A Review on Diabetes Mellitus: Current Update on Management and Treatment

Abstract

Diabetes mellitus (DM), or simply diabetes, is 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). Conventionally, diabetes has been divided into three types namely: Type 1 DM or insulin-dependent diabetes mellitus (IDDM) in which body fails to produce insulin, and presently requires the person to inject insulin or wear an insulin pump. This is also termed as "juvenile diabetes". Type 2 DM or non-insulin-dependent diabetes mellitus (NIDDM), results from insulin resistance, a condition in which cells fail to use insulin properly, with or without an absolute insulin deficiency. This type was previously
referred to as or "adult-onset diabetes". The third main type is gestational diabetes which occurs when women without a previous history of diabetes develop a high blood glucose level during her pregnancy. It may precede development of type 2 DM. Currently available pharmacotherapy for the treatment of diabetes mellitus includes insulin and oral hypoglycemic agents. Such drugs acts by either increasing the secretion of insulin from pancreas or reducing plasma glucose concentrations by increasing glucose uptake and decreasing gluconeogenesis. However these current drugs do not restore normal glucose homeostasis for longer period and they are not free from side effects such as hypoglycemia, kidney diseases, GIT problems, hepatotoxicity, heart risk problems, insulinoma and they have to take rest of life. Various herbal drugs have been also proved effective due to their beneficial contents in treatment of diabetes. The present review therefore is an attempt to focus on the physiological aspects of diabetes, its complications, goals of management, and synthetic and herbal treatment of diabetes.