Anatomical perspective to diabetes mellitus

CHAPTER ONE1.0 IntroductionDiabetes occurs in situations where there’s too many excretions of urine and can be causedby a lack of hormone called antidiuretic hormone or ADH that limits the amount of urinemade as in Diabetes Insipidus or it can also result from a higher blood sugar level as inDiabetes Mellitus (IDF, 2006).  Diabetes is a condition that impairs the body’s ability toprocess blood glucose, otherwise known as blood sugar. Diabetes mellitus, often referred tosimply as diabetes is a syndrome of disordered metabolism, usually due to a combination ofhereditary   and   environmental   causes,   resulting   in   abnormally   high   blood   sugar   levels(hyperglycemia) (WHO, 2014). Blood glucose levels are controlled by the hormone insulinmade in the beta cells of the pancreas (WHO, 2013). Diabetes and its treatments can causemany complications and may occur if the disease is not adequately controlled.Diabetes mellitus (DM) has been described as a ‘silent’ epidemic. Its presentation can eitherbe a slow onset and asymptomatic progression leading to secondary complications, or rapidlyemerging symptoms leading to complications and/or coma. The projection is that by year2030, an estimated 366-438 million (i.e., 7.8% of the world population) people will havediabetes, an increase of 54% compared to that predicted in 2010 (Whiting et al., 2011).Diabetes   is   a   long-term   condition   that   causes   high   blood   sugar   levels.   In   2013   it   wasestimated that over 382 million people throughout the world had diabetes (WHO, 2013). Itwas   also   agreed   that   diabetes   existed   in   different   classes   which   include;  TYPE   1

DIABETES,   TYPE   2   DIABETES,   PREDIABETES,   GESTATIONALDIABETES.Different kinds of diabetes can occur, and managing the condition depends on the type. Notall forms of diabetes stem from a person being overweight or leading an inactive lifestyle. Infact, some are present from childhood.A person with diabetes has a condition in which the quantity of glucose in the blood is tooelevated   (hyperglycemia).   This   is   because   the   body   does   not   produce   enough   insulin,produces no insulin, or has cells that do not respond properly to the insulin the pancreasproduces. This results in too much glucose building up in the blood (Haffner et al., 1992).This excess blood glucose eventually passes out of the body in urine. So, even though theblood has plenty of glucose, the cells are not getting it for their essential energy and growthrequirements (Wilson et al., 1981).After the recognition of diabetes by the Egyptians, various attempts were made to understandthe   heterogeneous   nature   of   the   disease,   pathophysiological   mechanisms,   appropriatetherapies and prevention strategies (whiting et al., 2004).1.1 HISTORY1.1.1 DiscoveryThe first recognition of what came to be known as diabetes mellitus(DM)  was documentedin the Egyptian ancient papyrus, discovered by Georg Ebers in 1862, dating back to 1550 BCwhich highlighted the first documented cases of DM over 3500 years