ABSTRACT
The diagnosis of diabetes mellitus encompasses a wide array of meta-
bolic diseases characterized by chronic hyperglycemia. Because insulin is
the only physiologically significant hypoglycemic hormone, hyper-
glycemia must be the result of either impaired insulin secretion by the
beta cells of the pancreas, resistance to the effect of insulin in the liver,
muscle, and fat cells, or a combination of these pathophysiologic situa-
tions. It is important to recognize that the hyperglycemia of diabetes is
not simply a reflection of abnormal glucose metabolism, but the result
of disturbed energy metabolism from inadequate insulin action with
widespread disturbances in carbohydrate, fat, and protein metabolism.
