Diabetes mellitus is the disease caused by excess glucose (sugar) in the bloodstream. There are basically two types of diabetes, called type 1 diabetes and type 2 diabetes:
Type 1 diabetes mellitus is a chronic disease that occurs when the pancreas produces very little or no insulin. Insulin is a hormone that helps the body to absorb and use glucose from food. Without insulin, glucose levels become higher than normal.
Type 2 diabetes mellitus is a chronic disease that occurs because of a combination of insufficient insulin production and body resistance to it. By explaining better, the patient produces less insulin than it should and it still works poorly. Type 2 diabetes is closely linked to being sedentary and overweight.
Excess urine, called in polyuria medicine, is one of the first signs and symptoms of diabetes.
Under normal conditions, there is no glucose in the urine because all the glucose that reaches the renal tubules is reabsorbed back into the blood.
However, when there is a high concentration of glucose in the blood, generally above 180 mg/dl, the amount of sugar that reaches the kidneys is so great that it is not able to preserve everything, allowing the loss of glucose through the urine.
Since we can not urinate pure sugar, the kidney needs to be diluted with water in order to eliminate it. Therefore, the greater the glycemia (concentration of glucose in the blood), the more intense the glycosuria (loss of glucose in the urine) and the greater the volume of urine produced.
If the diabetic patient urinates excessively, he will lose more water than was supposed, becoming dehydrated. Thirst is the body's primary defense against dehydration.
The diabetic patient who does not control their blood glucose, whether due to poor adherence to treatment or simply because they have not yet discovered that they have diabetes, end up in a vicious cycle. Excess glucose increases the amount of water lost in the urine, causing the patient to urinate very often. The loss of water causes dehydration, which in turn triggers an excessive thirst. The patient drinks a lot of water, but as glucose remains very high in the blood, he keeps urinating at all times.
Chronic tiredness is another common symptom of diabetes and occurs by two factors:
A. By dehydration: explained in the previous topic.
B. By the inability of cells to receive glucose: glucose is the main source of energy for cells; is the fuel of our organism. Who promotes the entry of blood glucose into the cells is insulin, which in type 1 diabetes is non-existent and type 2 diabetes does not work well. Therefore, diabetes mellitus is characterized essentially by the inability of the body to transport glucose into the cells, reducing the body's energy production capacity.
Weight loss is a very common symptom in type 1 diabetes. It can also occur in type 2 diabetes but it is not as frequent.
Insulin is also the hormone responsible for storing fat and for the synthesis of proteins in the body. As in type 1 diabetes there is absence of insulin, the patient stops storing fat and producing muscles. Also, since there is no glucose to generate energy, the cells end up having to generate it from the protein breakdown and fat stores of the body. Therefore, the body without insulin does not generate muscle or fat and still needs to consume the existing reserves.
As in type 2 diabetes there is circulating insulin, these effects are less evident. Furthermore, in type 2 insulin resistance is slowly establishing itself over years, unlike type 1 diabetes, which stops insulin production relatively rapidly. In fact, type 2 diabetes is associated with being overweight, which is the main cause of insulin resistance.
Because cells can not get glucose to generate energy, the body interprets this as if the patient were fasting. The body needs energy and the only way it knows to get it is through food.
One of the characteristics of diabetes weight loss is that it occurs despite the patient's frequent eating. The problem is that the glucose ingested is not harnessed and ends up being lost in the urine.
In type 1 diabetes there is initially increased hunger, but in later stages the patient becomes anorexic, which contributes even more to weight loss.
A very common symptom of diabetes is blurred vision. Excess glucose in the blood causes a swelling of the lens, the lens of the eye, changing its shape and flexibility, diminishing the ability to focus, which makes the vision blurred. The vision is often blurred when the blood glucose is very high, returning to normal after controlling for diabetes.
This change in eyes has nothing to do with diabetic retinopathy, the ophthalmological complication that can arise after years of diabetes. This will be explained in the second part of this article.
Excessive glucose in the blood, when it runs chronically, causes innumerable disturbances in the functioning of the organism. The difficulty in healing wounds occurs through a decrease in the function of the cells responsible for tissue repair, decrease in cell proliferation and difficulty in generating new blood vessels.
As explained in the topic above, diabetes also leads to disorders in the immune system by altering the functioning of defense cells. The diabetic can be considered an immunosuppressed patient and a higher risk of developing infections, including urinary tract infection, skin infections, candidiasis and pneumonia.
Diabetic ketoacidosis is a complication of type 1 diabetes and is often the first sign of diabetes. Because there is no insulin, the cells do not receive glucose and need to find another source to generate energy. As explained above, the solution is to burn fat and muscles. The problem is that these two alternative sources do not generate as much energy as glucose and still produce a huge amount of acids (called ketoacids), which leads to ketoacidosis.
Diabetic ketoacidosis usually occurs when blood glucose levels exceed 500mg/dl and is a medical emergency because it causes blood pH to drop to dangerous levels, leading to death. The signs and symptoms of ketoacidosis are nausea, vomiting, abdominal pain, mental confusion, prostration and difficulty breathing.
