Definition of DM

DM is a group of diseases characterized by hyperglycemia (elevated blood glucose) resulting from defects in insulin secretion, insulin action, or both.

Diagnostic criteria for DM

• Fasting plasma glucose ≥ 126 mg/dL (after at least 8 hours of fasting).
• Glycated A1c (HbA1c) ≥ 6.5%.
• Symptoms include: Thirst, increased daily urine amount, weight loss, and random plasma glucose ≥ 200 mg/ dL
• 2-hour plasma glucose ≥ 200 mg/dL during a 75-g oral glucose tolerance test.

In the absence of unequivocal hyperglycemia, diagnosis requires two abnormal test results obtained at the same time or at two different time points.

DM Classification

• Type 1 DM: pancreatic β cell destruction and insulin deficiency.
• Type 2 DM: insulin resistance.
• Other specific types: resulting from pancreatitis, endocrine disorders, or drug
• Gestational DM: high blood glucose first detected during pregnancy, in women without known diabetes.

Acute complications of DM

• Hypoglycemia: Low blood glucose levels may be caused by excessive medications, insufficient food intake, or excessive physical activity.
• Diabetic ketoacidosis: excessive ketone accumulation in the body may cause gastrointestinal symptoms and shortness of breath.
• Hyperglycemic hyperosmolar state: extremely high blood glucose levels combined with dehydration and altered consciousness.

Chronic complications of DM

1. Retinopathy: vision blurring or loss of vision.
2. Neuropathy: numbed and painful limbs, postural dizziness, constipation or diarrhea, and impotence.
3. Nephropathy: protein in urine, edema, hypertension, and renal failure.
4. Cardiovascular disease: atherosclerosis incurs stoke, myocardial infarction, lower limb circulation disturbance.
5. Foot ailment: ulceration, necrosis, gangrene, infection, and amputation.

DM Treatment

• Diet: Appropriate caloric intake and balanced nutrition.
• Exercise: At least 150 minutes of moderate-intensity exercise per week
• Medications: Oral medication or insulin injection as prescribed.
• Lifestyle: Maintain a regular lifestyle.

Goals for DM control

1. Plasma glucose before meal: 80 - 130 mg/dL.
2. Plasma glucose after meal: less than 180 mg/dL.
3. HbA1c: lower than 7.0 %.