Abstract

DIABETIC MELLITUS -A METABOLIC DISORDER AND ITS TREATMENT

Priya G. Shete*, Neha G. Shete and Rupali H. Tiple

ABSTRACT

Diabetes mellitus (DM) is a metabolic disorder resulting from a defect in insulin secretion, insulin action, or both. Insulin deficiency in turn leads to chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism. It is the most common endocrine disorder and by the year 2010, it is estimated that more than 200 million people worldwide will have DM and 300 million will subsequently have the disease by 2025. As the disease progresses tissue or vascular damage ensures leading to severe diabetic complications such as retinopathy, neuropathy, nephropathy, cardiovascular complications and ulceration. Thus, diabetes covers a wide range of heterogeneous diseases. Diabetes mellitus may be categorized into several types but the two major types are type 1 and type 2.High blood glucose levels are symptomatic of diabetes mellitus as a consequence of inadequate pancreatic insulin secretion or poor insulin-directed mobilization of glucose by target cells. Diabetes mellitus is aggravated by and associated with metabolic complications that can subsequently lead to premature death. This review explores diabetes mellitus in terms of its historical perspective, biochemical basis, economic burden, management interventions along with the future perspectives. Oral hypoglycaemic agents include sulphonylureas, biguanides, alpha glucosidase inhibitors, meglitinide analogues, and thiazolidenediones. The main objective of these drugs is to correct the underlying metabolic disorder, such as insulin resistance and inadequate insulin secretion. They should be prescribed in combination with an appropriate diet and lifestyle changes. The main side effects are weight gain and hypoglycaemia with sulfonylureas, gastrointestinal (GI) disturbances with metformin, weight gain, GI disturbances and liver injury with thiazolidinediones, GI disturbances, weight gain and hypersensitivity reactions with meglitinides and flatulence, diarrhoea and abdominal bloating with alpha-glucosidase inhibitors.

Keywords: Diabetes mellitus, treatment, insulin, oral hypoglycaemic agents, blood glucose levels, islets of langerhans.