SIGNS AND SYMPTOMS

• Increase of the thirst as for times and volume of precise liquid.
• Increase of the frequency and volume of urine.
• Loss of weight in spite of the increase of the appetite.
• Vaginitis, infections of the skin, blurry vision and frequent infections of bladder.
• Occasionally powerlessness in the man and disappearance of the menstruation in the woman.

URGENT SYMPTOMS

• Diabetic Cetoacidosis. The increase of the thirst and of the urine, the morning sickness, the deep and rapid respiration, the abdominal pain, and the breath with sweet smell is the symptoms that precede a gradual loss of the conscience in the diabetic cetoacidosis. This is more frequent that it happens in the insulin-dependent diabetics, often after the absence of a dose of insulin or when there is an infection.
• Comma hipoglucémico (reaction of insulin). The quake, the weakness or drowsiness followed by headache, confusion, evanescence, double vision or lacking in coordination are clear marks of a reaction of insulin. To all this the state follows him as of poisoning and possibly convulsions and unconsciousness. It is necessary urgent care.
• Comma hiperosmolar. It is a gradual loss of the conscience, more frequent in major persons in whom his diabetes does not need insulin injections. The comma hiperosmolar appears in conjunction or when other illnesses or an accident appear.

GENERAL INFORMATION. TYPES OF DIABETES

His incidence can be between 5 and 6 % of the population. Often a benign diabetes does not cause any external symptom for years. The origin of the name comes from the Greek and etymologically sweetness or honey means (mellitus) that goes on to turn (diabetes).

About 1 of every 10 diabetics is insulin-dependent. Hence the name of Diabetes Mellitus Insulinodependiente (DMID). The rest has a Diabetes not Insulin-dependent Mellitus (DMNID). The diabetes mellitus insulin-dependent is called also of type I, juvenile, prone - ketosis, or juvenile beginning of diabetes. But we will refer to her like DMID, the name that more clearly describes this illness.

The DMID can appear in any person and at any age. Typically affected persons are children and young adults (the young males at present have more risk than the young women). Most of the diabetics diagnosed before 19 years are insulin-dependent. It seems that there is a hereditary factor in the development of the diabetes. About 2 of every 3 diabetics belong to a family with diabetes history. Although the genetics is an important factor, the alone inherited characteristics are not sufficient to produce the illness, without the influence of other factors that are not completely well-known.

As the name indicates, the DMID differs from the DMNID in the fact that the insulin is or not necessary for the treatment. In the person with DMID the pancreas produces very little or nothing of insulin. The DMID symptoms develop very quickly (concerning months and even weeks). During the first year after the diagnosis there can be an improvement, called "period of honeymoon". During the same one insulin is not needed or his dose can be extensively diminished. In the finished development of the DMID, the insulin is necessary to prepare a cetoacidosis and even the death.

Other terms used for the DMNID are a beginning in the adult, stable one and guy II of diabetes. The persons with DMNID are usually older than 40 years.

The problem that the persons confront with DMNID is not an insulin absence. Although they can have a modest decrease of the hormone, also they can have more probability of having a concentration of normal or even developing insulin. His problem is that his body resists to the insulin. There are necessary big quantities of insulin to support the normal glucose quantity in blood.

Most of persons with DMNID are obese or they go on from his weight. The excess weight worsens the state of his diabetes, and the weight decrease usually has a favorable effect. Sometimes insulin injections are needed to support the glucose concentration in blood inside the normal limits, but not as in the DMID, since the absence of these injections does not produce cetoacidosis. There are oral medicines, called oral agents hipoglucemiantes that, often, they help in the DMNID but they do not cost for the DMID. When a loss of weight takes place, the need for insulin and hipoglucemiantes oral it is, often, limited or eliminated.

The pregnant women normally are young and if it appears a diabetes during the pregnancy is usually of the variety DMID. Nevertheless, if you are pregnant and develop a diabetes a specialist visits.

The third one, and much less frequent type of diabetes is the called secondary diabetes. This one can lead well a DMID or a DMNID, but it differs from them because his cause is another illness. The secondary diabetes can appear as a result of such illnesses as: Acromegalia, Cushing syndrome, hipertiroidismo, or surgical extraction of the pancreas.

DIAGNOSIS

If you urinate very often or are very thirsty, consult his doctor, who will determine the request of an analysis to see the sugar level in blood and urine. The glucose in the urine is called glucosuria. A high glucose concentration in blood calls itself the glucosuria as the hypoglycemia "a hyperglycemia" So much they happen in 2 types of diabetes DMID and DMNID.

The analysis of the substances of the urine called bodies cetónicos can help to distinguish between DMID and DMNID.

If the insulin is given in appropriate quantities, the person with DMID can, often, have an important cetonas quantity in the urine. On the other hand, in the DMNID only small quantities are occasionally.

If the person with DMID does not receive the insulin for a few days, the cetoacidosis will turn out to be almost sure. This bears a cetonas accumulation in blood and urinates, a deeper and rapid respiration and a gradual loss of conscience. If an urgent and rigorous treatment is not realized the death can be very probable.

The DMNID can develop gradually across a period of years. Often it is discovered by a routine analysis of urine or blood. To notice the classic triad of symptoms of increase of thirst, increase of volume of urine and loss of weight is necessary a very high glucose quantity in urine and blood.

THE DIABETES IS IMPORTANT

Up to the discovery of the insulin in 1921, the inevitable result of a DMID was the death. Nevertheless the modern medicines administered in a monitored program have made possible the effective handling of 2 varieties of diabetes DMID and DMNID.

Some insulin-dependent persons, experience very high or low extreme levels of the concentration of sugar in blood. This condition of the diabetes is usually identified with the "fragile", "unstable" terms, or "lábil". These individuals need a hospitalization to establish a "intensive therapy of insulin" that consists of 3 or 4 daily injections. Anyway a careful control of the life style, including diet and less it demands of insulin or oral medication can, in most cases, be sufficient so that the life of the diabetic is normal and productive.

Two types of mellitus diabetes, DMID and DMNID, have long and short periods of potential risk. The dangers in the short periods stem from the reactions of insulin (low concentrations of glucose) and from very high concentrations of glucose in blood. But these complications normally are solved by a program of diet, exercise and, if it is necessary, an adjustment in the dose of the medication. The cetoacidosis is another danger in the short periods that the diabetics must know.

There are two types of long-term effects. These develop very slowly and have very few early symptoms. One of the types is associated with the engrosamiento of the veins that in case of the long veins, they suppose for the diabetic in a high risk in case of blows, heart attacks and gangrene of the fingers. When the short or small veins support long danger periods problems can appear with the eyes, kidneys and nerves. The second type is associated with a long glucose elevation in blood (to see Arterioesclerosis in the Extremities).

WHAT DOCTOR CAN TREAT ME?

• ENDOCRINOLOGISTS
• Consult the Endocrinologist

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