By  Faosat Aragbaye

Diabetes mellitus is a disease that prevents the body from properly utilising the energy from the food consumed. Diabetes occurred in one the following situations:
•The pancreas (an organ behind the stomach), produces little insulin or no insulin at all. Insulin is a naturally occurring hormone produced by the beta cells of the pancreas, which helps the body use sugar for energy.
Or
•The pancreas makes insulin but insulin made doesn’t work as it should. This condition is called insulin resistance.
Type of diabetes
There are two main types of diabetes: Type 1 and Type 2:
•Type 1 diabetes occurs because the insulin-producing cells of the pancreas (beta cells) are damaged. In Type 1 diabetes, the pancreas makes little or no insulin, so sugar can;t get into the body’s cells for use as energy. People with Type 1 diabetes must use insulin injections to control their blood glucose. Type 1 is the most common form of diabetes in people who are under age 30, but it can occur at any age.
•Type 2 diabetes (adult onset) -In Type 2 diabetes (adult onset diabetes), the pancreas makes insulin, but it’s either doesn’t produce enough, or the insulin doesn’t work properly. Nine out of 10 people with diabetes have Type 2. This type occurs most often in people who are over 40 years old but can occur even in childhood if there are risk factors present.
•Other types of diabetes might result from pregnancy (gestational diabetes), surgery, , use of certain medicines, various illnesses and other specific causes.
Gestational diabetes
Gestational diabetes occurs when there is a high blood glucose level during pregnancy. As pregnancy progresses, the developing baby has a greater need for glucose. Hormone changes during pregnancy also affect the action of insulin, which brings about high blood glucose levels.
Pregnant women who have a greater risk of developing gestational diabetes include those who:
•Are over 35 years old.
•Are overweight.
•Have a family history of diabetes.
•Have a history of polycystic ovary syndrome (PCOS)
. Causes of diabetes.
The causes of diabetes are not known. The following risk factors may increase the chance of getting diabetes:
Type 1 diabetes
You’re more likely to get type 1 diabetes if you’re a child or teenager, you have a parent or sibling with the condition, or you carry certain genes that are linked to the disease.
Type 2 diabetes
•Family history of diabetes or a personal history of gestational diabetes.
•African-American, Hispanic, Native American, or Asian-American race, Pacific Islander or ethnic background.
•Injury to the pancreas (such as infection, tumor, surgery or accident).
•Autoimmune disease.
•Age (risk increases with age).
•Physical stress (such as surgery or illness).
There are risk factors that you might have more control over, including:
•High blood pressure.
•Abnormal blood cholesterol or triglyceride levels.
•Smoking.
•Being overweight.
Use of certain medications, including steroids
It is important to note that sugar itself doesn’t cause diabetes. Eating a lot of sugar can lead to tooth decay, but it doesn’t cause diabetes.
Symptoms of diabetes.
The symptoms of diabetes include:
•Increased thirst.
•Increased hunger (especially after eating).
•Dry mouth.
•Frequent urination.
•Unexplained weight loss (even though you are eating and feel hungry).
Other symptoms include:
•Weakness, tiredness
•Blurred vision.
•Numbness or tingling in the hands or feet.
•Slow-healing sores or cuts.
•Dry and itchy skin.
•Frequent yeast infections or urinary tract infections.
Symptoms of low blood sugar.
Most people have symptoms of low blood sugar (hypoglycemia) when their blood sugar is less than 70 mg/dl.
Common early symptoms of low blood sugar include the following:
•Feeling weak or dizzy, including trembling and feeling shaky.
•Feeling hungry.
•Sweating.
•Pounding heart.
•Pale skin.
•Feeling frightened or anxious.
Late symptoms of low blood sugar include:
•Feeling confused or being able to keep your mind on one subject.
•Headache.
•Poor coordination.
•Bad dreams or nightmares.
•Feeling cranky.
•Numbness in your mouth and tongue.
•Passing out.
Diagnosis
Diabetes is diagnosed with fasting sugar blood tests or with A1c blood tests, also known as glycated hemoglobin tests. A fasting blood sugar test is performed after you have had nothing to eat or drink for at least eight hours. Normal fasting blood sugar is less than 100 mg/dl (5.6 mmol/l). You do not have to be fasting for an A1c blood test. Diabetes is diagnosed by one of the followings:
•Blood sugar level is equal to or greater than 126 mg/dl (7 mmol/l).
• Two random blood sugar tests over 200 mg/dl (11.1 mmol/l) with symptoms.
• Oral glucose tolerance test with results over 200 mg/dl (11.1 mmol/l).
• A1c test is greater than 6.5 percent on two separate days
Management of diabetes
There is no cure for diabetes, but it can be treated and controlled. The goals of managing diabetes are to:
•Keep your blood glucose levels as near to normal as possible by balancing food intake with medication and activity.
•Maintain your blood cholesterol and triglyceride (lipid) levels as near the normal ranges as possible.
•Control your blood pressure. Your blood pressure should not go over 140/90.
•Decrease or possibly prevent the development of diabetes-related health problems.
Ways in managing diabetes include:
•Planning what you eat and following a balanced meal plan.
•Exercising regularly.
•Taking medication, if prescribed, and closely following the guidelines on how and when to take it.
•Monitoring your blood glucose and blood pressure levels at home.
•Keeping your appointments with your healthcare providers and having laboratory tests completed as ordered by your doctor.
Treatments
Type 1 diabetes
Insulin is the main treatment for type 1 diabetes. It replaces the hormone the body isn’t able to produce.
There are four types of insulin that are most commonly used. They’re differentiated by how quickly they start to work, and how long their effects last:
Rapid-acting insulin starts to work within 15 minutes and its effects last for 3 to 4 hours.
Short-acting insulin starts to work within 30 minutes and lasts 6 to 8 hours.
Intermediate-acting insulin starts to work within 1 to 2 hours and lasts 12 to 18 hours.
Long-acting insulin starts to work a few hours after injection and lasts 24 hours or longer.
Type 2 diabetes
Diet and exercise can help some people manage type 2 diabetes. If lifestyle changes aren’t enough to lower the blood sugar, there will be need to take medication.
These drugs lower your blood sugar in a variety of ways:
•Alpha-glucosidase inhibitors-Slow the body’s breakdown of sugars and starchy foods example-Acarbose (Precose) and miglitol (Glyset)
•Biguanides- Reduce the amount of glucose the liver makes. Example-Metformin (Glucophage)
•DPP-4 inhibitors-Improve the blood sugar without making it drop too low Linagliptin (Tradjenta), saxagliptin (Onglyza), and sitagliptin (Januvia)
Glucagon-like peptides-change the way your body produces insulin . Examples-Dulaglutide (Trulicity), exenatide (Byetta), and liraglutide (Victoza)
Meglitinides-stimulate the pancreas to release more insulin Examples -Nateglinide (Starlix) and repaglinide (Prandin).
SGLT2 inhibitors-release more glucose into the urine. Examples-Canagliflozin (Invokana) and dapagliflozin (Farxiga)
Sulfonylureas- stimulate the pancreas to release more insulin. Examples- Glyburide (DiaBeta, Glynase), glipizide (Glucotrol), and glimepiride (Amaryl)
Thiazolidinediones-help insulin work better. Examples–Pioglitazone (Actos) and rosiglitazone (Avandia)
Treatment can involve more than one of these drugs. Some people with type 2 diabetes also take insulin.
Diabetes complications
High blood sugar damages organs and tissues throughout the body. The higher the blood sugar is and the longer you live with it, the greater the risk for complications.
Complications associated with diabetes include:
•heart disease, heart attack, and stroke
•neuropathy
•nephropathy
•retinopathy and vision loss
•hearing loss
•foot damage such as infections and sores that don’t heal
•skin conditions such as bacterial and fungal infections
•depression
•dementia
Prevention-
Although diabetes risk factors like family history cannot be changed, there are other risk factors that you do have some control over. Implementing some of the healthy lifestyle habits below can improve these modifiable risk factors and help to decrease your chances of getting Type 2 diabetes:
•Eating healthfully.
•Being physically active.
•Lowering your stress.
•Limiting alcohol intake.
•Getting enough sleep.
•Quitting smoking.