Diabetes Mellitus

Diabetes Mellitus, medical terms, that often we know with diabetes or diabetes. Diabetes often kerennya language.
That is a disease in which the content of sugar in the blood of people with uncontrollable. Sugar is too high (hiperglikemia) is a case of diabetes most often found in comparison with the sugar under the nornal (hipoglikemia)

Diabetes Mellitus (DM) (from the Greek word διαβαίνειν, diabaínein, "penetrating" or "tap water", and the Latin word Mellitus, "sweet"), which are commonly known as diabetes is a disease marked by hiperglisemia (increased blood sugar) ongoing and varied, especially after meals. Other sources mentioned that the definition of diabetes Mellitus is a condition hiperglikemia chronicles accompanied by metabolik aberration due to hormonal disturbances, which cause various complications, chronicles the eyes, kidneys and blood vessels, accompanied by lesi on the membrane basalis in the examination with electron microscope. [2]

All types of diabetes Mellitus have similar symptoms and complications in the level of information. Hiperglisemia itself can cause dehydration and ketoasidosis. Long-term complications including cardiovascular disease (double the risk), chronic renal failure (the main cause of dialysis), Retina damage that can cause blindness, and nerve damage that can cause the most risk and gangren with concision. The more serious complications more common when the blood sugar control worse.

CAUSE

Formation of diabetes that is important due to a lack of insulin production (diabetes Mellitus type 1, the first known), or less sa sports network body to insulin (type 2 diabetes Mellitus, a more common form). In addition, there is a type of diabetes Mellitus, which is also caused by resistansi insulin that occurs in pregnant women. Type 1 requires the injection of insulin, whereas type 2 resolved with oral medication and insulin only if the medicine is not effective. Diabetes Mellitus in pregnancy usually recovers by itself after childbirth.

Understanding and patient participation is very important because blood glucose levels continue to change, because the success of maintaining blood sugar in normal limits can prevent complications of diabetes. Other factors that may reduce complications are: stop smoking, optimizing the rate of cholesterol, maintain a stable body weight, control high blood pressure, and to do sports regularly.


Table: The blood glucose during fasting and with the method as a benchmark enzimatik filter and the diagnosis DM (mg / dl). [2] Not sure yet DM DM DM
While the rate of blood glucose:
Plasma vena <110 110 - 199> 200
Capillary blood <90 90 - 199> 200
The rate of fasting blood glucose:
Plasma vena <110 110 - 125> 126
Capillary blood <90 90 - 109> 110


World Health Organization (WHO) recognizes three forms of diabetes Mellitus, namely type 1, type 2, diabetes and gestasional (occurs during pregnancy) [3].

Diabetes Mellitus Type 1

Diabetes Mellitus Type 1 - previously called insulin-dependent diabetes (IDDM, "a diabetic who depends on insulin"), or diabetic children, was characterized by the loss of insulin producing beta cells in the islands of Langerhans pancreas that occurs lack of insulin in the body. This type of diabetes can be suffered by children and adults.

Until now, type 1 diabetes can not be prevented. Diet and exercise can not cure or prevent diabetes type 1. Most diabetics have type 1 health and weight of both the disease began dideritanya. In addition, the body's sensitivity and response to insulin generally normal in this type of diabetics, especially in the early stages.

Most of the causes of loss of beta cells in diabetes type 1 is a mistake backlash autoimunitas destroy the pancreas beta cells. Autoimunitas reaction can be triggered by the infection in the body.

Currently, type 1 diabetes can only be treated with insulin, with carefully monitoring the level of blood glucose monitoring equipment through testing. The basic treatment of diabetes type 1, for even the most preliminary stage even though, is replacement of insulin. Without insulin, ketosis and diabetic ketoacidosis can lead to coma and even death can result. Emphasis is also given on lifestyle adjustments (diet and sports). Apart from the injection, in general, are also possible through the insulin pump, which allows for the input of insulin 24 hours a day at the dose level that has been determined, is also possible dose of (a bolus) of the insulin needed during the meal. And also for the possible entry of insulin through the "inhaled powder.

Type 1 diabetes care must continue to persist. Treatment will not affect the normal activities if sufficient awareness, appropriate care, and discipline in the examination and treatment started. Glucose level of the average for type 1 diabetes patients should close as possible to normal numbers (80-120 mg / dl, 4-6 mmol / l). Some doctors suggest up to 140-150 mg / dl (7-7.5 mmol / l) for those who have problems with the figures lower. such as "Frequent hypoglycemic events." Numbers above 200 mg / dl (10 mmol / l) are often followed by a feeling uncomfortable and urine that is too often causing dehydration. Numbers above 300 mg / dl (15 mmol / l) usually need treatment immediately, and can lead to ketoasidosis. Blood glucose level is low, which is called hypoglycemia, can often cause convulsions or loss of consciousness.

Diabetes Mellitus type 2

Diabetes Mellitus type 2 - previously called non-insulin-dependent diabetes Mellitus (NIDDM, "diabetes is not dependent on insulin") - occurs because the combination of "disability in the production of insulin and insulin resistance against" or "decreasing the sensitivity to insulin" (defek response, the network of insulin) that involve reseptor insulin in the cell membrane. In the initial phase of the major abnormalities are diminishing sensitivity to insulin, which is marked by the increasing rate of insulin in the blood. At this stage, hiperglikemia can be various ways and Anti-Diabetes Drugs that can increase sensitivity to insulin or reduce the production of glucose from hepar, but the more severe the disease, secretions insulinpun the wane, with insulin therapy and sometimes needed. There are several theories that would cause the occurrence and mechanism of resistance, but central obesity (fat around the waist concentrate in relation to the abdominal organs, and "it seems, subcutaneous fat) is known as factors predisposisi occurrence of resistance to insulin, may be in connection with the expenditure of adipokines (its a group of hormones) that damage the glucose tolerance. abdominal fat is especially active hormonally. Obesity is found in approximately 90% of patients developed world mendiagnose with type 2 diabetes. Other factors may include family history and brood, although the pitch in the decade] end of [that] has continued to increase began to affect teenagers and children.

Type 2 diabetes can go unnoticed for years in a patient [before / in front of] diagnosis [as / when] the visible symptoms are typically soft, or that do not exist, without ketoacidotic, and can be sporadic .. However, the difficulties that can irritate caused by unnoticed type 2 diabetes, including failure associated with kidney, disease, which vaskuler (including carotid disease / heart attack the main road), damaged the vision, and others

Type 2 diabetes usually, initially, treated with changes in the way of physical activity (usually increase), diet (generally Feed carbohydrate reduction), and through reduction in body weight. This endeavor can return hormone insulin sensitivity, even when weight loss / burden is modest, for example, around 5 kg (10 to 15 lb), most especially when it is in the deposits of abdominal fat. The next step, if necessary, treatment with oral [[antidiabetic drugs. [As / When / For] the production of hormones, insulin treatment is initially unimpaired, oral (often used in combination) cans still be used to increase the production of hormones, insulin (eg, sulfonylureas) and set a release / release that are not appropriate on glucose by the liver (Thin and retaliation hormone insulin to a certain extent (eg, metformin), and at the bottom thinner retaliation hormone insulin (eg, thiazolidinediones). If this fails, science hormone insulin treatment will be required to maintain normal or near normal glucose levels. A orderly way of life that checks on blood glucose is recommended in many cases, and most especially when the need to take the most treatment.

Diabetes Mellitus gestasional

Gestasional Mellitus diabetes (gestational diabetes Mellitus, GDM) also involves a combination of reaction and the ability of the hormone insulin is not enough imitate type 2 diabetes in some recognition. [It's] a reason;'s during pregnancy and may increase or vanish after the delivery of the disappeared. While the passenger may only temporarily, gestational diabetes can devastate the health of the fetus or mother, and about 20% -50% of women with gestational diabetes flower; a type 2 diabetes and (in) life.

Gestational diabetes Mellitus (GDM) occurs in approximately 2% -5% of all pregnancies. [It] is temporary and full can treat but not treated, can cause problems with pregnancy, including macrosomia (high birth weigh), truncated form of this disease and fetal heart since birth. [It] requires careful supervision of the medical throughout pregnancy.

Fetal / neonatal risk associated with GDM include anomaly since birth as related to the heart, nerves of the central system, and [as / when / because] truncated form of muscle. The hormone insulin improved things can prevent fetal syndrome cares surfactant production and cause it to the fetus everywhere. Hyperbilirubinemia can be caused by destruction of red blood cells. In that case, the perinatal mortality may occur, the most common placental abundance as a result of weak / poor in connection with the destruction / impairment that vaskuler. Induction / may be marked Pelantikan with reduced placental function. Cesarean section may be conducted if it cares fetus or an increased risk of luka-luka/kerugian associated with macrosomia, such as shoulder dystocia.

Symptoms

The classic triad of symptoms of diabetes are polyuria (frequent urination that), polydipsia (increased thirst and fluid inputs as a result of improved) and polyphagia (improved taste). Symptoms of this can breed; I truly fasting is set to print 1, particularly in children (weeks or months) but may be difficult to fully separated or absent & mdash; as well as expand; a far more slowly & mdash; set to print 2. Set printed 1 [in the] there may also be a weight loss / load (in addition to the normal or increased eating) and the fatigue that may be no more. These symptoms can also set into print 2 diabetes patients in whom diabetes is the less well-organized. Symptoms associated with the initial effects directly from the blood sugar level. If blood sugar up above 160-180 mg / dl, the glucose will be up to the water urine. If the measure is higher again, remove the kidney will be additional water to dilute the large amount of glucose lost. Because the kidneys produce urine in the amount of water is excessive, then the patient often berkemih in the number of the many (poliuri).

Poliuri result, the people who feel thirsty to drink so much (polidipsi).

A large number of calories lost in the urine of water, people experienced a decrease in body weight. To this mengkompensasikan people often feel the hunger that so many exceptional food (polifagi).

Other symptoms are vague views, dizziness, nausea, and less resilience during the exercise. Diabetics who are less controlled more sensitive to infection.

Because of the severe shortage of insulin, then undergo treatment before type I diabetics almost always experienced a decrease in body weight. Most diabetics have type II did not decrease body weight.

In type I diabetics, symptoms may arise suddenly and can quickly develop into a situation that called ketoasidosis diabetikum. Sugar in the blood are high, but because most of the cells can not use sugar without insulin, the cells take this energy from other sources. Tuesday was fat and produce keton, which is toxic chemicals that can cause blood to become acid (ketoasidosis). Early symptoms of ketoasidosis diabetikum is feeling thirsty and berkemih excessive, nausea, vomiting, fatigue and stomach pains (especially in children). Breathing becomes rapid and in the body because of trying to improve the acidity of blood. Tercium breath odor people smell like aseton. Without treatment, ketoasidosis diabetikum can develop into coma, sometimes within only a few hours.

Even after a start insulin therapy, type I diabetics can experience ketoasidosis if they ignore the one-time injection of insulin or experiencing stress due to infection, kecelakann or serious illnesses.

Type II diabetics can not show symptoms semala several years. If the severe shortage of insulin, the timbullah symptoms that often form berkemih and often feel thirsty. Ketoasidosis rarely happens. If blood sugar is very high (up to more than 1,000 mg / dl, usually occur as a result of stress, such as infection or drugs), then the patient will experience severe dehydration, which can cause mental confusion, dizziness, cramps and a condition called coma hiperglikemik-hiperosmolar non-ketotik.

Symptoms associated with the initial effects directly from the blood sugar level. If blood sugar up above 160-180 mg / dl, the glucose will be up to the water urine. If the measure is higher again, remove the kidney will be additional water to dilute the large amount of glucose lost. Because the kidneys produce urine in the amount of water is excessive, then the patient often berkemih in the number of the many (poliuri).

Poliuri result, the people who feel thirsty to drink so much (polidipsi).

A large number of calories lost in the urine of water, people experienced a decrease in body weight. To this mengkompensasikan people often feel the hunger that so many exceptional food (polifagi).

Other symptoms are vague views, dizziness, nausea, and less resilience during the exercise. Diabetics who are less controlled more sensitive to infection.

Because of the severe shortage of insulin, then undergo treatment before type I diabetics almost always experienced a decrease in body weight. Most diabetics have type II did not decrease body weight.

In type I diabetics, symptoms may arise suddenly and can quickly develop into a situation that called ketoasidosis diabetikum. Sugar in the blood are high, but because most of the cells can not use sugar without insulin, the cells take this energy from other sources. Tuesday was fat and produce keton, which is toxic chemicals that can cause blood to become acid (ketoasidosis). Early symptoms of ketoasidosis diabetikum is feeling thirsty and berkemih excessive, nausea, vomiting, fatigue and stomach pains (especially in children). Breathing becomes rapid and in the body because of trying to improve the acidity of blood. Tercium breath odor people smell like aseton. Without treatment, ketoasidosis diabetikum can develop into coma, sometimes within only a few hours.

Even after a start insulin therapy, type I diabetics can experience ketoasidosis if they ignore the one-time injection of insulin or experiencing stress due to infection, kecelakann or serious illnesses.

Type II diabetics can not show symptoms semala several years. If the severe shortage of insulin, the timbullah symptoms that often form berkemih and often feel thirsty. Ketoasidosis rarely happens. If blood sugar is very high (up to more than 1,000 mg / dl, usually occur as a result of stress, such as infection or drugs), then the patient will experience severe dehydration, which can cause mental confusion, dizziness, cramps and a condition called coma hiperglikemik-hiperosmolar non-ketotik.