Juvenile-onset diabetes and maturity-onset diabetes

Diabetes was first recorded in ancient Egypt in 1500 BC. The word “diabetes” is greek and means ‘fountai’ referring to the large amounts of urine produced by the disease in its early stages. Diabetic urine produced by the disease in its early stages. Diabetic urine smells sweet and its alternative name-‘mellitus’ comes from the Latin word for ‘honey’. Doctor can often find ususpected diabetes by finding sugar in urine tests. The urine of diabetic attracts ants looking for sugar and early methods of detecting diabetes included testing the urine for sweetness.
There are two major forms of diabetes

Type 1 (insulin-independent) diabetes known as juvenileonset diabetes is caused by a failure of the insulin-producing cells of the pancreas. It can begi at any age but is most common in younger people. The Insulin treatmen, a severe and dangerous disturbance of carbohydrate, fat and protein metabolism can occur within days or even hours.

Type 2 (non-insulin-dependent) diabetes or maturity-onset diabetes, usually affects people over the age 40 years . In most, the body is resistant to insulin, in association with obereating and hence obesity, and the prancreas cannot produce enough insulin to overcome this resistance.this failure usually worsens with age. The mechanism underlying this failure are not understood but there are strong genetic (hereditary) and environmental factors. The major manifestation is of high levels of blood glucose and disturbance of blood-fat levels. There are strong associations with high blood pressure and heart disease.

The risks
People with type 1 diabetes risk developing a metabolic acidosis (ketoacidosis), which can progress to unconsciousness. Ketoacidosis is caused by too little insulin, allowing fat breakdown and the production of poisonous acids-ketones. This may happen before the diagnosis of diabetes, as a result of the stress or infections of ant kind or major surgery, or from neglect of self-treatment.

The commonest risks are diabetic eye damage (diabetic retinopathy, kidney damage (nephropaty and nerve damage (neuropathy). The nerve damage can give rise to serious foot problems and impotence.
People with type 2 diabetes and those with Type 1 diabetes with poor glucose levels or kidney damage, are at particular risk of damage to the arteries. This can result in stroke , angina and heart attacks, or leg pain on walking , and gangrene, according to the arteries affected. Many such people also have high blood pressure and abnormal blood fat levels.

How to treat the diabetic and you will require lifelong treatment . this is largely self administered, so its effectiveness depends mainly on you.
Many people with diabetes learn how to measure their blood sugar values at home;others rely on urine testing. Whichever method you choose, you should maintain a close watch on how your diabetes responds to diet and other treatments.
Type 1 diabetes A diabetic person have to retain diet and daily injections of insulin to replace the missing hormone. Many people with established good control on an older insulin have continued to use the preparation that suits them.

Insulin can be taken only by injection; any insulin taken by mouth is destroyed by digestive juices before it is absorbed into the bloodstream. You will be shown how to use a syringe or pen injector to inject yourself just under the skin of your thigh , arm or abdomen. Most people learn how to do this efficiently within a few days. Parents will need to administer the injections to their diabetic children.

Type 2 diabetes A good diet alone can control this form or diabetes in one-third of affected people, and is a cornerstone of management in the rest. The aim is to control calorie intake in order to reduce the energy load on the body and to lose weight, to reduce intake of free sugar in order to smooth out absorption of glucose into the blood and to lower the intake of the fats most associated with damage to the arteries. Inpractice , this means following the type of healthy eating diet advised for everyone else but applying it more vigour. Avoidance of high calorie, high fat foods (for example, fried foods, biscuits, cakes, nuts, pastries, red meat and chocolate) is important with controlled intake of sugar-containing drinks and confectionery. Higher-fibre food, fruit and fresh vegetables are desirable and can protect against arterial disease.

The long term prospects
If the patient treat his diabetes sensibly, he can expect to lead a full and healthy life. However, patient with insulin dependency may find shift work problematic, as it can interrupt the regularity of diet and injections. Also, the diabetics must not work at heights, or drive public service or heavy-goods vehicles, because of the risk that they might become.

Even if the diabetics develop complications, the effect of these can be minimized by regular medical check-ups and hence early treatment. (taken from EPN Consultant Jakarta)

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