus

After the diagnosis of diabetes, diet and exercise are still the cornerstone for treatment, which together with hypoglycemic treatment, preventive interventions (e.g. flu vaccination) and regular check-ups for complications (cardiogram, endoscopy, etc. .) ensure a good quality of life for people with diabetes). Regular measurements of sugar and glycated hemoglobin are necessary to control the treatment. Desired values ​​for optimal regulation are fasting sugar (8-hour fasting) less than 120 mg/dl and postprandial (2 hours after a meal) less than 160 mg/dl. For glycated hemoglobin the desired values ​​are below 7%. These values ​​are individualized for each patient and determined by the attending physician.