Diabetes mellitus is a disease associated with insulin deficiency in the organism. Depending on the type of condition, it affects individuals from different age groups. A more common type 2 is typically diagnosed in the older population (40-80 years) and is characterized by a slow onset while type 1 is more prevalent in children and has a rapid onset. The condition is characterized by weight loss, hunger, frequent urination, thirst, and tiredness. Associated symptoms include dryness of skin, slow recovery of sores, and more frequent infections. The most prominent aggravating factor for the condition is obesity, and the respective alleviating factor is a healthy weight.
The most common concomitant diseases associated with diabetes are cardiovascular disease, hypertension, and vascular diseases. Since their treatment affects blood sugar levels, the treatment of diabetes must be adjusted accordingly.
The pathophysiology of type 2 diabetes can be described as a relative deficiency of insulin in contrast to the absolute deficiency characteristic for type 1 diabetes. In absolute deficiency, beta cells responsible for insulin production are destroyed by the malfunctioning immune system, which leads to the eventual insulin deficiency. The relative deficiency is caused by insulin resistance, where the available insulin is insufficient for normal body functioning. This prompts increased production and eventually wears off beta cells. Since insulin resistance usually increases over time, the condition aggravates unless addressed.
The primary differential diagnosis is diabetes mellitus type 2. The most reliable indicators of the diagnosis are the elevated levels of glycosylated hemoglobin and a high amount of plasma glucose. The patient diagnosed with type 2 diabetes usually reports being constantly tired and sleepy. Abdominal obesity or even excessive weight are corroborating factors. The tests are expected to show abnormally high blood sugar levels. Fatigue may occur in patients with severe forms of the disorder. Blurred vision, slow recovery of injuries, unreasonable weight loss, and frequent infectious diseases further increase the likelihood of the diagnosis.
Secondary differential diagnosis is hyperglycemia due to insulin resistance. Once the insulin-related tissues (e.g. liver) lose the ability to process insulin, an insulin deficiency develops. The rationale for the condition would be polydipsia (excessive thirst) and polyphagia (excessive hunger), blurred vision, tingling in lower extremities, dryness in the mouth, and restlessness. Cardiac arrhythmia may develop in severe cases of the condition.
Another secondary differential diagnosis is the hyperglycemia caused by the reduced secretion of insulin. In this scenario, the beta cells work at an abnormally high rate due to the reduced insulin absorption. This leads t their eventual decline and creates severe deficiency. The rationale for the conditions is mostly consistent with insulin resistance-induced hyperglycemia but can include pancreatic disorders and seizures in extreme cases.
The evidence-based practices that yield the best results for conditions identified in the differential diagnoses can be categorized into the lifestyle changes and pharmacological interventions. The former include physical exercise and healthy dietary habits. Since blood sugar can be decreased through regular exercise, moderate food intake, and avoidance of high-sugar foods, hyperglycemia can be controlled in this way, thus enhancing the effectiveness of the medications (American Diabetes Association, 2016). The latter includes consistent medication intake, blood sugar monitoring, and insulin intake adjustment. The combination of these practices decreases the severity of hyperglycemia-associated symptoms and alleviates the stress of the beta-cells (Inzucchi et al., 2015).
Once all of the identified components of the intervention are responsibly maintained by the individual, the condition can be maintained at the low-risk level. For the patient, the outcome can be described as the alleviation of the majority of symptoms and the elimination of risks associated with the condition, and, by extension, the improved quality of life.
References
American Diabetes Association. (2016). Standards of medical care in diabetes—2016 abridged for primary care providers. Clinical Diabetes: A Publication of the American Diabetes Association, 34(1), 3-21. Web.
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M.,… Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: A patient-centered approach: Update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care, 38(1), 140-149. Web.