diabetes%20mellitus
DIABETES MELLITUS
Diabetes mellitus (DM) is a heterogenous metabolic disorder characterized by the presence of hyperglycemia with carbohydrate, protein and fat metabolism disturbance which results from defects in either insulin secretion or action.
Patients with DM usually present with polyuria, polydipsia and unexplained weight loss.
Type 1 DM is caused by beta cell destruction which leads to complete insulin deficiency. It may be immune mediated or idiopathic.
Patients may present with ketoacidosis or acute onset of hyperglycemia while other patients may resemble type 2 DM or symptoms of other autoimmune disorders.
Type 2 DM is the most common form of diabetes. It is secondary to defect in insulin secretion concomitant with insulin resistance.
Majority of patients are asymptomatic. Ketoacidosis is uncommon and is usually secondary to stress (eg infection).

Definition

  • A heterogenous metabolic disorder characterized by the presence of hyperglycemia with carbohydrate, protein and fat metabolism disturbance which results from defects in either insulin secretion or action or both
  • Various genetic and environmental factors can cause progressive loss of β-cell mass and/or function that manifests clinically as hyperglycemia in both type 1 and 2 diabetes mellitus
    • When hyperglycemia occurs, patients with both type 1 and 2 diabetes mellitus are at risk of developing the same complications but with different rates of occurrence as well as progression
    • Better characterization of the many paths to β-cell dysfunction is required in the identification of individualized therapies for diabetes

Signs and Symptoms

  • Patients usually present with polyuria, polydipsia and unexplained weight loss

Type 1 Diabetes Mellitus

  • Most patients present with ketoacidosis or acute onset of hyperglycemia
  • Other patients have presentation similar to type 2 diabetes mellitus
    • Patients may have late onset and slow disease progression
  • Patients may also have other autoimmune disorders (eg Graves’ disease, Hashimoto’s thyroiditis, Addison’s disease)

Type 2 Diabetes Mellitus

  • Majority of patients are asymptomatic
  • Ketoacidosis is uncommon and usually secondary to stress (eg infection)
  • Diagnosis may not be obvious until complications have appeared
    • Hyperglycemia develops gradually and during early stage, symptoms are often not severe enough for the patient to recognize
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02 May 2019
At a recent Abbott lunch symposium held in conjunction with the joint 12th International Diabetes FederationWestern Pacific Region Congress & 10th Asian Association for the Study of Diabetes Scientific Meeting in KualaLumpur, Professor Shashank R. Joshi extensively discussed the issue of diabetes in obesity and the role of nutritionalintervention in addressing this growing problem.
Dr Joslyn Ngu, 19 Jun 2018

The transcultural Diabetes Nutrition Algorithm (tDNA) which involves a structured low-calorie meal plan, diabetes-specific meal replacements and enhanced physical activity, is effective for weight loss in patients with type 2 diabetes, a local study shows. [BMJ Open Diabetes Res Care 2017;5(1):e000384. Doi:10.1136/bmjdrc-2016-000384th]