Diabetes mellitus

Diabetes mellitus is a group of chronic metabolic disorders characterized by hyperglycemia (elevated blood sugar levels) due to defects in insulin secretion, insulin action, or both. Insulin, a hormone produced by the pancreas, is essential for glucose to enter cells and be used as a source of energy. When this process fails, glucose accumulates in the bloodstream, affecting various body systems.

Types of diabetes mellitus

There are several types of diabetes mellitus, each with its own causes and characteristics. The main types include:

Type 1 Diabetes

Type 1 diabetes, also known as juvenile or insulin-dependent diabetes, is an autoimmune disease in which the immune system attacks and destroys the beta cells of the pancreas that produce insulin. This results in an almost complete lack of insulin, forcing patients to rely on insulin injections to control their glucose levels. Although it can appear at any age, most cases are diagnosed in children, adolescents and young adults.

Type 2 Diabetes

Type 2 diabetes is the most common form of diabetes mellitus, accounting for approximately 90% of cases. In this type, the body develops insulin resistance, meaning that the cells do not respond properly to the hormone, or the pancreas does not produce enough insulin to keep glucose levels under control. Type 2 diabetes is mainly related to risk factors such as obesity, physical inactivity, an unhealthy diet, and a family history of diabetes. This form of diabetes generally appears in older adults, although in recent decades its prevalence has also increased in adolescents and young people due to a sedentary lifestyle and unbalanced diet.

Gestational diabetes

Gestational diabetes is a form of diabetes that appears during pregnancy and affects between 2% and 10% of pregnant women. This condition can cause complications for both the mother and the fetus, including an increased risk of developing type 2 diabetes in the future. In most cases, gestational diabetes disappears after childbirth, although it leaves mothers at higher risk for diabetes in the long term.

Other types of diabetes

Other, less common forms of diabetes mellitus include monogenic diabetes, which results from genetic mutations, and diabetes induced by medications or diseases, such as chronic pancreatitis or long-term use of certain medications such as corticosteroids.

Symptoms and diagnosis

Symptoms of diabetes mellitus vary depending on the type, but generally include:

• Excessive thirst and frequent urination.

• Constant hunger.

• Extreme fatigue.

– Unexplained weight loss (especially in type 1 diabetes).

– Blurred vision.

– Slow healing of wounds and frequent infections.

Diagnosis of diabetes is made through blood tests that measure glucose levels. The main tests include:

– Fasting blood glucose: A blood glucose level equal to or greater than 126 mg/dl after fasting for at least eight hours is indicative of diabetes.

– Glucose tolerance test: Blood glucose is measured before and after consuming a sugary drink. A level equal to or greater than 200 mg/dl two hours after ingestion is an indication of diabetes.

– Hemoglobin A1c: Measures the average blood glucose levels over the last three months. An A1c value equal to or greater than 6.5% indicates diabetes.

Causes and risk factors

Type 1 diabetes mellitus is an autoimmune disease with an exact cause still unknown. It is believed that certain genetic and environmental factors can trigger the destruction of beta cells in predisposed individuals.

On the other hand, type 2 diabetes is strongly associated with an unhealthy lifestyle. The most prominent risk factors are:

– Obesity: Excess body fat, especially in the abdomen, is associated with greater insulin resistance.

– Physical inactivity: Lack of exercise contributes to weight gain and decreased insulin sensitivity.

– Family history: Type 2 diabetes has a strong genetic component, and the risk increases if there is a family history.

– Diet high in fats and sugars: Unhealthy eating patterns are linked to weight gain and the development of insulin resistance.

– Age: Although it can occur at any age, the risk increases after age 45.

Long-term complications

Diabetes mellitus is a disease that, if not properly controlled, can lead to serious complications in different organs and systems. The main complications include:

• Cardiovascular damage: People with diabetes have a higher risk of heart disease, heart attack, and stroke.

• Diabetic neuropathy: Persistent hyperglycemia can damage nerves, causing pain, numbness, and loss of sensation, especially in the extremities.

• Diabetic nephropathy– Diabetes is one of the leading causes of kidney failure, as high levels of glucose damage the kidneys over time.

• Diabetic retinopathy: This disease damages the blood vessels of the retina and is one of the leading causes of blindness in adults.

• Complications in feet: Poor circulation and nerve damage can lead to serious infections, ulcers, and in extreme cases, the need for amputation.

Treatment and management of diabetes mellitus

Treatment of diabetes mellitus depends on the type and severity of the disease, but generally includes lifestyle changes, medication, and constant monitoring of glucose levels.

1. Diet and exercise: A healthy eating plan and regular physical activity are essential for controlling glucose levels, especially in type 2 diabetes. Recommendations typically include a diet rich in vegetables, lean proteins, healthy fats, and complex carbohydrates.

2. Medications: Type 1 diabetes requires insulin to survive. In type 2 diabetes, oral medications or insulin may be prescribed if glucose levels are not controlled with diet and exercise. Some of the most common medications include metformin, sulfonylureas, and SGLT2 inhibitors.

3. Glucose monitoring: People with diabetes should monitor their glucose levels regularly to keep them in healthy ranges and prevent complications. Glucose meters and, more recently, continuous monitoring systems are essential tools for daily disease management.

4. Education and psychological support: Diabetes education is key so that patients can manage their disease effectively. Additionally, psychological support is crucial, as diabetes is a chronic condition that can significantly impact quality of life.

Prevention of diabetes mellitus

In the case of type 2 diabetes, prevention is possible. Preventive strategies include:

• Maintain a healthy weight: Weight loss, even moderate, significantly reduces the risk of developing type 2 diabetes.

• Exercise regularly: At least 150 minutes of physical activity a week helps improve insulin sensitivity.

• Healthy eating: Limiting the consumption of added sugars, saturated fats and ultra-processed foods is essential.

• Avoid smoking and reduce alcohol consumption: These factors not only reduce the risk of diabetes, but also other chronic diseases.

Diabetes mellitus is a disease of enormous complexity that represents a growing challenge for health systems and society in general. Despite its devastating effects, prevention and proper control of this disease can make a difference in the quality of life of those who suffer from it. Increased public awareness, education, and access to adequate medical resources are essential to address the “silent epidemic” of diabetes mellitus and improve global health outcomes.