Drug-Induced Hyperglycemia and Diabetes Mellitus
2007
Diabetes mellitus (DM) has emerged as one of the most common diseases of this century.
Its incidence is on the rise and the numbers are projected to reach a dreaded level by the year
2030 (1). In the United States alone, 4000 cases of diabetes are diagnosed every day (2). Most of
them are type 2 diabetes mellitus (T2DM), and overall 8% of the population carries this
diagnosis (3). Hyperglycemia is the sine qua non for diabetes. It results from the disturbance of
normal glucose homeostasis. Under normal physiological conditions, plasma glucose
concentrations are maintained within a narrow range, despite wide fluctuations in supply
and demand, through a tightly regulated and dynamic interaction between tissue sensitivity to
insulin and insulin secretion (4). Several pathologic processes can result in the disturbance of
this balance. These range from autoimmune destruction of the b-cells of the pancreas with
consequent insulin deficiency in T1DM to abnormalities that result in insulin resistance in the
majority of T2DM. Impairment of insulin secretion and defects in insulin action frequently
coexist in the same patient with T2DM. It is often difficult to decipher which abnormality, if
either alone, is the primary cause of hyperglycemia (5).
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