• DIABETES ( From a Greek word meaning “ siphon “, referring to the increased output of urine) MELLITUS (From a Latin word meaning “ sweet“ 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 were
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.
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
Hyper osmolar hyperglycemic
non ketonic syndrome
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
Periphera l: 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)
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 attacks
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
E xcessive thirst
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
Finger stick glucose test
Fasting plasma glucose
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
Self monitored glucose
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 the liver. 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.