DIABETES MELLITUS

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Diabetes Mellitus is a complex condition in which the blood sugar levels are raised for a long period of time either because of inadequacy of insulin production or lack of body cell responses to insulin

Causes of Diabetes

Weight-Weight is the important risk factor in type 2 diabetes.
The more the weight the more the body becomes resistant to insulin.
Age-Risk of Diabetes increases after 45 years of age.
Family history-Those having family history of Diabetes have greater risk of acquiring diabetes.
Diet-Diet high in fats, calories and cholesterol and deficient in fibre increases risk of diabetes.
Lack of exercise and sedentary lifestyle.
Hormonal imbalances.

Types of Diabetes Mellitus

1- Diabetes Mellitus (Type 1)-Also known as insulin dependent diabetes mellitus or juvenile diabetes as it is usually diagnosed in childhood.
In this type the insulin production is not enough or very less.
They require insulin on daily basis to survive
2- Diabetes Mellitus (Type 2) -In this type the body is incapable of responding to insulin.
The body becomes insulin resistant.
It is most common type of Diabetes due to sedentary lifestyle and increased obesity.
3- Gestational Diabetes -It occurs in cases where there are high blood sugar level during pregnancy.
Occurs in women who previously delivered baby weighing more than 4.5kg(10lbs).

Pathogenesis

Type1 diabetes mellitus
Type 1 diabetes is considered to be an autoimmune disorder
In autoimmune disorder body attacks it’s own tissues and organs.
T1 DM results from destruction of insulin producing pancreatic beta cells.
Beta cell autoantigen, macrophages,B and T lymphocytes are involved in pathogenesis of T1 DM.
Activated macrophages,CD4+Tcells and beta cytotoxic CD8+Tcells destroy beta cells
Insulin antibodies, Islet antigen (IA 2) antibody, glutamic acid carboxylase also paly a major role in autoimmunity.
The Human leucocyte antigen (HLA) encoding the major histocompatibility complex proteins is known to be associated with increased susceptibility to T1 DM.
The HLA complex helps the immune system to distinguish body proteins from proteins made by viruses and bacteria.
Due to insulin deficiency there is excessive secretion of glucagon.
The excess glucagon secretion and insulin deficiency imparies the expression of genes for target tissue to respond normally to insulin resulting in T1 DM.

Type 2 Diabetes Mellitus

Inability of insulin to produce it’s desired effect on circulating glucose levels.
Destruction of pancreatic beta cells along with insulin resistance is associated with T2 DM.
Muscle fats and level cells fail to respond to insulin.
The main mechanism involves increased breakdown of lipids with in fat cells,lack of incretin,high glucagon levels.
Inability of insulin to suppress lipolysis results in increase plasma levels of fatty acids that in turn stimulates glucose production in liver.
The elevated free fatty acids also produces low grade inflammation which is also associated with T2 DM.
Genetic factors include insulin receptor and insulin receptor substrate gene polymorphisms that affects insulin signal.
Polymorphisms of beta3 adrenergic receptor gene associated with visceral obesity promote insulin resistance.
Adipokines are also seen to be involved in insulin resistance.
Other gene associated are ABCC8,CAPN10,GLUT2,TCF7L2.

Signs and Symptoms

  • High blood level of glucose
  • Frequent and painful urination
  • More thirsty and hungry
  • Feeling tired and dizzy
  • Lethargic feeling
  • Fatigue
  • Itching skin
  • Dry mouth
  • Blurred vision
  • Nausea
  • Vomitting
  • Smell of acetone in breathe
  • Increased susceptibility to Infections
  • Weight gain or loss
  • Slow healing if wounds, cuts and sores
  • High blood pressure

Diabetic Ketoacidosis

Diabetic ketoacidosis is complex disorder characterized by hyperglycaemia, acidosis and ketonaemia.
It occurs due to insulin deficiency that causes increase in counter regulatory hormones.
Insulin deficiency along with counter regulatory hormones leads to excessive production and accumulation of glucose in the body.
Insulin deficiency causes release of fatty acids and glycerol.
Glucagon stimulates liver to oxidize fatty acids into ketone bodies.
Ketone dissociates into anion and hydrogen ions.
Acidosis develops as body tries to maintain extracellular pH by binding hydrogen ions with bicarbonate ions.
Ketonaemia develops as the ability of tissue to utilize ketone bodies exceeds.
Kidney excrete large amount of ketone and glucose into urine that causes dehydration, ischemia that further worsen acidosis.

Diagnosis

  • Random blood sugar – By this test the level of glucose can be measured at any time irrelevant of diet.
    Blood glucose level of 200mg/DL or more indicates Diabetes.
  • Fasting blood sugar test-Blood sugar level of 126mg/DL indicates Diabetes.
  • Sugar level between range of 100-125mg/DL indicates prediabetes.
    Normal range is below 100 mg/DL.
  • Oral glucose tolerance test-Blood sugar level of 200 mg/DL indicates diabetes.
  • Sugar level with in range 140-200 mg/DL indicates prediabetes.
    Below 140 mg/DL indicates normal range.

Homoeopathic Medicines For Diabetes Mellitus

  • Syzygium Jambolanum
  • Cephalandra Indica
  • Rhus Aromatica
  • Acidum Phosphoricum
  • Gymnema Sylvestre
  • Uranium Nitricum
  • Helonias
  • Abroma Augusta
  • Iodium