Diabetes mellitus is a widespread group of endocrine diseases characterized by consistently high blood sugar levels. This condition results from either the pancreas not producing enough insulin or the body’s cells becoming resistant to insulin’s effects. Key symptoms of diabetes include increased thirst, frequent urination, unexplained weight loss, and blurred vision. If untreated, diabetes can lead to severe health complications, including cardiovascular, eye, kidney, and nerve disorders. Diabetes is responsible for approximately 4.2 million deaths annually, with 1.5 million of these deaths due to untreated or poorly managed diabetes.
Types of Diabetes
Type 1 Diabetes
Type 1 diabetes occurs when the pancreas produces little to no insulin. This form of diabetes is often diagnosed in children and young adults. The primary treatment for type 1 diabetes is insulin replacement therapy, which involves regular insulin injections to control blood sugar levels.
Type 2 Diabetes
Type 2 diabetes is the most common form, accounting for about 90% of all diabetes cases. It occurs when the body’s cells become resistant to insulin. This type is often associated with obesity and is more prevalent in adults, although it is increasingly seen in younger populations. Treatment for type 2 diabetes includes anti-diabetic medications like metformin and semaglutide, alongside lifestyle modifications such as diet and exercise.
Gestational Diabetes
Gestational diabetes occurs in some women during pregnancy and usually resolves after childbirth. However, it can increase the risk of developing type 2 diabetes later in life.
Global Prevalence and Impact
As of 2021, an estimated 537 million people worldwide had diabetes, representing 10.5% of the global adult population. This number is expected to rise to 783 million by 2045, marking a 46% increase. The prevalence of diabetes is rising most rapidly in low- and middle-income countries. Diabetes affects men and women almost equally and is the seventh leading cause of death globally. The annual global expenditure on diabetes-related healthcare is estimated at $760 billion.
Signs and Symptoms
Classic Symptoms
The classic symptoms of untreated diabetes include frequent urination, increased thirst, and unexplained weight loss. Other symptoms may include fatigue, blurred vision, and itching around the genitals due to fungal infections. About half of people with diabetes may not show any symptoms, particularly in the case of type 2 diabetes, which can develop slowly over many years.
Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is a serious complication that occurs primarily in type 1 diabetes but can also happen in type 2 diabetes under certain conditions. It involves the excessive production of ketone bodies, leading to symptoms such as nausea, vomiting, abdominal pain, and a distinctive fruity smell on the breath. DKA requires immediate medical attention.
Hyperosmolar Hyperglycemic State
The hyperosmolar hyperglycemic state (HHS) is another acute complication characterized by severe dehydration and extremely high blood sugar levels. This condition can lead to altered mental states and coma if not treated promptly.
Hypoglycemia
Hypoglycemia, or low blood sugar, is a common side effect of insulin treatment. Symptoms range from mild (sweating, trembling, palpitations) to severe (confusion, seizures, coma). Repeated episodes of hypoglycemia can lower the blood sugar level at which symptoms appear, leading to a lack of early warning signs.
Long-term Complications
Cardiovascular Disease
Diabetes significantly increases the risk of cardiovascular diseases, including heart disease and stroke. About 75% of deaths in people with diabetes are due to heart-related conditions.
Microvascular Complications
Eye Disease
Diabetic retinopathy, a leading cause of blindness in working-age adults, results from damage to the blood vessels in the retina. Other eye-related complications include cataracts and glaucoma. Regular eye exams are recommended for people with diabetes to detect and manage these conditions early.
Kidney Disease
Diabetic nephropathy is a major cause of chronic kidney disease and accounts for over half of the patients on dialysis in the United States. This condition results from damage to the kidney’s filtering units, leading to kidney failure if not managed effectively.
Nerve Damage
Diabetic neuropathy involves damage to the nerves and can cause various symptoms, including sensory loss, pain, and autonomic dysfunction such as digestive issues and erectile dysfunction. Neuropathy can also lead to diabetic foot problems, which are the most common cause of non-traumatic lower-limb amputations.
Hearing Loss
Hearing loss is another long-term complication associated with diabetes mellitus. Studies suggest that people with diabetes are at a higher risk of hearing problems compared to those without the condition.
Gallstones
Research indicates a link between type 2 diabetes and an increased risk of developing gallstones. People with diabetes are more likely to develop gallstones than those without the disease.
Cognitive Decline
Diabetes is associated with an increased risk of cognitive decline and dementia. Studies have shown that individuals with diabetes experience a greater rate of cognitive deterioration compared to those without the disease. Additionally, diabetes increases the risk of falls, particularly in elderly individuals treated with insulin.
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