Biochemistry Lectures/ Asst. Prof. Dr. Amal S.

Majeed
Faculty of Nursing/University of Kufa
1st Stage /1st Semester

Metabolic disorder of carbohydrate metabolism

Diabetes Mellitus
Diabetes mellitus is an important disorder of carbohydrate
metabolism. However, fat and protein metabolism are also affected in diabetic
condition. Diabetes means excretion of excessive volume of urine and mellitus
means sweet. So the word diabetes milletus refers to chronic excretion of large
volume of urine containing glucose.
Diabetes mellitus, caused by a deficiency in the secretion or action of
insulin, is a relatively common disease. Insulin is an endocrine hormone which
is secreted by β-cells of islets of Langerhans of pancreas. The abnormality in
glucose metabolism is indicative of diabetes or a tendency towards the
condition. Diabetes mellitus is really a group of diseases in which the regulatory
activity of insulin is defective.
Types of diabetes mellitus disease
There are two major clinical classes of the disease:
Type-I or insulin dependent diabetes mellitus (IDDM)
The disease begins early in the life and quickly becomes severe.
Type - II or non-insulin dependent diabetes mellitus (NIDDM)
The disease is slow to develop, milder and often goes unrecognized.
Signs and symptoms of diabetes
Some of the signs commonly experienced include:

 Frequent urination
 Excessive thirst
 Increased hunger
 Weight loss

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 Biochemistry Lectures/ Asst. Prof. Dr. Amal S. Majeed
Faculty of Nursing/University of Kufa
1st Stage /1st Semester

 Tiredness
 Lack of interest and concentration
 A tingling sensation or numbness in the hands or feet
 Blurred vision
 Frequent infections
 Slow-healing wounds
 Vomiting and stomach pain (often mistaken as the flu)

The development of type 1 diabetes is usually sudden and dramatic

while the symptoms can often be mild or absent in people with type 2 diabetes.

Risk Factors

The risk factors for type 1 diabetes are still being researched.
However, having a family member with type 1 diabetes slightly increases the
risk of developing the disease. Environmental factors and exposure to some viral
infections have also been linked to the risk of developing type 1 diabetes.

Several risk factors have been associated with type 2 diabetes and include:

 Family history of diabetes

 Overweight
 Unhealthy diet
 Physical inactivity
 Increasing age
 High blood pressure
 Ethnicity
 Impaired glucose tolerance (IGT)*

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 Biochemistry Lectures/ Asst. Prof. Dr. Amal S. Majeed
Faculty of Nursing/University of Kufa
1st Stage /1st Semester

 History of gestational diabetes

 Poor nutrition during pregnancy

Impaired glucose tolerance (IGT) is a category of higher than normal

blood glucose, but below the threshold for diagnosing diabetes.

Changes in diet and physical activity related to rapid development and

urbanisation have led to sharp increases in the numbers of people developing
diabetes.

Pregnant women who are overweight, have been diagnosed with IGT,
or have a family history of diabetes are all at increased risk of developing
gestational diabetes mellitus (GDM). In addition, having been previously
diagnosed with gestational diabetes or being of certain ethnic groups puts
women at increased risk of developing GDM.

Complications of Diabetes Mellitus

People with diabetes have an increased risk of developing a number of

serious health problems. Consistently high blood glucose levels can lead to
serious diseases affecting the heart and blood vessels, eyes, kidneys, nerves and
teeth. In addition, people with diabetes also have a higher risk of developing
infections. In almost all high-income countries, diabetes is a leading cause of
cardiovascular disease, blindness, kidney failure, and lower limb
amputation.

Maintaining blood glucose levels, blood pressure, and cholesterol at or

close to normal can help delay or prevent diabetes complications. Therefore
people with diabetes need regular monitoring.

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 Biochemistry Lectures/ Asst. Prof. Dr. Amal S. Majeed
Faculty of Nursing/University of Kufa
1st Stage /1st Semester

Interpretation of Side Effects & Complications of Excess Sugar

Some of Side Effects

 Loss of vision due to cataracts: Excessive blood sugar chemically

attaches to lens proteins, causing cloudiness.

 Skin infections sometimes occur because excess sugar in the blood

suppresses the natural defense mechanism like the action of white blood
cells. And sugar is an excellent food for bacteria for food to grow in.

 High blood glucose also helps bacteria in the mouth to grow, making
tooth and gum problems worse.

Some of Complications

 A reduction in blood flow to the feet can lead to tissue death, ulceration,
infection, and loss of toes or a major portion of one or both feet.
 Damage to renal blood vessels can cause severe kidney problems.
(Nephropathy)
 Damage to blood vessels of the retina can also cause blindness.
(Retinopathy)

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