title: General aspects of diabetes mellitus.
abstract: Diabetes mellitus is a heterogeneous group of disorders characterized by hyperglycemia due to an absolute or relative deficit in insulin production or action. The chronic hyperglycemia of diabetes mellitus is associated with end organ damage, dysfunction, and failure, including the retina, kidney, nervous system, heart, and blood vessels. The International Diabetes Federation (IDF) estimated an overall prevalence of diabetes mellitus to be 366 million in 2011, and predicted a rise to 552 million by 2030. The treatment of diabetes mellitus is determined by the etiopathology and is most commonly subdivided in type 1 and type 2 diabetes mellitus. There is a greater propensity towards hyperglycemia in individuals with coexisting genetic predisposition or concomitant drug therapy such as corticosteroids. The screening for diabetes mellitus may either be in the form of a 2hour oral glucose tolerance test, or via HbA1c testing, as recently recommended by the American Diabetes Association (ADA). Strong associations have been shown in observational studies suggesting poor clinical outcomes both with chronic hyperglycemia and acutely in intensive care settings. However, tight glycemic control in this setting is a contentious issue with an increased incidence of hypoglycemia and possible increase in morbidity and mortality. In a critically ill patient a glucose range of 140-180mg/dL (7.8-10.0mmol/L) should be maintained via continuous intravenous insulin infusion.
authors.affiliation: Centre for Endocrinology and Diabetes, Institute of Human Development, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK. Electronic address: uazman.alam@googlemail.com.
authors.forename: Uazman
authors.initials: U
authors.lastname: Alam
authors.affiliation: Centre for Endocrinology and Diabetes, Institute of Human Development, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
authors.forename: Omar
authors.initials: O
authors.lastname: Asghar
authors.affiliation: Centre for Endocrinology and Diabetes, Institute of Human Development, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
authors.forename: Shazli
authors.initials: S
authors.lastname: Azmi
authors.affiliation: Centre for Endocrinology and Diabetes, Institute of Human Development, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK; Weill Cornell Medical College in Qatar, Doha, Qatar.
authors.forename: Rayaz A
authors.initials: RA
authors.lastname: Malik
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents
keywords: Diabetes mellitus; MODY; inpatient glycemic control; type 1 diabetes mellitus; type 2 diabetes mellitus; variable rate insulin infusion