If you are a health-conscious person, you would have come across
the word diabetes mellitus or even heard of it a few times yourself.
Thus, with that in mind, I will focus briefly on the aspect of
classification and non-pharmacological therapy of DM.
Classification of Diabetes
Type 1 DM
Type 1 DM is known as insulin-dependent DM as patients have little or unable to synthesize insulin hormone. Hence the name, they will eventually be dependent on insulin injection for their survival.
This type of DM is a result of the autoimmune destruction of ²-cells (which produces the insulin hormone) in the pancreas. It mostly occurs in adolescent and children. In general, they are less than 30 years old with a lean body habitus. However in some cases, it could also be found at any age group.
Type 2 DM
On the other hand, Type 2 DM is different from Type 1 in which it is characterized by insulin resistance where in the initial stage, it lacks of insulin secretion. In such a case, although the pancreas retains some ability to produce insulin but it is insufficient to convert the blood glucose to glucagon following the body's needs resulting in accumulation of blood glucose. Alternatively, the body cells can also become resistant towards the insulin produced by the ²-cells. As a result, blood glucose level is increased and led to hyperglycemia (high blood glucose level).
Most individuals with type 2 DM exhibit abdominal obesity which itself can cause insulin resistance. Furthermore, patient usually has co-existence of other medical disorders such as hypertension, dyslipidemia (high triglyceride levels and low HDL-cholesterol levels), and heart diseases. Clustering of abnormalities is normally referred as "insulin-resistance syndrome" which can also increase the risk of developing macrovascular complications (ischaemic heart disease, cerebrovascular disease and peripheral vascular disease).
Owing to its gradual development in the age of onset and average of more than 30 years old in most patients, Type 2 is also known as maturity-onset DM. This type of DM is highly genetic predisposition regardless to ethnicity.
Gestational DM
GDM is defined as glucose intolerance which is found during pregnancy. It has complicated about 7% of all pregnancies. It is important to have a early clinical detection in pregnant women whereby such therapy will help to reduce the perinatal morbidity and mortality risk.
Non-Pharmacologic Therapy
Regardless of the type of DM, patient should take initiative in preventing the complications of DM. Apart from prescribed medications by doctor; non-pharmacologic therapies should not be neglected as well.
Diet
This is one of the cornerstones in DM management. Success cannot be achieved without a proper diet therapy even though if you comply fully with your given medications. The followings are general recommendations:
1.Obtain counseling from a dietitian on individual nutrition based on your health conditions. This is aim to provide a balanced diet to achieve and maintain a healthy body weight.
2.Restrict intake of high sugar-containing foods such as cakes and ice-cream and other carbohydrates.
3.Reduction of intake of saturated fats in all diabetic patients as it can complicate their abnormal medical conditions.
Physical Activity
Most diabetic patients can benefit from increased physical activity such as walking, aerobic exercise, gardening and cycling. However, the type and intensity should be individualized.
For example, an older patient should have a cardiovascular evaluation including a graded exercise test with imaging prior to beginning a moderate to intense exercise regimen.
It is advisable for those previously having a sedentary lifestyle patient to start exercise slowly. Preferably, a daily minimum of 3-5 times per weeks with at least 30 minutes each session. It is a good thing that physical activities are cumulative where three 10 minute sessions in a day is equivalent to a 30 minute session. This is most encouraging and you will no longer has any excuse to neglect the importance of physical activities.
If you have any doubt, consult with your doctor beforehand before initiating any non-pharmacologic therapy! Do not be take it upon yourself and put your health at risk!
Classification of Diabetes
Type 1 DM
Type 1 DM is known as insulin-dependent DM as patients have little or unable to synthesize insulin hormone. Hence the name, they will eventually be dependent on insulin injection for their survival.
This type of DM is a result of the autoimmune destruction of ²-cells (which produces the insulin hormone) in the pancreas. It mostly occurs in adolescent and children. In general, they are less than 30 years old with a lean body habitus. However in some cases, it could also be found at any age group.
Type 2 DM
On the other hand, Type 2 DM is different from Type 1 in which it is characterized by insulin resistance where in the initial stage, it lacks of insulin secretion. In such a case, although the pancreas retains some ability to produce insulin but it is insufficient to convert the blood glucose to glucagon following the body's needs resulting in accumulation of blood glucose. Alternatively, the body cells can also become resistant towards the insulin produced by the ²-cells. As a result, blood glucose level is increased and led to hyperglycemia (high blood glucose level).
Most individuals with type 2 DM exhibit abdominal obesity which itself can cause insulin resistance. Furthermore, patient usually has co-existence of other medical disorders such as hypertension, dyslipidemia (high triglyceride levels and low HDL-cholesterol levels), and heart diseases. Clustering of abnormalities is normally referred as "insulin-resistance syndrome" which can also increase the risk of developing macrovascular complications (ischaemic heart disease, cerebrovascular disease and peripheral vascular disease).
Owing to its gradual development in the age of onset and average of more than 30 years old in most patients, Type 2 is also known as maturity-onset DM. This type of DM is highly genetic predisposition regardless to ethnicity.
Gestational DM
GDM is defined as glucose intolerance which is found during pregnancy. It has complicated about 7% of all pregnancies. It is important to have a early clinical detection in pregnant women whereby such therapy will help to reduce the perinatal morbidity and mortality risk.
Non-Pharmacologic Therapy
Regardless of the type of DM, patient should take initiative in preventing the complications of DM. Apart from prescribed medications by doctor; non-pharmacologic therapies should not be neglected as well.
Diet
This is one of the cornerstones in DM management. Success cannot be achieved without a proper diet therapy even though if you comply fully with your given medications. The followings are general recommendations:
1.Obtain counseling from a dietitian on individual nutrition based on your health conditions. This is aim to provide a balanced diet to achieve and maintain a healthy body weight.
2.Restrict intake of high sugar-containing foods such as cakes and ice-cream and other carbohydrates.
3.Reduction of intake of saturated fats in all diabetic patients as it can complicate their abnormal medical conditions.
Physical Activity
Most diabetic patients can benefit from increased physical activity such as walking, aerobic exercise, gardening and cycling. However, the type and intensity should be individualized.
For example, an older patient should have a cardiovascular evaluation including a graded exercise test with imaging prior to beginning a moderate to intense exercise regimen.
It is advisable for those previously having a sedentary lifestyle patient to start exercise slowly. Preferably, a daily minimum of 3-5 times per weeks with at least 30 minutes each session. It is a good thing that physical activities are cumulative where three 10 minute sessions in a day is equivalent to a 30 minute session. This is most encouraging and you will no longer has any excuse to neglect the importance of physical activities.
If you have any doubt, consult with your doctor beforehand before initiating any non-pharmacologic therapy! Do not be take it upon yourself and put your health at risk!
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