Diabetes Mellitus: Starvation in the midst of plenty

How it all started

I and Wole have been friends since the past two years. I met him when I and family moved into the street just behind our secondary school. I had always teased Wole for being too thin and always eating but always getting fatigued. I had never suspected anything about him until just yesterday. We both urinated on almost the same place but when I got there minutes later to check for my missing purse, the particular spot where Wole urinated was crowded with ants. I quickly headed home to explain what I had seen to my mum, who was a nurse. On getting home, I realized Wole's mum was in our house. I quickly told my mum what I had seen. Both my mum and Wole's mum were shocked. “Does he urinate often?” asked my mum. “Yes” said Wole's mum in desperation. “Does he eat, drink and get fatigued easily?” asked my mum again. “Yes” muttered Wole's mum as anxiety started to dawn on her. To cut the story short, my friend Wole was later diagnosed of juvenile diabetes.

What I found out

credit

Diabetes mellitus (DM) is a disease characterized by excess glucose in the blood (hyperglycemia) and glucose in the urine (glucosuria). It is caused by the deficiency or diminished effectiveness of a hormone called insulin. This hormone is secreted by beta cells of the islets of Langerhans which are located in the pancreas and it regulates the utilization of glucose in the body. When diabetes mellitus is caused by deficiency of insulin, it is called insulin dependent diabetes mellitus, type 1 diabetes mellitus or juvenile diabetes when it develops at infancy or childhood. When diabetes mellitus is caused by a reduced effectiveness of insulin, it is called non insulin dependent diabetes mellitus or type 2 diabetes mellitus. In type 2 diabetes diabetes mellitus, the secretion of insulin is normal but the hormones which respond to insulin are non-responsive.

Causes

credit

• Genetic factors: Diabetes mellitus can be transferred via genes especially in those who develop the condition after forty years of age.

• Obesity: Recent research has linked obesity as a risk factor for the development of diabetes although the mechanism behind this is not fully understood.

• Cell degeneration: Degeneration of the beta cells of the islets of Langerhans.

• Pancreatitis: Inflammation of the pancreas (pancreatitis) may also cause diabetes mellitus.

• Autoimmunity: In autoimmunity, an antibody develops against a normal organ or tissue in the body and attacks the organ. Destruction of the beta cells of the islets of Langerhans due to the autoimmune diseases may also cause diabetes mellitus.

• Infection: Certain infections especially viral infections can cause destruction of the beta cells of the pancreas.

Signs and Symptoms

A patient with diabetes mellitus presents with a variety of signs and symptoms. These include:

• Hyperglycemia: Diabetes mellitus causes high blood glucose level. Insulin aids the utilization of glucose by cells. Thus, in a case where there is deficiency of insulin, glucose can no longer be used by the cells and it accumulates in the blood. Thus leading to high blood glucose level, a condition called hyperglycemia.

• Glucosuria: Since glucose cannot be used by the cells in the body and accumulates in the blood, the amount of glucose which gets filtered by the kidney also increases. This causes glucose to appear in urine which, on a normal day, would not be there. Thus causing glucosuria.

• Polyphagia: Polyphagia simply means too much eating. In DM, there is a high concentration of glucose in the blood. But unfortunately for the body cells, they cannot utilize this glucose due to deficiency of insulin. Thus, the body organs still send signals of hunger and starvation to the brain which stimulates the individual with DM to eat more. The food which is being eaten can also unfortunately not stop this starvation because the cells will still not be able to utilize the glucose gotten from them. This is the reason why diabetes mellitus is also referred to as “starvation in the midst of plenty”.

• Polydipsia: This means excess intake of water. Since glucose is osmotically active, it's excretion via urine will also cause excretion of a large amount of water. The individual with DM will have to make up for this water loss by drinking too much water. Polyuria (large volume of urine) occurs due to the excretion of water along with glucose.

• Fatigue: Due to the inability of body cells to utilize glucose, there is an extreme rate of fatigue as body cells and tissues will get tired and worn out easily.

• Loss of weight: Due to the inability to utilize glucose as energy source, the body cells then turn to fats and proteins for energy. The utilization of fats and proteins for energy will cause extreme weight loss.

Treatment

Diabetes mellitus is usually treated by the subcutaneous injection of insulin. A more intensive insulin treatment is usually required, if a long-acting insulin or administration of intermediate-acting insulin is not adequate to control blood sugar levels.

Conclusion

After Wole was diagnosed of juvenile diabetes, he started treatment immediately. He was given subcutaneous injection of insulin regularly under the supervision of an endocrinologist. Now, he is happy and living a normal life.

References

wikipedia
webmd
medicinenet

Images credit

image 1
image 2