Trauma Survivors Network - provided by ATS

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Diabetes Mellitus

Diabetes is a condition in which the body is unable to control the level of sugar (glucose) in the blood. Glucose is the source of energy for all the cells in the body. Glucose levels directly affect the body’s ability to sustain normal function, such as fighting infections and healing wounds. Therefore, patients with abnormal glucose levels (diabetes) are at greater risk for developing infections and are more likely to have trouble with wounds healing properly. All trauma patients are considered to be at risk for infection. A diabetic patient is at even greater risk. Physicians can treat diabetic patients with insulin to help normalize blood sugar levels; however, there is no substitute for a body that can affectively regulate its own blood sugar levels. 

Definition and Overview

Diabetes mellitus is a disorder of metabolism that affects the way the body uses sugar and can be classified as Type I or Type II. Type I or insulin dependent diabetes is where the body does not produce insulin, and Type II diabetes is non-insulin dependent where the body does not respond to the insulin that it produces. Insulin is produced by cells in the pancreas and is released in response to eating a meal to help store nutrients in cells and tissues of the body. There are over 20 million people in America with diabetes and more than 90% of them have Type II or insulin resistant diabetes. 


The symptoms include going to the bathroom frequently, weight loss or gain, increased thirst, flu like feelings, blurred vision, tingling and loss of sensation in the hands and feet, sore swollen gums, and sores or cuts that are slow to heal. All of these symptoms are caused by the body’s decreased sensitivity to insulin, making it more difficult to store sugars. Sugar accumulates in the blood stream instead of the cells, making the person hungrier, and also causing muscle to waste away because it is not able to store the energy that it needs. The body is slow to heal when glucose is high, and the sugars also affect the retina of the eye and the nerves that run to the hands and feet. With more sugar in the bloodstream water is more likely to stay in the blood stream causing the person to go to the bathroom frequently.

Treatment and Prognosis

Type II diabetes has no cure therefore the primary goal of the physician is to manage the disease. Carefully monitoring blood sugar and educating the patient on self-management is extremely important in preventing signs and symptoms of the disease. It is therefore important to try to avoid excessive sugar in the diet, exercise regularly, talk with the doctor about other medications that might affect blood sugar levels, be aware of changes in hormone levels, and be sparing with alcohol intake. Insulin injections are often prescribed by the doctor, and these will help the body absorb sugars better.

Many people can be borderline diabetic before becoming completely insulin insensitive; in these cases it is important to make lifestyle changes before fully developing the disease. This can be done by exercising more frequently, 30 minutes or more per day, losing weight, and eating a low fat and calorie diet. In most people well-controlled diabetes will not lead to any significant problems. However, if it is not adequately controlled people are at higher risk for heart disease, stroke, eye problems, delayed wound healing, nerve damage, and kidney problems.