1.1 Background of the study
Diabetes mellitus is defined as a metabolic disorder of multiple etiology characterized by chronic hyperglycemia with disturbances in carbohydrates , protein, and fat metabolism resulting from defects in insulin secretion ,insulin action or both (Alberti ,Defronzo,Keen,Zimmet.,1992). Llioja,Mott,Howard. (1988) reported that the presence of glucose circulating in the blood results in potential pathological complications.
Famuyiwa,Sulimani,Laajam,AL-Jesser,Mekki. (1992) reported that diabetes may present as an acute disorder with the classic triad of polyuria, polydipsia and unexplained weight loss, some patients may present for the first time in a coma. However, diabetes can also present as a sub acute condition over several months particularly in elderly patients in whom this triad is usually not so dramatic and may even be absent (Abdulkadir, 1993).
Scientists believe that a combination of genetic susceptibility and exposure to environmental factors cause increased incidence of this disease in individuals (Report of the Expert Committee on the diagnosis and classification of diabetes (1997).
Diabetes in addition to being a disease in itself is also a risk factor for coronary heart disease, myocardial infarction, angina and sudden death .It is a disease with specific complications (Mckeigue,Shah,Marmot:, 1991). Obesity is a major risk factor in diabetes mellitus (Alberti et al., 1992). Over 50% of patients with non insulin dependent diabetes mellitus (NIDDM) are obese (Ngwu, 2001)
Lyon,Vincce,. (1993) reported that most people with diabetes (more than 80%) die of cardiovascular disease. Diabetes doubles the risk of death from heart disease in women. Oldrizzi,Rugio,Mashio., (1994) reported that diabetes is classified into type 1 and type 2.It is a life long metabolic disease irrespective of the age of onset.
Type 1 diabetes mellitus also known as insulin dependent diabetes mellitus (IDDM) is an autoimmune disease which destroys the beta cells in the pancreas, the cell which produces insulin (Dietz, 1994). Bonnice (1998) reported that diabetes in childhood and adolescence is almost invariably type 1.The incidence is increasing in developed countries, while it is the subject of debate in Africa.