Diabetes mellitus is a disease characterized by
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Understanding Diabetes Mellitus: Characteristics and Complications
Definition and Metabolic Characteristics of Diabetes Mellitus
Diabetes Mellitus is a group of metabolic diseases primarily characterized by chronic hyperglycemia due to defects in insulin secretion, insulin action, or both . This persistent high blood sugar level results from either the autoimmune destruction of pancreatic β-cells, leading to insulin deficiency, or from insulin resistance where the body's cells do not respond properly to insulin .
Pathogenesis and Types of Diabetes Mellitus
Type 1 Diabetes Mellitus
Type 1 Diabetes Mellitus (T1DM), also known as autoimmune diabetes, is characterized by the destruction of pancreatic β-cells by the immune system, leading to an absolute deficiency of insulin . This type is often identified by the presence of autoantibodies targeting β-cell proteins and typically manifests in childhood or adolescence, although it can occur later in life. Patients with T1DM require lifelong insulin therapy to manage their blood glucose levels.
Type 2 Diabetes Mellitus
Type 2 Diabetes Mellitus (T2DM) is more prevalent and results from a combination of insulin resistance and an inadequate compensatory insulin secretory response . Unlike T1DM, T2DM can often be managed initially with lifestyle changes and oral glucose-lowering agents, although some patients may eventually require insulin therapy .
Symptoms and Acute Complications
Symptoms of Hyperglycemia
Common symptoms of marked hyperglycemia include polyuria (frequent urination), polydipsia (excessive thirst), weight loss, polyphagia (excessive hunger), and blurred vision . Chronic hyperglycemia can also impair growth and increase susceptibility to infections .
Acute Complications
Uncontrolled diabetes can lead to acute, life-threatening conditions such as ketoacidosis and the nonketotic hyperosmolar syndrome . These conditions require immediate medical attention to prevent severe outcomes.
Long-term Complications
Microvascular Complications
Long-term complications of diabetes include retinopathy, which can lead to vision loss, and nephropathy, which can progress to renal failure . Peripheral neuropathy increases the risk of foot ulcers, amputations, and Charcot joints, while autonomic neuropathy can cause gastrointestinal, genitourinary, cardiovascular symptoms, and sexual dysfunction .
Macrovascular Complications
Patients with diabetes have a higher incidence of atherosclerotic cardiovascular disease, peripheral arterial disease, and cerebrovascular disease . Hypertension and abnormalities in lipoprotein metabolism are also common in diabetic patients, further increasing the risk of cardiovascular complications .
Conclusion
Diabetes Mellitus is a complex group of metabolic disorders characterized by chronic hyperglycemia due to defects in insulin secretion or action. It encompasses both Type 1 and Type 2 diabetes, each with distinct pathophysiological mechanisms and management strategies. The disease is associated with significant acute and long-term complications affecting various organs, necessitating comprehensive management to mitigate these risks. Understanding the underlying mechanisms and symptoms is crucial for effective diagnosis and treatment.
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