DIABETES MELLITUS
Diabetes Mellitus (DM) is a disease caused by hyperglycemia or high glucose levels in the blood and abnormalities in metabolic processes due to insulin deficiency.
Types of Diabetes Mellitus
DM according to its classification is divided into two types. Type 1 diabetes is diabetes caused by the pancreas organ in the body that cannot produce the hormone insulin. Type 1 diabetes is mostly detected at the age of children to adolescents. Meanwhile, type 2 diabetes is caused because the body's cells become less sensitive to the hormone insulin, even though the production and levels of the hormone insulin are normal. In addition to diabetes type 1 and 2, there is also diabetes that can occur in pregnant women, namely gestational diabetes. Gestational diabetes is caused by hormonal changes and usually blood sugar levels will return to normal after the pregnant woman gives birth.
The Incidence Rate of Diabetes Mellitus
The International Diabetes Federation informed that in 2015 the number of DM sufferers reached 415 million people, and 98% of them were people with Type 2 DM. In 2030 there will be an increase in the population affected by Diabetes Mellitus at least 366 million people. In addition, WHO also stated that Indonesia was included in the 4 countries with the highest population suffering from DM along with China, the US, and India.
Diabetes Mellitus Risk Factors
In type 1 diabetes, the risk factor that influences it is thought to be genetic. Whereas in type 2 DM, there are two types of risk factors, namely risk factors that cannot be changed and risk factors that can be changed. Risk factors that cannot be changed include family history of DM and age 65 years and over. While the risk factors that can be changed include lifestyle, such as food consumed, smoking habits, rest patterns, physical activity and stress management.
Symptoms of Diabetes Mellitus
Common symptoms of DM, both type 1 and type 2, include:
1. Often feel thirsty and hungry (polydipsia and polyphagia)
2. Frequent urination (polyuria) especially at night
3. Often feel tired
4. There is weight loss for no reason
5. Muscle pain and tingling (neuropathy)
6. Wounds on the body that are difficult to heal
7. The presence of black spots on the neck, armpits, and groin (acanthosis nigrikans)
8. Erectile dysfunction or impotence in men
Complications of Diabetes Mellitus
Complications that can arise in type 1 and 2 DM are:
1. Diabetic retinopathy: eye or vision disturbances to cause blindness.
2. Cardiovascular disease: disease of the heart and blood vessels that causes an attack or swelling of the heart.
3. Diabetic nephropathy: kidney disorders that cause kidney damage to hemodialysis or dialysis.
4. Diabetic neuropathy: a nerve disorder that causes injuries to leg amputations
Diagnosing Diabetes Mellitus
In enforcing DM, the following examinations are required:
1. Periodic Blood Sugar Examination (GDS): aims to measure blood sugar levels at random at certain hours. The normal level of GDS is < 200 mg/dL
2. Checking Fasting Blood Sugar (GDP): aims to measure blood sugar levels after the patient has fasted for 8 hours first. Normal GDP level is < 126 mg/dL
3. 2 Hours Post Prandial Blood Sugar Check (GD2PP): aims to measure blood sugar levels after fasting, followed by measuring blood sugar levels 2 hours after eating. Normal GD2PP levels are < 200 mg/dL
4. HbA1c or
Hemoglobin A1c: aims to measure the average blood sugar level in red blood cells or hemoglobin over the last 3 months. This duration corresponds to the hemoglobin life cycle, which is 90 days. So this examination is more accurate to describe blood sugar levels in the long term. Normal HbA1c level is <6.5%
Diabetes Mellitus Treatment
DM treatment can be categorized as follows
Regulating diet: by increasing the consumption of nutritious foods such as protein, vegetables, fruit and avoiding foods high in calories and fat
Improve your lifestyle: avoid physical inactivity and increase your regular exercise and physical activity
Drugs: biguanides and sulfonylureas whose use is under doctor's advice
Insulin: treatment with insulin is absolutely necessary in type 1 diabetes because in type 1 diabetes the pancreas cannot produce insulin. In type 2 diabetes, insulin is usually used in patients whose blood sugar levels cannot be controlled with lifestyle modifications or medications. The proper use of insulin, of course, must be on the advice of a doctor
In essence, DM is a systemic disease that often occurs in the community due to lifestyle factors and inappropriate eating patterns and can cause various complications in the sufferer's organs, so that it can have an impact on a person's overall quality of life. Therefore, always pay attention to food intake and the condition of your body. If you experience some of the symptoms above, don't hesitate to immediately consult a doctor so that they can be treated immediately before they get worse. To carry out an examination, you can immediately make an appointment with the relevant doctor at the Hermina Pasteur Hospital or make a booking through the “Halo Hermina” application which can be downloaded on the appstore or play store application.
Created by : dr. Fitri Dwiyani, MARS
Reviewed by : dr. Adam Iskandar, Sp.PD