Diabetes Drugs

Diabetes mellitus is a multisystem disease associated with the loss of control of physiological glucose concentrations in the blood. The disease is broadly broken down into two types based on factors that include age, acuteness of onset, underlying glucose-handling deficit, and therapy. Type 1 diabetes usually manifests acutely in the young, secondary to some underlying insult (possibly infectious) to the islet cells of the pancreas, resulting in an absolute lack of insulin. Type 2 diabetes is more frequently associated with maturity, obesity, and gradually increasing blood glucose concentrations; it may be asymptomatic for some time and discovered on routine glucose screening. In fact, as weight increases among the general population of the developed world, type 2 diabetes is becoming an epidemic. Type 1 diabetes always requires insulin replacement therapy, whereas type 2 can frequently be controlled with diet, weight loss, and oral medications that enhance residual pancreatic function. Diabetes has been known since antiquity. In fact, the term diabetes mellitus comes from the Greek meaning “siphon and honey” due to the excess excretion (siphon or faucet) of hyperglycemic (sweetened, or honeyed) urine. In ancient times, most cases of diabetes were of type 1, with acute onset in the young, which was often fatal. Type 2 diabetes was extremely rare when sources of nutrition were scarce and obesity was not prevalent. Diabetes was also known as “wasting” because diabetics were not able to metabolize the sugar content of food and eventually died from wasting away. Because of the effect of excess blood glucose, the blood of the diabetic is hyperosmolar (concentrated), and this triggers compensatory thirst (in an attempt to dilute the hyperglycemia and return the blood to a normal concentration). This excess thirst results in the common diabetic symptom of polydipsia (excessive drinking secondary to thirst, resulting in the urge to drink frequently) and polyuria (excess urination). Even before many modern diagnosis tools became available, savvy doctors could diagnose diabetic men just by looking at their shoes for the telltale white spots from urine with high sugar content. In fact, tasting urine samples of diabetics was a routine diagnostic tool for diabetes. Even the breath of a severe diabetic was sweet—a sickly smell as a result of acidosis. In addition, it has been mentioned that ants would track to the urine of diabetics.