It is a medical condition where a person's body has a lack of insulin(or defective insulin) with the result the blood glucose rises out of control and overflows out of the blood into the urine.

Insulin is a hormone secreted by the endocrine glands called Islets of Langerhans in the pancreas. It's function is to regulate the level of glucose in the blood, maintaining the level between 70-140 mg/dl or a fasting state of 70-115 mg/dl.

• A common sign a patient notices is that ants are attracted to his pool of urine.
• There is a sudden loss of weight 5-10 kg in the last 3 months.
• The patient complaints of thirst (polydipsia) and frequency of micturition (polyuria).
• He feels tired and complaints of fatique.
• His wound and sores take a long time to heal. Many people feel fine when their diabetic condition is discovered through a routine medical examination.

1. Juvenile diabetes occur in children and is more severe because these children require insulin injections to control their medical condition.
2. Adults onset diabetes occur in adults usually past their middle age can be classified into 3 types:
   • Mild diabetes : can be controlled by diet and exercise
   • Moderate diabetes : can be controlled by drugs
   • Severe diabetes : can be controlled by insulin injection

1. Diabetes is usually diagnosed by testing positive for glucose in the urine.
2. Another method is to use the fasting blood glucose which should be between 70-115 mg/dl. Any value above 115 mg/dl is suspicious of having diabetes
3. The Glucose Tolerance Test or GTT is the best test to confirm the diagnosis of diabetes. It can also classify the disease into mild, moderate and severe. The subject comes to the lab having fasted 10-12 hours previously. He is given a drink of glucose 75g and the time clock is put at 0 hours. A sample of venous blood (2ml) is taken from him and he is also asked to provide a sample urine. This is repeated first and second hour later. The graph is plotted: Blood glucose level against time. The normal curve is shown on the graph.

1. When there is too much glucose in the blood, it becomes like a poison to the cells. It destroys the fine capillary system within the kidneys (the glomeruli) causing kidney disease, kidney failure and hypertension.
2. When the retinal blood vessels are destroyed, it leads to blindness.
3. If the coronary blood vessels are affected, it leads to heart disease, heart attack and death.
4. When blood vessels to the extremeties (toes) are affected, it leads to gangrene of the toes.
5. The brain cells are particular sensitive to the blood glucose level. Very high or very low blood glucose levels can cause the diabetic person to go into coma.
   e.g. Hyperglycaemic coma above 500 mg/dl blood glucose
   Hypoglycaemic coma below 40 gm/dl blood glucose

The diabetic person must consult his/her family doctor who will help the diabetes under control. Health education particularly on diabetes is important. Check your blood sugar regularly. There are special tests HbAI(Glycoslated Haemoglobin) and Fructosamine which can tell you how well you are controlling your diabetic condition for the past 2 months and 2 weeks respectively. The result comes back as good/fair/poor control.

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Further reading :

• Diabetes - Doctor's Guide to the Internet
• International Diabetes Web Site
• Diabetes link by Ikhram Shah Ismail
• Diabetes Risk Test Assessing your risk of developing diabetes
• Healthfinder guided tour - Diabetes

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