DIABETES SYMPTOMS: diabetes type 1, diabetes type 2
Type 1 diabetes mellitus
Type 1 diabetes is most commonly diagnosed in
children and adolescents, but can occur in adults as
well. It is an autoimmune disorder, in which the body's
own immune system attacks the beta cells in the Islets
of Langerhans of the pancreas, destroying them or
damaging them sufficiently to reduce insulin production.
The autoimmune attack may be triggered by reaction to an
infection, for example by one of the viruses of the
Coxsackie virus family. A subtype of type 1
(identifiable by the presence of antibodies against beta
cells) develops slowly and so is often confused with
Type 2. In addition, a small proportion of type 1 cases
has the hereditary condition maturity onset diabetes of
the young (MODY).
Some poisons (e.g. certain rat poisons) work by
selectively destroying certain types of cells, including
pancreatic beta cells, thus producing "artificial" type
1 diabetes. Other pancreatic problems including trauma,
pancreatitis or tumors (either malignant or benign) can
also lead to loss of insulin production.
Currently, type 1 is treated with insulin injections,
lifestyle adjustments, and careful monitoring of blood
glucose levels using blood test kits. The treatment must
be continued indefinitely. Experimental replacement of
beta cells (by transplant) is being investigated in
several research programs and may become clinically
available in future.
About 5-10% of all North American cases of diabetes
are Type 1 diabetics. The fraction of type 1 diabetics
in other parts of the world differs; this is likely due
to both differences in the rate of type 1 and
differences in the rate of other types, most prominently
type 2. Most of this difference is not currently
understood.
Formerly, type 1 diabetes was called "childhood" or
"juvenile" diabetes or "insulin dependent" diabetes.
Each term is a misnomer, especially since the
obesity epidemic in recent years has led to increased
incidence of type 2 diabetes in children and adolescents
in the USA, and insulin is used in some type 2 cases.
Symptoms often come on suddenly and include:
Increased thirst
Increased urination
Constant hunger
Weight loss
Blurred vision
Fatigue, or a feeling of being tired
Type 2 diabetes mellitus
Type 2 diabetes is characterized by "insulin
resistance" as body cells do not respond appropriately
when insulin is present. This is a more complex problem
than type 1, but is sometimes easier to treat, since
insulin is still produced, especially in the initial
years. Type 2 may go unnoticed for years in a patient
before diagnosis, since the symptoms are typically
milder (no ketoacidosis) and can be sporadic. However,
severe complications can result from unnoticed type 2
diabetes, including renal failure, and coronary artery
disease.
Type 2 diabetes was formerly known by a variety of
partially misleading names, including "adult-onset
diabetes", "obesity-related diabetes",
"insulin-resistant diabetes", or "non-insulin-dependent
diabetes" (NIDDM). It may be caused by a number of
diseases, such as hemochromatosis and polycystic ovary
syndrome, and can also be caused by certain types of
medications (e.g. long-term steroid use). About 90-95%
of all North American cases of diabetes are type 2, and
about 20% of the population over the age of 65 is a type
2 diabetic. The fraction of type 2 diabetics in other
parts of the world varies substantially, almost
certainly for environmental and lifestyle reasons. There
is also a strong inheritable
genetic connection in type 2 diabetes: having
relatives (especially first degree) with type 2 is a
considerable risk factor for developing type 2 diabetes.
The majority of patients with type 2 diabetes mellitus
are obese - chronic obesity leads to increased insulin
resistance that can develop into diabetes, most likely
because adipose tissue is a (recently identified) source
of chemical signals (hormones and cytokines).
Type 2 is initially treated by changes in diet and
through weight loss. This can restore insulin
sensitivity, even when the weight lost is modest e.g.
around 5 kg (10 to 15 lb). The next step, if necessary,
is treatment with oral antidiabetic drugs: the
sulphonylureas, metformin, or (if these are
insufficient) thiazolidinediones. When these have
failed, insulin therapy may be necessary to maintain
normal glucose levels.
Symptoms of Type 2 diabetes may include:
Frequent infections
Very slow healing of wounds or sores
Nausea
Fatigue, or a feeling of being tired
Increased urination
Increased thirst
Weight loss
Blurred vision
If you have these symptoms, please see your doctor
immediately
ARE YOU A
"HIDDEN DIABETIC"?
(Almost 1 person in 40 is!)
Are you over 40?
Are there any diabetics in your
family?
Are you overweight?
Any sudden weight loss?
Are you constantly thirsty?
Do you eat excessively?
Do you urinate frequently?
Do you tire easily?
Any change in your vision?
Does your skin itch frequently?
Do your wounds heal slowly?
Have you had a baby that weighs over 9
pounds at birth?
Are you often drowsy?
Any pain in your fingers and toes?
Every "Yes" you answer
to these questions increases the possibility
that you MAY be a "hidden diabetic". Did you
know that one out of 20 people have diabetes
and only half of these know they have the
disease?
When people KNOW they have diabetes, they
can follow their doctor's orders and lead
normal, happy lives. Complications can be
avoided. The "hidden diabetics" are the
reason that diabetes is one of the leading
causes of blindness, limb loss, and death in
the United States. Let's locate our
undiagnosed diabetics and urge them to seek
proper medical care.
See your doctor today! Find out for sure if
you are a "hidden diabetic". Your good
health is the most important thing - DO
IT NOW
