The causes of diabetes mellitus differs from one patient to another, but 2 main types of diabetes can be determined.

-          Type 1: Which is insulin dependant and occur due to disturbance in the immune systems or viral infection affecting pancreas, and usually affect children and young age.

-          Type 2: Non insulin dependant but can be treated by oral hypoglycemic  agents plus diet and exercise, and this type is most common, and occurs as result of many causes but we can simplify these causes in one sentence which is: Disturbance in the works of insulin inside the body.

Causes of Type 1 Diabetes Mellitus (IDD)

There are many causes of type 1 DM:

a.       Immunity factor
Immune system can destroy B cells of Pancreas that produce insulin by attacking these cells.

b.       Inflammatory Factor
Some viral infection can be transported to pancreas through blood leading to destruction of B cells producing insulin.

c.       Hereditary Factor
Hereditary factor play an important role in causing type 1 DM because of specific hereditary genes in some people. The prevalence of a child to be affected by DM increase if his brother or sister, or parents are diabetic but not reaching 10%.

Causes of Type 2 Diabetes Mellitus (NIDD)
Prevalence of type 2 DM reach 90%, and it affects all age group with no difference in age or sex, but its diagnosis is late.

Causes of Type 2 Diabetes Mellitus have 2 main factors:
1^st is hereditary and 2^nd is environmental.

1^st factor: Hereditary Factor
      This factor is transmitted from parents to children, if both parents are diabetic, so each two of 4 sons are type 2 diabetics and sometimes ratio reach more than 75%, and is related to environmental factors.

2^nd factor: Environmental Factor
      Concerning factors that lead to DM including:

1.       Gaining Weight
Gaining weight plays an important role in type 2 DM, studies proved that 80% of patients with DM are overweight (10-15kg) in a certain period of time before diagnosis of disease.

2.       Age
Type 2 DM affect all age group, different social standard, but prevalence increase with bigger age especially after age of 45 years.

3.       Sex
Type 2 DM is equal in both sexes until age of puberty, but prevalence increases in women as 2 times in men between ages of 35-65 years. Different type of diabetes occurs in female during pregnancy called Gestational Diabetes, and this type is transformed to type 1 DM later in life. 

4.       Lack of Exercise
Studies proved that people with lack of exercise are more susceptible to type 2 DM than people doing regular exercise, because exercise lead to better absorption of insulin.

5.       Bad Food Habits
Bad food habits and eating lot of fat, fast meals, sweets lead to increase in weight, accumulation of fat inside the cells of the body especially abdominal obesity and decrease sensitivity of cells to insulin and type 2 DM.

Question #2

What are the Symptoms of Diabetes Mellitus?

 Answer:
Symptoms of DM differ according to type and severity of the disease, Type 1 DM has acute symptoms while type 2 DM can be discovered accidentally on routine investigations.

Main symptoms are:

1.       Loss of weight
Especially in type 1 DM before starting treatment but in type 2 DM there is gaining weight at the beginning of the disease and there is loss of weight if there is delay in treatment.

2.       Polyurea, Polydepsia and dryness of mouth.

3.       Polyphagia because of disturbed metabolism.

4.       Decrease visual acuity.
Occurs suddenly if there is increase or decrease in blood sugar level, cataract cause decrease visual acuity, but real danger in retinopathy leads to loss of visual acuity if no proper treatment.

5.       Impotence
Men suffer from impotence and differ from patient to another and start at the beginning of DM.

6.       Skin infection and itching.
Especially in women at sexual areas because of Candida infection.

7.       Numbness and pain of limbs.