Diabetes Mellitus: causes, symptoms, diagnosis, and treatment methods. Learn the types, complications, prevention tips, and management strategies.
Diabetes Mellitus Introduction
Diabetes Mellitus is a chronic metabolic condition characterized by persistently high blood glucose due to insufficient insulin, impaired insulin action, or both. Early recognition of symptoms, accurate diagnosis, and a tailored management plan that combines medication, nutrition, and physical activity are crucial to prevent acute crises and long-term complications.
With consistent monitoring and lifestyle changes, many people maintain healthy, fulfilling lives while living with diabetes.
Diabetes Mellitus Causes, Symptoms, and Treatment Methods
What is Diabetes?
Diabetes is a condition that occurs when the level of sugar (glucose) in the blood is too high. It develops when the pancreas does not produce enough insulin, does not produce insulin at all, or when the body does not respond properly to the effects of insulin. Diabetes affects people of all ages. Most types of diabetes are chronic (lifelong), but all types can be managed with medications and/or lifestyle changes.
Glucose (sugar) mainly comes from the carbohydrates in your food and drinks, and it is the body’s main source of energy. Blood carries glucose to all the cells in the body to be used as fuel.
When glucose is in the bloodstream, it needs a “key” to reach its final destination. That key is insulin (a hormone). If the pancreas does not produce enough insulin or if the body does not use it properly, glucose builds up in the bloodstream, leading to high blood sugar (hyperglycemia).
Over time, consistently high blood sugar levels can cause health problems, such as heart disease, nerve damage, and eye issues.
What are the Types of Diabetes?
There are several types of diabetes. The most common include:
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Type 2 Diabetes: In this type, your body does not make enough insulin and/or the body’s cells do not respond normally to insulin (insulin resistance). This is the most common type of diabetes. It mainly affects adults but can also develop in children.
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Prediabetes: This stage precedes type 2 diabetes. Blood glucose levels are higher than normal but not high enough to be diagnosed as type 2 diabetes.
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Type 1 Diabetes: This is an autoimmune disease where the immune system attacks the insulin-producing cells in the pancreas for unknown reasons. About 10% of people with diabetes have this type. It is usually diagnosed in children and young people but can develop at any age.
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Gestational Diabetes: This type develops in some people during pregnancy. It usually disappears after childbirth, but if you have had gestational diabetes, you are at higher risk of developing type 2 diabetes later in life.
Other types of diabetes include:
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Type 3c Diabetes: This type occurs when the pancreas is damaged (other than by autoimmune causes), affecting its ability to produce insulin. Conditions such as pancreatitis, pancreatic cancer, cystic fibrosis, or hemochromatosis can damage the pancreas and lead to diabetes. Surgical removal of the pancreas can also cause type 3c diabetes.
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Latent Autoimmune Diabetes in Adults (LADA): Similar to type 1 diabetes but develops more slowly. It is usually diagnosed in people over 30.
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Maturity-Onset Diabetes of the Young (MODY): A type caused by an inherited genetic mutation that affects how the body produces and uses insulin. There are more than 10 different forms of MODY.
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Neonatal Diabetes: A rare type that occurs within the first six months of life. About 50% of infants with this type have the permanent form, while the condition resolves after a few months in the other half, though it may return later in life.
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Brittle Diabetes: A form of type 1 diabetes characterized by frequent and severe fluctuations in blood sugar levels. In rare cases, it may require a pancreas transplant for treatment.
What are the Symptoms of Diabetes?
Symptoms of diabetes include:
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Increased thirst and dry mouth
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Frequent urination
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Fatigue
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Blurred vision
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Unexplained weight loss
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Numbness or tingling in the hands or feet
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Slow-healing wounds or sores
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Frequent skin infections
It is important to talk to your healthcare provider if you or your child experience these symptoms.
Additional Details About Symptoms by Type of Diabetes
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Type 1 Diabetes: Symptoms of type 1 diabetes can develop quickly—over a few weeks or months. You may also develop additional symptoms that indicate a serious complication called Diabetic Ketoacidosis (DKA). DKA is a life-threatening condition that requires immediate medical treatment. Symptoms of DKA include vomiting, stomach pain, fruity-smelling breath, and difficulty breathing.
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Type 2 Diabetes and Prediabetes: You may not experience any symptoms at all, or you may not notice them because they develop slowly. A routine blood test may reveal high blood sugar levels before you notice any symptoms. Another possible sign of prediabetes is skin discoloration in certain areas of the body.
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Gestational Diabetes: You usually won’t notice symptoms of gestational diabetes. Your healthcare provider will screen you for gestational diabetes between the 24th and 28th week of pregnancy.
What Causes Diabetes?
Diabetes occurs when there is too much glucose in the bloodstream, regardless of the type. However, the reason for elevated blood glucose levels differs depending on the type of diabetes.
The causes of diabetes include:
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Insulin Resistance: Type 2 diabetes mainly occurs as a result of insulin resistance. Insulin resistance happens when muscle, fat, and liver cells do not respond properly to insulin. Several factors and conditions contribute to varying degrees of insulin resistance, including obesity, lack of physical activity, diet, hormonal imbalances, genetics, and certain medications.
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Autoimmune Diseases: Type 1 diabetes and LADA occur when the immune system attacks the insulin-producing cells in the pancreas.
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Hormonal Imbalances: During pregnancy, the placenta releases hormones that cause insulin resistance. Gestational diabetes may develop if the pancreas cannot produce enough insulin to overcome this resistance. Other hormone-related conditions, such as acromegaly and Cushing’s syndrome, can also lead to type 2 diabetes.
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Pancreatic Damage: Physical damage to the pancreas—whether due to a disease, surgery, or injury—can affect its ability to produce insulin, leading to type 3c diabetes.
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Genetic Mutations: Certain genetic mutations can cause MODY and neonatal diabetes.
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Long-Term Use of Certain Medications: Prolonged use of some medications, such as HIV/AIDS treatments and corticosteroids, can lead to type 2 diabetes.
What Are the Complications of Diabetes?
Diabetes can lead to both acute (sudden and severe) complications and long-term complications — resulting from excessively high or prolonged blood sugar levels.
Acute Complications of Diabetes
These potentially life-threatening complications include:
Hyperosmolar Hyperglycemic State (HHS):
This mainly affects people with type 2 diabetes. It occurs when blood sugar levels are extremely high (over 600 mg/dL) for a prolonged period, leading to severe dehydration and confusion. Immediate medical treatment is required.
Diabetic Ketoacidosis (DKA):
This primarily affects people with type 1 diabetes or those who have not yet been diagnosed. It happens when there isn’t enough insulin in the body. Without insulin, the body cannot use glucose as energy, so it begins breaking down fat instead. This process produces substances called ketones, which make the blood acidic. Symptoms include difficulty breathing, vomiting, and loss of consciousness. DKA requires immediate medical treatment.
Severe Hypoglycemia (Low Blood Sugar):
Hypoglycemia occurs when blood sugar drops below the healthy range. Severe hypoglycemia mainly affects people who use insulin. Symptoms include blurred or double vision, confusion, agitation, and seizures. Emergency treatment with glucagon and medical intervention are required.
Chronic Complications of Diabetes
Persistently high blood sugar levels can damage body tissues and organs, mainly due to harm to blood vessels and nerves that support body tissues.
Common cardiovascular problems (heart and blood vessels) include:
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Coronary artery disease
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Heart attacks
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Stroke
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Atherosclerosis (hardening of the arteries)
Other diabetes complications include:
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Nerve damage (Neuropathy): May cause numbness, tingling, or pain
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Kidney disease (Nephropathy): Can lead to kidney failure, dialysis, or kidney transplant
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Eye disease (Retinopathy): Can result in blindness
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Diabetic foot problems
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Skin infections
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Amputation
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Sexual dysfunction due to nerve and blood vessel damage (such as erectile dysfunction or vaginal dryness)
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Hearing loss
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Oral health problems, such as gum disease (periodontitis)
Living with diabetes can also affect your mental well-being. People with diabetes are two to three times more likely to develop depression compared to those without diabetes.
How Is Diabetes Diagnosed?
Healthcare providers diagnose diabetes by testing blood glucose levels through a blood test. There are three main tests used to measure blood glucose:
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Fasting Blood Glucose Test: In this test, you don’t eat or drink anything except water for at least eight hours before the test. Since food can significantly affect blood sugar levels, this test allows your provider to see your baseline blood sugar.
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Random Blood Glucose Test: This test can be done at any time, regardless of when you last ate.
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Oral Glucose Tolerance Test (OGTT): This test is commonly used to screen for and diagnose gestational diabetes.
How Is Diabetes Treated?
Diabetes is a complex condition, and its treatment requires multiple strategies. In addition, diabetes affects each person differently, so management plans are highly individualized.
The main aspects of diabetes treatment include:
Monitoring Blood Sugar Levels
Monitoring blood glucose is essential to determine how effective your current treatment plan is. It provides information on how well you are managing diabetes on a daily — and sometimes hourly — basis. You can check your levels through regular testing with a glucose meter and a finger-prick, and/or by using a Continuous Glucose Monitor (CGM). You and your healthcare provider will determine the optimal blood sugar range for you.
Oral Diabetes Medications
Oral medications help manage blood sugar levels in people who still produce some insulin, especially those with type 2 diabetes and prediabetes. People with gestational diabetes may also need oral medications. There are different types of medications, but metformin is the most common.
Insulin Therapy
People with type 1 diabetes need artificial insulin injections to live and manage their condition. Some people with type 2 diabetes also require insulin. There are several types of synthetic insulin, each beginning to work at different speeds and lasting in the body for varying durations. The four main methods of taking insulin are: insulin injections with a syringe, insulin pens, insulin pumps, and rapid-acting inhaled insulin.
Diet
Meal planning and choosing a healthy eating pattern are essential parts of diabetes management, since food greatly affects blood sugar levels. If you take insulin, carbohydrate counting in your food and drinks is a key part of treatment. The amount of carbohydrates you consume determines the insulin dose you need at mealtimes. Healthy eating habits can also help you manage your weight and reduce your risk of heart disease.
Exercise
Physical activity increases insulin sensitivity (and helps reduce insulin resistance), so regular exercise is an important part of diabetes management for everyone with the condition.
Because people with diabetes are at higher risk for heart disease, it is also important to maintain healthy:
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Weight
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Blood pressure
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Cholesterol levels
How Can You Prevent Diabetes?
You cannot prevent the autoimmune and genetic forms of diabetes. However, there are steps you can take to reduce your risk of developing prediabetes, type 2 diabetes, and gestational diabetes, including:
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Eating a healthy diet, such as the Mediterranean diet.
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Staying physically active. Aim for at least 30 minutes of exercise per day, five days a week.
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Working toward achieving and maintaining a healthy weight.
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Reducing stress.
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Limiting alcohol consumption.
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Getting adequate sleep (typically 7–9 hours) and seeking treatment for sleep disorders.
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Quitting smoking.
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Taking medications as directed by your healthcare provider to manage existing risk factors for heart disease.
It is important to know that there are some diabetes risk factors you cannot change, such as your genetics and family history, age, and ethnicity. Type 2 diabetes is a complex condition that involves many contributing factors.
What Is the Outlook for Diabetes?
The outlook (prognosis) for diabetes varies greatly depending on several factors, including:
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The type of diabetes.
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How well the condition is managed over time and the quality of medical care you receive.
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Your age at diagnosis and how long you’ve had diabetes.
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Whether you have other health conditions.
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Whether you develop diabetes-related complications.
Chronic high blood sugar can lead to serious complications, most of which are irreversible. Many studies have shown that untreated chronic hyperglycemia shortens lifespan and negatively impacts quality of life.
However, it is important to understand that you can live a healthy life with diabetes. The key factors for improving outlook include:
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Lifestyle changes.
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Regular physical activity.
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Dietary modifications.
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Routine monitoring of blood sugar levels.
FAQ – Diabetes Mellitus
What is the difference between Type 1 and Type 2 diabetes?
Type 1 is an autoimmune disease that destroys insulin-producing cells; Type 2 is mainly due to insulin resistance and/or reduced insulin production.
What are the most common early symptoms of diabetes?
Increased thirst, frequent urination, fatigue, blurred vision, and slow-healing wounds are typical early signs.
How is diabetes diagnosed?
Through blood tests such as fasting glucose, random glucose, and the oral glucose tolerance test (OGTT).
What are the dangerous acute complications of diabetes?
Diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic state (HHS), and severe hypoglycemia require urgent medical care.
Do all people with diabetes need insulin?
All people with Type 1 need insulin; some with Type 2 may also require insulin depending on control and disease progression.
Which lifestyle changes help manage diabetes?
Balanced diet (with carbohydrate counting if using insulin), regular exercise, weight management, and smoking cessation.
Can diabetes be prevented?
Autoimmune and genetic forms cannot be prevented, but the risk of Type 2, prediabetes, and gestational diabetes can be reduced with healthy lifestyle habits.
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