Mellitus definition
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Understanding Diabetes Mellitus: Definition and Key Characteristics
Definition of Diabetes Mellitus
Diabetes Mellitus is a group of metabolic diseases characterized by chronic hyperglycemia due to defects in insulin secretion, insulin action, or both . This condition leads to impaired metabolism of carbohydrates, proteins, and fats, resulting in elevated blood glucose levels.
Pathogenesis and Causes
The development of diabetes involves multiple pathogenic processes. These range from autoimmune destruction of the pancreatic beta-cells, leading to insulin deficiency, to abnormalities causing resistance to insulin action . Genetic and environmental factors both play significant roles in the disease's pathogenesis.
Symptoms and Acute Complications
Symptoms of marked hyperglycemia include polyuria (frequent urination), polydipsia (excessive thirst), weight loss, polyphagia (excessive hunger), and blurred vision . Acute, life-threatening complications of uncontrolled diabetes include hyperglycemia with ketoacidosis or the nonketotic hyperosmolar syndrome .
Long-term Complications
Chronic hyperglycemia in diabetes is associated with long-term damage, dysfunction, and failure of various organs, particularly the eyes, kidneys, nerves, heart, and blood vessels . Specific complications include:
- Retinopathy: Potential loss of vision.
- Nephropathy: Leading to renal failure.
- Neuropathy: Risk of foot ulcers, amputations, and Charcot joints.
- Autonomic Neuropathy: Causing gastrointestinal, genitourinary, and cardiovascular symptoms, and sexual dysfunction .
Patients with diabetes also have an increased incidence of atherosclerotic cardiovascular, peripheral arterial, and cerebrovascular diseases .
Classification of Diabetes Mellitus
Diabetes is broadly classified into two main types:
Type 1 Diabetes
Type 1 diabetes is characterized by an absolute deficiency of insulin secretion. It is often identified by serological evidence of an autoimmune process occurring in the pancreatic islets and genetic markers .
Type 2 Diabetes
Type 2 diabetes is more prevalent and results from a combination of resistance to insulin action and an inadequate compensatory insulin secretory response. This type can remain asymptomatic for a long period before being detected through abnormal carbohydrate metabolism tests .
Diagnosis and Management
The diagnosis of diabetes is based on plasma glucose measurements, either in the fasting state or after an oral glucose load. The degree of hyperglycemia can vary over time, reflecting the severity of the underlying metabolic process and its treatment .
Management strategies include lifestyle modifications such as weight reduction and exercise, oral glucose-lowering agents, and insulin therapy, depending on the severity and type of diabetes .
Conclusion
Diabetes Mellitus is a complex group of metabolic diseases with significant health implications. Understanding its definition, pathogenesis, symptoms, complications, and classification is crucial for effective diagnosis and management. The chronic nature of the disease necessitates ongoing monitoring and treatment to prevent acute and long-term complications.
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