Biochemical disturbance of DM:

1. on carbohydrate metabolis

• An increase in hepatic glucose output
• A decrease in peripheral glucose uptake & utilization
• Increase in Hepatic Glucose Output

Plasma glucose↓insulin↓inhibitory effect on glucagon secretion↑glucagon ↑gluconeogenesis&glycogenolysis.

2. on protein:

Decrease in Glucose Uptake↓insulin↓glucose & amino acid uptake↑protein breakdown↑plasma glucose↑plasma amino acids.

        3- on lipids:     

 ↓insulin tissue↑lipolysis (loss of weight)↓lipogenesis↑plasma fatty acids ↑ketone bodies and ketoacidosis results 

Individuals who are at high risk of developing Type II diabetes mellitus include people who:

• Are obese (more than 20% above their ideal body weight)
• Have a relative with diabetes mellitus
• Have been diagnosed with gestational diabetes or have delivered a baby weighing more than 4 kg
• Have high blood pressure (140/90 mmHg or above)
• Have a high density lipoprotein cholesterol level less than or equal to 35 mg/dL and/or a triglyceride level greater than or equal to 250 mg/dL.
• Have had impaired glucose tolerance or impaired fasting glucose on previous testing.

Several common medications can impair the body's use of insulin, causing a condition known as secondary diabetes. These medications include treatments for high blood pressure (thiazide diuretics), drugs with hormonal activity (oral contraceptives, thyroid hormone, progestins, and glucocorticorids), and the anti-inflammation drug indomethacin..

Role of trace supplement in DM:

Chromium. Several studies have had conflicting results on the effectiveness of chromium supplementation for control of blood glucose levels. Approximately 70% of the diabetics receiving 200 micrograms of chromium  daily reduced their need for insulin and medications.

Magnesium. Magnesium deficiency may interfere with insulin secretion and uptake and worsen the patient's control of blood sugar.

Vanadium. Vanadium has been shown to bring blood glucose to normal levels in diabetic animals.