Abstract:Introduction:Metabolic syndromes:Diabetes and oxidative stress:Abstract: Diabetes mellitus can harm the eyes, kidneys, nerves and heart. Micro vascular and macro vascular disorders are the leading cause of morbidity and death in diabetic patients. Hyperglycemia are able to increase the indicators of lipid per oxidation and oxidative stress in which free radicals have the most important role in the pathogenesis of these complication.
Therefore, antioxidants which combat oxidative stress must be able to prevent and repair free radicals induced damages. Although free radical contribute to kidney damage, atherosclerosis, diabetes, heart disease, nephrotoxicity and hepatotoxicity; however, clinical trials do not individually confirm a large impact on diabetic damage. It seems that antioxidants in vegetables, fruits and grains aid preventing diabetes complications; however, there is little verification that taking single antioxidants such as vitamin E or vitamin C defend these complications. The findings about combination antioxidants are also complicated and not totally clear. In this analysis paper we tried to present the function of oxidative stress on micro-vascular complications of type 2 diabetes mellitus. Other objective of this paper is to analysis the new findings about the role of various antioxidants on prevention and cure of diabetes mellitus as well as its complications including retinopathy, nephropathy and neuropathy.(2)Introduction: The occurrence of diabetes among adults has been increased a lot worldwide. It has been predicted that the number of adults with diabetes will increase from 135 million in 1995 to 30 million in 2025.
The age series of diabetic patients in developing and developed countries is among 45–64 and 63–65 years, correspondingly. Diabetes is the fourth most important cause of death globally and every 1 min 6 persons die from the complications of diabetes. (2) Diabetic causes arterial diseases in combination with neuropathy which accounts for more than 60% of all non-traumatic amputations in the United state (Us). Diabetes mellitus and impair glucose tolerance increase cardiovascular disease risk up to 8- fold. In addition, new blood vessel growth is impaired in reply to ischemia in diabetic patients, resulting in decreased security vessel formation in ischemic hearts and in non-healing foot ulcers .
(2)Discussion on Diabetes mellitus: Similarly Osteoporosis, Cushing’s syndrome and Scleroderma, Diabetes mellitus is a collection of metabolic disorders that is characterized by high levels of glucose in blood (hyperglycemia) and deficiency in production or action of insulin produced by the pancreas inside the body. Insulin is a protein (hormone) synthesized in beta cells of pancreas in reply to various stimuli such as glucose, sulphonylureas, and arginine on the other hand glucose is the major determinant . Long term rise in blood glucose levels is linked with macro- and micro-vascular complications leading to heart diseases, stroke, blindness and kidney diseases. Sidewise to hyperglycemia, there are several other factors that play vast role in pathogenesis of diabetes such as hyperlipidemia and oxidative stress leading to elevated risk of complications.(1)Types of Diabetes mellitus:Diabetes mellitus can be classified in two different ways, which are given below:Type I diabetes: Type 1 diabetes is suitable to immune mediate beta-cells damage, leading to insulin deficiency.
Idiopathic diabetes is the kind 1 diabetes with no recognized etiologies and is effectively inherited. Type II diabetes : Type II diabetes is appropriate to insulin secretary fault and insulin resistance. Gestational diabetes mellitus is any form of intolerance to glucose with start or first detection of pregnancy. However diabetes is mostly classified essentially into two main types: Type I Diabetes (IDDM) and Type II Diabetes (NIDDM). (1)Pathophysiology of diabetes: Whenever a person takes the meal, there is increase in blood glucose levels that stimulate insulin discharge resulting in an increase in transportation, biotransformation and storage space in muscles and fat tissues. In fasting situation, the glucose in blood is provided by liver that is used by the brain, with no any dependence on insulin. Besides the storage of glucose, insulin also inhibits the discharge of glucagon and lower the absorption of serum fatty acids leading to a reject in liver glucose production . Deficient insulin or resistance to insulin in the body results in decrease tissue uptake of glucose that results in intracellular hypoglycemia and extracellular hyperglycemia.
The intracellular hypoglycemia cause glucogenesis and gluconeogenesis that leads to fats breakdown and decreases protein production and gamma globulins , even as the extracellular hyperglycemia leads to hyperglycemic coma and osmotic dieresis . (1)Pathogenesis of type 1 Diabetes mellitus: In Insulin dependent diabetes mellitus (IDDM) there is a deficiency of insulin secretion due to the autoimmune destruction of beta pancreatic cells that leads to metabolic disturbances associated with IDDM . The end stage of b-cell destruction represents the onset of clinical disease leading to type 1 diabetes mellitus in which there are infiltrating monocytes, lymphocytes and a mixture of pseudoatrophic islets with some cells secreting somatostatin, glycogen and pancreatic polypeptide which then, consequently through immunogenic process, induces the disease . Autoimmunity, genetic makeup and environmental factors are responsible for islets cell destruction. (1)Pathogenesis of type II Diabetes mellitus: In Non-Insulin dependent diabetes mellitus (NIDDM) there are definite mechanisms broken down that keep regulation between tissue sensitivity to insulin which consequently leads to impair insulin secretion by the pancreatic beta cells and impaired insulin act through insulin resistance . In this type of diabetes, multiple genetic defects, and certain environmental factors particularly obesity are responsible for beta cell defects and peripheral tissue insulin resistant correspondingly.
(1)Complications of Diabetes: Diabetes is such a kind of disorder in which the patients are danger of complications all the time . It may be macrovascular (coronary heart disease, peripheral vascular disease and stroke), microvascular (neuropathy, retinopathy and nephropathy) and together micro- and macrovascular (diabetic foot). The death and morbidity of diabetes are connected more with macrovascular deterioration as compared to the risks of microvascular complications in elder people.
In general, complications of diabetes mellitus can be categorize into two groups . Metabolic acute complications: It is a complication that occur only for short period of time which include hypoglycemia, ketoacidosis and hyperosmolar non-ketonic coma.(1) Systemic late complications: It is a complication that occur for long period of time which include diabetic nephropathy, microangiopathy, diabetic neuro- and retinopathy, atherosclerosis and infections.
(1)Conclusion: Diabetes mellitus is one of the major metabolic disorder due to increase in blood glucose level. If the levels of blood glucose occur over a long period of time it may cause macro or microvascular diseases. Basically, in this disease beta cells of pancreas stops producing insulin or produce small amount of insulin that is not enough to maintain the blood glucose level. Diabetes is classified into two main types: type -1 that is called insulin dependent and type II is known as non-insulin dependent. However, diabetes may also cause a lot of complications in body such as heart disease, strokes etc Hypertension or High blood pressure:Abstract: