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Diabetes mellitus (DM), commonly referred to as diabetes, is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period.[2] Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger. If left untreated, diabetes can cause many complications.[3]Acute complications include diabetic ketoacidosis and nonketotic hyperosmolar coma.[4] Serious long-term complications include cardiovascular disease, stroke, chronic kidney failure, foot ulcers, and damage to the eyes.[3]

Diabetes is due to either the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced.[5] There are three main types of diabetes mellitus:

Prevention and treatment involve a healthy diet, physical exercise, not using tobacco and being a normal body weight. Blood pressure control and proper foot care are also important for people with the disease. Type 1 diabetes must be managed with insulin injections.[3] Type 2 diabetes may be treated with medications with or without insulin.[7] Insulin and some oral medications can cause low blood sugar.[8]Weight loss surgery in those with obesity is an effective measure in those with type 2 DM.[9]Gestational diabetes usually resolves after the birth of the baby.[10]

As of 2014, an estimated 387 million people have diabetes worldwide,[11] with type 2 diabetes making up about 90% of the cases.[12][13] This represents 8.3% of the adult population,[13] with equal rates in both women and men.[14] From 2012 to 2014, diabetes is estimated to have resulted in 1.5 to 4.9 million deaths each year.[7][11] Diabetes at least doubles a person's risk of death.[3] The number of people with diabetes is expected to rise to 592 million by 2035.[11] The global economic cost of diabetes in 2014 was estimated to be $612 billion USD.[15] In the United States, diabetes cost $245 billion in 2012.[16]

The classic symptoms of untreated diabetes are weight loss, polyuria (increased urination), polydipsia (increased thirst), and polyphagia (increased hunger).[17] Symptoms may develop rapidly (weeks or months) in type1 diabetes, while they usually develop much more slowly and may be subtle or absent in type2 diabetes.

Several other signs and symptoms can mark the onset of diabetes, although they are not specific to the disease. In addition to the known ones above, they include blurry vision, headache, fatigue, slow healing of cuts, and itchy skin. Prolonged high blood glucose can cause glucose absorption in the lens of the eye, which leads to changes in its shape, resulting in vision changes. A number of skin rashes that can occur in diabetes are collectively known as diabetic dermadromes.

Low blood sugar is common in persons with type 1 and type 2 diabetes. Most cases are mild and are not considered medical emergencies. Effects can range from feelings of unease, sweating, trembling, and increased appetite in mild cases to more serious issues such as confusion, changes in behavior, seizures, unconsciousness, and (rarely) permanent brain damage or death in severe cases.[18][19] Mild cases are self-treated by eating or drinking something high in sugar. Severe cases can lead to unconsciousness and must be treated with intravenous glucose or injections with glucagon.

People (usually with type1 diabetes) may also experience episodes of diabetic ketoacidosis, a metabolic disturbance characterized by nausea, vomiting and abdominal pain, the smell of acetone on the breath, deep breathing known as Kussmaul breathing, and in severe cases a decreased level of consciousness.[20]

A rare but equally severe possibility is hyperosmolar nonketotic state, which is more common in type2 diabetes and is mainly the result of dehydration.[20]

All forms of diabetes increase the risk of long-term complications. These typically develop after many years (1020), but may be the first symptom in those who have otherwise not received a diagnosis before that time.

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Diabetes mellitus - Wikipedia, the free encyclopedia

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