Seriousness: Every 5 seconds, one person dies due to diabetes-related complications.
Diabetes Mellitus: A group of metabolic diseases characterized by chronic hyperglycemia.
Diabetes Insipidus: Different condition, characterized by polyuria due to antidiuretic hormone issues.
Definition and Types
Commonality: Chronic hyperglycemia.
Cause: Either reduced insulin production or increased resistance to insulin.
Types of Diabetes Mellitus
Type 1 Diabetes: Severe reduction or absence of insulin production due to autoimmune destruction of beta cells in the pancreas.
Type 2 Diabetes: Insulin is produced but tissues are resistant to its action, initially normal or high insulin levels.
Gestational Diabetes: Hyperglycemia during pregnancy due to issues in insulin production and action.
LADA (Latent Autoimmune Diabetes in Adults): Autoimmune destruction of beta cells occurring in adults.
MODY (Maturity Onset Diabetes of the Young): Type 2 diabetes-like condition occurring in young people.
Secondary Diabetes: Caused by other factors like drugs (beta blockers, thiazides) or endocrine diseases (Cushing's syndrome).
Pathophysiology
Insulin Issues: Either production is reduced, or action is ineffective, or both.
Metabolic Disturbances: Not only carbohydrate metabolism but also lipid and protein metabolism.
Complications
Vascular Complications
Macrovascular Complications:
Coronary Artery Disease: More severe and diffuse atherosclerosis in diabetic patients.
Cerebrovascular Complications: Includes stenotic, thrombotic, embolic, and hemorrhagic CVAs (strokes).
Peripheral Vascular Disease: Especially in the lower limbs, leading to ischemia and diabetic foot disease.
Renal Vascular Disease: Affects large renal vessels, contributing to kidney damage.
Microvascular Complications:
Diabetic Retinopathy: Damage to retinal blood vessels, can lead to blindness. Two stages: non-proliferative and proliferative.
Diabetic Nephropathy: Damage to kidney's glomeruli due to thickened and leaky basement membranes, leading to end-stage renal disease.
Mortality and Morbidity
Global Impact: 500 million people worldwide suffer from diabetes; in the USA, around 36-37 million.
Diabetes-Related Deaths: 6 to 7 million annually.
Conclusion
Diabetes Mellitus: A serious, multifaceted disease with widespread systemic effects and severe complications. Effective management and understanding of the disease's mechanisms and types are crucial for reducing morbidity and mortality.