The Effect Of Antidiabetic Agent Glibenclamide And Meltformine On Lipids And Glycated Haemoglobin In Type 2 Diabetes Patient Attending Uith Ilorin

CHAPTER TWO
LITERATURE REVIEW
2.0 INTRODUCTION
Diabetes mellitus (DM) is a group of metabolic disorders characterized by a chronic hyperglycemic condition resulting from defects in insulin secretion, insulin action or both. Permanent neonatal diabetes is caused by glucokinase deficiency, and is an inborn error of the glucose-insulin signaling pathway (Njolstad et al., 2003).
The prevalence of diabetes is increasing rapidly worldwide and the World Health Organization (2003) has predicted that by 2030 the number of adults with diabetes would have almost doubled worldwide, from 177 million in 2000 to 370 million. Experts project that the incidence of diabetes is set to soar by 64% by 2025‚ meaning that staggering 53.1 million citizens will be affected by the disease (Rowley and Bezold, 2012). The estimated worldwide prevalence of diabetes among adults in 2010 was 285 million (6.4%) and this value is predicted to rise to around 439 million (7.7%) by 2030 (Shaw et al., 2010). There are two main types of Diabetes mellitus:
i.    Type 1 diabetes, also called insulin dependent Diabetes mellitus (IDDM), is caused by lack of insulin secretion by beta cells of the pancreas.
ii.    Type 2 diabetes, also called non-insulin dependent Diabetes mellitus (NIDDM), is caused by decreased sensitivity of target tissues to insulin.
The reduced sensitivity to insulin is often called insulin resistance and its causes are shown in Table 1.

In both types of Diabetes mellitus, metabolism of all the main foodstuffs is altered. The basic effect of insulin lack or insulin resistance on glucose metabolism is to prevent the efficient uptake and utilization of glucose by most cells of the body, except those of the brain (Guyton and Hall, 2006). As a result of this, blood glucose concentration increases, cell utilization of glucose falls increasingly lower and utilization of fats and proteins increases. The clinical characteristics of patients with type 1 and type 2 Diabetes mellitus are shown in Table 2.