From the Guidelines
Diabetes Mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both, as defined by the most recent guidelines 1. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels. Key aspects of diabetes include:
- Insufficient insulin production (Type 1) or ineffective insulin use (Type 2) as the primary causes
- Symptoms such as polyuria, polydipsia, weight loss, and blurred vision
- Long-term complications including retinopathy, nephropathy, neuropathy, and increased risk of atherosclerotic cardiovascular disease
- Importance of regular monitoring, lifestyle changes, and medication (such as metformin for Type 2 diabetes) in management
- Need for individualized insulin therapy for Type 1 diabetes and potentially for advanced Type 2 diabetes, with dosing based on blood glucose readings 2, 3. Management of diabetes requires a comprehensive approach, including:
- Medication: metformin is typically the first-line medication for Type 2 diabetes, starting at 500mg once or twice daily and potentially increasing to 2000mg daily
- Lifestyle changes: a balanced diet low in refined carbohydrates, regular physical activity (150 minutes weekly of moderate exercise), and maintaining a healthy weight
- Regular monitoring: blood sugar should be monitored regularly, with target fasting levels between 80-130 mg/dL and post-meal levels below 180 mg/dL
- Regular medical check-ups: necessary to monitor for complications affecting the eyes, kidneys, nerves, and cardiovascular system 1.
From the Research
Definition of Diabetes Mellitus
- Diabetes Mellitus (DM) is a common chronic disease that affects approximately 9% of the United States population 4
- It is characterized by a gradual decline in glycaemic control and progression from oral glucose-lowering monotherapy to combination therapy and exogenous insulin therapy 5
Types of Diabetes Mellitus
- Type 2 diabetes is a form of DM that is characterized by insulin resistance and impaired insulin secretion 5, 6
- Type 2 diabetes mellitus (T2DM) will need incrementally more complex therapeutic regimens to control hyperglycemia as the disease progresses 6
Management of Diabetes Mellitus
- Successful management of diabetes demands constant self-management on the part of the patient, including balancing diabetes medications, blood glucose monitoring, food intake, physical activity, and management of diabetes-related acute and chronic complications 4
- Lifestyle modifications, such as physical activity and healthy diet, can help improve glycemic control and reduce the risk of complications 7, 8
- Combining agents with differing modes of action and secondary effect profiles, such as sulfonylureas and thiazolidinediones, can be an effective approach to optimize long-term outcomes 5