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Diabetes Mellitus: Facts, Types, Symptoms, Causes and Treatments

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Diabetes mellitus (or diabetes) is a chronic, lifelong condition that affects your body’s ability to use the energy used in food. However, we have three major types of diabetes; which are type 1 diabetes, type 2 diabetes and gestational diabetes.

Diabetes is a metabolic disorder in which the body is unable to adequately regulate the level of sugar, mainly glucose in the blood, either due to poor sensitivity to protein insulin or insufficient insulin production by the pancreas.

Diabetes itself is not a mortality condition (1.3 million deaths worldwide) but is a significant risk factor for other causes of death and has a tremendous recordable disability. Also, diabetes is a significant risk factor for cardiovascular disease, kidney disease and blindness.

All types of diabetes mellitus have something in common. Usually, your body breaks the sugars and carbohydrates you eat in a particular sugar called glucose. However, glucose burns the cells into your body. Though the cells need insulin, a hormone, into your bloodstream to absorb the glucose and use it for energy. With diabetes mellitus, your body does not have enough insulin. However, it can not use the insulin that it produces or a combination of both.

Moreover, as the cells cannot enter the glucose, it builds up in your blood. High blood glucose can damage the small blood vessels in your kidneys, heart, eyes or nervous system. Therefore, diabetes – especially when left untreated. It can cause heart disease, stroke, kidney disease, blindness and nerve damage to the nerves in the feet as well.


Type 1 DM:

It is the results of the lack of adequate insulin of the pancreas. This form was previously referred to as “insulin dependent diabetes mellitus” (IDDM) or “juvenile diabetes”. The cause is unknown.

Treatment for type 1 diabetes involves taking insulin, which is injected into the fat under the skin below. The methods for injecting insulin include:

  • Spray
  • Insulin pens that use pre-filled cartridges and a fine needle
  • Jet injectors that use high-pressure air to send an insulin spray through the skin
  • Insulin pumps that give insulin through flexible tubes to a catheter under the skin of the abdomen

Type 2 DM:

It begins with insulin resistance, a condition in which cells do not respond well to insulin. As the disease progresses, a lack of insulin may also occur.

This form was previously referred to as “non-insulin dependent diabetes mellitus” (NIDDM) or “diabetes in adults.”

The most common cause is excessive body weight and not enough exercise. Type 2 DM accounts for about 90-95% of all diabetes cases.

Gestational Diabetes:

It is the third dominant form and occurs when pregnant women without a history of diabetes have a high blood sugar level.

Clinical Presentation

The Classical triad of diabetes mellitus is polydipsia (increased thirst), polyphagia (increased appetite and intake), and polyuria (increased urination caused by osmotic diuresis).

In the midst of increased appetite and desire for food, people with DM (usually Type 1) may still experience weight loss due to incorrect fat metabolism and degradation of fat stores.

Other prominent features include the presence of glucose and ketone bodies in the urine. Fatigue with weakness, irritability, blurred vision, numbness or tingling in the hands and feet are also present.


Weight management, dietary and dietary guidance combined with physical therapy/exercise prescribes the holistic treatment approach.

Pharmacological intervention

For Type 1 (Insulin Dependent) Diabetes requires intramuscular administration of insulin. Dosage is always expressed in USP units. Humalog is the fastest acting insulin, which occurs within 15 minutes. The PZI has the most extended peak of 8-20 hours and has the longest total duration of 36 hours. On the other hand, the Lantus is the only ‘no peak’ and lasts 24 hours.

For type 2 (non-insulin dependent) diabetes, popular oral hypoglycemia includes metformin and sulfonylurea. Also, insulin sensitizers such as Rosiglitazone and Pioglitazone are also prescribed.

Physiotherapy Management

A sound, customised exercise instruction is a cornerstone in the management of Diabetes Mellitus.

The goal is to address the above standard BMI score (25 and above) for overweight and obese patients. Numerous studies show that a regular exercise program for people with diabetes has a profound effect on the regulation of their blood glucose levels.