Diabetes mellitus (DM) is a chronic disorder of carbohydrate, protein, and fat metabolism in which there is a discrepancy between the amount of insulin required by the body and the amount of insulin available. DM affects over 10 million persons in the United States, and more than 35,000 people die from it each year. DM is classified into several categories (Table 1).
The beta cells of the pancreas produce insulin and a protein called C-peptide, which are stored in the secretory granules of the beta cells and are released into the bloodstream as blood glucose levels increase. Insulin transports glucose and amino acids across the membranes of many body cells, particularly muscle and fat cells. It also increases the liver storage of glycogen, the chief carbohydrate storage material, and aids in the metabolism of triglycerides, nucleic acids, and proteins.
Long-term complications such as disease of the large and small blood vessels lead to cardiovascular disease (coronary artery disease, peripheral vascular disease, hypertension), retinopa-thy, and renal failure. Diabetic patients also have nerve damage (neuropathy) that can affect the peripheral nerves, resulting in numbness and pain of the hands or feet.
Because diabetic patients are hyperglycemic, they are at higher risk for infection because an elevated glucose encourages bacterial growth. The combination of peripheral neuropathies with numbness of the extremities, peripheral vascular disease leading to poor tissue perfusion, and the risk for infection makes the diabetic patient prone to feet and leg ulcers.
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Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...