|
|
 |
|
| |
Diabetes
Diabetes is not a disease per se but rather a syndrome
which is diagnosed on the basis of blood sugar levels.
There is not just one form of diabetes, but several forms
corresponding to the different physiopathological mechanisms
involved. Type 1 diabetes, formerly known as insulin-dependent
diabetes, and type 2 diabetes are the most common forms
of diabetes but other forms also exist.
Hyperglycaemia in figures
Diabetes is diagnosed on the basis of hyperglycaemia,
in other words fasting blood sugar levels ("glycaemia")
higher than 7 mmol/L (126 mg/L) or blood sugar levels
at any time of day in excess of 11.1 mmol/L (200 mg/L).
If the patient has no symptoms, blood glucose levels must
be determined on a different day before a diagnosis of
diabetes can be made. In the event of excessively high
blood glucose levels (normally greater than 15 mmol/L),
there may be clinical symptoms such as thirst, frequent
desire to urinate, weight loss and fatigue. If left untreated,
chronic hyperglycaemia may have drastic long-term consequences
on individuals as a result of disabilities associated
with the complications of diabetes, and may ultimately
lead to death. The implications of the disease are also
important in terms of public health in view of the costs
engendered by complications (cardiovascular, ocular, renal,
etc). In some countries, diabetes is the primary cause
of blindness and hemodialysis (artificial kidney).
Type 1 diabetes
Type 1 diabetes generally occurs in children and young
adults and the presenting signs are clear (symptoms of
hypoglycaemia that in some cases can involve loss of consciousness).
It requires immediate treatment by injection of insulin.
In the majority of cases, this form of diabetes is an
autoimmune disease: in other words, the body wrongly identifies
pancreatic cells that secrete insulin as foreign bodies
and destroys them. Insulin treatment must be continued
throughout the person's lifetime, although major therapeutic
breakthroughs are impending, such as transplanting islets
of Langerhans (insulin-secreting cells) and the closed-loop
artificial pancreas.
Type 2 diabetes
Type 2 diabetes, also known as adult onset diabetes mellitus
or non-insulin-dependent diabetes, occurs mainly in middle-aged
adults. It is associated with weight gain, restricted
ability of the pancreas to secrete insulin and decreased
action of insulin on the various target tissues. The mechanism
responsible for this type of diabetes has not yet been
fully elucidated. Nevertheless, there is a genetic component
that generally affects several members of the same family.
Most people with diabetes throughout the world (almost
90%) are affected by type 2 diabetes, which has reached
epidemic proportions. In the majority of cases, hypoglycaemia
produces no clinical symptoms: people do not complain
of any specific symptoms and diagnosis is made upon routine
examination. The highest reported prevalence today is
of the order of 50% and affects populations whose lifestyle
has changed drastically over the last century, such as
certain Amerindian communities and Pacific islanders.
Treatment for this type of diabetes is based chiefly on
physical activity and balanced diet. In addition, therapy
involves oral medication (there are currently four different
therapeutic classes) and in some cases, insulin injections.
Copied from www.idfparis2003.org
|
|
