Premise
Diabetes mellitus, or more simply diabetes, is a metabolic disease caused by alterations in insulin, a key hormone for maintaining normal blood glucose (sugar) levels.
There are different types of diabetes mellitus, some decidedly more common and known than others. The most common types include type 1 diabetes, type 2 diabetes and gestational diabetes (also known as pregnancy-related diabetes).
The characteristic that all types of diabetes mellitus have in common is hyperglycemia, which is the high concentration of glucose in the blood.
Symptoms of diabetes
The symptoms of diabetes are all closely dependent on the phenomenon of hyperglycemia and the severity of the latter.
In other words, it is due to hyperglycemia that the diabetic complains of certain characteristic disorders, and it is because of a severe hyperglycemia that the aforementioned disorders are particularly intense and debilitating for the body.
Type 1 diabetes symptoms
Brief review of the causes of type 1 diabetes
The cause of type 1 diabetes is a reduced availability of insulin, due to the loss, by destruction, of the pancreatic cells responsible for the production of this hormone.
The typical symptoms of presenting type 1 diabetes consist of:
- Polyuria . It is the increase in the amount of urine released within 24 hours;
- Polydipsia . It is the anomalous increase in the sense of thirst. It depends on the phenomenon of polyuria, through which the patient eliminates many liquids;
- Paradoxical polyphagia . It is the increase in appetite and food intake, followed by weight loss (rather than an increase in body weight)
In a short time, these disorders can be associated with others, such as:
- Sense of recurrent fatigue;
- Blurred view;
- Headache;
- Slow healing from wounds;
- Skin itching;
- Irritability;
- Ease of developing infections.
When and how does it start?
In most cases, type 1 diabetes begins under the age of 20; in general, it appears at the time of puberty, but it is not infrequently its onset during childhood or, even, during the first year of life.
Typically, the onset of type 1 diabetes mellitus is sudden; the condition, in fact, is established within a few weeks / months.
The "honeymoon" phenomenon
Sometimes, patients with type 1 diabetes are the protagonists of a curious phenomenon. This phenomenon consists of a spontaneous regression, shortly after the onset of the disease, of typical symptoms, as if the patient had miraculously recovered. In reality, this is a completely transitory regression of symptoms, which lasts a few months and which, after this time, leaves the diabetic state in a definitive way.
In type 1 diabetes, the time frame that begins with the regression of symptoms and ends with the reappearance of the symptomatology takes the symbolic name of " honeymoon ".
Most relevant clinical signs
In the presence of type 1 diabetes, the most commonly detected clinical signs through laboratory tests are fasting hyperglycemia and especially after meals, and glycosuria (ie glucose in the urine).
When should I go to the doctor?
In a young person, the presence of the need to urinate often, associated with intense thirst and unexplained weight loss, represents an important alarm bell and, therefore, worthy of the immediate consultation of a doctor.
Type 2 diabetes symptoms
To learn more: Diabetes Symptoms
Brief review of the causes of type 2 diabetes
The possible causes of type 2 diabetes are the insensitivity of the tissues to the action of insulin and the progressive decline, up to the complete loss, of the ability - proper of pancreatic beta cells of the islets of Langerhans - to produce insulin.
The symptoms of type 2 diabetes coincide, in large part, with the symptoms of type 1 diabetes. Moreover, as stated at the beginning of the article, the symptomatology of diabetes mellitus depends on hyperglycemia and hyperglycemia characterizes both subtypes of diabetes mentioned above, although it arises from different circumstances.
Entering into the details of the symptomatological picture of type 2 diabetes, the carriers of this disease classically complain of polyuria, polydipsia, recurrent fatigue, vision problems, headache, slow healing of wounds, itching of the skin, irritability and easy to develop infections.
An attentive reader will have noticed that, in the previous list, there is no paradoxical polyphagia, which represents one of those symptoms typical of type 1 diabetes, but not of type 2 diabetes. This is not surprising, since, often, the type 2 diabetes patient is an obese person, tending to gain weight.
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When does he start?
Type 2 diabetes can occur at any age; however, statistics in hand, is a disease that mainly affects adults and becomes progressively more frequent starting from the age of 35-40.
A metabolic state intermediate between normality and type 2 diabetes: prediabetes
Quite frequently, people with type 2 diabetes have previously suffered from prediabetes, a metabolic condition that lies between normal and true diabetes mellitus (type 2).
Existing in two known forms as impaired fasting glucose and impaired glucose tolerance, prediabetes are almost always symptom-free and are reported for only one change, certainly important, which is hyperglycemia.
How do you start?
Unlike type 1 diabetes, type 2 diabetes is established very slowly and takes a long time (we are talking about years) to manifest the symptoms related to hyperglycemia; in some patients, it may even happen that these symptoms always remain very mild, almost imperceptible.
The slow appearance and the often mild symptomatology explain why, quite frequently, the diagnosis of type 2 diabetes occurs randomly, during laboratory tests performed for other reasons, in subjects that are only apparently asymptomatic.
Curiosity: is the random diagnosis of type 2 diabetes always a bolt from the blue?
Often, the causal discovery of type 2 diabetes concerns subjects who are undergoing clinical controls for a more in-depth assessment of circulatory disorders related to atherosclerosis .
In spite of the randomness of the diagnostic finding, the presence of diabetes mellitus in atherosclerotic subjects should not surprise at all, since those suffering from atherosclerosis have a marked tendency to develop the aforementioned metabolic disease.
Most relevant clinical signs
In the presence of type 2 diabetes, in addition to fasting and after-meal hyperglycemia and glycosuria, laboratory tests usually reveal at least another couple of important clinical signs, which are hypertriglyceridemia (or high triglycerides ) and hyperuricemia (increase in the amount of uric acid in the blood).
Remembering that often the patient with type 2 diabetes is an obese person, faced with the concomitant presence of fasting hyperglycemia, high triglycerides, hyperuricemia and obesity, doctors talk about a condition known as metabolic syndrome .
When should I go to the doctor?
The presence in an adult individual of the need to urinate often, associated with intense sects and risk factors of type 2 diabetes (eg: obesity, hypertension, sedentary lifestyle and high triglycerides), represents an important alarm bell and deserves a medical consultation immediate.
Gestational diabetes symptoms
To learn more: Gestational Diabetes Symptoms
Brief review of the causes of gestational diabetes
Gestational diabetes occurs when, faced with a condition of insulin resistance induced by some placental hormones, the pancreas is not able to respond adequately with a greater production of insulin (greater production of insulin which, instead, takes place in women pregnant without gestational diabetes).
When it is symptomatic - which is not always the case - gestational diabetes causes some of the same symptoms mentioned in pregnant women for type 1 diabetes and type 2 diabetes (eg, polydipsia, fatigue and polyuria). Therefore, the next sections of this part of the article will focus on other aspects, such as: when gestational diabetes appears, the possible effects of gestational diabetes on the fetus, which women are most at risk, etc.
When does it appear?
The genus, gestational diabetes appears at the end of the second trimester of pregnancy, ie around the 25th-26th week of gestation. This explains why blood tests aimed at the search for pregnancy-related diabetes in pregnant women begin as early as the 24th week of pregnancy.
Important note
In women who are at high risk of gestational diabetes (because they suffer from obesity, because they have a family history of type 2 diabetes, etc.), diagnostic tests aimed at finding the aforementioned metabolic disease start very early and must be repeated several times during pregnancy, especially between the 24th and 28th week of gestation.
Among the aforementioned diagnostic tests, in addition to blood tests, there is also the so-called oral glucose loading test (or oral glucose tolerance test ), which evaluates blood glucose 30, 60 and 120 minutes after oral administration of 75 grams of glucose.
Possible consequences of gestational diabetes on the child
If treated appropriately - as now happens in most circumstances - gestational diabetes has no consequences on the future unborn child. On the contrary, if an appropriate treatment is lacking, pregnancy-induced diabetes can involve phenomena such as:
- Fetal macrosomia . Doctors use this term to describe a newborn that is significantly larger than the average.
In the presence of gestational diabetes, the possibility of witnessing the phenomenon of fetal macrosomia depends on the large amount of glucose reaching the fetus, through the mother's blood (which has high concentrations of blood glucose, due to diabetes);
- Hypoglycemia at birth ;
- Jaundice at birth ;
- Polydramnios . The term polydramnios identifies the excessive production (therefore also presence) of amniotic fluid, in the amniotic sac;
- Respiratory distress syndrome . It is a medical condition that causes respiratory failure. This respiratory failure is due to an incomplete development of the lungs, which cannot adequately supply the entire body with oxygen.
- Intrauterine death ( stillborn fetus ), due to the presence of severe malformations that occurred during fetal life.
Furthermore, scientific studies have shown that children born to women with untreated gestational diabetes are more likely to develop obesity, prediabetes and type 2 diabetes mellitus in the coming years.
How does gestational diabetes evolve?
Usually, the metabolic alteration that characterizes gestational diabetes normalizes after delivery. However, statistical data in hand, women who have suffered from gestational diabetes are more likely than non-gestational diabetes to develop non-gestational diabetes in the following years (there is talk of an increase in probability equal to at least 17%).
When should I go to the doctor?
For your future health and that of the next unborn child, a pregnant woman should immediately contact her doctor and undergo all the necessary controls as soon as she becomes aware of the first typical symptoms of diabetes mellitus.
