DAINIK NATION BUREAU
Diabetes is an “iceberg” disease. Although increase in both the prevalence and incidence of type 2 diabetes have occurred globally, they have been especially dramatic in societies in economic transition, in newly industrialized countries and in developing countries. Currently the number of cases of diabetes worldwide is estimated to be around 347 million, of these more than 90 per cent are type 2 diabetes. An estimated 1.2 million people died from consequences of high blood sugar . More than 80 per cent diabetes deaths occur in low and middle income countries.
Unfavorable modification of lifestyle and dietary habits that are associated with urbanization are believed to be the most important factors for the development of diabetes. The prevalence of diabetes is approximately twice in urban areas than in rural population.
Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. Depending on the etiology of the DM， factors contributing to hyperglycemia include reduced insulin secretion decreased glucose utilization， and increased glucose production. DM causes end-stage renal disease (ESRD) non traumatic lower extremity amputations and adult blindness. Type 1 diabetes (Insulin-dependent diabetes mellitus) is the most severe form of the disease. Its onset is typically abrupt and is usually seen in individuals less than 30 years of age. This form of diabetes is immune-mediated in over 90 per cent of cases and idiopathic in less than 10 per cent cases. Exogenous insulin is therefore required for survival of type 1 DM.
Type 2 diabetes is much more common than type 1diabetes. It is often discovered by chance. It is typically gradual in onset and occurs mainly in the middle-aged and elderly.
Glucose intolerance developing during pregnancy is classified as gestational diabetes mellitus (GDM) . Insulin resistance is related to metabolic changes of late pregnancy and the increased insulin requirements may lead to diabetes.
Dr Sanjay Kumar Varun
Physician in Synergy Hospital, Dehradun