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    Diabetes Diabetes Presentation Transcript

    • 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,
        • How to control diabetes
        • the fundamentals of nutrition and exercise.
        • up-to-date information about recent innovations in treatment and
        • most importantly, you'll see that it's not just possible to live with diabetes; it's possible to live well.
      Dr. Sunita Gupta
      • 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.
      • Deficiency of insulin or insensitivity of its receptors
        • Causes Diabetes Miletus
      Dr. Sunita Gupta
    • 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.
      • In response to this, the Pancreas release Insulin into the blood.
      Dr. Sunita Gupta
    • 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
      • To use as fuel and
      • To convert to other needed chemicals, or
      • for storage.
      Dr. Sunita Gupta
    • 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….
      • Type 1 Diabetes
      • Type 2 Diabetes
      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,
        • protein synthesis, and
        • fat storage.
      • 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.
      • The net effect –
        • persistent high levels of blood glucose,
        • poor protein synthesis, and
        • other metabolic derangements, such as acidosis.
      Dr. Sunita Gupta
    • 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
        • and starves the body between the meals and overnight.
      The defective food processing cycle Dr. Sunita Gupta
    • 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,
        • the body relies on pancreas to produce two hormones insulin and glucagon
      Insulin vs Glucagon cycle – A comparison Dr. Sunita Gupta
    • 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
      • Diabetes mellitus –
      • Three main forms (WHO):
      • type 1 ,
      • type 2 , and
      • gestational diabetes
      • (occurs during pregnancy)
      Dr. Sunita Gupta
      • 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,
      • unexplained weight loss, and
      • lethargy.
      Dr. Sunita Gupta
    • 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.
      • Gestational diabetes : the hormones produced during pregnancy can cause insulin resistance in women genetically prone to develop Diabetes.
      Dr. Sunita Gupta
    • Diabetes - a genetic source?
      • Partly inheritance - Both type 1 and type 2 diabetes.
      • At least 10 genes found - links to the causes of Type-2 diabetes.
      Dr. Sunita Gupta
    • 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.
        • This risk increases with increase in number of relatives with diabetes.
      Dr. Sunita Gupta
    • 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).
        • plasma glucose
          • at or above 200 mg/dL (11.1 mmol/l) two hours after a 75 g oral glucose load.
        • random plasma glucose
          • at or above 200 mg/dL (11.1 mmol/l).
      Dr. Sunita Gupta
    • 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
        • a more formal glucose tolerance test.
      Dr. Sunita Gupta
    • 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 –
        • Diets high in saturated fat and refined carbohydrates and the modern sedentary lifestyle.
      Dr. Sunita Gupta
      • 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 …..
      • Diabetes causes:
        • Damage to eyes
        • heart disease and stroke,
        • retinal damage (blindness),
        • chronic renal (kidney) failure,
        • Poor healing of wounds (gangrene)
        • amputations
        • Impotence and difficulty passing urine in adults.
      Dr. Sunita Gupta
    • Acute complications from Diabetes
      • If Diabetes is not controlled properly,
      • acute complications may occur, like
      • dehydration
      • hypoglycemia,
      • ketosis,
      • acidosis.
      • Coma and
      • Even death
      Dr. Sunita Gupta
    • Deaths from different diseases due to complications of diabetes, 2005 (India) Dr. Sunita Gupta
      • Type 1 diabetes directly treatable
        • only with injected insulin
        • (insufficient or no insulin from pancreas)
        • dietary and lifestyle changes
      • Type 2 diabetes requires
        • dietary treatment together with
          • tablets
          • injections and,
          • frequent insulin supplementation.
      Dr. Sunita Gupta
    • Prevention
      • Other health problems that accelerate the toxic effects of diabetes are
        • obesity,
        • high blood pressure, and
        • lack of regular exercise.
        • elevated cholesterol levels,
        • smoking,
      • 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
        • Patient education,
        • His understanding of the disease, and
        • His participation in treatment.
      Dr. Sunita Gupta
    • Lifestyle changes - Type 1 diabetes
      • Make Changes in lifestyle
        • take drugs to reduce pressure.
        • take an appropriate diet,
        • quit smoking,
        • Exercise more,
        • wear diabetic socks,
      • to avoid higher risks of cardiovascular disease,
      • to control blood pressure and cholesterol
      • Combine the use of regular and/or synthetic insulin for better results
      Dr. Sunita Gupta
    • Lifestyle changes - Type 2 diabetes
      • Reduce the risk of long term complications:
      • This is achievable by combining
        • diet,
        • exercise and
        • weight loss (type 2),
        • various oral diabetic drugs (type 2 only), and
        • insulin use – when not responding to oral medications (more for type 2 than type 1).
      Dr. Sunita Gupta
    • Life-style dietary changes Dr. Sunita Gupta Smaller helpings Bigger helpings Moderate helpings
    • Conclusion
      • Diabetes mellitus is
        • a chronic disease,
        • without a cure.
      • Emphasize on role for
        • patient education,
        • dietetic support,
        • sensible exercise,
        • self glucose monitoring (both short and long term glucose blood levels within normal standards).
        • avoid short and long-term diabetes-related problems
        • Careful control to reduce the risk of long term complications.
      Dr. Sunita Gupta
    • 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
      • Check for ways to reduce your risk and avoid any complications.
      • Exercise and walk daily.
      Dr. Sunita Gupta
    • Possible solutions Dr. Sunita Gupta
      • Any questions?
      Dr. Sunita Gupta
          • Thank You for listening
      Dr. Sunita Gupta
    • 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%.