What is diabetes mellitus?

Diabetes mellitus occurs when our body is unable to maintain healthy levels of glucose resulting in high blood glucose. Insulin is a hormone that helps us turn blood glucose into energy. When the pancreas cannot produce enough insulin or the body does not use insulin effectively, this can lead to high blood glucose levels. This condition can lead to various complications if not well-managed. It is therefore important for people with diabetes to have regular medical follow-up, learn and apply diabetes self-care knowledge and skills to manage the condition well.

Different types of diabetes?

Treatment varies depending on the type of diabetes mellitus and the main types are:

Type 1 Diabetes

Type 1 diabetes is an autoimmune disorder, in which the body’s immune system attacks the insulin-producing cells. About 5-10% of individuals with diabetes have type 1 diabetes.

People with type 1 diabetes make very little to no insulin and require lifelong insulin therapy. Without insulin therapy, blood glucose levels continue to rise to high levels and may lead to a serious condition called diabetic ketoacidosis (DKA).

Type 2 Diabetes

About 90% of individuals with diabetes have type 2 diabetes, the most common form of diabetes. It usually affects people who are above 40 years old, overweight, and physically inactive. With increasing rates of childhood obesity, there has been an increasing number of children and teenagers with type 2 diabetes.

Gestational Diabetes (GDM)

Gestational diabetes is a form of diabetes that develops during pregnancy. GDM is diagnosed through an oral glucose tolerance test (OGTT) usually performed at the 24-28th week of pregnancy. High blood glucose levels may affect the developing baby. Treatment of GDM usually consists of modifying dietary intake of carbohydrates and regular blood glucose testing. Insulin injection treatment may be required if dietary measures alone fail to control blood glucose levels sufficiently.

GDM usually goes away after childbirth, but women with previous GDM are at higher risk of developing type 2 diabetes in the future and will need regular screening for type 2 diabetes.

Diabetes Related Complications

Hypoglycaemia and Hyperglycaemia Crisis

People with diabetes on insulin therapy or taking certain oral diabetes medications may experience hypoglycaemia. This occurs when there is mismatch of food intake, exercise and medications. It is important to recognize the symptoms of hypoglycaemia and treat it promptly to raise blood glucose to safe levels. Without proper treatment, blood glucose level can continue to fall and lead to more serious complications such as falls and loss of consciousness.

Symptoms of hypoglycaemia include:

Sweating
Hunger
Dizziness
Feeling shaky
Inability to concentrate or confusion
Fast heartbeat
Irritability

These symptoms need to be treated urgently with sugar intake which will resolve the symptoms rapidly.

Hyperglycaemic crisis is a serious condition caused by extremely high blood glucose levels, leading to severe dehydration. It is often triggered by acute illness, infection, or medication non-compliance and requires emergency/urgent treatment. People with a new diagnosis of type 1 diabetes can present with a hyperglycaemic crisis.

Symptoms of a hyperglycaemic crisis include:

Persistent high blood glucose level (.jpg>33mmol/L for type 2 diabetes, and .jpg>14mmol/L of type 1 diabetes)
Excessive thirst and dry mouth
Increased urination
Fever
Nausea and vomiting
Shortness of breath
Abdominal pain
Drowsiness or confusion
Hallucinations
Convulsions or Seizures
Coma

Chronic Diabetes Complications

Uncontrolled diabetes, in the long term, can lead to damage of various organs such as the eyes, heart, kidneys and nervous system. Uncontrolled diabetes is a major cause of blindness, kidney failure, heart attack, stroke and lower limb amputation. Early detection, close monitoring and effective management of diabetes are key strategies in preventing and delaying the development of chronic diabetes complications.