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Abstract
Abstract Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion and / or insulin action or both. The chronic hyperglycemia of diabetes is associated with long term damage, dysfunction, and failure of various organs especially the eyes, kidneys, nerves, heart, and blood vessels.The microvascular complications of both type 1 and type 2 DM result from chronic hyperglycemia. Large, randomized clinical trials of individuals with type 1 or type 2 DM have conclusively demonstrated that a reduction in chronic hyperglycemia prevents or delays retinopathy, neuropathy, and nephropathy. Other incompletely defined factors may modulate the development of complications. For example, despite long-standing DM, some individuals never develop nephropathy or retinopathy. Many of these patients have glycemic control that is indistinguishable from those who develop microvascular complications, suggesting that there is a genetic susceptibility for developing particular complications.Evidence implicating a causative role for chronic hyperglycemia in the development of macrovascular complications is less conclusive. However, coronary heart disease events and mortality are two to four times greater in patients with type 2 DM. These events correlate with fasting and postprandial plasma glucose levels as well as with the A1C. Other factors (dyslipidemia and hypertension) also play important roles in macrovascular complications.