Introduction This presentation will help you better understand and manage your diabetes. It covers the three main forms of diabetes, type 1 and type 2, as well as gestational diabetes. how your body metabolizes sugar, the fundamentals of nutrition and exercise. up-to-date information about recent innovations in treatment and Dr. Sunita Gupta
most importantly, you'll see that it's not just possible to live with diabetes; it's possible to live well.
Insulin is the principal hormone in the body It plays a key role in all forms of diabetes mellitus. It regulates uptake of glucose from the bloodstream into every muscle and all fat cells, But not into the cells of the central nervous system. Dr. Sunita Gupta
Deficiency of insulin or insensitivity of its receptors
When our body functions normally … The normal food processing cycle food is converted to glucose before it is used by the blood and body as fuel. As a result, blood glucose levels in the body rise. Dr. Sunita Gupta
In response to this, the Pancreas release Insulin into the blood.
When our body functions normally … The different organs involved in the normal food processing cycle about two-thirds of the body's cells use Insulin to absorb glucose from the blood Dr. Sunita Gupta
To convert to other needed chemicals, or
Normal glucose absorption Insulin binds to receptors on the cell membrane, much as a key fits into a lock, signal glucose transporters Glucose transporters move to the cell membrane and bind to glucose. Glucose enters the cell. Dr. Sunita Gupta
When the system fails to absorb glucose…. Dr. Sunita Gupta An immune system attack severely limits the ability of the pancreas to produce insulin Glucose cannot enter the cells.
Cells develop a resistance to insulin. Glucose builds up in the bloodstream.
When the insulin is high/ low Higher insulin levels increase certain processes, like cell growth and duplication, If the amount of insulin available is insufficient due to insulin insensitivity or resistance - poor response of the cells defective insulin, then glucose will neither be absorbed properly by those body cells that require it nor will it be stored appropriately in the liver and muscles. persistent high levels of blood glucose, poor protein synthesis, and Dr. Sunita Gupta
other metabolic derangements, such as acidosis.
When the body begins to malfunction… Glucose, after food is absorbed from the intestines and distributed to all the body cells through the bloodstream. The glucose concentration in the blood body keeps constant and avoids extra glucose right after every meal The defective food processing cycle Dr. Sunita Gupta
and starves the body between the meals and overnight.
When the body begins to malfunction… When glucose in the body is excess stored in the liver and muscles as glycogen . When glucose is in short supply, the body stimulates to eat food and/or mobilizes the stored glycogen. To maintain a constant blood-glucose level, Insulin vs Glucagon cycle – A comparison Dr. Sunita Gupta
the body relies on pancreas to produce two hormones insulin and glucagon
Diabetes mellitus Diabetes mellitus (or simply diabetes) is a condition when: the organism begins to malfunction – metabolic disorder levels of the hormone insulin in the blood become insufficient the body cells fail to respond to the insulin that is produced, or both. as a result, blood sugar levels grow abnormally high (hyperglycaemia)
This is Diabetes and is not curable.
Types of Diabetes Dr. Sunita Gupta
(occurs during pregnancy)
SYMPTOMS The characteristic symptoms are excessive urine production (polyuria) due to high blood glucose levels, excessive thirst and increased fluid intake (polydipsia) attempting to compensate for increased urination, blurred vision due to high blood glucose effects on the eye's optics, Dr. Sunita Gupta
unexplained weight loss, and
Statistical breakup of symptoms Dr. Sunita Gupta
CAUSES of Diabetes mellitus Type 1 diabetes - when the pancreatic cells are destroyed due to autoimmune system of the body. Type-2 diabetes - when due to high levels of blood sugar, the body is unable to utilize it’s insulin and move blood sugar into the cells to produce energy. Dr. Sunita Gupta
Gestational diabetes : the hormones produced during pregnancy can cause insulin resistance in women genetically prone to develop Diabetes.
Diabetes - a genetic source? Partly inheritance - Both type 1 and type 2 diabetes. Dr. Sunita Gupta
At least 10 genes found - links to the causes of Type-2 diabetes.
How genes influence Diabetes? Type 1 diabetes is triggered by some (mainly viral) infections, by stress or environmental exposure (such as exposure to certain chemicals or drugs). Type 2 diabetes - a stronger inheritance pattern. If first relatives have type 2 diabetes risk of developing type 2 diabetes is much higher. Dr. Sunita Gupta
This risk increases with increase in number of relatives with diabetes.
diagnosis Recurrent or persistent hyperglycaemia during Diabetes mellitus is diagnosed by any one of the following methods: fasting plasma glucose level at or above 126 mg/dL (7.0 mmol/l). at or above 200 mg/dL (11.1 mmol/l) two hours after a 75 g oral glucose load. Dr. Sunita Gupta
at or above 200 mg/dL (11.1 mmol/l).
Diabetes screening Diabetes screening is recommended at various stages of life, and For those with any of several risk factors. Diabetes screening could be a random blood glucose test, a fasting blood glucose test, a blood glucose test two hours after 75 g of glucose, or Dr. Sunita Gupta
a more formal glucose tolerance test.
Diabetes and Obesity The diabetes - an epidemic because in such a short time, like infectious diseases, it has spread so quickly. Excess body fat is the leading controllable risk factor type 2 diabetes. Indians lead the world in the number of diabetic patients. Alarming rise in obesity and diabetes around the world – Dr. Sunita Gupta Diets high in saturated fat and refined carbohydrates and the modern sedentary lifestyle. Here's how all those burgers and shakes add up: Worldwide, more than 1 billion adults are overweight or obese, Roughly 300 million considered obese. In 1985, about 30 million people had diabetes. By 2025, 350 million, or more than 10 times as many will suffer from this disease.
Worldwide, the disease is the fourth leading cause of death.
Incidence of diabetes between men and women Relation between BMI and incidence of diabetes Prevalence of diabetes between men and women across age Dr. Sunita Gupta
Impact of Diabetes on other diseases - complications Dr. Sunita Gupta
Complications from Diabetes Careless treatment or its poor management lead to serious complications ….. heart disease and stroke, retinal damage (blindness), chronic renal (kidney) failure, Poor healing of wounds (gangrene) Dr. Sunita Gupta
Impotence and difficulty passing urine in adults.
Acute complications from Diabetes If Diabetes is not controlled properly, Dr. Sunita Gupta
acute complications may occur, like
Deaths from different diseases due to complications of diabetes, 2005 (India) Dr. Sunita Gupta
TREATMENT Type 1 diabetes directly treatable only with injected insulin (insufficient or no insulin from pancreas) dietary and lifestyle changes dietary treatment together with Dr. Sunita Gupta
frequent insulin supplementation.
Prevention Other health problems that accelerate the toxic effects of diabetes are lack of regular exercise. elevated cholesterol levels, Women with high bp must be careful. They have a threefold greater risk of developing diabetes. For people with well-controlled blood sugar levels, the complications of diabetes are far less common and less severe, it is vital that for prevention of diabetes to organize His understanding of the disease, and Dr. Sunita Gupta
His participation in treatment.
Lifestyle changes - Type 1 diabetes Make Changes in lifestyle take drugs to reduce pressure. take an appropriate diet, to avoid higher risks of cardiovascular disease, to control blood pressure and cholesterol Dr. Sunita Gupta
Combine the use of regular and/or synthetic insulin for better results
Lifestyle changes - Type 2 diabetes Reduce the risk of long term complications: This is achievable by combining various oral diabetic drugs (type 2 only), and Dr. Sunita Gupta
insulin use – when not responding to oral medications (more for type 2 than type 1).
Life-style dietary changes Dr. Sunita Gupta Smaller helpings Bigger helpings Moderate helpings
Conclusion self glucose monitoring (both short and long term glucose blood levels within normal standards). avoid short and long-term diabetes-related problems Dr. Sunita Gupta
Careful control to reduce the risk of long term complications.
Some tips for avoiding complications Keep blood sugar levels as close to normal as possible Keep blood pressure under 130/80 mm Hg. Aim to keep LDL (unhealthy) cholesterol levels under 100 mg/dl, Aim to keep HDL (healthy) cholesterol levels over 40 mg/dl, Aim to keep triglyceride levels under 150 mg/dl. Practice good foot care (see "Damage to the feet and legs"). Regularly visit your doctor to assess overall health Dr. Sunita Gupta
Check for ways to reduce your risk and avoid any complications.
Possible solutions Dr. Sunita Gupta
Dr. Sunita Gupta
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What diabetes can lead to … Dr. Sunita Gupta
One Effect of Diabetes Dr. Sunita Gupta
Fast fact: Neuropathy Dr. Sunita Gupta People who maintain intensive blood sugar control reduce their risk for neuropathy by 60%.