Posted: March 18th, 2023
Diabetes Mellitus is a metabolic disorder marked by hyperglycemia, or high blood sugar levels.
There are three main forms of this illness, each with similar signs, symptoms, and consequences. However, they have different causes and affect different populations. In all cases, tough, the primary cause is that the pancreatic beta cells that produce insulin are unable to produce sufficient insulin, leading to hyperglycemia. There are various treatments for diabetes that reduce the symptoms, but there is no cure. Higher blood sugar in the body can have a number of other detrimental health consequences that affect the sufferer.
Improving control is a primary goal for sufferers and their doctors. There is no cure, as noted, and so controlling blood sugar is the way that the deleterious effects of the disease are minimized. Type 1 diabetes develops in childhood, while Type 2 is also known as adult-onset diabetes. The latter may not require insulin injections but can progress to the point where that is what is required. Both types can be controlled with insulin, available medically since 1921. Both are also often controlled using dietary management and some tablets.
A recent study of the control of diabetes for both types was undertaken over a ten-year period using the population of Germany as a test of diabetes care. This was a test of AGE products (for advanced glycation end products). These are a complex group of compounds implicated in diabetes related long-term complications. In this trial of a selection-free cohort of patients with insulin-treated diabetes mellitus, serum CML and pentosidine levels were examined in correlation to the patients’ quality of diabetes control and the prevalence of diabetes related long-term complications. The results for the population showed an increase in Type 1 diabetes, while Type 2 remained constant. The effects of different substances on the development of the disease was shown, though more research is needed to determine the precise contribution of each and how to overcome the problem (Schiel et al. 391-399).
Another report by Boulanger et al. examines advanced glycation end-products (AGEs) that result from a reaction between carbohydrates and the free amino groups of proteins, lipids, and DNA. It has been shown that non-enzymatic glycation is involved in glycated protein formation. AGEs are found in excess in pathological situations such as diabetes mellitus, renal failure, and aging, leading to AGE toxicity. Observers note that AGEs seem to be involved in the genesis of diabetic macro and also microangiopathy such as retinopathy and glomerulosclerosis. New drugs are being tested to prevent or break the AGE-protein cross-linkage, and dietary treatment, strict glycemic control, and the preservation of renal function are still the best approaches for preventing AGE formation and limiting their deleterious effects on the body (S8-16).
A study from Ethiopia extends the knowledge of the association between dyslipidemia and diabetes mellitus. The researchers note that various lipoprotein abnormalities have been described in patients with diabetes mellitus in some parts of the world, and the current research was undertaken to increase the limited information from African patients. The study found that triglycerides and low-density lipoprotein levels were significantly higher in patients with diabetes than in controls, while high-density lipoprotein levels were significantly lower in patients with diabetes. The researchers thus found that in Ethiopians with diabetes mellitus, dyslipidemia occurs more frequently than in controls. Because of this, the researchers recommended periodic screening for dyslipidemia in all Ethiopian patients with diabetes. They also suggested the need for other studies to assess the potential negative effect of dyslipidemia and obesity on morbidity and mortality in Ethiopians with diabetes (Siraj et al. 706-710).
The rise in childhood obesity has been linked to a rise in diabetes both in childhood and in later life, leading to speculation that there may be an increase in Type 2 diabetes in the next few years. A study by Eva M. Vivian finds a rise in Type 2 diabetes in children and adolescents worldwide. Vivian also notes that changing a child’s living environment to include physical activity and to provide a well balanced, low fat, high fiber diet are important steps for the maintenance of a desirable body weight and for improving insulin sensitivity. Doctors also recommend maintaining euglycemia with metformin, sulfonylureas, thiazolinediones, and insulin. Vivian also states that effective treatment of co-morbid problems such as hypertension and dyslipidemia can decrease the risk of cardiovascular complications. She further finds that the prevalence of type 2 diabetes in children will continue to rise until effective measures are taken to prevent obesity for this age group. To this end, parents shod ensure that children have a well balanced low fat, high fiber diet combined with physical activity to promote weight loss or maintenance, improve insulin sensitivity, and decrease the risk of diabetes and cardiovascular disease. Drug therapy is needed for children who cannot achieve satisfactory glycemic control through physical activity and diet alone. The primary reasons for the increase in diabetes among children are a sedentary lifestyle and a high calorie diet (Vivian 297-306).
Boulanger, E., J.L. Wautier, P. Dequiedt, and a.M. Schmidt. “Glycation, glycoxidation and diabetes mellitus.”
Nephrological Therapy (2006) 2 Suppl 1, S8-16.
Schiel, R., S. Franke, T. Appel, U. Voigt, I.S. Ross, R. Kientsch-Engel, U.A. Muller, and G. Stein. “Improvement of the quality of diabetes control and decrease in the concentrations of AGE-products in patients with type 1 and insulin-treated type 2 diabetes mellitus: results from a 10-year-prospective, population-based survey on the quality of diabetes care in Germany (JEVIN).” http://www.medscape.com/medline/publicationbrowser/123?pmid=15337629″ European Journal of Medical Research
2004), 9(8), 391-9.
Siraj, E.S., B. Seyoum, C. Saenz, and J. Abdulkadir. “Lipid and lipoprotein profiles in Ethiopian patients with diabetes mellitus.” http://www.medscape.com/medline/publicationbrowser/123?pmid=16713427″ Metabolism (2006) 55(6). 706-10.
Vivian, Eva M. “Type 2 Diabetes in Children and Adolescents – the Next Epidemic?” Current Medical Research and Opinion (2006) 22(2), 297-306.
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