Diabetes mellitus: pathophysiology and current trends in management

Diabetes mellitus is a group of disorders that have in common abnormal insulin function resulting in disordered carbohydrate, protein and fat metabolism, the cardinal feature being elevated blood glucose levels. Acute complications include diabetic ketoacidosis, hyperosmolar non-ketotic "coma" and hypoglycemia. Long-term complications develop over several years and cause more morbidity and mortality than the acute complications. Although the pathogenesis of long-term complications is still unknown, it is likely that it relates to the abnormal metabolic state that occurs in diabetes. Current techniques of monitoring diabetes include blood glucose self-monitoring and the measurement of glycosylated hemoglobin. Management focuses on dietary adjustments (caloric amount, timing and composition), exercise and medications. Patients are encouraged to participate in comprehensive diabetes education programs to learn about new aspects of treatment and prevention of complications.