COMPLICATIONS OF DIABETES MELLITUS: AN INSIGHT IN TO BIOCHEMICAL BASIS

Bunza J. M.* and Alhassan A. J.

ABSTRACT

Diabetes mellitus (DM) is a metabolic disorder characterized with hyper/hypoglycaemia, hypo/hyperinsulinemia. DM is associated with two broad metabolic complications viz; Short term complications including; diabetic ketoacidosis (DKA), hyperosmolar non ketotic coma (hyperosmolar hyperglycaemia state (HHS)) and hypoglycaemia, and the Long term systemic complications which are of two types; micro vascular complications such as such as diabetic nephropathy, diabetic retinopathy, diabetic microangiopathy, and diabetic neuropathy and the macro vascular complications include cardiovascular disease, heart attacks and stroke. The hyperglycaemia activates different signaling mechanisms such as an increased polyol pathway, advanced-glycation end products (AGEs) formation, activation of Protein Kinase C (PKC) and hexosamine pathway leading to over expression of reactive oxygen species and subsequent development of diabetic complications. Hyperinsulinaemia may grossly affect nutrient homeostasis viz; cell uptake of amino acids (all cells) and fatty acids, stimulation of glycolysis, inhibition of gluconeogenesis (liver), synthesis of glycogen (liver and muscle), triglyceride (liver and adipose) and protein (all cells) DNA synthesis, gene expression and growth promotion (mitogenic effects) (all cells), Inhibition of apoptosis (all cells) Stimulation of the N+ / K+ ATPase ‘pump’ (adipose and muscle). In conclusion DM as progressive chronic disease is closely related with complications such as diabetic nephropathy, diabetic foot, and diabetic retinopathy, cardiovascular disease. All these conditions must not be unconnected with altered metabolic status due to persistent abnormal glucose and insulin levels.

Keywords: Diabetes Mellitus, Complications, Oxidative Stress, Polyol Pathway.