Diabetes is defined as a metabolic disorder, in which there is presence of excessive blood sugar levels. The blood sugar levels are controlled by a hormone called insulin, which is the main regulatory chemical of the normal blood glucose.

Insulin is produced in beta cells of pancreas in islets of langerhans. Either there could be defect in beta cell resulting in absolute deficiency of low production of insulin or insulin has a low action of controlling glucose in body. All of these effects results in a condition called hyperglycemia in the body. As a consequence, there are further many complications impairing a number of functions in the body. It mainly affects heart, eyes, kidney, nerves and gums. The disease has genetic and environmental factors involved too.

TYPES OF DIABETES:

1. Type 1 Diabetes:
Type 1 diabetes or insulin dependent diabetes is in which the beta cells of pancreas are unable to or produce very low levels of insulin. It occurs mostly before the age of 30, though, any age could be effected. It is also known as 'juvenile diabetes.'

MECHANISM:
Most of the attack is of immune-mediated variety. Most affected people are otherwise healthy and of healthy weight when onset occur. Sensitivity and responsiveness to insulin are also normal.

TREATMENT:
There is no absolute cure for the disease but it could be managed by constant insulin supplements which could be given by syringes and pumps. Many are treated with combination of regular plus NPH insulin. Although the treatment is burdensome for the patient with constant monitoring of the blood glucose level, but is necessary.

2. Type 2 Diabetes:
Type 2 diabetes is one in which the cells produce adequate amount of insulin but the receptors are irresponsive to the insulin. Hence, it does not produce any of its functional effects.

MECHANISM:
There are many theories involving the mechanism of type 2. Central obesity, being the main theory, is in which abdominal fat which is hormonally active produce hormones called adipokins. These hormones are responsible for making the insulin receptor resistant to its effects. Other theories suggest familial and age factors being involved.

TREATMENT:
Firstly there should be weight loss, decreasing carbohydrate intake and increasing physical activity. The next step is oral antidiabetic drugs. Most commonly used is metformin, to control inappropriate release of glucose by the liver and attenuate insulin resistance to some extent. Other drugs which are commonly used are sulfonylurea and thiazolidinediones. If the treatment fails then insulin therapy is used to bring about the normal or near normal levels of glucose in the body.

3. Gestational Diabetes:
Gestational diabetes occurs in pregnancy and resembles type 2 diabetes. It may or may not resolve itself after pregnancy.

SYMPTOMS:

Frequently urinating; being thirsty; feeling hungry or tired; losing weight

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