A. Definition
Diabetes millitus (diabetes) is a metabolic disease characterized by hyperglycemia resulting from absolute insulin deficiency or resistance in the insulin receptor occurs simultaneously with relative insulin deficiency. (Azizahwati, 2008).
Diabetes mellitus is a group of metabolic diseases with characteristic hyperglycemia that occurs because of abnormalities of insulin secretion, insulin or both. (Soesilowati Soerachmad, 2008)
Insulin is a hormone that regulates blood sugar. Hyperglycemia or increased blood sugar, is a common effect of uncontrolled diabetes and over time will cause serious disruption of the body systems, especially the nerves and blood vessels.
Besides the direct effect of hyperglycemia in increasing both glucose uptake into the liver and peripheral tissues, insulin also has a central role in regulating blood glucose concentration. This hormone is produced by beta cells in pancreatic Langerhans island as a direct reaction to the state of hyperglycemia.

Mechanism of Insulin Release
The cells on the island of Langerhans can pass freely by glucose and insulin through pangangkut GLUT 2 (location of liver tissue, pancreatic beta cells, small intestine and kidney) which is a glucose transporter that functions in the process of glucose uptake and rapid panglepasan and glucose will experience phosphorylation by the enzyme glucokinase which has a high Km value. Therefore, blood glucose concentrations determine the flow through glycolysis, the citric acid cycle and the formation of ATP. Increasing concentrations of ATP inhibit aka K + channels that are sensitive to ATP, causing beta cell membrane depolarization, cell membrane depolarization circumstances this will increase the flow of incoming Ca 2 +-sensitive voltage and thereby stimulate insulin aksositosis.

The physiological insulin has an effect on the metabolism of the three main ingredients of food, namely carbohydrates, fats, and proteins. All three can supply energy. Carbohydrates are important because the rapid production of glucose as an energy source.
a. Effects Carbohydrate
The main task of insulin is to regulate the utilization of glucose by cells as an energy source, such as by launching pelintasannya through cell membranes and resorpsinya into muscle cells and fat cells. Also worked hipoglikemis Insulin, which lower blood sugar by stimulating the conversion of excess glucose into glycogen in liver and muscle.
b. Fat Stock
Stimulation of lipogenesis and inhibits lipolysis stimulates the synthesis of fat from glucose and entry into cells and inhibit penguraiaannya with insulin increases fat storage and prevent the use of fat as raw energy.
c. Protein Effect
Insulin stimulates amino acid entry into cells and increases protein synthesis from glucose.

B. Criteria for Diabetes Mellitus
1. Classic symptoms of DM when blood glucose + ³ 200 mg / dl (11.1 mmol / L)
Glucose as a result of a moment in a day regardless of time of last meal, or
2. Classic symptoms of DM + levels of fasting blood glucose ³ 126 mg / dl (7.0 mmol / L). Fasting means patients do not get extra calories at least 8 hours, or
3. Blood glucose levels 2 hours on oral glucose tolerance ³ 200 mg / dl (11.1 mmol / L). Performed oral glucose tolerance using a glucose load equivalent to 75 g glucose dissolved in water anhidrus (WHO).

C. Etiology
Symptoms of diabetes mellitus can be caused by hyperglycemia is high blood sugar levels, this arises because the absorption of glucose into the cell is hampered and impaired metabolism that can lead to:
1. Polyuria that is too much urination. If blood sugar levels to above the 160-180 mg / dL, the glucose will reach into the urine. If the level is even higher, the kidneys will release additional water to dilute a large number of glucose is lost. Because the kidneys produce urine in significant amounts. This causes dehydration and loss of eklektrolit in people, giving rise to body limp and lethargic.
2. Polydipsia is a result of dehydration it will always feel thirsty and cope with a lot of drinking.
3. Polifagia namely the desire to always keep eating arise because high blood sugar in the circulation so that blood circulation is not obstructed from reaching the brain and cause brain deprived of oxygen that stimulates the hypothalamus to issue orders hungry that an increase in appetite.
4. Weight loss begins to decline, mainly due to little or no insulin, so the hormone glucagon hormone works that stimulate lipolysis.
5. Other symptoms are tingling, itching of genital area, vaginal discharge, infection, poor healing, ulcers resulting loss, blurred vision, dizziness, nausea and drowsiness easy.