History, Epidemiology of Diabetes Mellitus and Foot Care in Diabetes: An Overview

Article excerpt

The most important clinical classes of DM are: (a) Insulin dependent diabetes IDDM (type I) patients may be of any age, are usually thin, and usually have abrupt onset of signs and symptoms with insulinopsnia before age 30. They depend on insulin therapy to sustain life (b) Non-sulin dependent diabetes mellitus NIDDM (type II). These patients usually are older than 30 years at diagnosis, obese, and have relatively few classic symptoms. There are other types of diabetes mellitus like gestational diabetes (GDM) which has onset during pregnancy.

What is diabetes mellitus (DM)?

Diabetes mellitus is a chronic disorder characterised by the abnormal metabolism of fuels, particularly glucose and fat. By tradition, the diagnosis of diabetes rests on the demonstration of an abnormality in glocuse tolerance. The array of entities called diabetes mellitus is the abnormality of glucose intolerance and the potential for developing complications from altered glucose and lipid metabolism.

The most important clinical classes of DM are: (a) Insulin dependent diabetes IDDM (type 1) patients may be of any age, are usually thin, and usually have abrupt onset of signs and symptoms with insulinopsnia before age 30. They depend on insulin therapy to sustain life (b) Non-sulin dependent diabetes mellitus NIDDM (type II). These patients usually are older than 30 years at diagnosis, obese, and have relatively few classic symptoms. There are other types of diabetes mellitus like gestational diabetes (GDM) which has onset during pregnancy.

Epidemiology of Diabetes Mellitus *IDDM

For insulin dependent diabetes, the commulative risk for siblings of diabetic patient is 6-10 per cent versus 0.6 per cent for the general population. Regarding the effect of parental genes, the offsprings of women with type I diabetes have a lower risk of disease (21%) than the off-springs of men with type I diabetes (6.1%). The reason for this disparity is unknown. The incidence of IDDM peaks at about 11-13 years of age. There is a stricking seasonal variation in the incidence in older children and adolescents, with lowest rates in spring and summer.

*NIDDM: The familial clustering of non-insulin dependents suggest a strong genetic component of the disease. The commulative risk for type II diabetes in siblings of diabetes patient is 10-33 per cent versus 5 per cent for the general population. Offsprings of women with type II diabetes have a two to three-fold greater risk of developing diabetes than offspring of men with the disease. The exact mode of inheritance is not known. Investigations in a number of developing countries have shown urban-rural differences of varying degree with generally higher rates in urban area.

Foot Care in Diabetes Mellitus

Since diabetes mellitus is a chronic disorder and affects a large segment of the population, it is a major public health problem and foot constitutes the commonest single reason for admission to hospital. …