الفهرس 
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Abstract
Diabetes mellitus (DM) is a multisystem disease with both biochemical and structural consequences. It is a chronic disease of carbohydrate, fat, and protein metabolism caused by the lack of insulin, which results from the marked and progressive inability of the pancreas to secrete insulin because of autoimmune destruction of the beta cells.
The two major types of diabetes are type 1 (previously called insulin-dependent diabetes mellitus, IDDM, or juvenile-onset diabetes) and type 2 (previously called noninsulin-dependent diabetes mellitus, NIDDM, or maturity-onset diabetes).
Both type 1 and type 2 diabetes share one central feature: elevated blood glucose level weather due to insufficiency of insulin or insulin action resistance.
Type 1 diabetes mellitus (T1DM) is a multi-factorial autoimmune disease characterized by insulin deficiency, due to the T-cell mediated destruction of pancreatic β-cells. The disease accounts for only about 5–10% of all cases of diabetes; however, its incidence continues to increase worldwide and it has serious short-term and long-term implications.
Long-term diabetes-related complications are divided into microvascular and macrovascular disorders, which account for most of the increased morbidity and mortality associated with the disease.
Cardiovascular disease (CVD) is the major cause of morbidity and mortality for individuals with diabetes and the largest contributor to the direct and indirect costs of diabetes. In type 1 diabetes the relative risk of CVD can be as much as 10-fold greater than that in non-diabetic individuals. Risk factors for cardiovascular disease in type 1 diabetes include the presence of diabetic nephropathy, autonomic neuropathy, dyslipidaemia, hypertension, and perhaps also specific microvascular cardiac disease.
Microvascular complications include diabetic retinopathy, neuropathy and nephropathy.
Diabetic nephropathy occurs in 20–40% of patients with diabetes and is the single leading cause of end-stage renal disease (ESRD).
The early clinical sign of renal involvement is defined as the appearance of pathological levels of urinary albumin excretion (microalbuminuria). It is well known that pathological albuminuria and proteinu