diabetes

1. Vajja Swathi
8th Sem

2. Diabetes mellitus is a metabolic disorder
characterized by chronic hyperglycemia with
disturbances in metabolism of
Carbohydrates,
Fats ,
Proteins
resulting from defects of
Insulin secretion,
Insulin action (or)
Both
Clinical Definition
Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications

3. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications

4. Type I Diabetes:
Have little or no insulin
secretory capacity.
Depend on exogenous insulin
to prevent metabolic
decompensation and death.
Symptoms are ACUTE and
appear relatively abruptly (i.e.
Over days or Weeks)
Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
Clinical presentation of Diabetes is heterogeneous
ranging from asymptomatic type to life threatening
diabetic ketoacidosis.

5. TYPE I DIABETES
OSMOTIC SYMPTOMS :
 Thirst and frequent drinking (POLYDIPSIA)
 More frequent urination, (POLYURIA)
Excessive hunger (POLYPHAGIA)
 Unexplained weight loss
 Fatigue and Lassitude
ASSOCIATED SYMPTOMS:
Muscular Cramps
Blurred vision
Cutaneous and Oro genital fungal or bacterial infections.
Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications

6. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications

7. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
 Insulin

 Glucose Utilization
+
 Glycogenolysis

Hyperglycemia

Glucosuria
 (osmotic diuresis)
 POLYURIA*
(and electrolyte imbalance)

POLYDIPSIA*
* Hallmark symptoms of
diabetes
 Insulin

 Protein Catabolism

 Gluconeogenesis
(amino acids  glucose)

Hyperglycemia

WEIGHT LOSS and Fatigue

8. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
Type II Diabetes:
Insulin resistance
 Body tissues do not respond to insulin
 Results in hyperglycemia
Decreased (but not absent) endogenous insulin
secretory capacity.
 Not dependent on insulin
for immediate survival
 Require insulin therapy
for optimal glycemic
control over time
 Clinical features of type 2
diabetes can be insidious

9. TYPE II DIABETES
ASYMPTOMATIC
Undetected hyperglycemia for many years
(asymptomatic phase)
OSMOTIC SYMPTOMS :
Classic symptoms may be quite mild
Thirst and frequent drinking (POLYDIPSIA)
More frequent urination (POLYURIA), Nocturia
Excessive hunger (POLYPHAGIA)
Weight Gain
Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications

10. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
ASSOCIATED SYMPTOMS:
Nonspecific complaints often
dominate
Fatigue and lassitude,
Blurred vision,
Dizziness,
Infections,
Delayed wound healing
Numbness of limbs.

11. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
Presence of Sufficient
Endogenous Insulin

NO Protein Catabolism

NO Gluconeogenesis
(amino acids  glucose)

NO WEIGHT LOSS

OVER WEIGHT (or) OBESE

12. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
Clinical features at presentation of
type 1 and type 2 diabetes

13. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
Develops during pregnancy.
Detected at 24 to 28 weeks of
gestation.
Associated with risk for
cesarean delivery, perinatal
death, and neonatal
complications.
Mother suffering from diabetic
vascular disease results in
IUGR.

14. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
Acute complications
Diabetic ketoacidosis
Hyperosmolar diabetic nonketotic coma
Chronic complications:
 MICROVASCULAR
Retinopathy
Nephropathy
Neuropathy
 MACROVASCULAR
Cerbrovascular,
Cardiovascular,
Peripheral vascular disease
 INFECTIONS

15. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications

16. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications

17. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications

18. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
Cerebrovascular disease
Ischemic heart disease
Peripheral vascular disease
Macro-vascular Complications

19. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
Risk:
Stroke 2 to 4 times
higher
Heart Disease 2 to 4
times higher
~75% of diabetes patients
have high blood pressure
(hypertension)
~75% of people with
diabetes have a dyslipidemia
(cholesterol disease)
CARDIOVASCULARDISEASES

20. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
CEREBRO VASCULAR DISEASES
Transient ischemic attack
Cognitive impairment
Cerebrovascular accidents
Stroke

21. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
Blockage of arteries in legs.
Contributing factor to amputations.
PERIPHERALARTERIALDISEASES

22. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
MICRO-VASCULAR
COMPLICATIONS
Retinopathy
Nephropathy
Neuropathy
i

23. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
MaculopathyRetinopathy
Proliferative
Retinopathy
RETINOPATHY
Normal
retina
Non proliferative
diabetic retinopathy

24. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
NEPHROPATHY

25. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications

26. Clinical
Definitio
n
Type 1
diabete
s
Type 2
diabete
s
Gestationa
l diabetes
Complications
DIABETICDERMPOATHY