Diabetes Mellitus

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diabetes mellitus

[‚dī·ə′bēd·ēz ′mel·ə·dəs]
(medicine)
A metabolic disorder arising from a defect in carbohydrate utilization by the body, related to inadequate or abnormal insulin production by the pancreas.

Diabetes Mellitus

 

a chronic disease characterized by all kinds of metabolic disorders, chiefly carbohydrate, caused by the absolute or (more often) relative deficiency of the pancreatic hormone, insulin.

Heredity plays a major role in the origin of functional insufficiency of the islands of Langerhans of the pancreas, which produce insulin; the functional insufficiency may result from a trauma, inflammation, sclereosis of the pancreatic vessels, infections, intoxication, psychological trauma, excessive consumption of carbohydrates, and overeating in general. The functional condition of the other endocrine glands—the pituitary, adrenals, thyroid, and so forth—and the central and autonomic nervous systems is another factor. Because of the insulin deficiency the liver and muscles become unable to convert sugar into glycogen, and all the tissues lose their capacity to oxidize sugar and use it as an energy source. Moreover, glyconeogenesis also takes place —that is, sugar is formed from proteins and fats. As a result, sugar accumulates in the blood—to as much as 0.2-0.4 g per 100 milliliters of blood or more (hyperglycemia). When the amount of sugar in the blood is more than 0.18 g (“kidney threshold”), some of the sugar in the renal tubules is not reabsorbed and is excreted in the urine (glycosuria).

In more severe cases, liver function weakens, glycogen ceases to be synthesized and accumulates, and the products of protein and fat decomposition are no longer rendered harmless. As a result, a substantial quantity of ketone bodies, especially acetoacetic and /3- hydroxybutyric acids appear in the blood and then in the urine. The accumulation of these acids disturbs the acid-base equilibrium, causing acidosis. Acidosis may result in a diabetic coma.

Diabetes mellitus patients suffer from an intensified appetite and thirst (hunger and thirst may not be very intense in mild cases), increased excretion of urine (up to 5–8 liters a day) with a high specific gravity, itching of the skin and external genitalia, inflammation of the oral mucosa, pain along the nerve trunks (polyneuritis), and muscular and sexual weakness. The menstrual cycle is disturbed in women; spontaneous abortions or stillbirths may occur in pregnant women. The blood cholesterol level rises in diabetics, promoting the early onset of atherosclerosis, which is often combined with hypertonia. Marked changes in the cardiovascular system, kidneys, and eyes are among the serious complications of diabetes mellitus.

Treatment is individualized, taking into account the specific metabolic disorder. In mild forms, a special diet is prescribed, taking into account individual energy expenditures, and exercise therapy (especially for obese persons); in some cases, sugar-reducing sulfanilamide preparations (which are particularly effective in elderly persons with a tendency toward obesity) are prescribed. In moderate and severe forms insulin therapy is undertaken; long-acting insulin preparations with a sugar-reducing action are used to prolong the action of insulin.

REFERENCES

Genes, S. G. Sakharnyi diabet, 5th ed. Moscow, 1963. (Bibliography.)
Diabet, edited by R. Williams. Moscow, 1964. (Translated from English; bibliography.)

L. M. GOL’BER

References in periodicals archive ?
Os pacientes com obesidade grau 1, apresentaram valores elevados de tolerancia a glicose ou diabetes melitus tipo2, diferente dos pacientes do sexo feminino que elevou com o aumento do IMC.
Segundo a OMS, o diagnostico de diabetes melitus e confirmado na observacao de glicemia basal (jejum) igual ou superior a 140mg/dl ou apos a sobrecarga oral de 75g de glicose (Teste de Tolerancia Oral a Glicose em 120 minutos) com resultado igual ou superior a 200mg/dl.
Assim, o exercicio fisico tem sido apontado como terapia util no controle do diabetes melitus tipo II e da obesidade, melhorando a composicao corporal, o estado psicologico dos individuos, bem como a sensibilizacao a insulina especialmente em individuos de meia idade e anciaos (Holloszy e colaboradores, 1986; Schneider e Morgado, 1995; Eriksson e colaboradores, 1997; Kahn e colaboradores, 1990; Miller e colaboradores, 1994).
Para Ferreira e Colaboradores (2005), o crescente aumento do diabetes melitus tipo 2 esta associados as dificuldades na aderencia das populacoes atuais a habitos de vida mais saudaveis estes fatos motivaram as pesquisas envolvendo intervencoes farmacologicas.
Para Molena-Fernandes e Colaboradores (2005), os estudos epidemiologicos apontam o sedentarismo (falta de atividade fisica) juntamente com dietas inadequadas, estilo da vida moderna e obesidade como sendo fatores importantes para o desenvolvimento do diabetes melitus tipo 2.
Tais patologias compreendem as doencas cardiovasculares, dislipidemias, diabetes melitus tipo 2, certos tipos de cancer, dificuldades respiratorias, problemas dermatologicos e disturbios do aparelho locomotor, condicoes que reduzem a expectativa de vida por levar a mortalidade precoce (Rexrode, Garfinkel, Oliveira e colaboradores citados por VelasquezMelendez, Pimenta e Kac, 2004; Willett, Dietz e Colditz citados por Beraldo, Vaz e Naves, 2004).
As dos tipos II e III estao associadas a hipertensao e diabetes melitus tipo II.
O Diabetes Melitus do tipo 2 e de maior incidencia, alcancando entre 90
250 milhoes de pessoas afetadas pelo diabetes melitus do tipo 2 no mundo
A maioria dos individuos portadores de diabetes melitus do tipo 2 e obesos demonstram diminuicao na glicose sanguinea apos uma atividade fisica de intensidade leve para moderada.
Existem efeitos cronicos promovidos pela atividade fisica regular no portador de diabetes melitus do tipo 2 como diminuicao da frequencia cardiaca de repouso; aumento do volume de VO2; melhora na utilizacao do oxigenio e diminui em repouso e em exercicio da pressao arterial, bem como melhora na glicemia de jejum (ACSM, 2004).
As mulheres na pos-menopausa, alem da tendencia ao ganho de peso por apresentarem alteracoes no metabolismo lipidico, devido a privacao estrogenica, que eleva as concentracoes de colesterol total, lipoproteinas e triglicerideos, acarretando a essa populacao, um alto risco a aterogenese, quando associadas a diabetes melitus e pressao arterial (Pasquali e colaboradores citado por De Oliveira e Mancini Filho, 2005).

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