Type 1 diabetes, Insulin Dependent Diabetes Mellitus (IDDM), Non-Insulin Dependent Diabetes Mellitus (NIDDM).

The causes of diabetes may be:-

• Destruction of the insulin producing cells of the pancreas – leads to type1 diabetes
• Diminished production of insulin by the pancreas
• Development of resistance to the actions of insulin

Type 1 diabetes is mainly seen in children and type 2 diabetes is mainly seen in middle age or older people. Type 1 diabetes is prevalent in persons having a particular HLA genotype.

Type 2 diabetes is hereditary to a large extent. If first degree relative has diabetes then there are high chances to get it later in life. It was thought that it is the disease of adults but due to obesity and lack of physical exercise it is caused in children also.

Positive family history is a risk factor for both type 1 and type 2 diabetes mellitus.

Obesity, polycystic ovarian disease, high cholesterol levels, cushing’s syndrome, growth hormone disorders like acromegaly, and diabetes in first degree relatives are the risk factors for type 2 diabetes.

Diabetes is diagnosed based on medical history, symptoms, blood test (blood sugar content), glucose tolerance test, C- peptide assay and islet cell antibody assay are the tests to diagnose diabetes.

Diabetes once ensued cannot be treated but with lifestyle modifications and requisite medications (wherever necessary) it can be definitely kept under control and one can lead a normal healthy life. Lifestyle changes help to gain control over diabetes to a large extent. Alterations in eating habits like controlled carbohydrate intake, fatty food and high calorie food together with right amount of physical exercise help to control diabetes effectively.

Since the pancreatic cells do not secrete insulin, insulin injections are given or insulin can be provided by insulin pump or by breathing insulin.

Control over hypertension, cholesterol, regular glucose monitoring and lifestyle modifications keep the diabetes in control.

Surgery for pancreatic transplant may be done but so far it has not become practically possible. Islet cell transplantation may be done. In this islet cells are injected in liver, there they inhabit themselves and produce insulin and help in completing the necessary insulin demand.

The type 2 diabetes is relatively easy to treat though it is more complex. If it is detected in early stages then it is easy to treat. Treatment is given mainly to avoid complications and consequent death and to have better quality of life after diabetes.

Small amount of regular physical exercise for prolonged period of time controls diabetes. Forty five minutes daily walking is enough and self monitoring of blood glucose is helpful in controlling diabetes.

Drugs used in diabetes belong to different classes and they are not interchangeable.

A physician only can decide an appropriate drug. The drugs function differently, they may reduce glucose release from liver, facilitate intake of glucose by body cells or increase insulin secretion.

Prognosis of diabetes is generally good provided the prescribed medications, life styles modifications, diet control and physical exercise is followed properly.

The acute complications of diabetes are hypoglycemia (less concentration of blood sugar than normal), ketoacidosis and non-ketotic hyper osmolar coma.

The chronic complications of diabetes are blur vision, blindness, injury to minute blood vessels and nerves carrying senses, impaired kidney function and heart diseases. Injury to minute blood vessels and nerves carrying senses results in slow healing of wounds.

Wounds take a long time to heal. If there is a wound on the leg and if it is not curer there may be multiple infections leading to a condition is called as diabetic foot ulcer. The ulcer may become a gangrene requiring amputation of the leg.

If symptoms of diabetes or complications are seen then it is better to call the health care provider.

Diabetes can be prevented by controlling fatty, sweet, and high calories food and thereby controlling weight. Physical exercise is also important in controlling diabetes. Screening for diabetes can prevent it. Some drugs can help in delaying the beginning of diabetes.