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O, often simply referred to as ³is a group of

metabolic diseases in which a person has high blood sugar, either because the
body does not produce enough insulin, or because cells do not respond to the
insulin that is produced. This high blood sugar produces the classical
symptoms of polyuria (frequent urination), polydipsia (increased thirst) and
polyphagia (increased hunger).

There are three main types of diabetes:

ap 2 results from the body's failure to produce insulin, and
presently requires the person to inject insulin.
ap 2 results from insulin resistance, a condition in which cells
fail to use insulin properly, sometimes combined with an absolute insulin
deficiency.
ap Î 2 is when pregnant women, who have never had diabetes
before, have a high blood glucose level during pregnancy. It may precede
development of type 2 DM.

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ther forms of diabetes mellitus include congenital diabetes, which is due to
genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid
diabetes induced by high doses of glucocorticoids, and several forms of
monogenic diabetes.



Type 1 diabetes mellitus is characterized by loss of the insulin-producing beta

cells of the islets of Langerhans in the pancreas leading to insulin deficiency.
This type of diabetes can be further classified as immune-mediated or
idiopathic. The majority of type 1 diabetes is of the immune-mediated nature,
where beta cell loss is a T-cell mediated autoimmune attack. There is no
known preventive measure against type 1 diabetes, which causes
approximately 10% of diabetes mellitus cases in North America and Europe.
Most affected people are otherwise healthy and of a healthy weight when onset
occurs. Sensitivity and responsiveness to insulin are usually normal,
especially in the early stages. Type 1 diabetes can affect children or adults but
was traditionally termed "juvenile diabetes" because it represents a majority of
the diabetes cases in children.



Type 2 diabetes mellitus is characterized by insulin resistance which may be

combined with relatively reduced insulin secretion. The defective
responsiveness of body tissues to insulin is believed to involve the insulin
receptor. However, the specific defects are not known. Diabetes mellitus due to
a known defect are classified separately. Type 2 diabetes is the most common
type.

In the early stage of type 2 diabetes, the predominant abnormality is reduced

insulin sensitivity. At this stage hyperglycemia can be reversed by a variety of

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measures and medications that improve insulin sensitivity or reduce glucose

production by the liver.

Î 

Îestational diabetes mellitus (ÎDM) resembles type 2 diabetes in several

respects, involving a combination of relatively inadequate insulin secretion
and responsiveness. It occurs in about 2%²5% of all pregnancies and may
improve or disappear after delivery. Îestational diabetes is fully treatable but
requires careful medical supervision throughout the pregnancy. About 20%²
50% of affected women develop type 2 diabetes later in life.

Even though it may be transient, untreated gestational diabetes can damage

the health of the fetus or mother. Risks to the baby include macrosomia (high
birth weight), congenital cardiac and central nervous system anomalies, and
skeletal muscle malformations. Increased fetal insulin may inhibit fetal
surfactant production and cause respiratory distress syndrome.
Hyperbilirubinemia may result from red blood cell destruction. In severe
cases, perinatal death may occur, most commonly as a result of poor placental
perfusion due to vascular impairment. Labor induction may be indicated with
decreased placental function. A cesarean section may be performed if there is
marked fetal distress or an increased risk of injury associated with
macrosomia, such as shoulder dystocia.

O  (DI) is a rare disease that causes frequent urination. The
large volume of urine is diluted, mostly water. To make up for lost water, a
person with DI may feel the need to drink large amounts and is likely to
urinate frequently, even at night, which can disrupt sleep and, on occasion,
cause bedwetting. Because of the excretion of abnormally large volumes of
dilute urine, people with DI may quickly become dehydrated if they do not
drink enough water. Children with DI may be irritable or listless and may have
fever, vomiting, or diarrhea. Milder forms of DI can be managed by drinking

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enough water, usually between 2 and 2.5 liters a day. DI severe enough to
endanger a person·s health is rare.

DI should not be confused with diabetes mellitus (DM), which results from
insulin deficiency or resistance leading to high blood glucose, also called blood
sugar. DI and DM are unrelated, although they can have similar signs and
symptoms, like excessive thirst and excessive urination.

Types of diabetes insipidus:

1.p The most common form of serious DI, central DI, results from damage to the
pituitary gland, which disrupts the normal storage and release of ADH.
Damage to the pituitary gland can be caused by different diseases as well as
by head injuries, neurosurgery, or genetic disorders. To treat the ADH
deficiency that results from any kind of damage to the hypothalamus or
pituitary, a synthetic hormone called desmopressin can be taken by an
injection, a nasal spray, or a pill. While taking desmopressin, a person should
drink fluids only when thirsty and not at other times. The drug prevents water
excretion, and water can build up now that the kidneys are making less urine
and are less responsive to changes in body fluids.
2.p Nephrogenic DI results when the kidneys are unable to respond to ADH. The
kidneys· ability to respond to ADH can be impaired by drugs³like lithium, for
example³and by chronic disorders including polycystic kidney disease, sickle
cell disease, kidney failure, partial blockage of the ureters, and inherited
genetic disorders. Sometimes the cause of nephrogenic DI is never discovered.
3.p Dipsogenic DI is caused by a defect in or damage to the thirst mechanism,
which is located in the hypothalamus. This defect results in an abnormal
increase in thirst and fluid intake that suppresses ADH secretion and
increases urine output. Desmopressin or other drugs should not be used to
treat dipsogenic DI because they may decrease urine output but not thirst and
fluid intake. This fluid overload can lead to water intoxication, a condition that

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lowers the concentration of sodium in the blood and can seriously damage the
brain. Scientists have not yet found an effective treatment for dipsogenic DI.
4.p Îestational DI occurs only during pregnancy and results when an enzyme
made by the placenta destroys ADH in the mother. The placenta is the system
of blood vessels and other tissue that develops with the fetus. The placenta
allows exchange of nutrients and waste products between mother and fetus.

Following is a comprehensive list of other causes of diabetes:

p Î 3-4   p   $

p Maturity onset diabetes of the young p Îrowth hormone excess (acromegaly)
(M
DY) p Cushing syndrome
p Mitochondrial DNA mutations p Hyperthyroidism
p Î     p cheochromocytoma
 !    p Îlucagonoma
p Defects in proinsulin conversion p  
p Insulin gene mutations p Cytomegalovirus infection
p Insulin receptor mutations p Coxsackievirus B
p 5 * O p O!
p Chronic pancreatitis p Îlucocorticoids
p cancreatectomy p Thyroid hormone
p cancreatic neoplasia p †-adrenergic agonists
p Cystic fibrosis
p Hemochromatosis
p Fibrocalculous pancreatopathy

61*1
2

The classical symptoms of diabetes are (frequent urination),

 (increased thirst) and $!(increased hunger). Symptoms

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may develop rapidly (weeks or months) in type 1 diabetes while in type 2

diabetes they usually develop much more slowly and may be subtle or absent.

crolonged high blood glucose causes glucose absorption, which leads to

changes in the shape of the lenses of the eyes, resulting in vision changes;
sustained sensible glucose control usually returns the lens to its original
shape. Blurred vision is a common complaint leading to a diabetes diagnosis;
type 1 should always be suspected in cases of rapid vision change, whereas
with type 2 change is generally more gradual, but should still be suspected.

ceople (usually with type 1 diabetes) may also present with 
7, a state of metabolic dysregulation characterized by the smell of
acetone; a rapid, deep breathing known as Kussmaul breathing; nausea;
vomiting and abdominal pain; and an altered states of consciousness.

A rarer but equally severe possibility is hyperosmolar nonketotic state, which

is more common in type 2 diabetes and is mainly the result of dehydration.

ften, the patient has been drinking extreme amounts of sugar-containing
drinks, leading to a vicious circle in regard to the water loss.

A number of skin rashes can occur in diabetes that are collectively known as
.


0
2

The cause of diabetes depends on the type. Type 2 diabetes is due primarily to
lifestyle factors and genetics.

Type 1 diabetes is also partly inherited and then triggered by certain

infections, with some evidence pointing at Coxsackie B4 virus. There is a
genetic element in individual susceptibility to some of these triggers which has
been traced to particular HLA genotypes (i.e., the genetic "self" identifiers
relied upon by the immune system). However, even in those who have

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inherited the susceptibility, type 1 diabetes mellitus seems to require an

environmental trigger.

Insulin is the principal hormone that regulates uptake of glucose from the
blood into most cells (primarily muscle and fat cells, but not central nervous
system cells). Therefore deficiency of insulin or the insensitivity of its receptors
plays a central role in all forms of diabetes mellitus.

Humans are capable of digesting some carbohydrates, in particular those most

common in food; starch, and some disaccharides such as sucrose, are
converted within a few hours to simpler forms most notably the
monosaccharide glucose, the principal carbohydrate energy source used by
the body. The most significant exceptions are fructose, most disaccharides
(except sucrose and in some people lactose), and all more complex
polysaccharides, with the outstanding exception of starch. The rest are passed
on for processing by gut flora largely in the colon. Insulin is released into the
blood by beta cells (†-cells), found in the Islets of Langerhans in the pancreas,
in response to rising levels of blood glucose, typically after eating. Insulin is
used by about two-thirds of the body's cells to absorb glucose from the blood
for use as fuel, for conversion to other needed molecules, or for storage.

*
(-*(6
Î62

Insulin is also the principal control signal for conversion of glucose to glycogen
for internal storage in liver and muscle cells. Lowered glucose levels result
both in the reduced release of insulin from the beta cells and in the reverse
conversion of glycogen to glucose when glucose levels fall. This is mainly
controlled by the hormone glucagon which acts in the opposite manner to
insulin. Îlucose thus forcibly produced from internal liver cell stores (as
glycogen) re-enters the bloodstream; muscle cells lack the necessary export

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mechanism. Normally liver cells do this when the level of insulin is low (which
normally correlates with low levels of blood glucose).

Higher insulin levels increase some anabolic ("building up") processes such as
cell growth and duplication, protein synthesis, and fat storage. Insulin (or its
lack) is the principal signal in converting many of the bidirectional processes
of metabolism from a catabolic to an anabolic direction, and vice versa. In
particular, a low insulin level is the trigger for entering or leaving ketosis (the
fat burning metabolic phase).

If the amount of insulin available is insufficient, if cells respond poorly to the

effects of insulin (insulin insensitivity or resistance), or if the insulin itself is
defective, then glucose will not have its usual effect so that glucose will not be
absorbed properly by those body cells that require it nor will it be stored
appropriately in the liver and muscles. The net effect is persistent high levels
of blood glucose, poor protein synthesis, and other metabolic derangements,
such as acidosis.

When the glucose concentration in the blood is raised beyond its renal
threshold (about 10 mmol/L, although this may be altered in certain
conditions, such as pregnancy), reabsorption of glucose in the proximal renal
tubuli is incomplete, and part of the glucose remains in the urine (glycosuria).
This increases the osmotic pressure of the urine and inhibits reabsorption of
water by the kidney, resulting in increased urine production (polyuria) and
increased fluid loss. Lost blood volume will be replaced osmotically from water
held in body cells and other body compartments, causing dehydration and
increased thirst.

O
Î 

2

Diabetes mellitus is characterized by recurrent or persistent hyperglycemia,

and is diagnosed by demonstrating any one of the following:

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ap Fasting plasma glucose level • 7.0 mmol/L (126 mg/dL).

ap clasma glucose • 11.1 mmol/L (200 mg/dL) two hours after a 75 g oral
glucose load as in a glucose tolerance test.
ap Symptoms of hyperglycemia and casual plasma glucose • 11.1 mmol/L
(200 mg/dL).
ap Îlycated hemoglobin (Hb A1C) • 6.5%.[14]

A positive result, in the absence of unequivocal hyperglycemia, should be

confirmed by a repeat of any of the above-listed methods on a different day. It
is preferable to measure a fasting glucose level because of the ease of
measurement and the considerable time commitment of formal glucose
tolerance testing, which takes two hours to complete and offers no prognostic
advantage over the fasting test.According to the current definition, two fasting
glucose measurements above 126 mg/dL (7.0 mmol/L) is considered
diagnostic for diabetes mellitus.

ceople with fasting glucose levels from 100 to 125 mg/dL (5.6 to 6.9 mmol/L)
are considered to have impaired fasting glucose. catients with plasma glucose
at or above 140 mg/dL (7.8 mmol/L), but not over 200 mg/dL (11.1 mmol/L),
two hours after a 75 g oral glucose load are considered to have impaired
glucose tolerance.
f these two pre-diabetic states, the latter in particular is a
major risk factor for progression to full-blown diabetes mellitus as well as
cardiovascular disease

nce we have crossed the reversible stage of pre-diabetes and enter diabetes
stage, certain changes start developing in our body. These changes occur due
to $!$! level with instability in the hormones as well as blood
vessels and nerves. When these changes become permanent in the body it
develops into serious O  and body indicates these
changes by steady symptoms.

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61*1
4(O

1* 
 


ap O retinopathy shows symptoms of pain in the eyes and may even result
in loss of vision.
ap / #7 & shows symptoms of swelling (edema) in the feet and
legs. It then passes over total body and as the disease progresses, blood
pressure also increases.
ap Tingling, burning, numbness, tightness, shooting or stabbing pain in the
hands, feet or other parts of your body, especially at night. Digestive problems
also occur if, the + controlling internal organs get damaged (autonomic
neuropathy).
ap You may have scanty or profuse sweating, difficulty of sensing when your
bladder is full, when there is a low blood sugar, increased sexual problems,
weakness, dizziness, and fainting.
ap $ (angina) or shortness of breath dizziness or light headache,
shoulder or stomach pain, fast heartbeat. You might not show any symptoms
until having a heart attack or stroke.

When alarming  given by the body are ignored and the same status
is maintained, it starts damaging body organs, such as heart, kidney, eye,
feet, and skin. The physiology for each and every affected organ is explained
one by one.

O $ are a family of nerve disorders caused by diabetes.

ceople with diabetes can, over time, develop nerve damage throughout the
body. Some people with nerve damage have no symptoms.
thers may have
symptoms such as pain, tingling, or numbness³loss of feeling³in the hands,
arms, feet, and legs. Nerve problems can occur in every organ system,
including the digestive tract, heart, and sex organs.

About 60 to 70 percent of people with diabetes have some form of neuropathy.

ceople with diabetes can develop nerve problems at any time, but risk rises

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with age and longer duration of diabetes. The highest rates of neuropathy are
among people who have had diabetes for at least 25 years. Diabetic
neuropathies also appear to be more common in people who have problems
controlling their blood glucose, also called blood sugar, as well as those with
high levels of blood fat and blood pressure and those who are overweight.

The causes are probably different for different types of diabetic neuropathy.
Researchers are studying how prolonged exposure to high blood glucose
causes nerve damage. Nerve damage is likely due to a combination of factors:

ap Metabolic factors, such as high blood glucose, long duration of diabetes,

abnormal blood fat levels, and possibly low levels of insulin
ap Neurovascular factors, leading to damage to the blood vessels that carry
oxygen and nutrients to nerves
ap Autoimmune factors that cause inflammation in nerves
ap Mechanical injury to nerves, such as carpal tunnel syndrome
ap Inherited traits that increase susceptibility to nerve disease
ap Lifestyle factors, such as smoking or alcohol use

Symptoms depend on the type of neuropathy and which nerves are affected.
Some people with nerve damage have no symptoms at all. For others, the first
symptom is often numbness, tingling, or pain in the feet. Symptoms are often
minor at first, and because most nerve damage occurs over several years, mild
cases may go unnoticed for a long time. Symptoms can involve the sensory,
motor, and autonomic³or involuntary³nervous systems. In some people,
mainly those with focal neuropathy, the onset of pain may be sudden and
severe.

Symptoms of nerve damage may include

ap Numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
ap Wasting of the muscles of the feet or hands

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ap Indigestion, nausea, or vomiting

ap Diarrhea or constipation
ap Dizziness or faintness due to a drop in blood pressure after standing or sitting
up
ap croblems with urination
ap Erectile dysfunction in men or vaginal dryness in women
ap Weakness

Symptoms that are not due to neuropathy, but often accompany it, include
weight loss and depression.

O $ can be classified as peripheral, autonomic, proximal, or

focal. Each affects different parts of the body in various ways.

1.p ceripheral neuropathy, the most common type of diabetic neuropathy,

causes pain or loss of feeling in the toes, feet, legs, hands, and arms.
2.p Autonomic neuropathy causes changes in digestion, bowel and bladder

function, sexual response, and perspiration. It can also affect the nerves
that serve the heart and control blood pressure, as well as nerves in the
lungs and eyes. Autonomic neuropathy can also cause hypoglycemia
unawareness, a condition in which people no longer experience the
warning symptoms of low blood glucose levels.
3.p croximal neuropathy causes pain in the thighs, hips, or buttocks and

leads to weakness in the legs.

4.p Focal neuropathy results in the sudden weakness of one nerve or a

group of nerves, causing muscle weakness or pain. Any nerve in the body
can be affected.

The best way to prevent neuropathy is to keep your blood glucose levels as
close to the normal range as possible. Maintaining safe blood glucose levels
protects nerves throughout your body.

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Too much glucose in the blood for a long time can cause diabetes problems.
This high blood glucose, also called blood sugar, can damage many parts of
the body, such as the heart, blood vessels, eyes, and kidneys. Heart and blood
vessel disease can lead to heart attacks and strokes. You can do a lot to
prevent or slow down diabetes problems.

You can do a lot to prevent diabetes eye problems.

ap Keep your blood glucose and blood pressure as close to normal as you can.
ap Have an eye care professional examine your eyes once a year. Have this exam
even if your vision is
K. The eye care professional will use drops to make the
black part of your eyes³pupils³bigger. This process is called  ! your
pupil, which allows the eye care professional to see the back of your eye.
Finding eye problems early and getting treatment right away will help prevent
more serious problems later on.

ap Ask your eye care professional to check for signs of  and !.
ap If you are pregnant and have diabetes, see an eye care professional during
your first 3 months of pregnancy.
ap Don·t smoke.
ap New research shows a strong link between diabetes rates and exposure to auto
exhaust, industrial smoke, and other types of fine particulate air pollution.

ap SKIN cR
BLEMS RELATED WITH DIABETES:
ap Scleroderma diabeticorum: While rare, this skin problem affects people with
type 2 diabetes, causing a thickening of the skin on the back of the neck and
upper back. The treatment is to bring your blood sugar level under control.
Lotions and moisturizers may help soften skin.
ap litiligo: litiligo, a skin problem more commonly associated with type 1
diabetes than type 2 diabetes, affects skin coloration. With vitiligo, the special

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cells that make pigment (the substance that controls skin color) are destroyed,
resulting in patches of discolored skin. litiligo often affects the chest and
abdomen, but may be found on the face around the mouth, nostrils, and eyes.
Current treatment options for vitiligo include topical steroids and
micropigmentation (tattooing). If you have vitiligo, you should use sunscreen
with a ScF of 15 or higher to prevent sunburn on the discolored skin.
ap Skin croblems Linked to Diabetes and Insulin Resistance
ap Acanthosis nigricans. This is a skin problem that results in the darkening and
thickening of certain areas of the skin especially in the skin folds. The skin
becomes tan or brown and is sometimes slightly raised and described as
velvety. Most often the condition, which typically looks like a small wart,
appears on the sides or back of the neck, the armpits, under the breast, and
groin.
ccasionally the top of the knuckles will have a particularly unusual
appearance. Acanthosis nigricans usually strikes people who are very
overweight. While there is no cure for acanthosis nigricans, losing weight may
improve the skin condition. Acanthosis nigricans usually precedes diabetes
and is considered to be a marker for the disease.
ap Skin problems linked to atherosclerosis: Atherosclerosis is a serious health
condition caused by the narrowing of blood vessels from a thickening of the
vessel walls due to plaque buildup. While atherosclerosis most often is
associated with blood vessels in or near the heart, it can affect blood vessels
throughout the body, including those that supply blood to the skin. When the
blood vessels supplying the skin become narrow, changes occur to the skin
due to a lack of oxygen, such as hair loss, thinning and shiny skin especially
on the shins, thickened and discolored toenails, and cold skin. Because blood
carries the white blood cells that help fight infection, legs and feet affected by
atherosclerosis heal more slowly when they are injured.
ap Necrobiosis lipoidica diabeticorum: Necrobiosis lipoidica diabeticorum (NLD) is
thought to be caused by changes in the collagen and fat content underneath
the skin. The overlaying skin area becomes thinned and reddened. Most
lesions are found on the lower parts of the legs and can ulcerate if subjected to
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trauma. Lesions have fairly well defined borders between them and normal
skin. Sometimes, NLD is itchy and painful. As long as the sores do not break
open, treatment is not necessary. If the sores do break open, see your doctor
for medical treatment.
ap Diabetic dermopathy: Also called shin spots, this skin condition develops as a
result of changes to the blood vessels that supply the skin. Dermopathy
appears as a shiny round or oval lesion of thin skin over the front lower parts
of the lower legs. The patches do not hurt, although rarely they can be itchy or
cause burning. Medical treatment generally is not necessary.
ap Digital sclerosis: Digital sclerosis is a health condition in which the skin on
your toes, fingers, and hands become thick, waxy, and tight. Stiffness of the
finger joints also may occur. The medical treatment is to bring your blood
sugar level under control. Lotions and moisturizers may help soften the skin.

O 
O1

Î1 4O


2

There is much controversy regarding what diet to recommend to sufferers of

diabetes mellitus. The diet most often recommended is high in dietary fiber,
especially soluble fiber, but low in fat (especially saturated fat).
Recommendations of the fraction of total calories to be obtained from
carbohydrate intake range from 1/6 to 75% ² a 2006 review found
recommendations varying from 40 to 65%.

catients may be encouraged to reduce their intake of carbohydrates that have

a high glycemic index (ÎI), although this is also controversial. (In cases of
hypoglycemia, they are advised to have food or drink that can raise blood
glucose quickly, followed by a long-acting carbohydrate (such as rye bread) to
prevent risk of further hypoglycemia.) But others question the usefulness of
the glycemic index and recommend high-ÎI foods like potatoes and rice.

For people with diabetes, healthy eating is not simply a matter of "what one
eats", but also when one eats. The question of how long before a meal one

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should inject insulin is asked frequently. The answer is that it depends upon
the type of insulin one takes and whether it is long, medium or quick-acting
insulin. If patients check their blood glucose at bedtime and find that it is low,
it is advisable that they take some long-acting carbohydrate before retiring to
bed to prevent night-time hypoglycemia.

Moderation is advised with regards to consuming alcohol and the use of some
drugs. Alcohol inhibits the glycogenesis in the liver and some drugs inhibit
hunger symptoms. This, together with impaired judgment, memory and
concentration caused by some drugs can lead to hypoglycemia.

Here is a diabetic diet chart that will help you ensure that your sugar-levels
are in place:

ap Befriend bitter gourd as it helps in lowering blood sugar efficiently.

ap Fenugreek seeds are also the best thing to have on your diabetic diet chart.
Îulping a few of these seeds along with water on an empty stomach early
morning will do wonders and will help you control diabetes effectively.
ap Îarlic is rich in potassium and it helps in replacing the potassium that you
lose out in your urine. It also has sulfur and zinc which are components of
insulin.
ap Include lot of fiber in your diet. An ideal diabetic diet chart is the one which
has soluble fibers that are found in food sources like apples, soybean,
oatmeal, and kidney beans as these help in slow digestion and the right
absorption of nutrients. Slow absorption of nutrients will mean slow release of
glucose which is essential for those suffering from diabetes.
ap Make sure you include ample fluids in your daily diabetic diet chart. This will
ensure that your body is well hydrated.
ap Including flaxseed in your diet is a good idea as it will help in maintaining the
sensitivity of the cell membrane and will facilitate insulin production.
ap If you feel like eating rice, then choose brown rice instead of white rice.

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ap You can eat almost all fruits. However, make sure you avoid bananas, sapota,
mangoes, and other fruits that are high in sugar levels.
ap It is a good idea to keep condiments, spices, and alcoholic beverages away
from your diabetic diet chart.

If you are diabetic, you need to consume food in small quantities at regular
intervals. Just as too much of bingeing is not recommended, fasting is also not
advisable either.

Following a mild exercise regime will also help in controlling your blood sugar
levels. A proper diet that is based on a diabetic diet chart combined with a
light exercise regimen will definitely help you. Last but not the least, do not
forget your insulin shots or your pills.

X$$6$$$8$9

Follow the healthy eating plan that you and your doctor or
dietitian have worked out.

Be active a total of 30 minutes most days. Ask your doctor

what activities are best for you.

Take your medicines as directed.

Check your blood glucose every day. Each time you check your
blood glucose, write the number in your record book.

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Check your feet every day for cuts, blisters, sores, swelling,
redness, or sore toenails.

Brush and floss your teeth every day.

Control your blood pressure and cholesterol.

Don·t smoke.

O 44/ 1O
4/
1 2

Diabetes mellitus is a chronic disease which is difficult to cure. Management

concentrates on keeping blood sugar levels as close to normal ("euglycemia")
as possible without presenting undue patient danger. This can usually be with
close dietary management, exercise, and use of appropriate medications
(insulin only in the case of type 1 diabetes mellitus.
ral medications may be
used in the case of type 2 diabetes, as well as insulin).

catient education, understanding, and participation is vital since the

complications of diabetes are far less common and less severe in people who
have well-managed blood sugar levels. Wider health problems may accelerate
the deleterious effects of diabetes. These include smoking, elevated cholesterol
levels, obesity, high blood pressure, and lack of regular exercise.

 

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There are roles for patient education, dietetic support, sensible exercise, with
the goal of keeping both short-term and long-term blood glucose levels within
acceptable bounds. In addition, given the associated higher risks of
cardiovascular disease, lifestyle modifications are recommended to control
blood pressure.

1 

ral medications-Routine use of aspirin has not been found to improve
outcomes in uncomplicated diabetes.

ap A new, extended-release form of metformin is now available.

Insulin - Type 1 treatments usually include combinations of regular or NcH

insulin, and/or synthetic insulin analogs.

Biguanides :

Brand Name: Îlucophage XR

Îeneric Name: metformin hydrochloride extended release

You may notice a metallic taste in your mouth.

ap If you already have a kidney problem, taking metformin may make it worse.
Make sure that, before you start taking metformin, your doctor knows your
kidneys work well.
ap If you are vomiting, have diarrhea, and can't drink enough fluids, you may
need to stop taking metformin for a few days.

ap
nce in a while people on metformin can become weak, tired, or dizzy and
have trouble breathing. If you ever have these problems, call your doctor or get
medical help right away.

ap Sulfonylureas:

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ap Brand Name: Amaryl, DiaBeta, Diabinese, Dymelor, Îlucotrol, Îlucotrol XL,

Îlynase cresTab, Micronase,
rinase, Tolinase
ap Îeneric Name: glimepiride, glyburide, chlorpropamide, acetohexamide,
glipizide, glipizide, glyburide, glyburide, tolbutamide, tolazamide
ap Some of the side effects of this diabetic medicine:
ap hypoglycemia
ap an upset stomach
ap a skin rash or itching
ap weight gain
ap Some of the side effects of this diabetic medicine:
ap If you take pioglitazone or rosiglitazone, it is important for your health care
provider to check your liver enzyme levels regularly.
ap Call your doctor right away if you have any signs of liver disease: nausea,
vomiting, stomach pain, lack of appetite, tiredness, yellowing of the skin or
whites of the eyes, or dark-colored urine.
ap (Some people who took troglitazone, another thiazolidinedione, have had
serious liver problems. Troglitazone is no longer available.)
ap You may gain weight while taking these medicines.
ap You may be at risk for developing anemia, which will make you feel tired.
Anemia causes your blood to carry less oxygen than normal.
ap You may have swelling in your legs or your ankles, also called edema

Insulin is given externally while treating a diabetic patient. There are 20 types
of insulin available in many forms. Human insulin is made from bacteria.
Certain changes are made in the bacterial DNA and cloned to make insulin.
Food and Drug Administration (FDA) U.S., approved the first human insulin in
1982.


 

ap
verdose of Insulin

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ap Delayed or skipped meals

ap Uneven absorption of insulin
ap Deteriorated functioning of the kidney

Decreased secretions of thyroid or hypoglycemia are sweating, dizziness,

excessive hunger, increase in pulse rate, and blurred vision. Eating small
amounts of food that is rich in sugar gives temporary relief from hypoglycemia.
Hypoglycemia directly affects the brain tissues. Severe hypoglycemia may
result in coma. The sugar levels should be checked immediately after
hypoglycemia. Checking sugar levels helps in further treatment of diabetes.

Weight gain: In diabetes, calories are not well-utilized. Intake of insulin

increases the use of calories consumed by human body, this leads to weight
gain. Weight gain in diabetes can be a serious issue. Diabetic patients must be
very careful about the changes in their weight.

Loss of fatty tissues: Taking frequent injections of insulin can damage the fatty
tissues in the injected area. Improper hygiene during medication may cause
infections.

Allergic reactions: The area where the insulin is injected turns red and
becomes itchy. Edema (swelling) is observed on a part or the whole body in
some cases, due to excessive water retention. These side-effects are usually
seen in first few weeks of therapy. In case allergic reactions last for more than
two weeks, you should consult your physician. Syringes and pens used to take
insulin should never be shared with others to avoid infections.

Upper respiratory tract problems: Coughing, respiratory tract infections and

difficulty in breathing is seen in patients taking insulin via a pump. lery few
patients are recommended to take insulin using an insulin pump.

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Interactions with other drugs: The effect of insulin is nullified by many drugs
consumed. These drugs may cause hyperglycemia in diabetic patients.
ral
diabetic medications, alcoholic beverages, sulfonamide antibiotics, aspirin,
Fibrate cholesterol medications, growth hormones are some of the drugs with
which insulin reacts. catients should consult the doctor if they are on some
other drugs before taking insulin.

cregnant women should take insulin only under medical observation. Breast-
feeding mothers must adjust their insulin dosage with their diabetic diet.
Insulin is prescribed by the physician taking into consideration many other
aspects. Some of these aspects are your age, lifestyle, individual body
response to insulin and blood sugar levels. Insulin must be taken under
proper medical observation.

(1*
( 
**/
(2

Homoeopathy is a system of medicine which has a different approach to

disease and remedy from that of conventional or Allopathic medicine. In the
Allopathic approach, medicines are used that work against diseases and their
symptoms. In Homoeopathy, the symptoms of an illness are viewed as a direct
manifestation of the body's attempt to heal itself and a Homoeopathic
substance is given that is capable of producing similar symptoms if given to a
well person. In so doing, Homoeopathic attempts to stimulate the body's own
natural healing capacity with Homoeopathic remedies acting as a trigger for
the body's own healing forces.

The disease is intimately associated with the life of the individual and is a
result of internally concealed causes and also external causes (environment,
viral and bacteriological diseases, and traumas).

Homeopathy offers natural, effective remedies for patients suffering from

Diabetes. The symptoms expressed by patients depend on the individuality of
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the person, type of diabetes and the complications that arise from having
diabetes over time. As Homeopathic remedies are chosen for the whole person
rather than for a disease, it also considers symptoms that arise from other
complications . The duration of the treatment and the progress depend on the
type of diabetes, the associated symptoms and vary from person to person.
Homeopaths generally ask you to continue the medications you are currently
on until your body starts responding to the treatment and produces and uses
the insulin.

O8$($9

J. Ellis Barker, homeopath from 1930s said: ´disease is incurable only when
the patient is deadµ. And we agree. There are N
incurable diseases!
The point is that it is hard to treat homeopathically someone so dependent on
allopathic drugs (insulin)-but it is not impossible-but you need a very close
supervision of qualified homeopath.

Success in the homeopathic treatment of any disease depends on following the

principles laid down in the philosophy of Hahnemann and expounded by the
wisest of his followers as they interpreted these principles in terms which
present day prescribers can understand.

These principles are clear, practicable and satisfying. Man is a triune being,
spiritual, mental, physical. All diseases, or disorders, partake of these three
realms. Therefore, we treat the man, not his organs by themselves. We strive to
learn the patient's reactions to the disorder present, reactions in the spiritual,
mental and physical spheres. We become acquainted with him and try to
separate the abnormal or morbid in his case from that which is normal.

This means the gathering of symptoms, the arrangement of them for study into
the three classes mentioned, making the spiritual the most important, the
mental next and the physical last, also making the symptoms predicated of the

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patient as a whole far more important than those predicated of one part or only
a few parts.

It means suiting a remedy to the patient, not to one of his parts, whether this
remedy is well known for the disease in question or not. It means preparing the
remedy to act on the plane of this particular patient's disorder. It means
watching the results of a prescription and judging therefrom whether or not a
curative process is developing. It means choosing a better remedy or following
along with the one first chosen and its complementary remedies.

The homeopathic physician, therefore, has no special treatment for diabetes.

The diabetic patient is treated just as every other patient is treated. Like every
other case, much depends on how far tissue change has taken place at the
beginning of treatment, that is whether this has advanced far enough to render
the patient incurable. Homeopathy can cure any curable case of diabetes and it
has done wonderful things with diabetics who have been considered incurable
by other methods. A so-called incurable may have to return for further
treatment at intervals if sugar returns after freedom and good health. Advanced
cases may never cease treatment altogether but may live as long as other
people and die of something else.
r such a patient may be palliated
wonderfully on the way to death.

In diabetics we are dealing with borderland cases, with what is called an

ultimate in organic disorder. Homeopathy, used for chronic ills from early life,
very rarely develops an ultimate. Its power in prevention is marvelous. But,
mind you, I am talking about principles and their practice, not about the
weaknesses of human nature and human endeavor in physicians as well as in
patients.

You will want to know whether the strictly homeopathic physician uses insulin.
I cannot answer for all of them. I know that some will not allow it, will take it
away at the beginning of homeopathic treatment, regarding it as an element of

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interference. Since insulin is not really a drug, I think some permit its use.
f
one thing I am sure. A patient accustomed to insulin in large doses over a long
period is enabled to reduce that dosage soon after beginning treatment and
may cut it down one-half or three-quarters or cut it out altogether. The
pancreas, if not too far gone, comes back wonderfully toward normal
functioning.

Diabetes can be cured by homeopathic medicines. Homoeopathy is an

alternative system of medicine. It has great scope for Diabetic patients.
Homeopathy is totally safe and uses minimum doses so it is perfect to be used
in treatment of chronic conditions like diabetes. The homoeopathic medicines
not only help in reducing or lowering blood sugar or blood glucose values but
also help in maintaining overall wellness and good health.

The commonly used medicines in Homeopathy for diabetes are Arsenic,

chosphorus, chosphoric acid, Lactic acid etc. There cannot be any one
homeopathic medicine for all diabetics in general, because homoeopathy
believes in individualization. That means that every diabetic patient is unique
in homeopathy.

A Homeopath will take a detailed case taking before he or she prescribes any
medicine for you. Every diabetic patient will have certain general symptoms
which are common to all diabetics and some special symptoms which are
peculiar only to him or her.

For example a diabetic patient may complain of increased thirst which is just a
common symptom of all diabetics. But on detailed questioning he may tell you
that he feels like drinking large quantities of water at frequent intervals. Now
that is very peculiar is it not? He may tell you he cannot tolerate warm water.
May be he likes to have his water iced.

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All these physical peculiarities are considered along with his or her mental and
emotional symptoms. Cravings and aversions to certain articles of food,
memory, intelligence, intuition fears, disposition, dreams and desires of the
patient are also considered in the case taking. In addition to this the genetic
make up, the constitutional tendencies and the pathological changes in the
body are all analyzed.

The best part about Homeopathic treatment is that it can not only be used
independently but also as a compliment to other methods of conventional
treatment.

Homeopathic treatment is also an alternative method of treatment for diabetes.

However, controlling your blood sugar becomes easy with a good knowledge of
diabetic foods to eat AND foods to avoid.

(1*
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2

Uranium nitrate. [Uran]

This remedy is praised highly by Hughes and others in diabetes originating in
dyspepsia. It has polyuria, polydypsia, dryness of the mouth and skin. It
causes sugar in the urine. Dr. Laning said that no remedy gives such
universally good results; it lessens the sugar and quantity of the urine; he
recommended the 3X trituration. It is when the disease is due to assimilative
derangements that Uranium is the remedy, and symptoms such as defective
digestion, languor, debility and much sugar in the urine, enormous appetite
and thirst, yet the patient continues to emaciate. Syzygium jambolanum is a
remedy capable of diminishing the amount of sugar in the urine, especially
when used in the tincture and lower triturations, and some cases have been
reported cured, but it cannot be considered a reliable drug , and its use seems
entirely palliative.

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chosphoric acid [chos]

corresponds to diabetes of nervous origin; the urine is increased, perhaps
milky in color and containing much sugar. It suits cases due to grief,
worriment and anxiety, those who are indifferent and apathetic, poor in mental
and physical force. It is unquestionably curative of diabetes mellitus in the
early stages, great debility and bruised feeling in the muscles. There will be loss
of appetite, sometimes unquenchable thirst and perhaps the patient will be
troubled with boils. When patients pass large quantities of pale colorless urine
or where there is much phosphatic deposit in the urine it is the remedy. It thus
may be a remedy in the form known as diabetes insipidus. Hering considered
clumbum one of the most important remedies in diabetes mellitus. Causticum,
Scilla and Strophanthus may be of use in diabetes insipidus. Lycopodium
cured a case in a weary, wretched patient; emaciated, increased appetite and
great thirst; pale, profuse urine. Eight quarts in 24 hours.

chosphorus. [chos]
Useful in diabetes and pancreatic diseases, especially in those of a tuberculous
or gouty diathesis. The pancreatic involvement will call attention to
chosphorus. Natrum sulphuricum corresponds to the hydrogenoid
constitution, with dry mouth and throat,and Arsenicum should be studied in
diabetic gangrene, thirst and emaciation. Sudden and extreme dryness of the
mouth and marked physical restlessness are also guiding symptoms to this
remedy, especially with a dark watery stool. Dr. c.Jousset reports positive
success where the mouth is dry; frequent, abundant urination and tendency to
skin eruption.

Lactic acid. [Lact]

An exceedingly good remedy in the gastrohepatic variety of diabetes and good
results often follow its use. It has a fine clinical record. The symptoms are:
urinates copiously and freely, urine light yellow and saccharine, thirst, nausea,
debility, voracious appetite and costive bowels. Dry skin, dry tongue,

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gastralgia. Acetic acid is also a valuable diabetic remedy, and it has passing of
large quantities of pale urine, intense thirst, hot, dry skin and marked debility
Carbolic acid may also be found useful.

Bryonia. [Bry]
Should not be neglected in this disease. No remedy has dryness of the lips as a
symptom of hepatic disorder more marked than Bryonia, and this is often one
of the first symptom of diabetes. There is a persistent bitter taste, the patient is
languid, morose and dispirited, thirst may not be extreme nor the appetite
voracious, the patient may lose strength through inability to eat. codophyllum
has a bitter taste, but the tongue is flabby. It may be of use in the disease.
Chionanthus is a remedy used by the Eclectic School upon the indications of
thirst, frequent and copious urine; constipation with stools light colored, devoid
of bile. Functional liver disorders. Argentum metallicum. Hahnemann suggests
the use of this remedy in diuresis, it is decided use in diabetes insipidus. The
urine is profuse, turbid and of sweet odor. Micturition is frequent and copious.
Natrum sulphuricum. Hinsdale reports good results with this remedy. It has
polyuria, intense itching of the skin, especially upon the upper surface of the
thighs. It is the Tissue Remedy of diabetes.

Insulin. [Insulin]
Long before the discovery of Insulin Dr.cierre Jousset of caris prepared a
pancreatic juice on a glycerine basis which he administered to diabetic patients
in doses of 10 or 20 drops a day in water and had results sufficiently good to
consider pancreatic juice, orally administered, as a remedy of great value in
diabetes. Dr. Cartier, his practical successor, praised it insisted on smaller
doses given by mouth as larger doses and hypodermic injections of it had no
effect in ordinary diabetes. Baker advises the homoeopathic strengths of
Insulin 3d to 30th and reports happy results therefrom. Îreat care must be
taken not to overdose. Boericke says that it maintains the blood sugar at a

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normal level and the urine remains free of sugar. Epileptic convulsions and
mental derangements have been produced by hypodermic use of this hormone.

Ferrum iodatum [Ferr-i]as natural diabetes remedy

This diabetic remedy is preferred if: Scrofulous affections, glandular
enlargements, and tumors. Crops of boils. Acute nephritis following eruptive
diseases. Uterine displacements. Body emaciated Anemia Exophthalmic goitre
following suppression of menses. Debility following drain upon vital forces.
Impetigo of the cheek. Urine dark. Sweet smelling. Crawling sensation in
urethra and rectum. Difficulty in retaining urine. Incontinence in anaemic
children.
Dosage: Third trituration. Does not keep long.

Îrindelia robusta [Îrin]as natural diabetes remedy

Both Îrindelia robusta and Îrindelia squarrosa have been used as diabetes
remedy for the symptoms here recorded. There is practically no difference in
their action, although the Î. Squarrosa is credited with more splenic
symptoms. Induces paralysis, beginning in extremities. Its action is shown on
the heart first quickening, then retarding it. croduces a paresis of the pneumo-
gastric, interfering with respiration. Smothering after falling asleep. Asthmatic
conditions, chronic bronchitis. Bronchorrhoea with tough mucus, difficult to
detach. Raises the blood pressure. Nausea and retching of gastric ulcer. Sugar
in urine.
Dosage: Tincture in 1 to 15 drop doses, also lower potencies.

crocedure of homeopathic diabetic remedies treatment

Homeopathic natural diabetes remedies are effective in the treatment of
diabetes without any side effects. But don·t give up the diabetes medication,
take diabetes remedy along with regular medicines till the glucose level reaches
normal. Then slowly reduce the dosage of the diabetic medicine. For type 1
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diabetes, this diabetes remedies only helps to reduce the quantity of insulin
shots & prevent any diabetes complications. Never stop insulin shots because
there is no alternative treatment that totally replaces insulin shots

*+($, originated by Mumbai based homeopath Dr crafull

lijaykar, attempts to understand the basic constitution of the patient and uses
the same as the basis of prescribing. With over 20 years practice and 50,000
plus patients, he has connected homeopathy to embryology through his theory
of seven levels of suppression.

Moreover, Dr lijaykar illustrates that when a symptom is treated locally it is

suppressed to a deeper level in the organism. Cure, on the other hand, should
result from outside, namely in the reverse order of the suppression. This
phenomenon is already well known in homeopathy as the Hering's Law of
Direction of Cure. Dr lijaykar has emphasised this law and uses it as a strict
yardstick to judge whether what is happening in a given case is suppression or
cure.

credictive homoepathy explains homoeopathic principles keeping in mind the

research and discoveries in the field of embryology, human biochemistry,
genetics, physiology, among others. With this, homeopathy now comes under
the purview of the most scientific sciences. It has brought about a sense of
transparency and mathematics in homeopathy removing adhocism.

Interestingly, practitioners have adopted predictive homoepathy methods, both

in India and abroad, but homeopathy colleges are yet to embrace it. The
international seminar on predictive homoepathy was held in Delhi this
February and was attended by over 1,400 delegates.

Homeopaths treat the individual rather than the disease; whereas "credictive
homoepathy," according to Dr Anita Salunkhe, "attends to individuals

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metabolic problems, his genetic code and his tendency, which invites the
disease. If the cause at the genetic level is treated, effects which are in the form
of disease, will just disappear and that too permanently."

Chronic illnesses, allergic asthma, high blood pressure, diabetes, thyroid

problems and even chronic skin conditions like psoriasis, lichen planus,
urticaria, sun allergy, among others cannot be eliminated or permanently
cured with the existing mode of treatment only because the genetic tendency of
the individual is not treated.

The relationship between diseases and illnesses is predictable if one tries to

understand the embryological origin and development of man, of course
genetically governed. As a rule, all the major diseases suffered by a patient -
barring traumatic diseases have their origin in smaller ailments either treated
or maltreated. As a rule all diseases have a precursor and a follower. Dr
craveen Sharma, lecturer in Neurosurgery, KEM Hospital, who admits to
sending `difficult cases' to be treated by predictive homoepathy practitioners
says, "My experience with predictive homoepathy has been wonderful. Its
scientific as it describes progression of disease from outer layer to inner ones.
While in cure reversal of this order is maintained."


*
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2

In view of the rapidly increasing number of the diabetic population, cositive

Homoepathy picked the gauntlet and established the first Homoeopathic
Diabetic clinic in A.c- The ´DIABETIC CELLµ. It was started in ------2008 by ---
----. Since then many diabetic patients are benefitted across the state and also
from various parts of the country. Though the results were not uniform among
all the patients 76 percent of all our patients are happy with the benefits they

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are receiving from Homeopathy. Many patients· sugar levels are under control
and free from different complications like neuropathies, nephropathies,
retinopathies and foot complications. There is improved quality of life among
the patient folks and leading a happy life similar to a non-diabetic person.

cositive Homeopathy·s Diabetic cell has been a great success in improvising

the general health and well being among diabetic patients without any side
effects. Treatment is also aimed at the associated conditions like
Hypertension, Hypercholesteraemias, Hypothyroidism, Arthritis, Spondylosis
etc.

In our system, we can practice single remedy prescription. This is very much
curable process, no temporary relief and don·t give suppressive treatment.

We give treatment based upon constitutionals.

We follow predictive homeopathy

ap This is very much curable treatment

ap
ne medicine has developed resistant strains to viruses/human alike
ap In old concept they have not been able to get good results.This concept
remained second to allopathy

We Use new concept

We approach simplification of reaching the similimum with out violating the

seven cardinal principals of homeopathy. In old concept ,prescriptions are
blind .They never gave results and it gives temporary relief.

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New concept predictive:

ap Hering law is a must, this way treatment occurs at curable process.

ap Bases on dermal layers different layers according to cure we give
treatment.

0

40


 *
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 -

Mr.XX

Age-

Sex-

Regd.no-

cresenting complaints

H /o present illness

cast history

Family history

chysical generals:

Appetite:

Thirst:

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Bowels:

Urine:

Sweat:

Sleep;

Dreams:

Menses:

Mental generals and life space investigation:

Case analysis:

c