danger of diabetes mellitus

Diabetes mellitus is a chronic metabolic disorder condition characterized by persistent hyperglycemia. It is caused by a lack of insulin secretion by the Langerhans beta cells of the pancreatic gland, insulin resistance, or both.

Diabetes mellitus is broadly classified into three types based on causes and clinical manifestations, including type 1 diabetes mellitus (DMT1), diabetes mellitus type 2 (DMT2), and gestational diabetes (DM in pregnancy).

Diabetes Mellitus Type 1 (DMT1) occurs in about 5% to 10% of DM cases, which is caused by damage to insulin-producing beta cells in the pancreas gland. This causes an absolute lack of insulin secretion.

Diabetes Mellitus Type 2 (DMT2) occurs in 90% of DM cases. DMT2 is caused by a lack of response of the body's cells to insulin, or it is called insulin resistance. Diabetes mellitus is a world health problem. The International Diabetes Federation (IDF) organization estimates that there are at least 463 million people aged 20-79 years in the world who suffer from DM. Along with increasing age, the prevalence of DM also increases. Changes in lifestyle and increased obesity, the prevalence of DMT2 also increased.

Gestational Diabetes Mellitus (DMG) is a condition of hyperglycemia detected during pregnancy and blood sugar levels return to normal after delivery. GDM generally occurs in the second or third trimester of pregnancy. Women with DMG have a higher risk of developing type 2 diabetes mellitus later in life. DMG can be exacerbated by hypertension, preeclampsia, and hydramnios. The fetus in the womb is at risk of having an increase in body weight and size, called macrosomia (big baby) or congenital abnormalities. Even after birth, babies can experience respiratory distress syndrome (respiratory distress syndrome) or obesity later in life.

RISK FACTORS

1. Obesity

2. Lack of physical activity

3. High-calorie diet

4. Genetic (having a family member with DM)

5. History of hypertension

6. Having previous gestational diabetes mellitus

7. History of giving birth to a macrosomic baby (> 4,000 grams) in a previous pregnancy

People with diabetes mellitus can experience classic symptoms, such as polyuria (frequent urination), polydipsia (frequently thirsty), polyphagia (frequently or quickly feel hungry), and weight loss.

In addition, other symptoms can include blurred vision, tingling in the hands or feet, fatigue, wounds that take a long time to heal, and/or bacterial or fungal infections.

The diagnosis of diabetes mellitus is carried out by examining blood sugar levels. Diagnostic criteria for diabetes mellitus include:

1. Fasting blood glucose level >126 mg/dl. Fasting blood sugar is taken after the patient has fasted (no caloric intake) for at least 8 hours.

2. Plasma glucose level >200 mg/dl 2 hours after Oral Glucose Tolerance Test (OGTT) with 75 gram glucose load.

3. Blood glucose level >200 mg/dl accompanied by classic symptoms.

4. Examination of HbA1c levels >6.5%. This examination can show blood glucose levels in the last 2 to 3 months.

Diabetes screening is indicated in asymptomatic adults if

1. blood pressure is more than 135/80 mmHg

2. Overweight or has at least one or more risk factors (genetic with DM, BP >140/90 mmHg, HDL level <35mg/dL, and/or triglyceride levels) >250mg/dL)

3. The American Diabetes Association (ADA) recommends screening at age 35 in the absence of the above criteria.

CAUSES OF COMPLICATIONS

Uncontrolled persistent hyperglycemia can cause various complications, both acute and chronic. Diabetes mellitus is one of the causes of cardiovascular disease (CVD), blindness, kidney failure, and limb amputation. In addition, acute complications in people with diabetes mellitus include hypoglycemia, hyperglycemia crisis (diabetic ketoacidosis and hyperglycemia hyperosmolar state) and diabetic hyperglycemic state. coma. Chronic complications in microvascular, consisting of nephropathy, neuropathy, and retinopathy. In large blood vessels (macrovascular) such as coronary heart disease (CHD), peripheral artery disease (PAD), and cerebrovascular disease.

 

TREATMENT

The most basic treatment for DMT1 and DMT2 is diet and exercisepatterns.

Dietary settings adjust to the calorie needs needed by people with diabetes mellitus. The high prevalence of consumption of sweet foods and drinks can play a role in the occurrence of diabetes mellitus.recommendeddiet is a diet low in saturated fat, refined carbohydrates, high in fiber and unsaturated fat.

Physical activity adjusts to the body's ability, combined with food intake. People with diabetes mellitus must be physically active, which can be done like aerobic exercise for 90 to 150 minutes per week, or other moderate intensity activities. In people with DMT2 who are obese, the target is weight loss to an ideal body weight and controlled blood sugar.

The first line of medical therapy for people with diabetes mellitus is metformin. Apart from metformin, other therapies such as sulfonylureas, dipeptidyl peptidase-4 (DPP-4) inhibitors. Glucagon-like peptide-1 (GLP-I) receptor agonists, Sodium-glucose co-transporter-2 (SGLT2) inhibitors, pioglitazone, in patients with liver disorders can use alpha-glucosidase inhibitors, and insulin. People with diabetes mellitus need to monitor blood sugar levels regularly. At least once every 6 months it is necessary to evaluate treatment and lifestyle modifications. It is expected that people with diabetes mellitus can live a healthy life and the disease can be controlled.