Overview

Diabetes mellitus (DM) is considered as one of the major burden in health care systems and is now a global epidemic threat that has amplified several folds over the past 2 decades. Over the past three decades, the global burden of DM has swelled from 30 million in 1985 to 382 million in 2014, with current trends indicating that these rates will only continue to rise (Wild et al., 2004). The latest estimates by the International Diabetes Federation (IDF) projects that 592 million worldwide will have DM by 2035. In India, about 50.8 million subjects are suffering from DM, which is expected to rise to 87 million by 2030 (Shaw et al., 2011). Patients with DM are prone to development of multiple secondary complications. The complications associated with DM are macrovascular (due to damage to large blood vessels) or microvascular (due to damage to small blood vessels). The microvascular complications includes damage to eyes (retinopathy) causing blindness, to nerves (neuropathy) causing diabetic foot ulcers (DFUs) and subsequent amputation in severe infection, and to kidneys (nephropathy) leading to renal failure. Large prospective clinical analysis has reported a strong interrelationship between hyperglycemia and microvascular complications in patients with DM (DCCT., 1993; UKPDS., 1998). The hyperglycemia in DM is also linked to accelerated atheroscelerotic macrovascular disorders affecting blood supply to vital organs such as brain, heart, and lower limbs (Cade., 2008). The condition pathogically is similar to vascular disorders in nondiabetics, but is more progressive and extensive in diabetic subjects (Ras-Mandsen et al., 2013). The overall risk of cardiovascular complications is increased by two to six fold in diabetic subjects.

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