Diabetes is a metabolism disorder characterized by an increase in blood sugar level due to the insufficiency of the hormone called insulin secretion by the pancreas gland. The insulin hormone works to transport glucose in the cell for cell metabolism and usage, however, in conditions like diabetes, the glucose is failed to be brought inside the cell due to absent or less insulin secreted.
Generally, there are two types of diabetes, Type 1 Diabetes Mellitus which is characterized by absolute deficiency of insulin and Type 2 Diabetes Mellitus characterized by reduction in insulin hormone. Diabetes is considered to be a chronic disease that brings along many complications such as peripheral vascular disease, stroke and heart attacks.
Some common signs and symptoms of this endocrine disorder is drinking too much water, eating a lot of food, feeling lethargy unusually, and having unexplained weight loss for a period of time.
Diagnosis of Diabetes
Diagnosis of diabetes is done based on venous blood glucose health screening results. For symptomatic patients, a positive result from venous blood is considered diagnostic while for asymptomatic patients, two readings from different occasions is required to make a diagnosis of diabetes mellitus.
Below are the diagnostic value used commonly in clinical practice;
| Fasting plasma glucose | Random plasma glucose |
| >7.0 mmol/l | >11.1 mmol/l |
For readings below 7.0 and and 11.1 mmol/l, a further confirmation test has to be done and it is called as the modified oral glucose tolerance test. Other investigations such as HbA1C are taken to evaluate the content of glucose in red blood cells up to 3 months prior. This test is often used to evaluate patients compliance towards medications and control of their diabetes.
Normally, reading of HbA1C should be below 6.5% to indicate a well controlled diabetes mellitus.
Treatment of diabetes mellitus
- The first mainstay treatment for diabetes is lifestyle changes. A proper diet and regular physical exercise are key to a healthy lifestyle. Your doctor will most probably refer you to a dietician to advise you on a well balanced diet and monitor progression of disease.
- If the disease is not optimized from a well balanced diet, your doctor will then start you with single oral hypoglycemic agents such as metformin or gliclazide. Type of medication is then tallied to patients’ medical profile and underlying disease. At this point you are advised on frequent monitoring of blood glucose at home.
- If oral hypoglycemic agents do not reflect positive results, you will be switched to insulin injection. Insulin is given subcutaneously at any areas such as your arms, abdomen, thighs or buttocks. The insulin regime will be decided by your doctor depending on your control of blood glucose. The most common regime is the basal bolus regime, where you will be injected 4 times daily, 3 after meals and 1 before bed.
Checkup and monitoring of diabetes patient
All diabetic patients will be followed up by doctors accordingly. The follow up period differs for all patients depending on severity and urgency of treatment. Throughout the follow up period, patients will be accessed on different systems to evaluate the complications of disease. Below are some examples of assessments done on diabetic patients.
- Eye examination : Diabetic patients are prone to get eye diseases like diabetic retinopathy and advanced diabetic eye disease.
- Leg examination : Diabetic patients can also diabetic foot ulcers as a complication of the disease.
- Neurological examination : Diabetic patients often complain of numbness and tingling sensation described as gloves and stockings feelings over their distal hands and limb.
- Lipid profile and Blood pressure : These are two common concomitant diseases with diabetic mellitus.
