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Diabetes Mellitus

Prevalence, Clinical Presentation And Diagnosis, Complications, Treatment, Management Of Hypertension And Excess LipidsPerspective

Diabetes mellitus is a failure to control blood sugar levels so that they become too high. It is classified into two categories. Type 1 diabetes (also called juvenile diabetes) is characterized by an acute destruction of insulin-secreting beta cells in the pancreas by autoantibodies. Insulin is a hormone essential to maintaining blood sugar at a normal level. Diabetes results in the abolition of insulin secretion by the pancreas, severe hyperglycemia (high blood sugar) and production of ketones. Type 2 diabetes (also called adult onset diabetes) is characterized by a gradually increasing blood sugar level resulting from a combination of resistance to the action of insulin at the cellular level and a gradual decline of insulin secretion by the pancreas.

Diabetes mellitus is a common disease in the older population. The vast majority of elderly subjects have type 2 diabetes, which means that the degree of hyperglycemia is variable and rarely results in the production of ketones. Since the degree of hyperglycemia is variable and elderly subjects are often not aware of the symptoms of high blood sugar (see below), there may be a few years of asymptomatic disease before a diagnosis of diabetes is made.

Considering the aging trend in American society, an increased prevalence of diabetes is expected among the elderly population. The economic and sociological impacts of this health problem will dramatically increase by the middle of the twenty-first century. More research will be necessary to understand the disease and the mechanisms involved in the progression of associated complications.

DANIEL TESSIER TAMAS FÜRLÖP GRAYDON S. MEINELLY

See also CHOLESTEROL; DIET; DISEASE PRESENTATION; HEART DISEASE; HIGH BLOOD PRESSURE.

BIBLIOGRAPHY

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