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By Michael Martin, DO

DIABETESAs a family doctor, I see many patients with diabetes. Although someone of any age may have it, it is more common as we age. Most people are referring to diabetes mellitus when they talk about diabetes. Diabetes is a dysfunction of insulin which causes our blood glucose to become elevated. Often patients will present with frequent urination, increased thirst, increased hunger, blurred vision, poor wound healing, and weight loss.

What is Type I Diabetes Mellitus?
Type I diabetes mellitus is a result of a lack of insulin, a hormone made in the pancreas, that causes glucose, or sugar, in our blood to go into our cells to be used to make energy. Because there is a lack of insulin, our glucose cannot enter the cells. Type I diabetes mellitus was formerly called juvenile diabetes because it was more commonly seen in children and infrequently seen in adults. Insulin dependent diabetes was also another name formerly used to describe type I diabetes mellitus because these patients need to be given supplemental insulin because they can no longer produce enough on their own. It is thought to be the result of an insult to the pancreas causing a decrease in insulin production. Most often, this type usually has a fairly rapid onset.

What is Type 2 Diabetes Mellitus?
Type 2 diabetes mellitus, formerly called adult-onset diabetes or non-insulin dependent diabetes mellitus, is caused by a lack of response to insulin. The most common patients with type 2 tend to be physically inactive and overweight. 90% of diabetes cases are type 2 diabetes mellitus. Many of the patients can be managed effectively with an improved, calorie reduced diet and exercise. These patients will often need medication up to and including insulin if their disease progresses as it is easy to tell them to lose weight and exercise, but very hard to get compliance. This is the form of diabetes that is rapidly growing, not just in the United States, but worldwide. Education, healthy eating and exercise habits established early in life are thought to be the best preventive measures.

Diabetes Tends to Progress Throughout Life
Regular care to monitor the patient’s health status is very important. Vision problems from diabetes can be devastating, with blindness as the worst visual outcome. Regular eye exams with the eyes dilated give your doctor the best view inside the eyes and are considered the stan-dard of care. Early detection and intervention are extremely important to preserve vision. Nerves can become damaged causing debilitating pain, tingling, and numbness that may never go away. Kidneys can become so damaged that they do not function leading to dialysis. Foot ulcers and wounds can be unnoticed due to poor nerve function and many times progress to hospitalization and amputation. Diabetes increases your risk of a heart attack to that of someone who has already had a heart attack.

How Does a Person Protect Themselves?
Eat right, exercise and see your doctor. Your doctor can evaluate you and determine if you have an increased risk of diabetes or if you have diabetes. Discussion of your health, symptoms, risk factors, family history, and other aspects are very important. Laboratory testing and physical examination are the final pieces of the puzzle to allow your doctor to make a diagnosis.

The University of Tennessee
Family Medicine Center
294 Summar Drive
Jackson, TN 38301

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