Diabetes mellitus, or simply diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because

the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced.[2] This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst), and polyphagia (increased hunger). There are three main types of diabetes mellitus (DM).

Type 1 DM results from the body's failure to produce insulin, and currently requires the person to inject insulin or wear an insulin pump. This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes". Type 2 DM results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. This form was previously referred to as non-insulin-dependent diabetes mellitus (NIDDM) or "adult-onset diabetes". The third main form, gestational diabetes, occurs when pregnant women without a previous diagnosis of diabetes develop a high blood glucose level. It may precede development of type 2 DM.

Other forms of diabetes mellitus include congenital diabetes, which is due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes.

Type 1 diabetes
Main article: Diabetes mellitus type 1

Type 1 diabetes mellitus is characterized by loss of the insulin-producing beta cells of the islets of Langerhans in the pancreas, leading to insulin deficiency. This type can be further classified as immune-mediated or idiopathic. The majority of type 1 diabetes is of the immune-mediated nature, in which beta cell loss is a T-cell-mediated autoimmune attack.[6] There is no known preventive measure against type 1 diabetes, which causes approximately 10% of diabetes mellitus cases in North America and Europe. Most affected people are otherwise healthy and of a healthy weight when onset occurs. Sensitivity and responsiveness to insulin are usually normal, especially in the early stages. Type 1 diabetes can affect children or adults, but was traditionally termed "juvenile diabetes" because a majority of these diabetes cases were in children. "Brittle" diabetes, also known as unstable diabetes or labile diabetes, is a term that was traditionally used to describe the dramatic and recurrent swings in glucose levels, often occurring for no apparent reason in insulin-dependent diabetes. This term, however, has no biologic basis and should not be used.[7] There are many reasons for type 1 diabetes to be accompanied by irregular and unpredictable hyperglycemia, frequently with ketosis, and sometimes serious hypoglycemia, including an impaired counterregulatory response to hypoglycemia, occult infection, gastroparesis (which leads to erratic absorption of dietary carbohydrates), and endocrinopathies (e.g., Addison's disease).[7] These phenomena are believed to occur no more frequently than in 1% to 2% of persons with type 1 diabetes.

Type 2 diabetes
Main article: Diabetes mellitus type 2
Type 2 diabetes mellitus is characterized by insulin resistance, which may be combined with relatively reduced insulin secretion.[2] The defective responsiveness of body tissues to insulin is believed to involve the insulin receptor. However, the specific defects are not known. Diabetes mellitus cases due to a known defect are classified separately. Type 2 diabetes is the most common type. In the early stage of type 2, the predominant abnormality is reduced insulin sensitivity. At this stage, hyperglycemia can be reversed by a variety of measures and medications that improve insulin sensitivity or reduce glucose production by the liver.

Gestational diabetes
Main article: Gestational diabetes
Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness. It occurs in about 25% of all pregnancies and may improve or disappear after delivery. Gestational diabetes is fully treatable, but requires careful medical supervision throughout the pregnancy. About 20 50% of affected women develop type 2 diabetes later in life. Though it may be transient, untreated gestational diabetes can damage the health of the fetus or mother. Risks to the baby include macrosomia (high birth weight), congenital cardiac and central nervous system anomalies, and skeletal muscle malformations. Increased fetal insulin may inhibit fetal surfactant production and cause respiratory distress syndrome. Hyperbilirubinemia may result from red blood cell destruction. In severe cases,

perinatal death may occur, most commonly as a result of poor placental perfusion due to vascular impairment. Labor induction may be indicated with decreased placental function. A Caesarean section may be performed if there is marked fetal distress or an increased risk of injury associated with macrosomia, such as shoulder dystocia. A 2008 study completed in the U.S. found the number of American women entering pregnancy with pre-existing diabetes is increasing. In fact, the rate of diabetes in expectant mothers had more than doubled from 1999 to 2005.[9] This is particularly problematic as diabetes raises the risk of complications during pregnancy and increases the potential for the children of diabetic mothers to become diabetic in the future.

Diabetes diagnostic criteria

Condition

2 hour glucose

Fasting glucose

HbA1c

mmol/l(mg/dl)

mmol/l(mg/dl)

Normal

<7.8 (<140)

<6.1 (<110)

<6.0

Impaired fasting glycaemia

<7.8 (<140)

6.1(110) & <7.0(<126)

6.06.4

Impaired glucose tolerance

7.8 (140)

<7.0 (<126)

6.06.4

Diabetes mellitus

11.1 (200)

7.0 (126)

6.5

All of us know someone suffering from diabetes. This sums up the prevalence of diabetes. It is, apart from being one of the most prevalent diseases in the world, also a disease that opens up a Pandora's Box of many complications. No wonder it is a dreaded disease and people who are diabetic end up getting other medical problems as well. Diabetes is a group of diseases with one thing in common - a problem with insulin. The problem could be that your body doesn't make any insulin, doesn't make enough insulin or doesn't use insulin properly. --------------------------------------------------------------------------------------------------------------------------------------

The pancreas, which is an organ present in the abdominal cavity of the body, secretes this hormone insulin. This hormone is the key to the way your body processes food because it helps maintain the proper level of a sugar (glucose) in your blood. Glucose is your body's fuel. Cells use glucose to produce energy to grow and function. Glucose is escorted by insulin through your bloodstream and insulin helps in unlocking cells to allow glucose to enter. In diabetes, lack of insulin or the resistance of your cells to insulin prevents the right amount of glucose from entering your cells. The unused glucose builds up in your blood, a condition called hyperglycemia. The disease occurs in two types:

TYPE 1 DIABETES:
This is the type of diabetes that generally affects young people and requires treatment with insulin.

Profile of Insulin Hormone secreted in the islets of Langerhans by the pancreas

Sustainer of glucose in the blood Fat guarder preventing organs from exhausting energy Energy saver Drop in insulin production results in Diabetes mellitus or diabetes.

Big Shots of Insulin Insulin is administered before intake of food. Short Acting Insulin is meant for light meal such as breakfast and evening meals. Long Acting Insulin is meant for heavy meal such as lunch and dinner. Rapid Onset Fast Acting Insulin is followed by immediate consumption of food. Dosage of insulin depends on the diet of the diabetic.

Insulin & Mealtime Ideal gap between administering insulin and food consumption is Half an hour before food intake in case of Short Acting Insulin One hour before food take in case of Long Acting Insulin Eat immediately in case of Rapid Onset Fast Acting Insulin

Insulin Tools Insulin injection is simplified through : Insulin Syringes: A single use, disposable plastic syringes with fine needles. Insulin Pen: A dispenser resembling a pen which contains insulin Insulin Pumps: A pre-programmed pump worn around the abdomen that administers insulin on time.

Insulin Injection Abdomen and thighs are the ideal locations to inject and easy to reach. Best place to inject insulin is in the area of fatty tissues. Change the location of the injecting spot. Self injection is easy to learn. If you cannot do it yourself make arrangement for a nurse or your relatives to give you an injection.

For humans, by humans Initially animals were a source for making insulin since it almost matched the human insulin. As some patients exhibited allergies, it was replaced by genetically engineered insulin for human insulin.

TYPE 2 DIABETES:
This type of diabetes generally develops after age 40. Diabetes can develop gradually, often without symptoms, over many years. It may reveal itself too late to prevent damage. In fact, you may first learn you have diabetes when you develop one of its common complications heart disease, kidney disease or vision problems. Today, better methods of diabetes control, new medications and easier ways to take insulin enable most people who develop type 1 or 2 diabetes to live a long and healthy life.

Type 2 diabetes, is called the adult onset or the insulin non-dependent diabetes. This occurs when the body fails to produce adequate insulin or is unable to make proper use of it. It manifests mostly after 40 years, although recently it has been seen to occur prematurely.