(Diabetes Mellitus, Diabetes type-2)

Diabetes is disease consisting of high blood sugar resulting from inadequate insulin, insulin resistance or both.
Type 1 diabetes starts in childhood and is characterized by absence of insulin. Without insulin therapy these individuals are unable to survive.

Type 2 diabetes is the more common type of diabetes. In most type 2 diabetics, specially early in the course of disease, there is adequate insulin but the body is resistant to its action.
In some individuals apart from insulin resistance there is also lower level of insulin.

Risk factors for developing diabetes

  • Higher than normal body weight
  • Low level of physical activity
  • Unhealthy diet
  • Genetic risk and Family history:
Family history may not always mean genetic risk of diabetes. A person may have multiple family members with diabetes due to unhealthy lifestyle in multiple family members.
It is also important to note that even if someone carries the risk genes for diabetes does not mean that person will get diabetes. Genes for diabetes are influenced by environmental factors (mainly lifestyle). Genetic testing is not done for assessing the risk for diabetes as the test is not available for routine clinical use.

To summarize, type 2 diabetes which is quite common in El Paso, is most often related to lifestyle choices even in the presence of genetic or family history.

Symptoms of diabetes

  • Most often in early diabetes there are no symptoms
  • When the diabetes advances and the blood sugar levels become quite high there may be symptoms of increased urination, increased thirst and hunger.
  • Advanced untreated diabetes may result in unintentional weight loss due to loss in the muscle mass.
  • Symptoms may be related to complications of diabetes (see below)
  • A very high blood sugar, 600 and above, can cause severe dehydration and if untreated can also result in coma and death.

Complications of diabetes.
Diabetes affects almost all organs of the body. Majority of complication result from damage to the small and large blood vessels in different organs.
Common complications are:
  • Increased risk of coronary artery disease and heart attacks
  • Increased risk of strokes
  • Kidney disease and eventually kidney failure
  • Eye disease and blindness
  • Diabetic neuropathy affects nerves resulting most commonly in decreased or abnormal sensation.
  • Reduced wound healing

What is the course of diabetes
Diabetes is a chronic disease ( duration is either many years or lifelong)

Is there a cure for diabetes
It depends on the insulin levels (measured as C-peptide), stage of the disease, body weight and metabolic syndrome.
If diabetes is associated with low insulin level and not much insulin resistance there is usually no cure but the disease can be controlled with medications and insulin. It is still important to follow a good lifestyle as more number of medications and/or insulin is needed if the lifestyle is unhealthy. Where is fewer medications may be able to achieve a good control if lifestyle is good.

There is a possibility of cure if diabetes is associated with normal/high insulin levels, insulin resistance, obesity, unhealthy lifestyle. The probability of cure is higher during the early stages of disease. As the disease advances complete resolution of diabetes becomes less likely. Cure mainly depends on removing the underlying cause i.e. decreasing insulin resistance by weight loss and healthier lifestyle. It is important not to stop the medications or insulin while trying to improve lifestyle. The blood sugar should be monitored closely at home. The medications are slowly reduced and discontinued under physician supervision as the diabetes improves.