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Practical Considerations in the Management of Diabetes Mellitus

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Abstract

The purpose of this article is to present briefly certain concepts which the writers consider basically important in the management of uncomplicated diabetes mellitus. Most of the program to be discussed agrees in principle with teachings of recognized clinics on diabetes. There are, of course, variations in opinion concerning the details of management among various groups. Since diabetes is a common and chronic disorder of variable severity, and untreated diabetes is often compatible with life for long periods of time, these divergent opinions are understandable. The objectives of treatment remain the same with all groups, that is, maintenance of the patient in a good state of general health, and prevention of the occurrence of complications.

The pathologic physiology of diabetes mellitus is still a controversial subject involving intricate glandular interrelationships and the role of insulin in metabolic processes in body tissues, particularly in the liver and muscles. Brilliant contributions have been made but much remains to be done. From the practical standpoint the responsible disturbing factor may be considered a deficiency in the production of insulin with resultant hyperglycemia, glycosuria, tissue destruction with increased nitrogen excretion, a tendency to ketosis, acidosis, and coma, and a variety of well known symptoms whose number and severity differ with the severity of the disorder.

The diagnosis of diabetes mellitus as a clinical entity should be established with care. Not all examples of glycosuria and not all cases manifesting a decreased tolerance during the glucose tolerance test belong in this classification. Obviously, renal glycosuria. . .


 

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