There are disturbances which cause great concern as to their great impact on the population. A clear example is diabetes mellitus. This set of metabolic disorders has in common that they cause an increase in blood sugar (hyperglycemia).
Diabetes has a high global prevalence. By 2015, they had been diagnosed approximately 400 million cases worldwide. Alarming data, and even more so if the forecasts indicate that this value will increase, in particular one of the types of diabetes: type II.
Diabetes through history
Humanity has suffered from this chronic disease since ancient times. There are data that were already recognized cases for the year 1500 BC in ancient Egypt.
It was not until a few years later that the physician of ancient Greece, Areteo de Cappadocia, named this disorder, which has remained to this day.
“Diabetes” means “goes through” in GreekAs it refers to one of the most striking symptoms of the disease, low water retention.
Types of Diabetes
There are different types of diabetes, many of which are minor, but they all have this in common. they cause hyperglycemia and the resulting problems of this: nervous, cardiovascular and renal complications.
We can mainly divide it into four groups: type I diabetes, type II diabetes, gestational diabetes and other types. In the latter group, MODY syndrome stands out, although diabetes is also caused indirectly, for example by an infection of the pancreas or induced by drug treatment.
1. Diabetes mellitus type 1 (DM1)
Formerly called “insulin-dependent diabetes” or “childhood diabetes”, it represents about 5% of diagnosed cases.
Type I diabetes is characterized by absence of the hormone insulin, Which stimulates the absorption of glucose into the blood by cells. This disappearance is due to the destruction of the β cells of the islets of Langerhans in the pancreas, the site of hormone production, due to the immune system.
this disorder it usually develops in children or adolescents, Although there are cases of onset of the disease in adulthood, which are known as LADA (“latent autoimmune disease in adults”, i.e. “disease latent autoimmune in adults ”).
The risk of suffering from DM1 is somewhat complex, as it is a combination of a genetic predisposition and the interaction of certain environmental factors that trigger the problem (infection or diet). This makes it difficult to prevent the disease.
Symptoms that indicate this alteration of metabolism are frequent excretion of urine, unusual thirst, continuous hunger, weight loss, irritability and fatigue. They appear suddenly and their only treatment is the lifelong supply of insulin to the patient, in addition to tight control of the blood sugar level, as he is easily stretched into ketone coma.
2. Diabetes mellitus type 2 (DM2)
Formerly known as “non-insulin-dependent diabetes”, it is the most common type of diabetes, being between 85% and 90% of cases who are diagnosed. Hyperglycemia is caused by an organism’s resistance to insulin or a lack of insulin secretion, but never by an autoimmune attack.
the main ones risk factors are linked to lifestyle, Such as lack of exercise, overweight, obesity or stress. Since this is a complex disease, there are other relevant factors such as genetics or alterations in the intestinal flora itself. It is a chronic disease that usually appears in adulthood (over 40), although cases are starting to be seen in young people.
The symptoms are very similar to those of type I diabetes but to a lesser extent, because it is a sequential process and not a sudden one. The biggest problem is that it is diagnosed once it takes a while for the disease to develop.
Initial treatments usually consist of exercise and diet, because if it is not very developed it is possible to reverse the effects. In more severe cases, treatment with anti-diabetic drugs is necessary, which reduces blood sugar levels, although in the long term insulin injections may be necessary.
3. Gestational diabetes mellitus (GDM)
It is a form of prediabetes that can appear during second or third trimester of pregnancy. It is detected as hyperglycemia in mothers who, before pregnancy, were not diagnosed with another type of diabetes.
One possible cause of this disorder is that hormones produced during pregnancy interfere with the functionality of insulin. During the first trimester of pregnancy, blood sugar can be monitored to rule out DMG.
Some risk factors have had DMG in another pregnancy, multiple miscarriages, or a family history of diabetes.
More than the symptoms, the bigger problem is the consequences of this increase in blood sugar which, although it does not reach the values set to diagnose diabetes, are higher than normal.
Gestational Diabetes this can trigger problems during childbirth by macrosomia (excessive growth of the baby) and increase the predisposition of the child and the mother to suffer from the disease. The usual treatment is lifestyle control, i.e. exercise and diet.
4. MODY syndrome and other types
The last group is a tailor-made drawer where all types of diabetes are grouped together, the incidence is much lower, like type 3.
However, we can be noted for its incidence, between 2% and 5% of diagnoses: it is the MODY syndrome.
Also called monogenic diabetes, the acronym stands for English “Early maturity diabetes in young people” (“Mature diabetes that occurs in young people”) because it looks like DM2 but develops in non-obese adolescents. Unlike the rest, this disorder is monogenic (caused by a single gene) and is not a complex disease. The greatest risk is to have a family history of this type of disorder.
So far, up to 6 different genes have been found that can develop the syndrome. All they have in common is that when mutated, β cells do not synthesize or release insulin properly, which leads to diabetes. It is first treated with anti-diabetic drugs orally, although in the long term, insulin is injected as in DM2.