The disease that makes your urine taste like honey?: Diabetes Mellitus

Diabetes mellitus, the full name of the well-known diabetes, is the most common and most talked about non-communicable disease in the world. This does not go unnoticed and for this reason it is also the most researched field of science, and although we already know a lot about the disease, we still have a lot to discover.

But for those of you who prefer some figures, according to the World Health Organization (WHO), diabetes affected 8.5% of people over the age of 18 in 2014, caused 1.5 million deaths in 2019, and 48 % of all diabetes-related deaths occurred before age 70. Diabetes caused a 5% increase in premature mortality rates (death before age 70) between 2000 and 2016. Interestingly, diabetes-related premature mortality declined in high-income nations between 2000 and 2010, but then it increased between 2010 and 2016. Instead, the same death rates have risen steadily in lower-middle-income nations during both times.

Given these statistics, the severity and onset of the disorder, it is necessary to be well informed about the disease in order to be in a better position to help yourself or your family.

What is the diabetes? understanding the disease

Diabetes is a long-term disease that affects the way the body converts food into energy . Most of the food that is eaten is converted to sugar (also known as glucose) and absorbed into the bloodstream. When blood glucose levels rise, the pancreas is forced to release insulin. Insulin is a hormone that allows sugar from the blood to enter the body’s cells and be used for energy.

When you have diabetes, your body doesn’t make enough insulin or doesn’t use it as effectively as it should . When there is not enough insulin or when cells stop responding to insulin, excess sugar remains in the bloodstream. Understandably, having a bunch of pebbles or sugar crystals passing through and eroding our blood vessels and organs in the long run causes them to become damaged. It is like a continuous drop of water on a rock that, over time, ends up causing a hole in the rock. The effect of erosion over time is clear, and in the case of diabetes it can lead to major health problems such as heart disease, vision loss and kidney disease.

What are the types of diabetes?

Diabetes is a chronic (long-term) disease that affects the way the body converts food into energy. However, this effect can be achieved through different mechanisms , which translates into different diseases with different considerations, populations and treatments. Thus, there are three main types of diabetes : type 1 diabetes, type 2 diabetes and gestational diabetes (during pregnancy). Of these, type 2 diabetes is the most common.

It is worth mentioning that, in addition to the most common types, there are other forms of diabetes: MODY, gestational diabetes, LADA, diabetes 3c,…

Diabetes Mellitus Type 1 (DM1)

The body does not make insulin in type 1 diabetes. The body converts the carbohydrates you eat into blood sugar (blood glucose), which it uses for energy, and insulin is a hormone needed to transport glucose from the bloodstream to the cells of the body.

Type 1 diabetes is the result of the invasion of lymphocytes, our own defense cells (hence an autoimmune disease ), and the death of specific cells in the pancreas that secrete insulin, or in technical terms, the beta cells of the islets of Langerhans. Insulin secretion decreases when beta cell mass is reduced until the available insulin is no longer sufficient to maintain normal blood glucose levels. Hyperglycemia develops after the loss of 80-90% of beta cells, and diabetes can be identified in the patient.

Originally, the term used to describe type 1 diabetes was insulin-dependent diabetes or juvenile diabetes. It usually affects children, adolescents, and young adults, but it can affect anyone at any age. Type 1 diabetes is less common than type 2; approximately 5-10% of diabetic patients are type 1.

Diabetes Mellitus Type 2 (DM2)

With type 2 diabetes, the insulin your pancreas makes can’t work properly, or your pancreas can’t make enough insulin. This means that your blood glucose (sugar) levels continue to rise.

Insulin is a hormone produced by the pancreas that works as a key for sugar from the blood to enter the cells of the body to be used for energy. Insulin resistance occurs when cells in your muscles, fat, and liver don’t respond well to insulin and can’t easily absorb glucose from your blood. Consequently, your pancreas produces more insulin to help glucose enter your cells. When the pancreas becomes overworked, unable to keep up, blood sugar levels rise, triggering prediabetes and type 2 diabetes. Blood sugar levels that are too high are harmful to the body and can lead to other health problems important. One of the main reasons for insulin resistance to exist is the presence of an enzyme in adipose tissue, that is, obesity .

Type 2 diabetes affects approximately 90-95% of diabetics. Type 2 diabetes is most common in those over 45 years of age, but it is affecting a growing number of adolescents and young adults.

gestational diabetes mellitus

Gestational diabetes is diabetes that can develop during pregnancy , even in women who did not previously have diabetes. When your body doesn’t produce enough insulin during pregnancy, you have gestational diabetes. The body produces more hormones and experiences other changes during pregnancy, such as weight gain. As we mentioned, the increase in adipose tissue increases insulin resistance and, therefore, increases the body’s insulin needs. Pregnancy can increase the risk of high blood pressure if you have gestational diabetes. It can also increase the chances of having a large baby that requires a C-section.

It is usually diagnosed from a blood test between 24 and 28 weeks of pregnancy and, fortunately, it tends to disappear after delivery . However, having had gestational diabetes increases the risk of developing type 2 diabetes soon afterward, so it’s reasonable to be followed up by your family or community medicine doctor or gynecologist a few months later.

Other forms of diabetes:

Maturity diabetes of youth (MODY): Caused by a mutation (or change) in a single gene that means that, if a parent has this genetic mutation, each child has a 50% chance of inheriting it. This usually results in children with this mutation developing this form of diabetes before the age of 25 , regardless of their weight, lifestyle, etc.

Diabetes 3c: In one way or another, we know that the pancreas is essential as a producer of insulin. Well, type 3c diabetes is a type of diabetes that develops when another disease causes damage to the pancreas . Diseases related to type 3c are pancreatic cancer, pancreatitis, cystic fibrosis or hemochromatosis. You can also develop type 3c if part or all of your pancreas is removed due to other damage.

Neonatal diabetes: The name is pretty self-explanatory. However, unlike type 1 diabetes, neonatal diabetes is not autoimmune in origin .

Steroid-induced diabetes: Some people who take corticosteroids may develop diabetes and it is more common in people at increased risk of type 2 diabetes, since corticosteroids, by themselves, tend to raise blood glucose levels .

Latent autoimmune diabetes in adults (LADA): It is a type of diabetes that seems to be somewhere between type 1 and type 2 diabetes . Some parts are more like type 1, and some are more like type 2. That’s why some people call it type 1.5 diabetes . It is not currently classified as a separate type of diabetes, but some medical research is being carried out to try to determine exactly how it differs from type 1 and type 2 diabetes.

Others: There are other forms of diabetes linked to rare genetic syndromes, such as conditions called Alström syndrome, Wolfram syndrome, among others.

Symptoms of diabetes mellitus

The problem with diabetes is that it is usually a silent disease . That is, the symptoms may not exist. It is one of the diseases known as silent killers.

When there are symptoms, the thirst increases considerably, lately you are not satisfied with food and you urinate more than usual . Some even lose weight for no apparent reason. In addition, you can feel weak and exhausted and, in the worst cases, the longest-standing cases, vision can even be blurred, hands and feet are numb or tingly, sores or cuts are slow to heal.

In type 1 diabetes, symptoms can appear suddenly , over a few weeks or months. Symptoms first appear if you are a teen, teenager, or young adult. Nausea, vomiting, or stomach pains, as well as yeast infections or urinary tract infections, are other symptoms. While in type 2, symptoms may not be seen at all, or they may be missed because they build up slowly over time. Although symptoms usually appear in adults, prediabetes and type 2 diabetes are on the rise in people of all ages. And in the case of gestational diabetes, the symptoms are often not noticeable . Sometime between weeks 24 and 28 of your pregnancy, your obstetrician will test you for gestational diabetes.

three important messages

• The life that a diabetic should lead is the one that we should all lead with one exception, a ban on sugary foods, in terms of soluble sugars, not those called complex. The potato, for example, contains complex sugars.
• As part of the lifestyle that we should all lead, exercise is essential. Diet is not enough , neither for adults nor for children.
• Once we have been diagnosed with diabetes, especially in cases of acquired diabetes, such as type 2 diabetes, long-term damage is devastating (heart attack, stroke, limb amputation, among others) and often avoidable . How? With adequate control of your glucose levels and a lifestyle different from the one that led you to develop the disease (in the case of not being the other types linked to genetics).

References:

Diabetes (2021). WHO: World Health Organization. https://www.who.int/news-room/fact-sheets/detail/diabetes

Diabetes Basics (2021). CDC: Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/index.html

Diabetes Overview (s.f.). ADA: American Diabetes Association. https://www.diabetes.org/diabetes

Types of diabetes. (2017). Diabetes UK. https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes

What is Diabetes? (2016). NIDDK: National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes