الفهرس 
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Abstract
Diabetes mellitus is a metabolic disorder of multiple etiology, characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action or both.
There are two main types of diabetes: T1D is caused by the autoimmune destruction of the beta cells of the pancreas and represents approximately 10% of all cases with diabetes. At present, lifelong insulin therapy is the only treatment for the disease. Without exogenous insulin injections, individuals with T1D will not survive. The prevalence of T1D is <1% in most populations. Type 2 results from defect(s) in insulin secretion, almost always with a major contribution from insulin resistance. T2D is the most common form of the disease, accounting for approximately 90% of all affected individuals. Typically, T2D is managed with diet, exercise, oral hypoglycemic agents and sometimes exogenous insulin.
IGT and/or impaired fasting glycaemia (IFG) refer to a stage that is intermediate between normoglycaemia and diabetes and they represent risk categories for future development of diabetes mellitus. About one third of IGT subjects develop type 2 diabetes mellitus and the annual incidence rate ranges from 2% to 10% per year depending on the population and major risk factors.
Gestational diabetes is a state of carbohydrate intolerance resulting in hyperglycaemia of variable severity, with onset or first recognition during pregnancy. It may be appropriate to screen pregnant women belonging to high-risk population groups during the first trimester of pregnancy in order to detect previously undiagnosed diabetes mellitus.
There are a number of factors that might explain the increasing prevalence of diabetes mellitus. Rates of obesity are increasing, while people are becoming less physically active; both of these factors increase the risk of developing diabetes. In addition, the prevalence of diabetes mellitus increases with age, and there is evidence that the current life expectancy in Egypt now exceeds 65 years.
People are presenting with type 2 in their twenties and thirties, and in some countries it is emerging in children. This pattern of younger age of onset extends the potential burden of therapy and complications to an even younger age group and for a longer period of an individual’s lifespan.
Symptoms of diabetes include polydepsia, polyuria, polyphagia, weight loss, blurred vision, frequent skin, bladder or gum infection, irritability, tingling or numbness in hands or feet, slow to heal wounds, extreme unexplained fatigue and sometimes there are no symptoms