Study of Diabetes and Diabetes Mellitus:

Diabetes : Glycosuria is a pathological condition and is due to deficiency or lack of insulin which cause diabetes.

Diabetes Mellitus: Diabetes mellitus is a syndrome of impaired carbohydrate fat and protein metabolism caused by lack of insulin secretion or decrease sensitivity of the tissue to insulin.

Classification of Diabetes of Mellitus:

(1) IDDM: Insulin Dependent Diabetes Mellitus

(2) NIDDM: Non Insulin Dependent Diabetes Mellitus

(1) IDDM: Insulin Dependent Diabetes Mellitus or Type-I or Juvenile onset Diabetes:

       It is due to the lack of secretion of insulin.

Cause: It may be due to destruction of pancreatic β cells . The cause of β cells destruction may be due to.

• Viral Infection
• Autoimmune Disorder
• Hereditary tendency of β cell degeneration.

Onset: It occurs at about 14 years of age and for this reason it is called as Juvenile diabetes mellitus.

Symptoms: It may develop symptom such as ‘PPP’.

• Poly Uria : Frequent urination
• Poly Dypsia: Excessive thirst
• Poly Phagia: Excessive hunger

           In this patient are not obese. They might develop metabolic complication such as

(a) Ketoacidosis

(b) Hyperglycemic

(2) NIDDM: Non Insulin Dependent Diabetes Mellitus or Type-II or Adult onset diabetes mellitus: It iscaused due to decreasesensitivity of the tissue to insulin. It is also known as non insulin dependent diabetes mellitus.

Cause: It is caused by decrease sensitivity of the tissue to insulin (insulin resistance). This may be due to in adequate insulin receptors on the cell surface.

Onset: It occurs after the age of 40 there for this syndrome is called adult onset diabetes.

Symptoms: Like type-1 diabetes it is associated with multiple metabolic disorders, abnormalities and symptoms diabetes.

                     Ketoacidosis is usually not present in Type-2 diabetes. This syndrome is often found in obese person.

Treatment:

• It can be treatment in early stages by diet control, exercise and weight reduction.
• Drugs that increase insulin sensitivity such as- Thiazolidinedions and metformin.
• Drugs that cause additional release of insulin by the pancreas such as- Sulfony 10-ureas may also be used.
• Later stage: Insulin administration is often required to control blood glucose.

Clinical features of diabetes mellitus: (P¹P¹P¹)

• P¹: Poly urea
• P¹: poly dypsia
• P¹:Poly phagia

Glycosuria: The glucose absorb during a meal is not metabolized at the normal rate and there for it accumulates in the blood increased blood glucose cause lose of glucose in the urine.

Secondary Effect: High glucose concentrated causes tissue injury this in turns leads to increase risk for heart attack, blindness , cataracts.

Diagnosis: Diagnosis can be confirmed by finding glycosuria and blood glucose concentration but fasting blood glucose level on suspected for diabetes are diagnosed by glucose tolerance test (GTT).            

Other diagnosis made for diabetes mellitus are:

• Urine testing
• Blood glucose estimation
• Glucose tolerance test (GTT)
• Glycated hemoglobin estimation

Glycosuria: Normally the urine contains about 0.05 gm of sugar such small quantity can not be detected by Benedict’s test but under certain cashes considerable amount of glucose or other sugar may be excreted in the urine.

                     Excretion of detectable amount of sugar in urine is known as glycosuria. Thus, glycosuria is general term used for sugar in the urine.

Glucose excreted→ Glucosuria

Fructose excreted→ Fructoseuria

Galactose excreted→ Galactosuria

Lactox excreted→ Lactoxuria

Glucosuria: Glucosuria may be classified into following groups.

• Elementary Glucosuria
• Renal Glucosuria
• Diabetes Glucosuria

• Elementary Glucosuria: This is due to an increased rate of absorption of glucose from the intestinal.
• Renal Glucosuria: This is due to an impaired tubular reabsorption of glucose.
• Diabetes Glucosuria: This is due to lack of insulin which causes diabetes mellitus.