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Diabetes mellitus (DM) or hyperglycemia (in a more generalized term, high blood sugar) is a metabolic disorder that is now highly prevalent in the world population. Most of the food that people consume is converted into glucose, which enters the bloodstream following absorption–assimilation mechanisms. As a natural process, cells in our body utilize glucose for growth and energy. The glucose balance is maintained by a hormone called insulin that is secreted by the beta cells of pancreas. Hypotheses at the backdrop of DM occurrence are either (i) enough insulin is not produced and secreted resulting in increased level of glucose in blood, or (ii) insulin is insensitive to glucose, or (iii) insulin is non-targeted etc. If DM remains uncontrolled over time, it leads to serious damage to many of the body's systems, especially the nerves and blood vessels. This paper develops an enquiry into diabetes from many angles: (i) Diabetes as a disorder, its complications, causes, diagnostic tests, and treatment; (ii) Analysis of retinal and plantar images to characterize diabetes complications; (iii) How analysis of heart rate variability signals can depict diabetes; (iv) Biomedical engineering of the glucose–insulin regulatory system, and its employment in the modeling of the oral glucose tolerance test data, to detect diabetes as well as persons at risk of being diabetic; (v) Application of the glucose–insulin regulatory system to formulate an insulin delivery system for controlling blood sugar.
Diabetes mellitus (DM), of which type II has been described as an international epidemic, is a major cause of death. Diabetic peripheral neuropathy (PN) is a condition secondary to hyperglycemia, where progressive loss of peripheral nerve function, including sensory and motor functions, occurs over time. Early detection of PN-related impairments may be helpful for the management of patients with DM. Among the methods for the evaluation of these impairments, only that for joint position sense (JPS) requires both motor and sensory involvement. The purpose of the current study was to compare the JPS of the lower limb joints in patients with no or mild diabetic PN to those of normal controls both during weight-bearing (WB) and non-weight-bearing (NWB) conditions using 3D motion analysis methods. The results supported the hypothesis that in well controlled diabetic patients with no or mild PN, JPS deficits can be found only at the ankle joint during WB conditions, resulting in overestimation of dorsiflexion angles. This suggests that at the very early stage of development of diabetic PN, distal joint involvement precedes that of proximal joints. Early detection of these changes, through the assessment of the JPS for all the lower limb joints under both NWB and WB conditions, will be helpful for the development of clinical preventive and treatment programs for patients with DM, even if their glucose level are well controlled. Gait and balance training in these patients should emphasize proprioception training exercises during WB conditions.