In diabetes mellitus, glucose level is increased. These increased levels enter in various organs via blood and cause degenerative function in various organs. Hence diabetes mellitus is called whole blood disease. Mainly the insulin inaction is due to the quantitatively less synthesis of insulin which is necessary for glucose transport glucagone formation and triglycerides synthesis and the synthesis of nucleic acid protein. Red cell haemoglobin on prolonged association with high glucose level are converted into glycosylated haemoglobin which replaces the functional haemoglobin and this participates in the further proliferation of the various organs. In order to find out the levels of these biochemical parameters we carried out this study.

Whole blood originates principally from RBC and measurement of these fractions is valuable for the identification of average blood glucose level of 120 days. The present study was undertaken to determine the role and other related biochemical parameters, insulin and glucose along with the lipid study in the different stages in Type I and Type II diabetes particularly, therefore in the present plan of studies attempts have been made to elucidate the functional attributes of these tests for the early detection of diabetes and to monitor the management of disease.

Obesity is an abnormal growth of adipose tissue due to an enlargement of fat cell size (Hypertrophic Obesity) or increase in fat cell number (Hyperplastic Obesity) or a combination of both. A body mass index of 25 or more in males and females confirms.

The main source of energy for body tissue is glucose. A fixed range of glucose concentration in different body tissue is essential to maintain a normal metabolism of the related tissue as a raised or low concentration either affects the normal metabolism of tissue or is pathognomonic of certain diseases like increase in blood glucose levels reflecting the deficiency of glucose utilization resulting into the Diabetes Mellitus.

World Health Organization has laid down the following values for diagnosing Diabetes Mellitus and differentiating from impaired glucose tolerance (Table 1).

The classification of diabetes mellitus adopted by WHO1,2 is as follows:

A) Diabetes Mellitus

• Insulin Dependent Diabetes Mellitus (Type I)
• Non-insulin Dependent Diabetes Mellitus
  (Type II)
• Malnutrition - Related Diabetes Mellitus
• Other types (Secondary to pancreatic, hormonal, drug induced, genetic and other abnormalities)

B) Impaired Glucose Tolerance

C) Gestational Diabetes Mellitus

Fifty healthy individuals properly scrutinized by the Physicians without any pathophysiological abnormalities. They were considered to obtain base line data of glucose insulin and glycosylated haemoglobin level.
Hundred patients suffering from carbohydrate intolerance were labelled as Group Obese Type II diabetes Mellitus. In accordance with the WHO guidelines and further divided into controlled (50) and uncontrolled (50) obese diabetic patients.
The following parameters were studied in both the groups on using ready to use kits.

1. Fasting blood sugar (GOD/POD method)3
2. Post prandial blood sugar (GOD/POD method)3
3. Fasting insulin level (Transiasia Elisa reader)4
4. Post prandial insulin levels (Transiasia Elisa reader)4
5. Glycosylated haemoglobin (Column chromatography)5

Results obtained for blood sugar, insulin and glycosylated haemoglobin are shown in Table 2 and Fig. 1.

In Type II obese controlled diabetic patients the fasting blood sugar level is found to same as normal individuals also post prandial blood sugar is normal and fasting insulin level and post prandial insulin level is found to be the same as normal individuals and there is no change in their glycosylated haemoglobin.

In Type II obese uncontrolled diabetic patients the fasting blood sugar level as well as post prandial sugar level are 2 times of the normal individuals and their fasting as well as Post prandial insulin level are 2 times of the normal individuals whereas their glycosylated haemoglobin level increased 4 times in comparison to normal individuals.

In diabetes mellitus, insulin secretion is inadequate to normalize glucose metabolism either because of peripheral tissue resistance to insulin action or failure to secrete or both, absolute and relative efficacy of the insulin causes the diabetes mellitus. Type II NIDDM patients does not require insulin therapy in general to avoid ketoacidosis. Many of the scientists have reported higher serum insulin level in diabetic and normal subjects. However, it appears that values noted in continental subjects are far more than noted in India.6
It has been shown that diabetic patients belonging to diabetes mellitus and other conditions where hyperglycaemia exists denote an elevation of glycosylated haemoglobin. The determination of glycosylated hemoglobin therefore was proved to be of high diagnostic and prognostic value in control of the disease.7-9

Fig. 1 : Normal vs type II obese uncontrolled and controlled diabetes.