Diabetes mellitus

Diabetes is a metabolic disease characterized by high glucose (sugar) concentration in serum and in urine.

The Latin name Diabetes mellitus means “sweet urine”.

The main problem underlying Diabetes is relative or absolute deficiency of the hormone Insulin.

This hormone is produced in the pancreas and is secreted into blood as a reaction to increasing sugar levels.

Insulin is responsible for glucose transfer from the blood into various body cells, where glucose is indispensable for the generation of energy.

Diabetics suffer from Insulin deficiency, from impairment in its function or from increased tissue resistance to Insulin and thus, when blood sugar levels increase, an adequate response of Insulin release is absent.

As a result, glucose accumulates in blood. This condition is called Hyperglycemia.

When glucose level surpasses a certain threshold, it is also excreted in urine. This condition is called Glycosuria.

The symptoms resulting from elevated glucose levels are increased secretion of urine, thirst and weight loss.

There are two main types of Diabetes: Type 1 (IDDM, Insulin dependent Diabetes Mellitus) and type 2 (NIDDM, non-Insulin dependent Diabetes Mellitus).

Type 1 Diabetes, also known as youth onset Diabetes, is usually manifested in childhood, its cause is Insulin deficiency resulting from destruction of the pancreatic cells responsible for Insulin secretion. Therapy consists of obligatory external Insulin supply.

Type 2 Diabetes, also called adult onset Diabetes, develops in adults, usually after age 40, is more frequent in females and its incidence increases markedly in obesity. It has a strong hereditary component. Its primary cause is low reactivity or increased resistance of the tissues to Insulin.

This condition of high Insulin resistance is closely related to the condition named “Metabolic Syndrome” or “Syndrome X”.

This syndrome includes central obesity (in the abdominal area and around organs), Hypertension, disturbed blood lipid levels, cardiovascular diseases, tendency to hyper-coagulation and more.

Treatment includes changes in life style: physical activity, appropriate diet, weight reduction and orally administered drugs. Sometimes, also Insulin treatment is necessary.

High blood sugar levels increase the risk for the development of vascular damage such as Atherosclerosis, and therefore Diabetes is a major risk factor of Ischemic heart disease.

Vascular damage in diabetes patients is not limited to only cardiac vessels, but can also include multi-system damage involving kidneys, lower extremities, brain, heart and eyes.

An additional damage that afflicts diabetic patients is neural damage.

The combination of peripheral nerve damage resulting in altered sensitivity to pain with increased tendency to Atherosclerosis may make the treatment of diabetic patients more difficult and deteriorate their condition.

For example, due to Coronary artery damage, the diabetic patient is exposed to a higher risk of heart attack on the one hand, while the nerve lesion with altered sensitivity may affect the manifestation of the attack and interfere with early diagnosis, on the other hand.