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Diabetes

What is Diabetes?

Diabetes is a disease that occurs when your blood glucose is too high. Blood glucose is your main source of energy and comes from the food you eat. Insulin, a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy. Sometimes your body doesn’t make enough or any insulin or doesn’t use insulin well. Glucose then stays in your blood and doesn’t reach your cells. Over time, having too much of glucose in your blood can cause health problems. Although diabetes has no cure, you can take steps to manage your diabetes and stay healthy.

What health problems can people with diabetes develop?

Over time, high blood glucose leads to problems such as:
• Heart disease
• Stroke
• Kidney disease
• Eye problems
• Dental disease
• Nerve damage
• Foot problems

Signs and symptoms

Many patients with type 2 diabetes are asymptomatic. Clinical manifestations include the following:

• Classic symptoms: Polyuria, polydipsia, polyphagia, and weight loss
• Blurred vision
• Lower-extremity paresthesias
• Yeast and fungal infections

Approaches to prevention of diabetic complications:

By monitoring:

• HbA1c every 3-6 months
• Annual eye examinations
• Annual microalbumin checks
• Foot examinations periodically
• Blood pressure < 130/80 mmHg
• Statin therapy to reduce low-density lipoprotein cholesterol

Overall Goals:

Diabetes mellitus treatment not only starts with drugs or insulin, a lot depends on
– Diet
– Exercise
– Lifestyle modification

The goals of therapy for diabetes mellitus are to
1. Prevent long-term complications of DM.
A major focus on comprehensive cardiovascular risk reduction
2. Individualized glycemic targets and glucose-lowering therapies
3. Eliminate symptoms related to hyperglycemia.

Symptoms of diabetes usually resolve when the plasma glucose is < (200 mg/dL), and thus most DM treatment focuses on achieving the first and second goals.

Ongoing aspects of Comprehensive Diabetes Care:

The morbidity and mortality of Diabetes mellitus can be greatly reduced by timely and consistent surveillance, including the detection, prevention, and management of DM-related complications.

Such screening procedures are indicated for all individuals with DM, but many individuals with diabetes do not receive these or comprehensive diabetes care.

In addition to the physical aspects of DM, social, family, financial, cultural, and employment-related issues may impact diabetes care.

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