Diabetes Mellitus

It is a condition in which the level of sugar is increases in blood (hyperglycemia) and later on in urine (glycosuria) also. It is a metabolic disorder due to lack of insulin. It is worldwide in distribution. It is predicated that by the year of 2025 India will be the capital of diabetes.

Types Of Diabetes:

Basically it is divided into two major categories type I diabetes and type II diabetes. Type-I is also known as insulin dependent diabetes mellitus (IDDM), patient requires insulin for their management, otherwise, they run the risk of developing ketoacidosis. Type II diabetes is non-insulin dependent diabetes mellitus (NIDDM), yet it does not mean that these patients do not require insulin. It is simply means that patients can easily be controlled without insulin except in a few complications. These two types do not show an absolute distinction in the matter of age and requirement of insulin.

Type I diabetes mellitus – it is considered as autoimmune disorder. Genetic factors are major determinant while the environmental factors are as trigger. Chromosome No 6 is affected and environmental factors such as a virus work as a trigger to produce the changes in the chromosome. These changes lead the autoimmune process of destruction, and inflammation of pancreas occur, that causes the damage of beta cells of pancreas. If more than 90% beta cells are destroyed then insulin is needed to manage the case of diabetes. That is why this type of diabetes is called as IDDM.

Type II diabetes mellitus- The cause of NIDDM is still elusive. It is neither chromosome linked, not there is any evidence of autoimmunity or virus playing role in its aetio-pathogenesis. Various factors that play important role are; Genetics as twins are more prone to type II diabetes, failure of beta cell of pancreas(which produce Insulin), some environmental factors like physical inactivity and obesity, and the age of above 40 years.

Gestational diabetes- Some times diabetes may occur for the first time in pregnancy in woman genetically predisposed to type I and type II. This is due to relative lack of insulin. Although insulin levels are high in pregnancy due to stimulating effect of placenta but it is still insufficient to cater the needs during pregnancy, it results in hyperglycemia. This hyperglycemia may or may not disappear after delivery. Repeated hyperglycemia during repeated pregnancies predisposes to development of permanent diabetes mellitus.

Symptoms and Signs

Type I diabetes- Increase urination (Polyuria) is a common symptom. This result in a loss of glucose as well as free water and electrolytes in the urine, a hyper-osmolar state develops, which creates unquenchable thirst. Person drinks plenty of water.

Blurred vision, which often develops as the lenses and retinas are exposed to hyper-osmolar fluid.

Weight loss despite normal or increased appetite is a common feature of type I diabetes. The weight loss is initially due to depletion of water, glucose and triglycerides.

Total body potassium loss and general catabolism of muscle protein contribute to the weakness. Lowered plasma volume produces symptom of postural hypotension (low blood pressure).

Type II diabetes- It begins in middle age usually. These patients may be overweight. Symptoms begin gradually diagnosis in asymptomatic patients is made by routine urine examination. These patients present mostly with recurrent eye symptoms like blurred vision, recurrent styes, premature development of cataract or some times with retinopathy.

Urine infections, chronic diarrhea,, dilatation of stomach, malabsorption of food are common with type II diabetes.

Female presents with itching vulva (pruritis vulvae) and inflammation of vagina, menstrual irregularities, recurrent abortion, infertility etc.

Tingling sensation in the extremities with numbness (peripheral neuritis) is very important feature.

Skin can show multiple boils, itching, non-healing wounds and some times carbuncles.

Mild hypertension often present in obese diabetics.


Diagnosis of Diabetes

Urine examination for glucose and ketone bodies.
Blood examination for oral glucose tolerance test, fasting plasma glucose, and plasma glucose after two hours of food, Glycated hemoglobin measurements are some common tests done for diagnosis of diabetes.

Management

The goals of therapy irrespective of the type of diabetes are:

To achieve a normal metabolic state by bringing the blood glucose to normal or near normal levels without inducing hypoglycemic episode.
To maintain ideal body weight as far as possible
To keep the patient symptoms free.
To allow the patient to lead a normal life
To prevent or retard the onset of complications.

The various treatment options include:
Diet alone
Diet + Oral hypoglycemic agents (OHA)
Diet + Insulin
Diet + OHA + Insulin

Homeopathic Treatment:

Homeopathy has very effective role in Diabetes Type II . There are 64 homeopathic medicines for different group of symptoms in patients of Diabetes.
Some homeopathic medicines when used in Mother Tincture doses keep blood glucose level in normal values very effectively like Insulin. Complications to other organs due to High Glucose level in blood can also be resolved very well by homeopathic medicines.Recent cases of Diabetes Type II can be cured by Homeopathic medicines. Homeopathic medicines can also be used with Conventional treatment and insulin for effective Glucose control .

Role Of Physical Activity in Diabetes

Walking 5 Km a day give effective control on blood glucose level in patients of Diabetes Mellitus Type II. Walking and exercise reduce the tissue resistance to Insulin activity. Obese person can reduce their weight by exercise and it further improve the Insulin Activity on tissues. So,walking with diet control can maintain the blood glucose level but physician's opinion is final answer to best diabetes control.