( From a Greek word meaning “ siphon “, referring to the increased output of urine)
(From a Latin word meaning
Diabetes mellitus (DM) is a set of related diseases in which the body
Cannot regulate specifically sugar( glucose) in the blood.
known also as glycosuria (glucose in urine)
• Figures for the year 2007 show that the 5 countries with
the largest amount of people diagnosed with diabetes
• India (40.9 million),
• China (38.9 million),
• US (19.2 million),
• Russia (9.6 million), and
• Germany (7.4 million).
• Currently, India is the diabetes capital of the world.
• Glucose in the blood gives
you energy to perform
normal glucose level
• daily activities, run for a bus, (100mg/dl)
ride your bike,
take an aerobic exercise class,
glucose is produced in liver.
Insulin is produced by beta cells of
langerhans of pancreas
In a healthy person, the blood glucose level
is regulated by several hormones, including insulin.
Insulin allows glucose to move from the blood
into liver, muscle, and fat cells, where it is used for fuel
• Type 1 diabetes
• Type 2 diabetes
Type 1 diabetes:
•Type 1 diabetes comprises
about 10% of total cases of diabetes.
The majority of type 1 diabetes is of
the immune-mediated nature, where beta
cell loss due to T-cell mediated autoimmune attack. There is no known
preventive measure against type 1 diabetes
•Type 1 diabetes can occur in an older individual due to destruction of
pancreas by alcohol, disease, or removal by surgery. It also results from
progressive failure of the pancreatic beta cells, which produce insulin
•People with type 1 diabetes require daily insulin treatment to sustain life
• At least 90% of patients
with diabetes have type 2 diabetes.
• The pancreas secretes insulin,
but the body is partially or
completely unable to use the insulin.
This is sometimes referred
to as insulin resistance.
• The body tries to overcome
this resistance by secreting more and more insulin (hyper inslunemia)
• It causes Dystocia It is abnormal or
difficult child birth.
• The Gestational diabetes occurs in about 2%–5% of
all pregnancies and may improve or disappear after delivery
• Untreated gestational diabetes can damage the health of the fetus or mother. Risks
to the baby include macrosomia (high birth weight),
• Gestational diabetes is fully treatable but requires careful medical supervision
throughout the pregnancy
• About 20%–50% of affected women develop type 2 diabetes later in life
• Pre-diabetes is a common condition related
to diabetes. In people with pre-diabetes, the
blood sugar level is higher than normal but
not high enough to be considered diabetic.
• Weight loss
• Poor wound healing: High blood sugar levels prevent white blood cells,
which are important in defending the body against bacteria and also in
cleaning up dead tissue and cells, from functioning normally. When these cells
do not function properly, wounds take much longer to heal and become
infected more frequently
• Common complication of
diabetes affecting the blood vessels
in the retina (the thin light-sensitive
membrane that covers the back of the eye).
If untreated, it may lead to blindness
• Non proliferative: retinopathy is the earlier stage. (bleeding) in the retina
with leakage of blood causing a "wet retina" or protein deposits
• Proliferative retinopathy is the second stage. New abnormal vessels
develop in the retina and grow towards the center of the eye.
• It is the disorder related to nerves
• Peripheral: causes pain or loss of feeling in the toes, feet, legs, hands
• Autonomic: Autonomic neuropathy causes changes in digestion, bowel and
bladder function, sexual response, and perspiration (sweating)
• Proximal neuropathy :causes pain in the thighs, hips, or buttocks and
leads to weakness in the legs
• With damage to the nervous system,
a person with diabetes may not be
able to feel his or her feet properly (dysesthesia).
• Normal sweat secretion and oil production that lubricates the skin of
the foot is impaired leads to formation of foot ulcers
• Damage to blood vessels and impairment of the immune system
from diabetes make it difficult to heal these wound
• Amputation of leg is the only treatment
• Hypoglycemia (low blood sugar) is a
commonly perceived problem
Generally, hypoglycemia is defined as
a serum glucose level (the amount of sugar or
glucose in your blood) below 70 mg/dL, (normal-100mg/dl)
• Difficult in speech or slurred speech
• Confusion, dizziness, Dysphoria, anxiety, moodiness, depression, Fatigue,
weakness, apathy, lethargy.
• Diabetic nephropathy typically affects the network
of tiny blood vessels (the microvasculature) in
the glomerulus, a key structure in the kidney
composed of capillary blood vessels.
• The glomerulus is critically necessary for the filtration
of the blood. Features of diabetic nephropathy include
the nephrotic syndrome with excessive filtration of protein
into the urine (proteinuria
• The levels of glucose causes the accumulation of fat in blood vessels
leading to the hardening of the walls of the vessels which leads
diminished blood supply cause the atherosclerosis further leads to heart
• in diabetic keto acidosis, the body shifts from its normal fed metabolism (using
carbohydrates for fuel) to a fasting state (using fat for fuel). The resulting
increase in blood sugar occurs
• These fatty acids are converted to ketones by a process called oxidation.
The body consumes its own muscle, fat, and liver cells
Loss of appetite,
• As the body contains
high amount of glucose in blood it
encourages the growth of bacteria,
fungus in infections as we know that
glucose serves as the source of energy
• It is a serious condition in which the blood sugar level gets very
high. The body tries to get rid of the excess blood sugar by
eliminating it in the urine. This increases the amount of urine
significantly and often leads to dehydration so severe that it can
cause seizures, coma, and even death
• The test involves sticking the
patient's finger for a blood sample
which is then placed on a strip. The
strip goes into a machine
that reads the blood sugar level.
• Finger stick blood glucose values
may be inaccurate at very high or very
low levels, so this test is
only a preliminary screening study
• The patient will be asked to eat or drink nothing for 8 hours
before having blood drawn (usually first thing in the morning).
If the blood glucose level is greater than or equal to 126
mg/dL without eating anything, they probably have diabetes.
• This test is a measurement of how high blood sugar levels have
been over about the last 120 days (the average life-span of the
red blood cells on which the test is based).
• Excess blood glucose hooks on to the hemoglobin in red blood
cells and stays there for the life of the red blood cell.
• The percentage of hemoglobin that has had excess blood sugar
attached to it can be measured in the blood
• A healthy diet is key to
controlling blood sugar levels
and preventing diabetes complications.
• If the patient is obese and has
had difficulty losing weight on their own, talk to a healthcare
provider. He or she can recommend a dietitian
• Regular exercise, in any form, can help reduce
the risk of developing diabetes. Activity can
also reduce the risk of developing complications
of diabetes such as heart disease, stroke, kidney
failure, blindness, and leg ulcers
• As little as 20 minutes of walking three times
a week has a proven beneficial effect. Any exercise is beneficial; no matter how
light or how long, some exercise is better than no exercise
• Excessive alcohol use is a known risk
factor for type 2 diabetes. Alcohol consumption can cause low
or high blood sugar levels, increase in triglycerides, which is a
type of fat in our blood.
• Chronic alcohol causes pancreatitis &damage
to beta cells of langerhans
• Smoking: If the patient has diabetes,
and you smoke cigarettes , they are raising the
risks markedly for nearly all of the complications of diabetes.
• Smoking damages blood vessels and contributes
to heart disease, stroke, and poor circulation in the limbs. If someone needs
help quitting, talk to a healthcare provider.
• Check blood sugar levels frequently, at least
before meals and at bedtime, and record the
results in a logbook.
• Sulfonylureas: These drugs stimulate the pancreas to make more insulin.
Ex. Glipizide (Glucotrol) glyburide
• Biguanides: These agents decrease the amount of glucose produced by
Ex- Metformin, phenformin,butformin
• Alpha- glucosidase inhibitors: These agents slow absorption of the
starches one eats. This slows down glucose production.
Ex- Miglitol(Glyset), Acarbose(Glucobay)
• Meglitinides: These agents stimulate the pancreas to make more insulin.