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Diabetes mellitus (IPA /?da??'bi?ti?z/ or /?da??'bi?t?s/, /m?'la?t?s/ or /'m?l?t?s/), often referred to simply as diabetes (Ancient Greek d?aß?t?? "to pass through urine"), is a syndrome of disordered metabolism, usually due to a combination of hereditary and environmental causes, resulting in abnormally high blood sugar levels (hyperglycemia).^[2] Blood glucose levels are controlled by a complex interaction of multiple chemicals and hormones in the body, including the hormone insulin made in the beta cells of the pancreas. Diabetes mellitus refers to the group of diseases that lead to high blood glucose levels due to defects in either insulin secretion or insulin action. ^[3]

Diabetes develops due to a diminished production of insulin (in type&_160;1) or resistance to its effects (in type&_160;2 and gestational).^[4] Both lead to hyperglycaemia, which largely causes the acute signs of diabetes excessive urine production, resulting compensatory thirst and increased fluid intake, blurred vision, unexplained weight loss, lethargy, and changes in energy metabolism. Monogenic forms, e.g. MODY, constitute 1-5&_160;% of all cases.^[5]

All forms of diabetes have been treatable since insulin became medically available in 1921, but there is no cure. The injections by a syringe, insulin pump, or insulin pen deliver insulin, which is a basic treatment of type&_160;1 diabetes. Type&_160;2 is managed with a combination of dietary treatment, medications and insulin supplementation.

Diabetes and its treatments can cause many complications. Acute complications (hypoglycemia, ketoacidosis, or nonketotic hyperosmolar coma) may occur if the disease is not adequately controlled. Serious long-term complications include cardiovascular disease (doubled risk), chronic renal failure, retinal damage (which can lead to blindness), nerve damage (of several kinds), and microvascular damage, which may cause impotence and poor wound healing. Poor healing of wounds, particularly of the feet, can lead to gangrene, and possibly to amputation. Adequate treatment of diabetes, as well as increased emphasis on blood pressure control and lifestyle factors (such as not smoking and maintaining a healthy body weight), may improve the risk profile of most of the chronic complications. In the developed world, diabetes is the most significant cause of adult blindness in the non-elderly and the leading cause of non-traumatic amputation in adults, and diabetic nephropathy is the main illness requiring renal dialysis in the United States.^[6]

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