Diabetes Mellitus is a condition which the body cannot use sugar level. This because by insufficient insulin secretion or ineffectiveness of insulin or both.

Cause

        Type I Diabetes.  Due to the pancreas is unable to produce sufficient insulin.  Usually affecting young adult, age 30 or under.  They are not over weight.

        Type II Diabetes.  Is the more common type, due to either insufficient insulin production or the body was unable to use insulin efficiently.  Patient usually older than 30 years old, over weight, with family history of diabetes in parents, brothers, sisters.

        Diabetes may be caused by pancreatic disease with or without association with multiple endocrine syndromes, after surgical removal of pancreas.  It also can occur during pregnancy.

Signs and symptoms

        1. Increase frequency and amount of urination.
        2. Thirsty and weakness.
        3. Eat more than normal and still losing weight.
        4. Skin itching especially around the genital area.
        5. Numbness of fingers and toes.
        6. Loss of libido.
        7. Blurring of vision, change eye glasses
        8. Having baby weight more than 4,000 gm.

How to know if you have diabetes   

        1. Have sign and symptoms of diabetes.
        2. Fasting blood sugar equal or more than 126 mg/dl in more than one occasion.

Treatment

        Diabetes in an un-curable chromic disease and need a lifelong treatment. A co-operation between the patient and caregiver is essential and strictly follow these advices.

        1. Diet control
            -  Reduce intake of refined starch, deserts.
            -  Avoid animal fat internal organ meat, fried food.
            -  Avoid sweet fruits with soft meat, durian, dry fruit.
            -  Avoid smoking and drinking (alcohol, beer)

        2. Exercise
            Do regular exercise to help lower the sugar.  During exercise the body consumes energy which derived from blood sugar and help lowering the blood sugar level.  Exercise also increase sensitivity of tissue to insulin and use the sugar and not strenuous, such as walking with pace, easy jogging, swimming, aerobic exercise.

        3. Medication
            Both oral and injectable medication are available, strictly follow the doctor's advices.

Prevention of diabetes complication

        1. Hypoglycemia excessively (low blood sugar).  Symptoms are palpitation, tremor, sweating, cold and clammy, hunger, anxiety, decrease mental alertness, confusion, may loss conscious.  Remedy by taking sugarly drink or sugar, candy.  Take the patient to the hospital immediately or call EMS (emergency medical service) if the patient is unconscious or severely incapacitated.

        2. Hyperglycemia (Excessively high blood sugar). Symptoms are frequent urination, feed thirsty, weight loss, feel weak, nausea and/or vomiting, short of breath, decrease mental alertness or become lethargic.

        3. Other complications
            - Eye, blurring of vision, double vison, should contact and ophthalmologist.
            - Kidney, reduced kidney function, should reduce salt, protein intake and avoid drugs which can danger kidney.
            - Nervous system, keep good control of blood sugar. Have frequent exercise of hand and feet.
            - Heart and circulation, avoid causes leading to hardening of artery such as high blood lipid level, obesity, smoking, high blood pressure, lack of exercise and irregular follow up with doctor.  Regular doctor follow up will allow adjustment of treatment for optimal blood sugar control.

What to do if you have diabetes

        1.  Follow doctor's medical instruction, know your medication and always carry the medication with you.
        2.  Know the side effect of the medication.  Consult your doctor if suspicious of having side effect from the medication.
        3.  Know what to do when you have inter-current illness, having an excessive low or high blood sugar.
        4.  If you are diabetes and think you may be pregnant, tell your doctor right away because oral diabetes medication can pass into the fetus and excreted in breast milk.  This may affect the fetus or infant.
        5.  Combination of alcohol and oral diabetes medication may lead to excessively low blood sugar.  It sometimes causes high blood sugar.
        6.  Do regular exercise as instructed by your doctor.
        7.  Avoid smoking and drinking alcohol and beer.
        8.  Check urine and blood sugar regularly.
        9.  Always carry sugar pack, candy with you and take it if you feel hungry, having blurred vision, palpitation or fainting spell.
        10.It is important to take good care of your feet and toes hygiene to prevent infection and complication that may follow.  Massage your feet and toes to improve circulation.  Wear comfortable shoes.  Avoid an injury, if you have a cut or puncture wound of the feet, call your doctor.
        11.See your doctor regularly and whenever needed.

See your doctor if you have any of the follow

        - Excessively low blood sugar and not better after trying to correct it.
        - Have any wound of the foot or swelling.
        - Feel weak and connot lie flat.
        - Weakness of arms and/or legs.
        - Feel tired.
        - Having fever.
        - Have any infection in the body.
        - Excessively high blood sugar.