Diabetes Mellitus
Diabetes MellitusDefinition Diabetes Mellitus
Diabetes mellitus (DM) is a metabolic disease characterized by high plasma glucose levels (hyperglycemia) caused by impaired secretion of insulin, insulin action or both.
There are 2 types of Diabetes mellitus on the basis of the initiation of the disease, namely:
Type-1, Insulin Dependent Diabetes Mellitus (IDDM) or juvenile typeIn this type there is destruction of pancreatic beta cells, so it is not cells produce insulin and therefore can not absorb glucose from the blood. Increased blood glucose levels so that excess glucose released by urine. This type is more common in the age of 30 years and most often begins in aged 10-13 years.
2. Type-2, Non Insulin Dependent Diabetes Mellitus (NIDDM) or adult typeThis type is independent of insulin, usually occurs in over 40years with a greater incidence in overweight people and the elderly.
Cause of Diabetes mellitus
Deficiency of the hormone insulin, which serves to utilize glucose as a source energy and synthesize fat.Type-1 cause is not so obvious can be caused by viral infection cause auto-immune reaction to combat excess virus, but it hereditary factors play a role.
Type-2 due to declining function of cells and the accumulation of amyloid betaaround the beta cells.
Function of insulin insufficiency caused by impaired or deficient production of insulin by beta cells of Langerhans pancreas gland, or due to lack of responsiveness of cells to insulin.
Clinical Overview of Diabetes mellitus
a. Patients often complain of weakness, sometimes feel tingling or a sense of chronic numbness and itching.b. Patients generally suffer from polyuria (lots of urination) polydipsia (Lots of drinking) and polyphagia (eat a lot).c. Weight loss can not be explained.d. In addition, people will feel very thirsty, loss of energy, feeling faint and tired.e. In case of further decrease in visual acuity may occur
Diagnosis of Diabetes mellitus
Based on the symptoms of diabetes with the 3P (polyphagia, polyuria, polydipsia).
Diagnosis can be confirmed by determination of blood sugar levels.a. When blood glucose levels when 200 mg / dlb. Fasting blood glucose 126 mg / dlc. on Oral Glucose Tolerance Test (TTGO) obtained test results content 2 hour blood sugar of 200 mg / dl after 75 g glucose administration.
Management of Diabetes mellitus
a. Common actions are done for patients with diabetes, among others; diet with caloric restriction, exercise when insulin resistance occurs exercise regularly can reduce it, quit smoking because nicotine can affect the uptake of glucose by cells.b. if public action is not effective in lowering blood glucose in patients Type-2 diabetes, it can be given oral antidiabetic:- Chlorpropamide started with 0.1 g / day in one provision, the maximum 0.5 mg / day- Glibenclamide start with 5 mg / day in one provision, the maximum 10 mg / day- Start with Metformin 0.5 g / day in 2 - 3 times of administration, the maximum 2 g / day.These drugs should be started with the smallest dose. After 2 weeks of treatment, dose can be increased.c. In patients with Type-1 diabetes given insulin for life, not encouraged to drink oral antidiabetics.
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