Abstract
Diabetes today is a major issue to healthcare professionals because the number of patients is rising daily. Currently, it is referred to as a lifestyle disorder and manufacturing is responsible for its development.While Modern medicine treats the disease on its basis of symptoms, and mostly palliates the cities, whereas Homoeopathic approach doesn’t treat the disease, but patients as an individual.
Introduction
Diabetes mellitus is a metabolic disorder of several etiologies. It is characterized by chronic hyperglycemia together with disturbances in and metabolism of protein, fats and carbohydrate due to defects in either the secretion or action of insulin, or both. These are linked to specific microvascular complications of retinopathy that can result in blindness, nephropathy with potential renal failure, and neuropathy and it is also associated with an increased risk of macrovascular disease.
Keywords: Type 2 Diabetes Mellitus, Etiology, Insulin Resistance, Genetic Predisposition, C- Peptide, Constitutional Medicine.
Insulin
T2DM accounts for the majority of diabetes cases globally. It is characterized by insulin resistance and with the relative insulin deficiency (i.e., patients secrete insulin but not in sufficient amounts to overcome the insulin resistance).
- Insulin is a polypeptide hormone generated by the beta cells of the islets of Langerhans of pancreas.
- Insulin is a protein made of two chains alpha and beta.
- It consists of 2 amino acid chains that are joined together by disulphide bonds and there is one intra chain disulphide bond.
- The sensitivity of receptors to insulin has a major role to play in the causation of diabetes mellitus.
Etiopathogenesis
- Genetic Predisposition
- Environmental changes
- Lifestyle choices
Genetic Predisposition:
- There are 70 variants of gene responsible for development of the disease but,TCF7L2 variant gene is most commonly found at risk of developing type 2 diabetes, other variants result in much lower risk than this.
- Such genes may affect β – cell apoptosis, regeneration, glucose sensing, glucose metabolism.
- In type 2 DM, no HLA relationship has been identified and autoimmune mechanisms are not operative.
Obesity:
- As obesity is the major cause of insulin resistance, intra-abdominal fat, ‘Central’ adipose tissue may amplify insulin resistance by releasing FFAs and hormones (adipokines). Modern Sedentary life is a major factor that predisposes to type 2 diabetes.
- Obese subjects show a relative resistance to the action of insulin due to a reduction in the number of insulin receptors on the target cells.
- Obese individuals have greater plasma FFA levels primarily because of their greater fat mass, adipocytes may directly influence systemic insulin sensitivity.
- Increased hepatic glucose output accounts for increased FPG level
- whereas decreased peripheral glucose utilization results in postprandial hyperglycemia.
Symptoms of Diabetes
- Osmotic symptoms-
- Polyuria
- polydipsia
- Weight loss in spite of polyphagia
- Tiredness
- weakness
- Generalised pruritus
- Recurrent urogenital infections
- Delayed healing of wounds
Diabetes lifestyle objective
- To enhance health through optimum nutrition
- To supply energy for reasonable body weight , normal growth and development
- In order to maintain glycemic control
- In order to attain blood lipid levels
- To individualise the diet based to complications and co-morbidities
- Achieve ideal level physical activity
- suggest other behavioural modification for: smoking, other tobacco products and alcohol Advocate stress management
Investigations
- Fasting blood sugar
- Postprandial blood glucose
- Oral glucose tolerance test
- Glycosylated haemoglobin (HbA1c)
- C Peptide
It measures the amount of C peptide in the blood or urine, it determines how much insulin the body is producing, also this test can show the difference between insulin made by the body (endogenous) and insulin from medication (exogenous).
Homoeopathic Therapeutics
Acetic Acid: Abundant sugar in the urine increased and light coloured. Great thirst with drops, disagree cold drinks, vomiting after every kind of food, oedema, gangrenous ulcer, pale waxen skin, diminished sensibility of the surface of the body, extreme prostration.
Argentum Metallicum: Profuse, turbid sweetish urine, < at night, sometimes like whey, which disturbs him at night and wake up often, he also experiences extreme weakness and emaciation, face pale and sallow, scrotum and feet oedematous and itching, pruritus scrotum, foetid taste in mouth, disposition to gangrene.
Uranium Nitrate: Defects of digestion and assimilation, hepatogenic diabetes. Lead to the accumulation of sugar in the urine. General languor, vertigo, cold feeling, debility, purulent discharges from eyelids and nostrils with ulceration of cheeks from acrid discharge, copious salivation, vomiting with great thirst, putrid eructation, urgent desire to evacuate bladder and rectum, frequent micturition, cough with purulent discharge from nostril, lung infiltrated with grey tubercles, stiffness in the loins, languor upon rising from bed, fishy-smelling of urine, prostration, and restlessness at night.
Bryonia Alba: Exceedingly irritable, everything puts him out of humor. Delirium; wants to go home, talks of business affairs, Abnormal hunger, loss of taste. Thirst for large quantity of water with dryness of mouth.
Lycopodium: For persons intellectually keen, but physically weak; upper part of body emaciated, lower part semi-dropsical. Desire for sweet things, Excessive hunger, eating ever so little creates fullness. Pain in back before urinating; ceases after flow; slow in coming, must strain. Retention, Polyuria during the night.
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- Holt RIG, Cockram CS, Flyvbjerg A, Goldstein BJ. Textbook of diabetes. 5th ed. Chichester, West Sussex, Uk ; Hoboken, Nj, Usa: Wiley Blackwell; 2017.
Dr Chaitra H Pawar
PG Scholar,Department of Practice of Medicine
Father Muller Homoeopathic Medical College, Deralakatte, Mangalore, Karnataka
Under the guidance of Dr G RAJACHANDRA
