• 250 BC The Word Diabetes First UsedApollonius of Memphis coined the name"diabetes” meaning "to go through" or siphon.He understood that the disease drained morefluid than a person could consume.Gradually the Latin word for honey, "mellitus,"was added to diabetes because it made theurine sweet.
Definition:-• Diabetes mellitus is a chronic systemic disease characterized by either a deficiency of insulin or a decrease ability of the body to use insulin.
What is Diabetes Mellitus? A chronic syndrome of• impaired carbohydrate, protein, an d fat metabolism owing to insufficient secretion of insulin or to target tissue insulin resistance, characterized by polydipsia, polyuria and polyphagia.
Type-I Diabetes mellitus:-• In this form of diabetes mellitus the Beta cells of pancreas that normally produce insulin which are destroy by an auto-immune response.• As a result insulin injection are needed to control the elevated blood sugar level.
CLASSIFICATION Type 1 diabetes mellitus is characterized by loss of the insulin- producing beta cells of the islets of Langerhans in the pancreas leading to insulin deficiency. Type 1 diabetes can affect children or adults but was traditionally termed "juvenile diabetes" because it represents a majority of the diabetes cases in children.• TYPE1 DIABETES
Type-2 Diabetes mellitus:-• It refers from decreased sensitivity to insulin or decrease production of insulin.• This type of patient firstly treated by diet and exercise and secondary by oral hypoglycemic drug.
TYPE 2 DIABETES Type 2 diabetes mellitus is characterized by insulin resistance which may be combined with relatively reduced insulin secretion. At this stage hyperglycemia can be reversed by a variety of measures & medications that improve insulin sensitivity or reduce glucose production by the liver.
Causes:-• 1) Age- > 40yrs.• 2) Obesity• 3) Family history.
Gestational D.M. :- • Onset is during pregnancy usually 2nd & 3rd trimester. • It may be due to hormonal secretion by the placenta which inhibit the action of insulin.
GESTATIONAL DIABETES Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness. It occurs in about 2%–5% of all pregnancies and may improve or disappear after delivery. This is particularly problematic as diabetes raises the risk of complications during pregnancy, as well as increasing the potential that the children of diabetic mothers will also become diabetic in the future.
DIAGNOSIS Diabetes mellitus is characterized by recurrent or persistenthyperglycemia, and is diagnosed by demonstrating any one of the following – * Fasting plasma glucose level ≥ 7.0 mmol/L (126 mg/dL). * Plasma glucose ≥ 11.1 mmol/L (200 mg/dL) two hours after a 75 g oral glucose load as in a glucose tolerance test. * Symptoms of hyperglycemia and casual plasma glucose ≥ 11.1 mmol/L (200 mg/dL) * Glycated hemoglobin (Hb A1C) ≥ 6.5%.
Investigations:- • 1) Fasting blood glucose. • 2) Random blood glucose. • 3) Postprandial blood glucose level. • 4) Oral glucose tolerance test. • 5) Urine test for ketonuria. • 6) Urine test for proteinuria.