DIABETES MELLITUS B.PHARM 2ND SEMESTER PATHOPHYSIOLOGY

1. PATHO PHYSIOLOGY
B.Pharm 2nd semester
PPT By
Arun Kumar Dutta
Student of GIST,Gunupur

2. CONTENTS
• Definition
• Types
• Etiology
• Pathogenesis
• Sign and symptoms
• Complications
• Diagnosis
• Plan of treatment

3. DEFINITION
• Diabetes mellitus (DM) is a metabolic disease, involving
inappropriately elevated blood glucose levels.
• Too much sugar in the blood caused by problems with insulin
production .
• This include type-I diabetes (deficiency of insulin) and type-II
diabetes(initially excessive , then deficiency).

4. TYPES
• There are three main types of DM
1. Type-1 DM
2. Type-2 DM
3. Gestational diabetes

5. TYPES
• Type-1 DM:- It results from the body’s failure of insulin production by β-cells of the
islets of Langerhans in the Pancreas , leading to insulin deficiency .Only about
10% of all people with diabetes have Type-1 disease. Most people who have Type-1
diabetes develop the disease before age 30 although it can develop later in life
• Type-2 DM:- this form of DM which accounts for 90% of those with diabetes
,encompasses individual who have insulin resistance , diminished tissue
sensitivity to insulin , impaired β-cell function (delayed or inadequate insulin
release)and excessive or inappropriate glycogen secretion. Type-2 diabetes may
occur at any age but more common in people older than the age of 40.
• Gestational diabetes:- Blood sugar elevation during pregnancy is called
Gestational diabetes.

6. ETIOLOGY
• Although the specific etiology is unknown. Autoimmune destruction of
β-cells does not occur but it is attributed to typical genetic makeup,
familial history , obesity and defect in insulin receptor.
• Type-2 diabetes also tends to run in families, obesity, excess
production of growth hormone, high level Corticosteroids.

7. PATHOGENESIS

8. SIGN AND SYMPTOMS
• Ketoacidosis
• Presence of glucose in urine
• Polydipsia(increased thirst)
• Polyuria
• Fatigue and headache
• Blurred vision
• Loss of weight
• Slow healing cuts sores.

9. COMPLICATIONS

10. DIAGNOSIS

11. PLAN OF TREATMENT
• Non pharmacological :- Diet, controlling weight avoid excessive salt in take, avoid
alcohol.
• Pharmacological:-
1. Drugs improving insulin availability
a. Exogenous insulin – Isophane, Protamine
b. Sulfonylureas – Tolbutamide, Glimepiride
2. Drugs over coming insulin resistance
a. Biguanide - Metformin
b. Thiazolidinediones – Rosiglitazone
c. Alpha-glucosidase inhibitors – Miglitol , Acarbose
3. DPP-4 inhibitors – linagliptin , Alogliptin
4. SGLT2 inhibitors – Empagliflozin, Dapagliflozin