BIOCHEMICAL PROFILE OF DIABETES MELLITUS by DR MUSTANSAR FJMC LAHORE

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BIOCHEMICAL PROFILE OF DIABETES MELLITUS
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DR MUSTANSAR FJMC LAHORE

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BIOCHEMICAL PROFILE OF DIABETES MELLITUS by DR MUSTANSAR FJMC LAHORE

  1. 1. BIOCHEMICAL PROFILE OF DIABETES MELLITUS DR MUSTANSAR
  2. 2. In 1500 BC Diabetes First Described In Writing• Hindu healers wrote that flies and ants were attracted to urine of people with a mysterious disease that caused intense thirst, enormous urine output, and wasting away of the body © 2004, John Walsh, P.A., C.D.E.
  3. 3. • 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.
  4. 4. 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.
  5. 5. 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.
  6. 6. A glucose (C6H12O6).
  7. 7. Classification ofDiabetes.Mellitus.:-
  8. 8. 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.
  9. 9. Before Insulin JL on 12/15/22 and 2 mos laterBefore insulin was discovered in 1921, everyone with type 1 diabetes died within weeks to years of its onset © 2004, John Walsh, P.A., C.D.E.
  10. 10. 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
  11. 11. Causes:-• 1) Genetic factors.(HLA)• 2) Immunological factors.• 3) Environmental factors.
  12. 12. 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.
  13. 13. 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.
  14. 14. Causes:-• 1) Age- > 40yrs.• 2) Obesity• 3) Family history.
  15. 15. 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.
  16. 16. 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.
  17. 17. Clinical Manifestation:- • Polydypsia. • Polyphasia. • Polyuria. • Hyperglycemia. • Blurred vision. • Diabetic ketosis. • Diabetic ketoacidosis. • Dry skin. • Slow healing wound. • Weakness.
  18. 18. 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%.
  19. 19. 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.
  20. 20. DIABETES MELLITUS
  21. 21. Glycemic Control A1C% Mean Plasma Glucose (mg/dl) 6 135 7 170 8 205 9 240 10 275 11 310
  22. 22. Glycemic Control• HgA1C < 6% - normal.• HgA1C < 7% - goal.• HgA1C 7.0 - 7.5% - good control.• HgA1C > 7.5% - additional therapy• Pre-prandial glucose 90-130 mg/dl• Peak postprandial glucose < 180 mg/dl• HgA1C every 3 months unless at goal then every 6 months.
  23. 23. Management:-• The main management or goal is to normalise insulin activity and blood glucose level to reduce the vascular and nephropathic complications.
  24. 24. 5FIVEmain components ofmanagement of diabetes mellituspatient’s are:-
  25. 25. Cont..• 1) Diet• 2) Exercise• 3) Monitoring• 4) Education• 5) Medication
  26. 26. MEDICATION Medication may be 2 types• Insulin Oral medications
  27. 27. CONCLUSION• FOODS TO BE TAKEN FOODS NOT TOBE TAKEN •Fruits & veg •High in fat •High in sugar •Garlic, ginger •Radish •High in salt •Spinach •Low starchy carbohydrate foods

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