ABSTRACT
Abstract ..................................................................................................... 4 1.1 Introduction ...................................................................................... 4
1.1.1 Epidemiology ....................................................................... 5 1.2 Classification of Diabetes ................................................................ 8
1.2.1 Type 1 Diabetes .................................................................... 9 1.2.2 Type 2 Diabetes .................................................................. 10 1.2.3 Gestational Diabetes .......................................................... 10
1.3 Pathophysiology ............................................................................. 10 1.3.1 Type 1 Diabetes .................................................................. 10 1.3.2 Type 2 Diabetes .................................................................. 13 1.3.3 b-Cell Dysfunction ............................................................ 13 1.3.4 Insulin Resistance .............................................................. 17
1.4 Genetics and Molecular Basis of Diabetes .................................... 20 1.4.1 Type 1 Diabetes .................................................................. 20 1.4.2 Type 2 Diabetes .................................................................. 22 1.4.3 Linkage Disequilibrium (LD) Analysis Reveals the
Genomics of Diabetes ......................................................... 24 1.4.4 Protein Kinase B (PkB) and its Role in Diabetes .............. 25 1.4.5 Vascular Endothelial Growth Factor (VEGF) Modulates
Vascular Complications in Diabetes ................................... 27
1.4.6 Cytokine SNPs Associated with T2DM ......................... 29 1.5 Personalized Treatment-prospects .............................................. 30 1.6 Causes and Risk Factors of Diabetes ......................................... 32
1.6.1 Diet ................................................................................ 32 1.6.2 Smoking ......................................................................... 33 1.6.3 Physical Inactivity .......................................................... 33 1.6.4 Obesity .......................................................................... 34 1.6.5 Ethnicity ........................................................................ 34 1.6.6 Genetic Susceptibility .................................................... 35
1.7 Free Radicals and Oxidative Stress in Diabetes .......................... 36 1.8 Physical Stress and Diabetes ....................................................... 38 1.9 Role of Dietary Sugars in Insulin Resistance .............................. 39
1.10 Obesity and Diabetes ................................................................... 40 1.11 Diagnosis of Diabetes .................................................................. 41
1.11.1 Fasting Plasma Glucose Test (FPG) ............................. 42 1.11.2 Random Plasma Glucose Test (RPG) ........................... 42 1.11.3 The Oral Glucose Tolerance Test (OGTT) ..................... 43 1.11.4 Glycated Haemoglobin (HbA1C) .................................... 43 1.11.5 Diagnosis of Gestational Diabetes ................................. 43 1.11.6 Prediabetes Tests ............................................................ 44 1.11.7 Continuous Glucose Monitoring (CGM) ....................... 44 1.11.8 Glucose Biosensors ........................................................ 46 1.11 9 Nanotechnology in Glucose Monitoring........................ 49
1.12 Diabetes Prevention and Management ......................................... 51 1.12.1 Diet control .................................................................... 53 1.12.2 Exercise/Physical Activity ............................................ 56 1.12.3 Diabetic Foot Care: Orthotics and Foot Wear .............. 57
1.13 Complications Associated With Diabetes .................................... 59 1.13.2 Macro and Microvascular Complications ...................... 61 1.13.3 Diabetic Peripheral Neuropathy .................................... 68
1.14 Therapeutic Strategies .................................................................. 70 1.14.1 Modern Medicine .......................................................... 71
1.14.2 Herbal Medicine ............................................................ 79 1.14.3 Alternative Treatment Strategies ................................... 86 1.14.4 Integrated and Holistic Approach in Diabetes
Management .................................................................. 89 1.15 Conclusion ................................................................................... 90 Keywords ................................................................................................ 91 References ............................................................................................... 91
ABSTRACT
The diabetes has emerged as a major health problem worldwide, with serious health-related and socioeconomic impacts on individuals and populations. Diabetes is a complex disease linked with multiple factors and is associated with significant mortality and morbidity, leads to loss of quality of life. Apart from glucose dysregulation, both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) are associated with damaging effects on tissues, with eventual progression to devastating complications. Diabetes increases the risk of macrovascular diseases (stroke and peripheral vascular disease), microvascular diseases (retinopathy and nephropathy), neuropathies, and the consequences that stem from these (congestive heart failure, diabetic foot). Individuals with the disease have to make major lifestyle changes and learn to live with timely monitoring of blood glucose, using multidrug treatment and insulin therapy, and proper dealing with complications of the disease. Several potentially modifiable risk factors are related to diabetes including obesity, physical inactivity, and dietary factors. Many of the factors associated with diabetes are modifiable, and research is currently focused on ways to prevent diabetes. Several efficacious and economically acceptable treatment strategies are currently available to reduce the burden of diabetes complications.
