Diabetes Mellitus


Sugar diabetes                                              


  • The body requires glucose (a form of sugar) to provide the energy needed to perform its functions.  In fact, all body tissue, especially the brain, needs continuous glucose.  Hormones in the body carefully control blood sugar levels.  Insulin prevents the blood sugar from becoming too high.  Since Insulin is produced by the beta cells in the pancreas, diabetes occurs when the pancreas does not produce enough Insulin, or the cells and tissues cannot utilize that Insulin properly (Insulin resistance).
  • Diabetes is often categorized into two types: Type I (Insulin-dependent) and Type II (non-Insulin dependent).  Type I is sometimes called juvenile onset diabetes.  In general, the onset of diabetes in those below 25 years of age is generally diagnosed as Type I diabetes, and is caused by the pancreas not making enough Insulin.  In general, the onset of diabetes in those above 40 years of age is due to Insulin-resistance.
  • Occasionally, younger obese children will have Insulin-resistance type diabetes.
  • When the blood sugar becomes high, the body tries to get rid of the excess sugar by trying to urinate it off.  This leads to Dehydration and is the reason diabetic symptoms are usually excessive thirst and urination.

  • Type I diabetes:
    1. Excessive thirst
    2. Frequent and large volume urination
    3. Dehydration
    4. Rapid weight loss
  • Type II diabetes:
    1. Thirst
    2. Frequent urination
    3. Dehydration
    4. Frequent female Yeast Infections
    5. Sometimes, there are no symptoms

  • Strong genetic component (family history) especially Type II diabetes
  • Pancreatic tissue damage (rare cause)


  • Follow diabetic diet guidelines -- avoid concentrated sugars such as sodas, juices, deserts, and high sugar fruits such as grapes
  • Medications:
    1. Oral hypoglycemic medications such as Glipizide -- "pushes" the pancreas to produce more Insulin
    2. Glucophage -- helps tissue to overcome Insulin resistance
    3. Insulin injections -- various short and long acting forms available to supplement Insulin
  • Note: Current medical studies show that controlling blood sugars with proper diet and medication decreases the chance of complications.  In addition, controlling blood pressure and cholesterol if they are elevated also helps decrease the risk of diabetic complications.

  • Retinopathy -- eye damage and blindness may occur
  • Higher risk of glaucoma
  • Higher risk of Cataracts
  • Nephropathy -- kidney damage
  • Neuropathy -- damage to nerves occurs, especially in the lower legs.  In addition, Neuropathy may affect the nerves to the heart so that a diabetic may not feel chest pain from a heart attack.  Another form that affects the heart is called autonomic dysfunction, in which the heart does not increase its rate when it needs to.  Also, the stomach, intestines, and colon may be affected, and not function properly (gastroparesis).  See section on diabetic Neuropathy for a more detailed explanation.
  • Heart disease -- angina, heart attacks, and "silent heart" attacks
  • Vascular disease -- hardening and blockages of various arteries of the body
  • Low Blood Sugar due to diabetic medications can lead to Comas and Seizures.


  • Emergency Conditions:
    1. Diabetic Ketoacidosis occurs in Type I diabetics when their blood sugar becomes elevated.  There is such stress on the body that the muscles break down to form glucose and ketones.  This condition is a medical emergency.
    2. A Hyperosmolar Coma is a complication of Type II diabetes, which is characterized by severe Dehydration.  This is also an emergency medical condition.
  • Diabetic Monitoring:
    1. Blood sugar monitoring as prescribed by your doctor.  Remember blood sugar checks are usually done before meals and before bed, unless your doctor gives you different instructions.
    2. Proper monitoring of blood pressure, heart, and cholesterol levels are very important
    3. Eye exams by an ophthalmologist yearly (Diabetic Retinopathy can be treated especially if found early)
    4. Regular foot exams by your doctor or a podiatrist
    5. Urine -- 24 hour collection for protein should be done every 1-2 years
    6. Hemoglobin A1C blood test usually every 4 months -- assess sugar control over this time
  • What Happens If My Blood Sugar Drops Too Low?

- Diabetic medications sometimes cause blood sugars to drop dangerously low.  Symptoms include sweating, heart pounding, and clammy hands.  In this instance, you need sugar immediately (orange juice or soda will work). Low Blood Sugar can cause Seizures, Strokes, or Comas.  If symptoms do not improve rapidly, you need immediate emergency medical treatment.