Diabetes Mellitus Diagnosis

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diabetes mellitus diagnosis


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Treatment for Diabetes Mellitus

Healthy eating; Regular exercise; Weight loss; Possibly, diabetes medication or insulin therapy; Blood sugar monitoring. These steps will help …Diet and exercise can help some people manage type 2 diabetes. If lifestyle changes aren’t enough to lower your blood sugar, you’ll need to take …At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus (T2DM). These agents are used as monotherapy or in combination with sulfonylurea, metformin, meglitinide, DPP-4 inhibitors, GLP-1 receptor agonists, or …Type 2 diabetes: If you have this type, your treatments can include medications (both for diabetes and for conditions that are risk factors for …Insulin remains the mainstay of treatment for patients with type 1 diabetes. Insulin is also an important therapy for type 2 diabetes when blood glucose levels …People with type I diabetes and some people with type 2 diabetes may need to inject or inhale insulin to keep their blood sugar levels from becoming too high. People with type 1 diabetes almost always require insulin therapy and will become very sick without it. Many people with type 2 diabetes require insulin as … Both nonpharmacologic and pharmacologic therapies are used to reduce insulin resistance. Nonpharmacologic approaches include a low-calorie diet, …Type 2 diabetes is a long-term medical condition in which your body doesn’t use insulin properly, resulting in unusual blood sugar levels.In most cases, type 2 diabetes treatment begins with weight reduction through diet and exercise. A healthy diet for a person with diabetes is …Diabetes mellitus (DM) is a hereditary disease caused by the accumulation of glucose in the blood [1]. Studies showed that the number of diabetic patients …

treatment for diabetes mellitus


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Complications With Diabetes Mellitus

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Complications With Diabetes Mellitus

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Diabetes Mellitus ICD 10

Code I10 is the diagnosis code used for Type 2 Diabetes Mellitus. · ICD (International Statistical Classification of Diseases and Related …ICD-10-CM Code E11 Type 2 diabetes mellitus · The ICD code E11 is used to code Hyperosmolar hyperglycemic state · Coding Notes for E11 Info for medical coders on …Drug or chemical induced diabetes mellitus. · E09.43: Drug or chemical induced diabetes mellitus due to underlying condition with diabetic …Note: The ICD-10 code for long term, current insulin use (Z79.4) would not be added in this case. The patient is a Type 1 (insulin-dependent) diabetic and …Type 2 diabetes mellitus (E11.-). There is a combination code for type 2 diabetes with chronic kidney disease, and the tabular instructs the coder to use an … ICD code browser for Advanced orthopedic center educational site for postgraduate learners. … Non-insulin-dependent diabetes mellitus …In this situation, it might be more accurate to code Type 2 diabetes mellitus with hyperglycemia. (E11.65). ICD-10 does not currently define hyperglycemia, but …ICD-10-CM Code for Type 2 diabetes mellitus without complications E11.9. ICD-10 code E11.9 for Type 2 diabetes mellitus without complications is a medical …ICD-10 Codes for Other Types of Diabetes · Other specified diabetes mellitus with diabetic arthropathy: E13.61 · Other specified diabetes mellitus … Kode ICD 10 Untuk Diabetes Karena Kondisi yang Mendasari ·

Diabetes Mellitus ICD 10

Diabetes mellitus Karena kondisi yang mendasarinya Dengan arthropathy diabetes: E08.61 …If the type of diabetes that the patient has is not documented in the medical record, E11 codes for type 2 diabetes should be used as a default. ICD-10-CM Coding Tip. Secondary Diabetes Mellitus. In an effort to aid Health Information Management Coding and Medical Billing Professionals with. This is due to the creation of combination codes that are greatly used in coding for diabetic conditions. In ICD-10-CM, the combination code includes the type …Common Diabetes ICD-10 Diagnosis Codes. E10.22/E11.22 Diabetes, Renal Complication … E10.35XX Type 1 Diabetes Mellitus with Proliferative Retinopathy. Question: What would be the appropriate ICD-10 code for 250.03 Type 1 Diabetes mellitus, juvenile, uncontrolled? A note under the code for type 2 diabetes mellitus with diabetic chronic kidney disease instructs coders to use an additional code to identify …

Diabetes Mellitus

Diabetes mellitus is a collective term for chronic metabolic diseases which, if left untreated, lead to permanently high blood sugar levels. Depending on the etiology, they are divided into diabetes mellitus type 1, diabetes mellitus type 2, specific special forms of diabetes, and gestational or gestational diabetes.

Type 1 Diabetes Mellitus

Type 1 diabetes mellitus often occurs in children and adolescents. Immune-mediated destruction of the insulin-producing beta cells in the islets of Langerhans in the pancreas leads to an absolute insulin deficiency. Insulin autoantibodies (IAA), cytoplasmic islet cell antibodies (ICA), antibodies against the enzyme glutamate decarboxylase (GADA), and antibodies against tyrosine kinase IA-2 (IA-2A) play a decisive role. More information about type 1 diabetes mellitus.

Type 2 Diabetes Mellitus

Type 2 diabetes mellitus is the most common form of diabetes at over 90 percent. In the process, an initially impaired insulin effect on the body cells (insulin resistance) turns into reduced insulin secretion in the islets of Langerhans without therapy. In addition to a pronounced genetic disposition, the disease is closely linked to metabolic syndrome. More information about type 2 diabetes mellitus.

Diabetes Mellitus

Specific Forms Of Diabetes (Formerly Type 3 Diabetes)

“Specific forms of diabetes” represent a very heterogeneous group of diabetes diseases pathophysiologically and therapeutically. The following causes are differentiated:

Diseases of the exocrine pancreas or destruction of pancreatic tissue, for example

    • Pancreatitis
    • cystic fibrosis
    • Hemochromatosis
    • Pancreatic cancer
    • Pancreatic surgery
    • Endocrinopathies such as Cushing’s syndrome, acromegaly, hyperthyroidism, pheochromocytoma, primary hyperaldosteronism, glucagonoma, somatostatinoma

Drug-chemically-induced; Medicines that affect glucose metabolism include

    • Anti-infectives such as pentamidine or moxifloxacin
    • Neuroleptics such as chlorpromazine, perphenazine, risperidone, and olanzapine
    • Antihypertensive drugs such as atenolol and metoprolol
    • Hormones such as glucocorticoids, thyroxine, and oral contraceptives
    • Lipid-lowering drugs such as nicotinic acid derivatives and statins
    • Immunosuppressants such as tacrolimus and cyclosporine A.
    • Antibodies such as pembrolizumab and nivolumab

Genetic defects in beta cell function, especially

    • MODY diabetes
    • mitochondrial forms of diabetes
    • transient or permanent neonatal diabetes
    • Genetic defects in the action of insulin, for example, type A insulin resistance, lipoatrophic diabetes, leprechaunism, Rabson-Mendenhall syndrome
    • Other genetic syndromes and diseases associated with diabetes such as trisomy 21, Klinefelter syndrome, Turner syndrome, Huntington’s disease, porphyrias, Friedreich’s ataxia (FRDA), Biedl-Bardet syndrome, Prader-Willi syndrome (PWS), Rare autoimmune-mediated forms of diabetes, for example in “stiff person” syndrome (SMS), presence of anti-insulin receptor antibodies

More information about “Specific Forms of Diabetes”.

Gestational Diabetes (Formerly Type 4 Diabetes)

Gestational diabetes (GDM) is a glucose tolerance disorder diagnosed for the first time during pregnancy. Pregnancy hormones such as cortisol, estrogen, progesterone, and prolactin act as insulin counterparts and mediate an increasingly increased insulin resistance, which is accompanied by a falling beta-cell compensation. More information about gestational diabetes.

Acute Inflammation Of The Pancreas

Acute inflammation of the pancreas (pancreatitis) is a serious illness that can be life-threatening and requires urgent treatment. In most cases, the extremely severe abdominal pain causes those affected to seek help quickly. More about symptoms, causes, diagnosis, treatment, and prevention of acute pancreatitis.  Acute pancreatitis is an acute inflammation of the pancreas. The pancreas is the Latin name for pancreas, hence the disease name pancreatitis. Chronic pancreatitis is distinguished from acute pancreatitis.

The most common cause of acute inflammation of the pancreas is biliary tract diseases such as gallstones. For example, if a stone clogs the end of the bile duct, it creates a blockage of bile in the direction of the liver and, at the same time, a blockage of digestive secretion in the pancreas. The digestive secretion cannot drain away, it accumulates there, irritates, and damages the tissue. Inflammation is the result. This is when the pancreas begins to digest itself.

Acute pancreatitis can be life-threatening. The earlier the – often intensive medical – treatment begins in a hospital, the better the chances of recovery.

Structure And Function Of The Pancreas

The pancreas is located across the upper abdomen on the posterior abdominal wall. It is around 15 centimeters long and weighs around 100 grams. Medical professionals divide the pancreas into the head, body, and tail. The head of the pancreas is adjacent to the duodenum, and the tail of the pancreas is adjacent to the spleen. Very close to the pancreas are the colon, liver, gallbladder, stomach, and kidneys.

The pancreas produces up to 2 liters of digestive secretion every day, which it releases into the small intestine. The digestive secretion consists of enzymes such as protein-splitting proteases (for example trypsin and chymotrypsin), starch-splitting amylases, and fat-splitting lipases. These enzymes are needed to absorb food components from the small intestine into the blood. The secretion also contains alkaline bicarbonate, which neutralizes the acidic gastric juice as soon as it enters the intestine.

In addition to the enzymes, the pancreas produces important hormones, for example, insulin, which lowers blood sugar, and its counterpart, glucagon, which increases blood sugar levels. Both hormones are produced in the so-called islets of Langerhans.


The incidence of acute pancreatitis is around 5 to 10 cases per 100,000 population. Inflammation of the pancreas is most common between the ages of 40 and 60. Women are more often affected because they more often suffer from biliary tract diseases.


The main symptom of acute pancreatitis is a sudden, belt-shaped, severe pain in the upper abdomen. Often this pain radiates to the back, sometimes to the chest. The pain can last for minutes. Many of those affected describe it as the pain of annihilation. Relief is often only brought about by a gentle posture with knees drawn up while sitting or lying down.

Another symptom of acute inflammation of the pancreas is what doctors refer to as the “elastic, elastic belly”. The stomach feels similar to an inflated air mattress. The abdominal wall is tense, but not very hard.

If the bile ducts are also affected, which often happens due to the proximity of both organs, the skin and mucous membranes (especially the conjunctiva) turn yellow. Doctors call this jaundice. In addition, the urine turns dark and the stool light.

Other typical symptoms of acute pancreatitis are:

    • fever
    • Nausea and vomiting
    • Low blood pressure (hypotension) up to circulatory shock
    • Fear of death or fear of not being able to survive the pain.


If pancreatic tissue dies due to inflammation and the dead tissue is then colonized by bacteria, accumulations of pus in the abdomen or even blood poisoning (sepsis) are the result. In severe cases, the heart, lungs, and kidneys can fail completely.

Acute Inflammation Of The Pancreas


Gallstones are the leading cause of pancreatitis.

Alcohol consumption is the cause of acute pancreatitis in a good 30 percent. It does not have to be alcoholism or alcohol abuse. Not all heavy drinkers develop pancreatitis. But the other way round also applies: In correspondingly sensitive people, even small amounts of alcohol can trigger acute pancreatitis.

Rare causes of pancreatitis

    • certain medications (such as pain relievers, diuretics, beta-blockers, ACE inhibitors, lipid-lowering drugs, antibiotics, and cytostatics)
    • Smoking and other drugs
    • Viral infections (e.g. mumps), bacteria (e.g. salmonella), and worm diseases (e.g. ascariasis and clonorchiasis)
    • Lipid metabolism disorders (especially increased triglyceride levels)
    • Overactive parathyroid glands.

A certain genetic component is also discussed. In some people, however, no cause of acute pancreatitis can be determined.


Rapid diagnosis of acute pancreatitis is particularly important because the inflammation is severe and can be fatal. The typical severe pain usually quickly steers the suspicion in the right direction. The suspected diagnosis after the first physical examination and the taking of the medical history is followed by further diagnostic procedures.

For example, blood tests are used to check whether certain enzyme levels and/or the number of white blood cells is increased. If a gallstone triggers the inflammation, increased bilirubin, ASAT, gamma-GT, and alkaline phosphatase values ​​can be detected. In severe cases, an increased blood sugar concentration is noticeable.

Urine and stool examinations can further substantiate the diagnosis of acute pancreatitis. As a rule, increased enzyme concentrations can be detected in the urine. The amount of the enzyme elastase is usually measured in the stool. A noticeably decreased amount of enzyme suggests that the pancreas is no longer producing enough digestive enzymes.

Cholangiography And Other Imaging Tests

The suspected diagnosis of acute pancreatitis is confirmed almost exclusively with imaging diagnostics. These primarily include ultrasound and X-ray examinations of the chest and abdomen. Computed tomography can determine the severity of the inflammation.

If gallstones cause pancreatitis, endoscopic retrograde cholangiography (ERC) can provide more precise information. An endoscope is pushed through the esophagus to the small intestine. Contrast media in the bile ducts make constrictions or blockages, for example, due to stones, visible. The bile and pancreatic ducts can also be assessed with magnetic resonance cholangiopancreatography (MRCP).


Acute pancreatitis can be difficult, and sometimes life-threatening. That is why the therapy will be carried out in an inpatient setting, i.e. in a clinic. Often it is even necessary to stay in the intensive care unit.

Medical Therapy

The main aim of drug therapy for acute pancreatitis is to relieve severe pain and combat inflammation. Pain relievers such as tramadol, buprenorphine, piritramide, and pethidine as well as antibiotics such as metronidazole, carbapenems, and fluoroquinolones are used. In addition, those affected usually receive plenty of fluid through the veins in order to stabilize the circulation.

If the pancreas can no longer produce enough insulin due to acute pancreatitis, this deficiency is also compensated with medication in order to avoid hypoglycemia or diabetes.

Remove Gallstones

Various surgical procedures can be considered for the removal of gallstones. If possible, gallstones are now removed with an endoscopic procedure. A tube is inserted into the abdominal cavity through a small incision, through which the surgeon grabs the gallstones with a pair of pliers and pulls them out. Large gallstones can be shattered with sound waves during this procedure.

But there are also gallstones that cannot be reached or removed with this minimally invasive procedure. Then the abdominal cavity has to be opened in the classic way (laparotomy). More about gallstone treatment

Rinse Out Sources Of Inflammation

Sometimes the cavities in the pancreas also become inflamed. Pancreatic secretions and pus can accumulate there. The doctor can remove such foci of inflammation during an endoscopy via a thin connecting tube between the cavity and the small intestine or the stomach. In addition, an irrigation catheter can be inserted from the outside under an X-ray view. In this way, the cavities are emptied (drained). Sometimes an operation is also necessary.

Food Abstinence In Acute Pancreatitis

In the case of acute pancreatitis, the patient is not allowed to eat anything; absolute so-called food abstinence must be observed. Of course, drinking alcohol or smoking is also not allowed. If necessary, artificial food must be given through the veins or through a tube that opens directly into the small intestine. When the signs of inflammation subside, a careful diet is built up with easily digestible foods.


Basically, to prevent pancreatitis, a healthy lifestyle with sufficient exercise and a varied, healthy diet is recommended. The following also applies:

    • Have triggers eliminated, for example, surgical removal of gallstones or a gallbladder containing stones
    • Refrain from alcohol and nicotine, especially if you have a family predisposition to pancreatitis
    • reduce increased blood lipid levels
    • Get treatment for parathyroid disorders
    • Have your doctor replace drugs that promote pancreatitis with other drugs.

Silent Heart Attack Diabetes

It’s called a silent heart attack. It can happen to anyone, but diabetes makes you more likely to have one. You might not feel anything at all. Studies have shown that up to 16 percent of participants with Type 2 diabetes are also likely to have suffered a silent heart attack. It is… Diabetes is a chronic disease that causes your blood glucose (sugar) levels to rise too high. Consistently high blood glucose levels or levels that …A silent heart attack is a heart attack that does not produce the hallmark symptoms of chest pain and difficulty breathing. It is estimated that…Chest pain is certainly the predominant symptom of ischemic heart disease and the one most commonly used to establish the type and the efficacy of treatment. Your heart health is at risk if your diabetes is not well controlled. In fact, diabetics are known to suffer from silent heart attacks and sudden …What are the warning signs of heart attack and stroke? · weakness or numbness of your face, arm, or leg on one side of your body · confusion, or trouble talking or​ …People with diabetes are more prone to having a silent heart attack. High sugar and poor blood circulation dull their nerve cells due to which they don’t experience. Did you know? Undiagnosed diabetes may lead to a ‘silent heart attack …

Silent heart attack diabetes

Diabetes plagues a majority of Indians, many of whom are at risk of …SMI and regular heart attacks share the same risk factors: smoking, being overweight, lack of exercise, high blood pressure, high cholesterol levels, and diabetes. How are heart disease and diabetes linked? People suffering from type 1 and type 2 diabetes are more likely to be at risk from heart attacks, strokes and high …some patients with diabetes may not experience any typical symptoms before facing heart failure or sudden death.” Most of us are aware of the typical symptoms of …Both diabetics and nondiabetics with silent exertional myocardial ischemia differed from symptomatic subjects … Diabetes mellitus and coronary heart disease.ECG stress test can be recommended in the first intention if maximal heart rate can be … Diabetes mellitus; Silent myocardial ischemia; Coronary artery disease; …When it comes to heart attacks, both men and women share the same risk factors, namely diabetes, high blood pressure, high cholesterol, …People with diabetes are at a much greater risk for heart attack, stroke, and high blood pressure. … Silent heart disease in young people with diabetes. A silent heart attack is milder than a traditional heart attack but is just as … silent heart attacks are more common in older adults with diabetes …Be aware of the risks, complications, and symptoms of heart attacks and … of heart attacks in people with diabetes are clinically “silent,” meaning that they have..The Not-So-Sweet Truth About Heart Disease and Diabetes · What diabetics and heart patients share. In addition to high blood sugar levels, diabetics typically

Glycemic Index Used To Measure Blood Sugar Levels

In one case, a high-carbohydrate diet can be just the right way to get overweight under control. Others seem to be exactly the opposite. Scientific studies underline this statement: the less fat and the more carbohydrates people ingest, the fatter and sicker they get! The reasons for this are complex: There are carbohydrates that get very quickly from the intestines into the bloodstream and cause a rise in blood sugar levels.

Influence Of Carbohydrates On Insulin Levels

Insulin – a hormone from the pancreas – now has to regulate the blood sugar level back into the normal range. If the blood sugar level rises sharply, there is an enormous activation of insulin and, as a result, a drop in blood sugar below the norm. This hypoglycemia manifests itself as tiredness and an increased appetite for sweet foods. If you give in to cravings and eat foods rich in carbohydrates, the blood sugar can again rise above the norm and cause further insulin activation. Accordingly, hypoglycemia and hypoglycemia alternate regularly with a corresponding release of insulin.

This is where the problem begins: a high-carbohydrate diet can be a cause of increased insulin levels. As medical research has shown, an excess of insulin means that the organism does not burn fats that it ingests with food, but instead increasingly stores it as fat reserves, while at the same time reducing fat loss. In short: high insulin levels can lead to weight gain. However, the influence of carbohydrate foods on this process varies. Some have the ability to raise blood sugar levels more than others.

Glycemic Index Used To Measure Blood Sugar Levels

The so-called glycemic index (GI) is used to assess which carbohydrates are “good” and which are “bad”. The GI is a measurement that tells you how much your blood sugar level rises after consuming a certain food. A low GI is below 40, a medium is 40-70 and a high one is above 80. The selection of carbohydrate sources with low and medium GI is advantageous, as these cause only slight fluctuations in blood sugar and insulin and thus disinhibit fat burning.

Glycemic Index

The Glycemic Index is a practical tool for diet planning for weight loss, but it should not be overstated. Studies show that there are strong intra- and inter-individual differences in the GI. Intra-individual differences mean that one and the same person can have different blood sugar levels depending on the time of day and previous physical activity. Early in the morning, there is typically a lower increase in blood sugar levels and thus insulin than in the evening, as the cells’ insulin sensitivity decreases over the course of the day. Exercise also leads to a lower increase in the level of glucose in the blood. This means that there can be differences of up to 30% in the GI for the same person and the same food.

It should also be borne in mind that when determining the glycemic index, the food was eaten in isolation and contained exactly 50 g of carbohydrates, which does not correspond to natural eating habits at all. Rather, our food consists of a combination of different foods, which can have a strong influence on the course of the blood sugar level. Combining carbohydrates with fat, protein, and/or fiber results in a slower or faster rise in blood glucose than with isolated administration.

In addition, there are foods with a relatively high GI, but due to their low carbohydrate content, they do not trigger any significant fluctuations in blood sugar. For example, to take in 50 g of carbohydrates by eating carrots with a high GI of 71, one would have to consume around 850 g of carrots. The actual effect on the blood sugar level and thus on the insulin release is correspondingly small with a normal portion of 100-150 g.

With regard to the insulin response, the glycemic index alone is of little informative value, since the insulin response is dependent on both the type and the number of carbohydrates supplied and is also influenced by other nutrients. In order to take this into account, the term “Glycemic Load” (GL) has recently been used, translated as glycemic load or glycemic load. The GL is calculated by dividing the glycemic index by 100 and multiplying the result by the number of carbohydrates consumed. Accordingly, z. B. with 5.3 the value for the glycemic load of 100 g carrots. Large portions of pasta, rice, potatoes, and pastries have a high glycemic load. Scientific studies show an increased risk of developing diabetes and cardiovascular disorders in a diet with high GL.

Increased Glucose In The Blood

The amount of energy a person spends during the day depends on the processes of glucose oxidation in the body. The normal adult content varies between 3.2 and 5.5 mmol / l. Highly elevated blood glucose levels indicate serious disturbances in metabolic processes, possible onset of development of endocrine diseases, pathologies of the digestive system.

The causes of permanently and temporarily elevated blood glucose levels

The main factor causes an increase in sugar concentration in the body – malnutrition. Excessive consumption of carbohydrates, presence in the products of harmful chemical additives, and addiction to “heavy” foods lead to the development of comorbidities:

    • Diabetes mellitus;
    • acute and chronic pancreatitis;
    • Pathology of the kidneys, liver;
    • Thyroid disease;
    • Disorders of the endocrine system.

Also, a temporary increase in glucose concentration can trigger certain medications, stress, alcohol, and other toxic substances.

Signs of high blood sugar levels

Characteristic symptoms of the described condition:

    • Dry mouth;
    • frequent and abundant urination;
    • Worsening the ability of the skin to heal;
    • frequent headache;
    • Reduction of visual acuity;
    • Itching;
    • Increased fatigue;
    • Presence of boils, purulent pimples;
    • insufficient activity of the immune system

If at least 1-2 of these symptoms appear, you should see a doctor.

What to do if blood sugar is increased?

General recommendations for high sugar levels are the proper organization of a diet with restriction of carbohydrate consumption, refusal of bad habits, time allocation for physical activity.

If it has been discovered diseases, accompanied by an increase in the amount of glucose in the blood, you should treat them.


Micronutrient Therapy For Type 2 Diabetes Mellitus

The figures published by the IDF (International Diabetes Federation) at the end of 2006 speak for themselves: instead of the previously estimated 30 million, 246 million people worldwide suffer from diabetes.

Scientists forecast a diabetic share of 12 percent for Germany by the year 2010. The question is, who should and can still pay for it? Already today, the treatment and follow-up cost amount to up to 27 billion euros, according to the German Diabetic Confederation.

Almost all of us could easily prevent this “widespread disease”: weight reduction, sufficient physical activity, healthy food rich in vital substances with a low glycemic index – preferably vegetarian. In addition, a good micronutrient supply has a very high priority: both in the prevention and in existing insulin resistance and even more so in diagnosed diabetes mellitus type 2.

Diabetes mellitus type 2 has numerous threatening consequences, which can be prevented or at least mitigated with sufficient availability of micronutrients. In addition, diabetics have found a greater need for micronutrients and simultaneously lower blood levels.

In diabetics, the formation of free radicals is particularly pronounced. This is also evident in the sequelae, which can take a very dramatic course:

Nervous dysfunction, kidney disease, visual disturbances (cataracts) are not uncommon; at worst, blindness or amputations of the limbs may occur. Pathological changes in the blood vessels (micro-and macroangiopathy) can be the trigger for stroke and heart attack.

A preventive and good supply of antioxidant agents such as vitamin C, E, selenium, zinc, cysteine, coenzyme Q10, glutathione, and other vital substances can counteract these secondary diseases.

Not only do micronutrients have the function of protecting against free radicals, they also help the diabetic to keep his blood vessels elastic, intact, and functional. Here is the amino acid arginine to mention. It causes dilation of the blood vessels and has a hypotensive effect.

Bringing blood sugar regulation back into balance is the key to existing insulin resistance. Orthomolecular medicine can be an important element in achieving this goal: Chromium and biotin are able to positively influence glucose metabolism; also deficiencies of zinc, copper, and manganese are associated with glucose intolerance.

In summary, orthomolecular medicine in diabetes mellitus is a useful therapeutic approach and can make a significant contribution to relieving the symptoms. The sooner, the better and more effective.

New Hormones Can Revolutionize Diabetes Treatment

Diabetes mellitus now affects more people than ever, with nearly one in ten Americans suffering from it, and the number of diabetics in developing countries is growing rapidly. And while treatments are constantly improving as research progresses, the currently available therapeutic options are far from ideal. But a major breakthrough in diabetes research recently reported by a group of scientists in the journal Cell Phone offers a new hope for radically new and improved ways to combat this disease.

The research team at Harvard led by Douglas Melton focused on the pancreatic beta cells that are responsible for the production of insulin. In type I diabetes, these cells are gradually destroyed by the body’s immune system, and in type II diabetes, but at some point begin to fail as the disease progresses, making them a prime target for possible new therapeutic approaches for diabetes. In healthy people, beta cells usually divide at a rather sluggish rate, with the total remaining more or less constant. But it has been known for some time that under certain conditions, such as pregnancy, they can multiply much faster. The aim of the scientists was what exactly triggers this proliferation, and whether this will then be used to increase their numbers for therapeutic purposes.

Working with mice as model animals, she first devised a way to replicate her body’s perception as if insulin lacked what they hoped would replicate the beta cells faster. They did this by using an injection of insulin receptor antagonists, which prevents the insulin binding to its receptors in different tissues, effectively blocking its action. The effect of this blockade turned out exactly as they had hoped: when mice were given the insulin antagonist, their beta cells responded rapidly by dividing faster and more numerous.


Once the beta cells were awakened in division faster, the scientists were able to investigate what mechanism lay behind this effect. First, they quickly ruled out the possibility that the insulin antagonist acted directly on the beta cells. This could then only mean that another substance released to other tissues and acting on the beta cells in the pancreas – a description incorporating a hormone – had to be responsible. How many hormones are peptides and thus encoded by specific genes, then researchers decided how the administration of insulin antagonists affects gene expression in different tissues. In particular, a gene caught their attention because its expression in liver cells greatly increased in response to insulin receptor blockade. Furthermore, this gene had some properties that it encodes for a peptide secreted from the cells, as suggested for a hormone. They called the gene and its product betatrophin, which comes from the Greek and translates into about ‘beta nutritious.’ Importantly, humans also possess a betatrophin gene and the hormone is also produced in the human liver.

The last step was to show that they really found the right substance. Instead of trying to isolate betatrophin or somehow produce and inject it into the mice, additional copies of the gene are inserted betatrophin them into the liver cells, thereby significantly increasing the production of the hormone. The beta-cell response was fast and vigorous: once betatrophin production started in the liver, its proliferation rate increased by more than 30-fold! As a result, the pancreas of the mice was elevated in betatrophin able to produce larger amounts of insulin, to the point that glucose tolerance was even better than that of healthy mice.

Extrapolating these results to humans, it is not difficult to imagine what this means for diabetics. Injecting betatrophin once a week, for example, would increase the proliferation of their ailing beta cells, increasing insulin production and ensuring natural glycemic control – which is far better than having to rely on insulin injections.

Of course, it is far too early to celebrate a new revolution in diabetes therapy. It remains to be seen if the results in mice are also reproduced in humans; It has happened before that results that very promising mice could be replicated in human clinical trials are being sought. We thus have to wait for further studies, and until scientists are able to produce enough to try it in betatrophin humans, we can not be sure what to really expect.

But the discovery of a new hormone that can increase the proliferation of insulin-producing cells is still exciting news. Because even if the further research ultimately proves disappointing, or shows that the real story behind betatrophin is more complicated than it looks now, there will still be radically new leadership in the search for better treatments for diabetes – and with it the hope for a healthier and longer life for the billions of diabetics worldwide.