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  • 1.  
  • 2. 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
  • 3.
    • 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
  • 4. 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
  • 5. 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
  • 6. 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
  • 7. 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.
  • 8. 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
  • 9. 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
  • 10. 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
  • 11. 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.
  • 12. Types of Diabetes
    • Diabetes mellitus –
    • Three main forms (WHO):
    • type 1 ,
    • type 2 , and
    • gestational diabetes
    • (occurs during pregnancy)
    Dr. Sunita Gupta
  • 13. 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,
    • unexplained weight loss, and
    • lethargy.
    Dr. Sunita Gupta
  • 14. Statistical breakup of symptoms Dr. Sunita Gupta
  • 15. 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
  • 16. 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
  • 17. 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
  • 18. 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
  • 19. 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
  • 20. 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.
  • 21. 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
  • 22. Impact of Diabetes on other diseases - complications Dr. Sunita Gupta
  • 23. 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
  • 24. 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
  • 25. 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
  • 27. 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
  • 28. 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
  • 29. 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
  • 30. Life-style dietary changes Dr. Sunita Gupta Smaller helpings Bigger helpings Moderate helpings
  • 31. 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
  • 32. 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
  • 33. Possible solutions Dr. Sunita Gupta
  • 34.
    • Any questions?
    Dr. Sunita Gupta
  • 35.
        • Thank You for listening
    Dr. Sunita Gupta
  • 36. What diabetes can lead to … Dr. Sunita Gupta
  • 37. One Effect of Diabetes Dr. Sunita Gupta
  • 38. Fast fact: Neuropathy Dr. Sunita Gupta People who maintain intensive blood sugar control reduce their risk for neuropathy by 60%.