WHAT IS DIABETES MELLITUS?
Diabetes Mellitus is a condition in which the body cannot regulate the amount of sugar (glucose) in the blood. Diabetes includes Type I Diabetes, Type II Diabetes, Gestational Diabetes, Metabolic Syndrome, and Pre-Diabetes.
In a healthy person, the blood glucose level is regulated by several hormones, primarily insulin. Insulin is produced by the pancreas, an organ lying behind the stomach. Insulin allows glucose to move out of the blood into cells throughout the body where it is used for energy production.
People with diabetes either do not produce enough insulin (Type I Diabetes) or cannot use insulin properly (Type II Diabetes) or both (which occurs with several forms of diabetes). In diabetes, glucose in the blood cannot move efficiently into cells, so blood glucose levels remain high. This not only starves all the cells that need glucose for energy production, but it also harms certain organs and tissues exposed to the high glucose levels.
Type I Diabetes
The body stops producing insulin or produces too little insulin to regulate blood glucose level.
- Type I Diabetes involves about 10% of all people with diabetes in the United States.
- Type I Diabetes is typically diagnosed during childhood or adolescence. It was also known as juvenile-onset diabetes or insulin-dependent diabetes mellitus (IDDM).
- Type I Diabetes can occur in an older individual due to destruction of the pancreas by alcohol, disease, or removal by surgery. It also results from progressive failure of the pancreatic beta cells, the only cell type that produces significant amounts of insulin.
- People with Type I Diabetes require insulin treatment daily to sustain life.
Type II Diabetes
Though insulin is still produced by the pancreas, the Type II Diabetic is partially or completely unable to use this insulin. This is sometimes referred to as insulin resistance. In such cases, the pancreas tries to overcome this resistance by secreting more and more insulin. People with insulin resistance develop type 2 diabetes when they fail to secrete enough insulin of good quality to cope with the demands.
- At least 90% of adult diabetics have Type II Diabetes.
- Type II Diabetes is typically diagnosed in adulthood, usually after age 45 years. It was known as adult-onset diabetes mellitus, or non-insulin-dependent diabetes mellitus (NIDDM). These names are no longer used because Type II Diabetes now occurs in younger people, and some people with Type II Diabetes require insulin therapy.
- Type II Diabetes is usually controlled with oral medications, diet , weight loss, and exercise.
Gestational diabetes mellitus (GDM) is a form of diabetes that occurs during pregnancy.
- Although gestational diabetes typically resolves after delivery of the baby, a woman who develop gestational diabetes is more likely than other women to develop Type 2 Diabetes later in life.
- Women with gestational diabetes are more likely to have large babies.
Metabolic Syndrome (also referred to as syndrome X) is a set of abnormalities in which insulin-resistant diabetes (Type II Diabetes) is almost always present along with hypertension (high blood pressure), hyperlipidemia (high fat levels in the blood (increased serum lipids, predominant elevation of LDL cholesterol, decreased HDL cholesterol, and elevated triglyceride level, central obesity, and abnormalities in blood clotting and inflammatory responses. A high rate of cardiovascular disease is also associated with metabolic syndrome.
In patients with pre-diabetes, the blood sugar level is higher than normal but not yet high enough to be considered diagnostic of diabetes.
- Pre-diabetes increases a person's risk of developing type 2 diabetes, heart disease or stroke.
- Pre-diabetes can typically be reversed (without insulin or medication) with lifestyle changes such as losing a modest amount of weight and increasing physical activity levels. Weight loss can prevent, or at least delay, the onset of Type II Diabetes.
- Pre-diabetic people may develop diabetes within 10 years if they don't make lifestyle changes such as exercising more and maintaining a healthy weight.
About one third of adults with diabetes do not know they have diabetes.
- About 1 million new cases of diabetes is diagnosed occur each year, and diabetes is the direct or indirect cause of at least 200,000 deaths each year.
- The incidence of diabetes is increasing rapidly due to many factors, amongst which the most significant are unbalanced nutrition, obesity, lack of exercise and a sedentary lifestyle.
Complications of Diabetes
Both Type I and Type II Diabetes ultimately lead to hyperglycemia - a condition of abnormally high blood sugar level. If present over a long period of time, hyperglycemia damages the heart, retina of the eye, the kidneys, the nerves, and blood vessels.
- Damage to the heart - diabetic cardiomyopathy.
- Damage to the retina - diabetic retinopathy, a leading cause of blindness.
- Damage to the kidneys - diabetic nephropathy, a leading cause of kidney failure.
- Damage to the nerves - diabetic neuropathy, a leading cause of foot wounds and ulcers, frequently leading to foot and leg amputations.
- Damage to the nerves in the autonomic nervous system can lead to a weakening of the stomach (gastroparesis), chronic diarrhoea, and an inability to control heart rate and blood pressure during postural changes.
- Diabetes accelerates atherosclerosis (the formation of atherosclerotic plaques inside the arteries), which can lead to blockages or a clot formation (thrombus). Such changes can then lead to heart attack, stroke, and decreased circulation in the arms and legs - peripheral vascular disease.
- Diabetes predisposes people to hypertension, hypercholesterolemia, and hypertriglyceridemia. In the presence of hyperglycemia, these conditions increase the risk of heart disease, kidney disease and blood vessel complications - diabetic angiopathy and micro-angiopathy.
Diabetes can contribute to a number of acute and serious medical problems:
- Hypoglycemia (low blood sugar level): may occur intermittently in most people with diabetes. It can result from taking too much anti-diabetic medication, especially insulin (sometimes called an insulin reaction), missing a meal or meals, exercising more than usual or taking certain medications for other conditions. It is very important to recognize hypoglycemia and be prepared to treat it at all times. Headache, feeling dizzy, poor concentration, tremor of the hands, and cold sweating are common symptoms of hypoglycemia. A person can faint or have a seizure if the blood sugar level becomes too low.
- Infections associated with diabetes: Infections are frequently more dangerous in someone with diabetes because the body's normal ability to fight infections is impaired. Moreover, infections may worsen glucose control, which may further delay recovery from infection.
- Diabetic keto-acidosis (DKA): is a serious condition in which uncontrolled hyperglycemia (usually due to complete lack of insulin or a relative deficiency of insulin) over time creates a build-up of ketones (acidic waste products) in the blood. High levels of ketones can be very harmful. This typically happens to people with Type I Diabetes who do not have good blood glucose control. Diabetic keto-acidosis can be precipitated by infection, stress, trauma, missing medications like insulin, or medical emergencies such as a stroke or a heart attack.
- Hyper-osmolar hyperglycemic non-ketotic syndrome: is a serious condition in which the blood sugar level gets very high. The body tries to get rid of the excess blood sugar by eliminating it in the urine. This increases the amount of urine significantly, and often leads to dehydration so severe that it can cause seizures, coma and even death. This syndrome typically occurs in people with Type II Diabetes who are not controlling their blood sugar levels, who have become dehydrated, or who have stress, injury, stroke, or are taking steroid medications.
LASER TREATMENT OF DIABETES MELLITUS
Laser treatment of diabetes mellitus can be carried out in all cases or at all stages of diabetes (diabetes type I and type II, gestational diabetes, any other form of diabetes) in order to lower the blood sugar level to normal as well as help control the latter.
Laser treatment of diabetes mellitus is also useful to treat diabetic complications in the diabetic patient, first, to keep the patient away from complications, and secondly to decrease the degree of diabetic complications, in order to give a better quality of life to the diabetic patient.
Laser treatment can be safely and effectively used to treat diabetes mellitus and its complications in diabetic patients parallelly suffering from diseases of other organs and systems, e.g. cardiovascular, renal, nervous, musculo-skeletal, etc. Furthermore, diseases of the just-named organs and systems can also be successfully treated with the help of various modes of laser treatment.
Laser treatment can be used parallelly with medications (anti-diabetic tablets and insulin injections) in order to rapidly control and normalize blood sugar level as well as treat diabetic complications.
Laser treatment will rapidly allow the patient to decrease the number of anti-diabetic tablets or amount of insulin intake upon rapid improvement of his health condition. In many cases, if patient follows the laser treatment and advices of his treating doctor well, he may improve his state of health and get rid of all medications, living with a normal blood sugar level and no complications.
Laser treatment can be safely and effectively used to treat diabetic complications, such as diabetic foot ulcers as shown below. No skin grafting and no stem cell therapy have been used to cure the large diabetic ulcer completely. Only laser treatment has helped cure the defect completely with full growth of the skin over it. Please see images below.