Diabetes mellitus is commonly identified as a disease of glucose metabolism: an imbalance between chemical hormones that control the level of glucose in the body results in high glucose content. Insulin is the chief hormone that regulates this: diabetes mellitus results when the level of the hormone is absent or low (insulin deficiency), or more often, if the hormone is unable to act as well as it should (insulin resistance)
Treatment consists in setting right the balance. Diet and exercise to bring the body weight to the desirable range, and to improve the action of available insulin.
If these are insufficient by themselves, medicines are available to help out: to increase the secretion of insulin by the pancreas, which produces it, improving the efficiency of insulin action, changing the secretion of other hormones to improve the action of insulin, or newly introduced agents that act by other means
It is important to know that diabetes mellitus, or hyperglycaemia does not exist alone. It is often accompanied by other conditions such as hypertension, abnormal levels of blood lipids and often obesity or overweight. All these together are responsible for the ill-effects of diabetes: viz diseases of nerves, kidney and eyes, together with a propensity to develop vascular disease of the heart, brain and limbs
The bottom line is, treatment of diabetes consists of monitoring and controlling blood glucose, along with blood pressure, lipids and body weight. All these together are responsible for the complications of diabetes.
Unlike the normal body, which ‘automatically’ adjusts the secretion of different chemical hormones to maintain the level of metabolites such as glucose in the normal range, drugs given to lower glucose are not so regulated; many run the risk of lowering glucose to abnormally low levels. Therefore one must monitor glucose levels (often) and lipids and other parameters (less often) to ensure that all values stay in the desirable range.
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