DM is a metabolic dysfunctional disease that builds up glucose level in the blood stream and, causes harm to the cells of brain, kidney, nerve, circulatory system, red blood corpuscles and lower limbs etc. leading grave complications. In both of the common types of diabetes, environmental factors interact with genetic susceptibility to determine which people develop the clinical syndrome. However, the underlying genes, precipitating environmental factors and pathophysiologies differ substantially of Type- 1 or Type- 2 diabetes. Type- 1 diabetes was previously termed insulin-dependent diabetes mellitus and is invariably associated with profound insulin deficiency requiring replacement therapy. Type-2 was previously termed non-insulin dependent diabetes mellitus because patients retain the capacity to secrete some insulin and was treated without insulin replacement therapy.
Type- 1 diabetes is a slowly progressing T. cell mediated autoimmune disease; destructing insulin-secreting cells in the pancreatic islets takes place over many years. Hyperglycemia accompanied by classical symptoms of diabetes occurs only when there destruction of 70-90% of beta- cells.
Genetic predisposition: These factors account for about one-third of the susceptibility to type-1 diabetes.
Environmental factors: Although genetic susceptibility appears to be a prerequisite for the development of Type-1 diabetes, it is proposed that reduced exposure to immunosuppressant during childhood either delay or can stop early development of clinical manifestation. Our experience has shown that homoeopathic treatment if started early during childhood diseases, is more beneficial in delaying early on set of DM
Metabolic disturbances in Type-1 diabetes: When progressive beta-cell destruction has crossed a threshold, at which adequate insulin secretion and normal blood glucose levels can no longer be sustained. Hyperglycemia leads to glycosuria and dehydration.
Type- 2 Diabetes pathology: in more complex condition than Type-1 diabetes because there is a combination of resistance to the action of insulin in liver and muscle together with impaired pancreatic beta- cell function leading to relative insulin deficiency and slowly progressive insulin deficiency develops. Insulin resistance with diabetes excessive production of glucose in the liver and under-utilization of glucose in skeletal muscle result form resistance to the action of insulin we also take care of triggering factor or contributory hypertension etc.
Genetic predisposition of Type-2: the etiology is very important as many genes are involved.
Environmental factors: epidemiological studies provide evidence that Type 2 diabetes is associated with over eating, when combined with obesity and under activity, middle-aged people with DM eat significantly more and are fatter and less active than their non-diabetic siblings’ obesity as a diabetogenic factor, genetically predisposed both to insulin resistance and to beta- cell failure.
Management guide: The methods of treatment of diabetes are dietary/life style modification, oral anti-diabetic homoeopathic remedies and compulsory agent supplementation is done. To manage a case we are to take into consideration the following facts, duration of diabetes, early age at on set of disease, to be careful about glacocated hemoglobin (HbA1c) Hypertension, and protein in urine, dyslipideamia and obesity.
Treatment is to relieve the symptoms of hyperglycemia and to achieve near normal metabolism as is practicable
Achieve good glycaemic control
Reduce hyperglycemia and avoid hypoglycemia
Weight management is essential part
Reduce the risk of micro and macro vascular complications
Avoid high protein and other athrogenic food.