Mini Review - (2022) Volume 13, Issue 2
Diabetes is chronic disease occurred due to increased blood glucose level because of the body cannot produce at all or secrets in sufficient insulin hormone or not use it effectively. Hence, the nonexistence of insulin or the cell is not sensitive to use insulin leads to increased blood glucose level which is the hallmark of diabetes.
Diabetes; Metabolism; Diabetes mellitus; Insulin; Haemoglobin
Diabetes is chronic disease occurred due to increased blood glucose level because of the body cannot produce at all or secrets in sufficient insulin hormone or not use it effectively. Hence, the nonexistence of insulin or the cell is not sensitive to use insulin leads to increased blood glucose level which is the hallmark of diabetes [1].
Diabetes mellitus is a serious, chronic metabolic disorders that characterized by high sugar level either when the pancreas does not produce enough insulin, or when the body cannot effectively use insulin. Type 2 Diabetes Mellitus (T2DM) accounts about 90% of all diagnosed cases of diabetes among adults [2]. Type-2 Diabetes Mellitus (T2DM) is the most common form of diabetes sometimes called age-onset or adult-onset diabetes. It is a milder form of diabetes because of its slow onset (sometimes developing over the years) and because it usually can be controlled with diet and oral medications. The consequences of uncontrolled and untreated T2DM, however, are just as serious as those of Type I. The causes of Diabetes Mellitus are unclear. However, there seem to be hereditary (genetic factors) and environmental factors involved [3]. Type 2 diabetes constitutes about 85–95% of all diabetes in high-income countries with a higher percentage in low- and middle-income countries due to rapid sociocultural changes, ageing populations, increasing urbanization, reduced physical activity and unhealthy lifestyle and Behavioral patterns [4].
Classifications of Diabetes Mellitus
According to the current classification there are two major types: type 1 diabetes (T1DM) and type 2 diabetes (T2DM). The distinction between the two types has historically been based on age at onset, degree of loss of β cell function, degree of insulin resistance, presence of diabetes- associated autoantibodies, and requirement for insulin treatment for survival. However, none of these characteristics unequivocally distinguishes one type of diabetes from the other, nor accounts for the entire spectrum of diabetes phenotypes [5].
Type 1 diabetes is characterized by the rate of β-cell destruction is rapid in some individuals and slow in others. The rapidly progressive form of T1DM is commonly observed in children but may also occur in adults. Some patients, particularly children and adolescents, may present with ketoacidosis as the first manifestation of the disease. Others may have modest hyperglycaemia that can rapidly change to severe hyperglycaemia and/or ketoacidosis in the presence of infection or other stress. Still others, particularly adults, may retain residual β-cell function sufficient to prevent ketoacidosis for many years. At the time of classical clinical presentation with T1DM, there is little or no insulin secretion as manifested by low or undetectable levels of C-peptide in blood or urine [6].
Type 2 diabetes is characterized by a combination of peripheral insulin resistance and inadequate insulin secretion by pancreatic beta cells. Insulin resistance, which has been attributed to elevated levels of free fatty acids and proinflammatory cytokines in plasma, leads to decreased glucose transport into muscle cells, elevated hepatic glucose production, and increased breakdown of fat. A role for excess glucagon cannot be underestimated; indeed, type 2 diabetes is an islet paracrinopathy in which the reciprocal relationship between the glucagon- secreting alpha cell and the insulin-secreting beta cell is lost, leading to hyperglucagonemia and hence the consequent hyperglycemia. For type 2 diabetes mellitus to occur, both insulin resistance and inadequate insulin secretion must exist. For example, all overweight individuals have insulin resistance, but diabetes develops only in those who cannot increase insulin secretion sufficiently to compensate for their insulin resistance. Their insulin concentrations may be high, yet inappropriately low for the level of glycemia [7].
Diagnostics of Diabetes Mellitus
Four diagnostic tests for diabetes are currently recommended, including measurement of fasting plasma glucose; 2-hour (2-h) post-load plasma glucose after a 75 g oral glucose tolerance test (OGTT); HbA1c; and random blood glucose in the presence of signs and symptoms of diabetes. People with fasting plasma glucose values of ≥ 7.0 mmol/L (126 mg/dl), 2-h postload plasma glucose ≥ 11.1 mmol/L (200 mg/dl), HbA1c ≥ 6.5% (48 mmol/ mol); or a random blood glucose ≥ 11.1 mmol/L (200 mg/ dl) in the presence of signs and symptoms are considered to have diabetes. If elevated values are detected in asymptomatic people, repeat testing, preferably with the same test, is recommended as soon as practicable on a subsequent day to confirm the diagnosis [8].
Diabetes Mellitus Drugs Therapy
The four major groups of antidiabetic agents
The four major groups of antidiabetic agents are Biguanides which reduce gluconeogenesis in the liver include metformin, Insulin secretagogues which stimulate the pancreas to secrete insulin such as sulfonylureas, Insulin sensitizers which improve sensitivity of peripheral tissues to insulin such as thiazolidinediones and Insulin analogues which provide insulin exogenously [9]. In the absence of contraindication metformin is the first and most widely used pharmacological treatment. It lowers blood sugar levels and help to reduce cardiovascular risk without increased risk of hypoglycaemia and weight gain.
A role for excess glucagon cannot be underestimated; indeed, type 2 diabetes is an islet paracrinopathy in which the reciprocal relationship between the glucagon-secreting alpha cell and the insulin-secreting beta cell is lost, leading to hyperglucagonemia and hence the consequent hyperglycemia. Protease inhibitors may bind to as yet uncharacterized target proteins that regulate lipid metabolism, leading to elevated circulating fatty acids that could interfere with insulin signaling or enter the fatty acid cycle and compete with glucose cycle intermediates. Biguanides which reduce gluconeogenesis in the liver include metformin. The burden of diabetes is even higher in developing countries and in Ethiopia; systematic review result showed that prevalence of diabetes mellitus is between 2% and 6.5%. Diabetes is chronic disease occurred due to increased blood glucose level because of the body cannot produce at all or secrets in sufficient insulin hormone or not use it effectively. The common risk factors for occurrence of complications were gender, long duration with diabetes, poor and inadequate glycemic control, negative attitude towards diabetes, poor treatment adherence, and poor knowledge about the disease and its management.
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Citation: Gudisa Bereda. Awareness on Diabetes Mellitus. J Diabetes Metab, 2022, 13(2): 921.
Received: 03-Feb-2022, Manuscript No. jdm-22-16113; Editor assigned: 05-Feb-2022, Pre QC No. jdm-22-16113(PQ); Reviewed: 19-Feb-2022, QC No. jdm-22-16113; Revised: 24-Feb-2022, Manuscript No. jdm-22-16113(R); Published: 03-Mar-2022, DOI: 10.35248/2155-6156.1000921
Copyright: © 2022 Gudisa Bereda. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
