DIABETES MELITUS.??
Diabetes mellitus, commonly known as diabetes is a disease characterized by hyperglycemia (elevated blood sugar levels) that the constant and varied, especially after eating. Other sources mention that the reference to diabetes mellitus is a state of chronic hyperglycemia accompanied by various metabolic disorders caused by hormonal disorders, which cause a variety of chronic complications in the eyes, kidneys and blood vessels, accompanied by lesions in the basal membrane in the electron microscope examination
All types of diabetes mellitus have similar symptoms and complications at advanced level. Hyperglycemia itself can lead to dehydration and ketoacidosis. Long-term complications including cardiovascular disease (multiple risk), chronic failure ginjaldialisis), retinal damage which can lead to blindness, and nerve damage that can cause impotence and gangrene with risk of amputation. A more serious complication is more common when poor control of blood sugar levels. (the main cause
Establishment of a major diabetes is due to a lack of insulin (diabetes mellitus type 1, the first known), or less sensitivity of body tissues to insulin (diabetes mellitus type 2, the more common form). In addition, there are also types of diabetes mellitus caused by insulin resistance that occurs in pregnant women. Type 1 requires insulin injections, while type 2 treated with oral medication and only requires insulin if the tablets are ineffective. Diabetes mellitus in pregnancy is generally recovered by itself after childbirth.
> Patient understanding and participation is very important because blood glucose levels change continuously, because the success of keeping blood sugar within normal limits may prevent the complications of diabetes. Another factor that may reduce complications are: stop smoking, optimizing cholesterol levels, maintain a stable body weight, controlling high blood pressure, and exercise regularly. Types of Diabetes Mellitus Diabetes mellitus type 1 Diabetes mellitus type 1 – used to be called insulin-dependent diabetes (IDDM, ‘insulin-dependent diabetes “), or diabetic children, characterized by the loss of insulin-producing beta cells in pancreatic Langerhans islands so that there is a shortage of insulin in the body. This type of diabetes can be suffered by children and adults. Until now, type 1 diabetes can not be prevented. Diet and exercise can not cure or prevent type 1 diabetes. Most people with type 1 diabetes have weight and health are good when the disease began his acquaintances. In addition, the sensitivity and response of the body to insulin is generally normal in this type of diabetes, especially in the early stages. The cause of most of the loss of beta cells in type 1 diabetes is the autoimmune reaction that destroys mistakes beta cells of the pancreas. Autoimmune reactions can be triggered by an infection in the body. Currently, type 1 diabetes can only be treated with use insulin, by carefully monitoring the level of glucose monitoring devices testing of blood through the blood. Basic treatment of type 1 diabetes, even for the earliest stages though, is the replacement of insulin. Without insulin, ketosis and diabetic ketoacidosis can lead to coma and even lead to death. Emphasis was also placed on lifestyle adjustments (diet and exercise). Apart from giving injections in general, it also allows delivery of insulin through a pump, which allows for the provision of inputs of insulin 24 hours a day at dose levels which have been determined, it is also possible dose (a bolus) of insulin needed at mealtime. And possible also for the administration of insulin input through the “inhaled powder.” Type 1 diabetes treatment should continue. Treatment will not affect normal activities, if sufficient awareness, appropriate care, and discipline in the examination and treatment performed. The average glucose level for patients with type 1 diabetes should be as close as possible to the normal number (80-120 mg / dl, 4-6 mmol / l). Some physicians suggest up to 140-150 mg / dl (7-7.5 mmol / l) for those with problems with the lower number. such as “frequent hypoglycemic events.” Figures above 200 mg / dl (10 mmol / l) are often accompanied by discomfort and urinating too frequently, causing dehydration. Figures above 300 mg / dl (15 mmol / l) usually require immediate treatment and can lead to ketoacidosis. Low levels of blood glucose, called hypoglycemia, can cause seizures or frequent loss of consciousness. Diabetes mellitus type 2 Diabetes mellitus type 2 – once called non-insulin-dependent diabetes mellitusinsulin receptor in cell membranes. In the early stages the most important abnormality is reduced sensitivity to insulin, which is marked by rising levels of insulin in the blood. At this stage hyperglycemia can be over in different ways and Anti Diabetes Drugs that can increase sensitivity to insulin or reduce the production of glucose from the liver, but the more severe the disease, secretory insulinpun diminishing, and sometimes requires treatment with insulin. There are some theories that say the exact cause and mechanism of this resistance, but central obesity (fat concentrated around the waist in relation to Abdominal Organs, note it Seems, subcutaneous fat) is known as a predisposing factor to insulin resistance, possibly in connection with the expenditure of adipokines (its a group of hormones) that damage the glucose tolerance. Abdominal fat is especially active hormonally. Obesity was found in approximately 90% of the developed world to diagnose patients with type 2 diabetes. Other factors may include the brood and family history, although in the decade that was] the end [it] has been rising steadily began to affect teenagers and children. (NIDDM, “diabetes is not dependent on insulin”) – due to a combination of “defects in the production of insulin” and “insulin resistance” or “reduced sensitivity to insulin” (the defect tissue response to insulin) involving type 2 diabetes may go unnoticed for years in a patient [before / in front of] the diagnosis [as / when] the visible symptoms are typically soft or does not exist, without ketoacidotic, and can be sporadic .. However, difficulties can be caused by irritating unnoticed type 2 diabetes, including kidney failure related to, vascular diseases (including diseases pulse / main street of a heart attack), vision damage, and other Diabetes Type 2 usually, initially, treated by way of changes in physical activity (usually increase), diet (primarily the reduction of carbohydrate intake), and through weight reduction. This can restore insulin sensitivity, even when loss of weight is modest, for example, around 5 kg (10 to 15 lb), most especially when it is in abdominal fat deposits. The next step, if necessary, treatment with oral [[antidiabetic drugs. [As / When / Because] insulin production is initially unimpaired treatment, oral (often used in combination) can still be used to improve insulin production (eg, sulfonylureas) and regulate the release / release that are not based on glucose by the liver (and attenuate insulin retaliation to some extent (eg, metformin), and substantially attenuate insulin retaliation (eg, thiazolidinediones). If this fails, the science of the hormone insulin treatment will be necessary to maintain normal or near normal glucose levels. A an orderly way of life of blood glucose checks is recommended in many cases, most particularly and necessary when taking most medications Gestational Diabetes Mellitus Gestational diabetes mellitus (GDM) involves a combination of reaction capability and expenditure that is not enough insulin, mimicking the type 2 diabetes in some recognition. There can be cured during pregnancy and after childbirth. GDM may be harmful to the fetus or the mother’s health, and about 20-50% of women with GDM survive. GDM occurs in about 2-5% of all pregnancies. GDM temporary and can fully treated but not treated, may cause problems with pregnancy, including macrosomia (high birth weigh), the fetus suffered disability and suffering from heart disease since birth. The patient requires medical supervision throughout the pregnancy. Risk of Fetal / Neonatal associated with GDM includes oddity from birth, such as dealing with the heart, the central nerves system, and [as / when / because] truncated form of muscle. The hormone insulin improved things may inhibit fetal distress syndrome, surfactant production and cause of the things that Facebook fetal breathing. Hyperbilirubinemia may be caused by destruction of red blood cells. In the case of an annoying, perinatal death may occur, most commonly as a result of placental abundance of weak / poor in relation to the destruction / weakening of the vascular space. Induction / Appointment may be characterized by reduced placental function. Section Induced might do if things are marked fetal distress or an increased risk of luka-luka/kerugian associated with macrosomia, such as shoulder dystocia. Symptoms The classical triad of diabetes symptoms is polyuria (lots of urine), polydipsia (drinking a lot) and polyphagia (eating a lot). These symptoms may develops very fast set printed 1, particularly in children (months or weeks) but may be difficult to separate or completely absent & & mdash; as well as developing the much more slowly & mdash; set printed 2. Set printed 1 [in / to] there may also be a loss of weight (in addition to normal or increased eating) and fatigue that can not be reduced anymore. These symptoms may also manifest set printed 2 diabetes in patients whose diabetes is poorly controlled. Initially the symptoms associated with the direct effects of high blood sugar levels. If blood sugar levels to above 160-180 mg / dL, the glucose will not come into the urine. If levels are higher, the kidneys will get rid of extra water to thin the large number of glucose is lost. Because the kidneys produce urine in excessive amounts, so people often urinate in significant amounts (poliuri). Due poliuri the patients feel excessive thirst so much to drink (polidipsi). A large number of calories lost in the urine, patients experienced weight loss. To compensate for this is that patients often feel hungry so incredibly much to eat (polifagi). Other symptoms are blurred vision, dizziness, nausea and decreased endurance during exercise. Patients with poorly controlled diabetes are more susceptible to infection. Because of severe insulin deficiency, before treatment of diabetes type I almost always lose weight. Most type II diabetics do not experience weight loss. In type I diabetics, symptoms occur suddenly and can quickly develop into a condition called diabetic ketoacidosis. In blood sugar levels are high, but since most cells can not use glucose without insulin, so these cells take energy from other sources. Broken down fat cells and produce ketones, which is a toxic chemical that can cause the blood to become acidic (ketoacidosis). The early symptoms of diabetic ketoacidosis is thirst and frequent urination, nausea, vomiting, fatigue and abdominal pain (especially in children). Breathing becomes deep and rapid as the body attempts to repair the blood acidity. Patient breath smells like the smell of acetone. Without treatment, diabetic ketoacidosis can progress to coma, sometimes within just a few hours. Even after starting insulin therapy, type I diabetic ketoacidosis may develop if they missed an insulin injection once or experiencing stress due to infection, accident or serious illness. Type II diabetics may not show symptoms for several years. If the more severe insulin deficiency, the symptoms arose in the form of frequent urination and thirst. Ketoacidosis is rare. If blood sugar is very high (up to more than 1000 mg / dL, usually results from stress-such as infections or drugs), then the patient will experience severe dehydration, which can cause mental confusion, dizziness, convulsions and a condition called coma hiperglikemik-hiperosmolar non-ketotik. Diabetes and fasting patient sufficient control with settings just do not have difficulty eating when fasting. Patients who are quite restrained with a single dose of the drug also had no difficulty in fasting. Medicines given during fasting. For controlled with oral hypoglycemic drugs (OHO) high dose, the drug is given at a dose greater than before the breaking of dawn dose. For those who use insulin, the insulin used the medium term given the time to break the fast course. While patients must use insulin (DMTI), a double dose, is recommended for not fasting in the month Ramadha. However, patients with diabetes mellitus should still maintain your diet and exercise to maintain body health …
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