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Diabetes


What is diabetes mellitus ?

Diabetes mellitus is a clinical syndrome characterized by hyperglycaemia due to relative or absolute deficiency of insulin. It has both acute and chronic complications. All organs like brain, heart, kidney, eyes, blood vessels and peripheral nerves are affected.

Writings from the earliest civilizations (Asia Minor, China, Egypt, and India) refer to boils and infections, excessive thirst, loss of weight, and the passing of large quantities of a honey sweet urine which often drew ants and flies. About 1000 BC condition like diabetes was described by Sushruta. About 150 AD - A Greek philosopher named it 'DIABETES' meaning 'SYPHON’, i.e. the disease that drains the patients of more fluid than they could consume. He also differentiated between Diabetes mellitus and Diabetes insipidus. Gradually latin word for honey “ mellitus was appended to diabetes because of the link with sweet urine. About 1000 AD, Greek physicians prescribed exercise, preferably on horseback, to "employ moderate friction" and alleviate excess urination. Excess sugar in blood and urine was documented by John Rollo (1798).

Types of diabetes mellitus

The two major types of diabetes were recognized in 1969. They are

  • Type I - Insulin dependent diabetes mellitus (IDDM)
  • Type II – Non insulin dependent diabetes mellitus (NIDDM)

Type I Diabetes (IDDM) or Juvenile onset diabetes usually manifests before adulthood and accounts for 5% of cases. Diabetes mellitus (both types combined) is globally the seventh leading cause of death, more than 150 million people being affected globally. However, about 50% of the cases remain undetected .

The prevalence of type 2 diabetes is increasing all over the world particularly in the developing countries. It has emerged as a major public health problem in our country. Despite the extensive research and better treatment modalities the morbidity and mortality is increasing and is a matter of concern.

In recent years NIDDM has posed a serious threat to humanity because of its magnitude and prevalence. It may be regarded as disease of late adult life and elderly population. Increasing weight and obesity are directly related to its incidence and causation. It is understood that every 7th adult is diabetic. Complications can extend to various problems like retinopathy, nephropathy, neuropathy etc. resulting into increased morbidity and mortality.

Causative/modifying factors of Diabetes mellitus

  • Genetic defect in Beta cells
  • Genetic defect in insulin production
  • Pancreatic diseases
  • Drug induced
  • Infections
  • Immune mediated
  • Genetic syndromes
  • Gestational diabetes
  • Impaired glucose
  • Homeostasis
  • Environmental factors
  • Obesity
  • Life style
  • Repeated pregnancies

Clinical Features

  • Having to urinate more often than usual
  • Sudden, unintended weight loss
  • Constant thirst
  • Extreme hunger
  • Weakness and fatigue
  • Being cross or irritable
  • Blurred vision or decline in sight
  • Cuts that heal slowly, especially on the feet
  • Frequent infections
  • Tingling or numbness
  • Frequent skin infections or itchy skin

Diagnostic criteria

Symptoms of diabetes are associated with -

  • Random plasma glucose concentration more than or equal to 200mg/dl.
  • Fasting plasma glucose more than or equal to 126mg/dl.
  • Two hour plasma glucose more than or equal to 200mg/dl during a 75g OGTT.

Long term complications

  • Diabetic ketoacidosis
  • Hyperosmolar non ketotic coma
  • Lactic acidosis
  • Hypoglycaemia
  • Macrovascular complications
  • Ocular complications
  • Neuropathy
  • Nephropathy

OCULAR COMPLICATIONS:

  • Transient visual disturbance secondary to osmotic changes.
  • Retinopathy, responsible for 80% of cases of blindness in in diabetic patients.
  • Cataracts also develop earlier in diabetic patients.
  • Glaucoma may also occur.

NEPHROPATHY:

  • Albuminuria.
  • Hypertension.
  • Progressive renal insufficiency.

NEUROPATHY:

  • Distal symmetrical polyneuropathy
  • Focal neuropathy.
  • Autonomic neuropathy.

MACROVASCULAR COMPLICATIONS :

  • Atherosclerosis
  • CAD
  • Acute MI
  • PAD
  • CVD
  • POD
  • Hypertension
  • Dyslipidaemia

HOW HOMEOPATHY CAN HELP ?

The aim of homeopathy is not only to bring down the blood sugar level but also to take care of fundamental cause and disease process. It also takes care of the ultimate cause of disease. Managing patients with the diabetes mellitus effectively requires a great deal of time, effort and patience. The task of rendering quality care to our diabetic patients is stupendous and challenging.

As condition type 2 diabetes mellitus or non-insulin dependent diabetes mellitus is a chronic disease and affect the individual as a whole, so the homoeopathic system of therapeutics, which is based on the holistic concept can provide an efficacious therapy to control the condition.