Diabetes mellitus is a clinical syndrome characterized by hyperglycemia due to insulin deficiency or resistance. There are two main types: type 1 caused by autoimmune destruction of beta cells and type 2 associated with insulin resistance. Symptoms include increased thirst, frequent urination, and weight loss. Diagnosis involves blood glucose or HbA1c tests. Treatment focuses on managing blood sugar levels through lifestyle changes, oral medications, or insulin injections. Homeopathic remedies like Syzygium jambolanum and Insulinum may help control symptoms. The document provides details on the pathogenesis, diagnosis and management of both type 1 and type 2 diabetes mellitus.

1. DIABETES
MILLITUS
SUBMITTED TO : DR.
SURUCHI
SUBMITTED BY : DIVYA
DORA

2.  Diabetes Mellitus is a Clinical
Syndrome characterized by an
increase in Plasma Blood
Glucose(Hyperglycemia), either
due to absolute or relative
deficiency of Insulin.

3. TYPES OF DIABETES MELLITUS
TYPE 1
 Insulin Dependent Diabetes
Mellitus.
 Immune mediated Diabetes
Mellitus.
 Juvenile Diabetes Mellitus.
 It is caused by Autoimmune
destruction of insulin
producing beta cells in
Pancreas.
TYPE 2
 Non- Insulin Dependent Diabetes
Mellitus.
 Non- Immune mediated Diabetes
Mellitus.
 Adult Diabetes Mellitus.
 Cells and tissues are resistant to
action of insulin.

4. PATHOPHYSIOLOGY
GENERAL
 Insulin is released into the blood by Beta cells found
in the Islets of Langerhans in the pancreas, in
response to rising levels of blood glucose, typically
after eating.
 Lower glucose levels results in decreased insulin
release from the beta cells and results in the
breakdown of glycogen to glucose.
 This process is mainly controlled by the hormone
Glucagon, which acts in the opposite manner to
insulin.

5.  Insulin plays a critical role in balancing glucose levels in
the body:
 It can inhibit the breakdown of glycogen or the process of
gluconeogenesis.
 It can stimulate the transport of glucose into fat and muscle cells.
 It can stimulate the storage of glucose in the form of glycogen.

6. PATHOGENESIS OF DM TYPE 1
 Slowly developing autoimmune disorder in which
there is progressive destruction of insulin
secreting beta cells of pancreas leading to hyper
glycaemia. So these patients respond to
exogenous insulin shot.
 Diabetes is partly inherited, with multiple genes,
including certain HLA genotypes, known to
influence the risk of diabetes.
 In genetically susceptible people, the onset of
diabetes can be triggered by one or more
environmental factors, such as a viral infection or
diet.
 Among dietary factors, gluten may lead to type 1
diabetes, but the mechanism is not
fully understood.

8. METABOLIC DISTURBANCE IN TYPE 1 DIABETES
MELLITUS
Beta cell Destruction
 Hyperglycemia
Hyperglycemia becomes toxic to remaining beta cells and ultimately all cells burn out leading to
profound insulin deficiency.
 Decrease Insulin
Decrease Insulin
Decrease Uptake of glucose by peripheral cells
Decrease Anabolism
Increase Catabolism

12. METABOLIC CHANGES IN TYPE 2 DIABETES MELLITUS

13. SIGNS OF DIABETES MELLITUS
 Acanthosis Nigricans
 Diabetic Ulcers
 Hypertension
 Prayers Sign

14. DIABETES DIAGNOSIS
1. Random Glucose Test = >=200 mg/dl
2. Fasting Glucose test = >=125 mg/dl
3. HBA1C = > 5.6%(normal)
It is a Non Enzymatic covalent attachment of glucose to Hemoglobin.
It is done twice in a year to assess Glycaemia control.
4. OGTT(Oral Glucose Tolerance Test)

15. Eye Examination- Diabetic Retinopathy.
Examination of lower limbs and feet.

16. MANAGEMENT OF DIABETES MELLITUS
Aim
To improve symptoms of Hyperglycemia.
To minimize the risks of long-term microvascular and macrovascular complication.
TYPE 2 DIABETES MELLITUS
1. First Line of Treatment (Dietary & life style
modification).
2. Oral Anti-Diabetic drugs in those with serve
symptomatic hyperglycemia.
3. Knowledge of Diabetes & about symptoms of
hypoglycemia & hyperglycemia.
4. Exercise.
5. Stop Smoking.
6. Avoid precipitating factors.
7. calories reduction.
TYPE 1 DIABETES MELLITUS
1. Insulin Shots.
2. No medicines required.
3. Diet based on usual food intake,
balanced with insulin & exercise pattern.
4. Advice high carbohydrate, low fat, &
low cholesterol diet taken.

17. ADMINISTRATION OF INSULIN
 Fastest absorption from abdomen, followed by arm, thigh,
Buttock.
Drug of spoil Diabetes
METFORMIN.
SULFONYLUREAS.
Adverse Effects of Insulin
 Local allergic reactions.
 Insulin Lipodystrophy.
 Insulin resistance
DRUG THERAPY: INSULIN

19. DIFFERENCE BETWEEN TYPE 1 AND TYPE
2 DIABETES MELLITUS
TYPE 1 DIABETES MELLITUS
 Age : <20 years.
 Weight : Normal weight.
 Genetics : 6%.
 Always associated with HLA DR3 and DR4.
 Pathogenesis : Autoimmune beta cell destruction.
 Islet cells : Destruction.
 Clinical features : polyuria, polydipsia, polyphagia,
weight loss, fatigue.
 Acute complication : DKA (Diabetic Ketoacidosis)
TYPE 2 DIABETES MELLITUS
 Age : >30 years.
 Weight : Obese.
 Genetics : 70-80%.
 Not associated .
 Pathogenesis : Insulin resistance.
 Islet cell : No.
 Clinical features : Fatigue, impaired
healing, repeated infection.
 Acute Complication : Hyper osmolar non-
ketotic coma.

20. RESREACH ARTICLES ON DIABETES
 Epidemiological studies demonstrate that some diabetes patients have an increased
risk of developing AD compared with healthy individuals.
• Metabolic disorder such as glucose/lipid metabolism, oxidative stress, mitochondrial
dysfunction and protein changes occurs by DM are associated with an impaired insulin signal
pathway. These metabolic factors increase the prevalence of AD in diabetes patients.
 Post Transplantation Diabetes Mellitus in Kidney Allograft Recipients.
• The insulin resistance that occurs in the end-stage kidney is aggravated in the post-
transplantation period. The development of PTDM is thought to be similar to that of type-2
DM in the general population where insulin resistance is a prominent feature.
 Type 2 Diabetes Mellitus as a risk factor for covid-19.
• Type 2 Diabetes Mellitus (T2DM) is considered a risk factor for a poor prognosis in covid –19.
These mechanisms include impaired neutrophil degranulation and complement activation,
increased glucose concentration in airway secretion, which significantly increases viral
replication. Decreased viral clearance, and a more significant presence associated
comorbidities.

21. HOMOEOPATHIC MANAGEMENT OF
DIABETES MELLITUS
SYZYGIUM JAMBOLANUM
 The most useful remedy in diabetes mellitus. No other remedy causes in so marked degree the diminution
and disappearance of sugar in the urine.
 Prickly heat in upper part of the body. Great thirst, weakness, emaciation.
 Great thirst, weakness, emaciation.
 Very large amount of urine, specific gravity high.
 Old ulcers of skin Diabetic Ulceration.
 Dosage: It is given in lower potencies and Q.
URANIUM NITRICUM
 Causes glycosuria and increased urine. The great emaciation, debility and tendency to ascites and general
dropsy. Copious urination Diuresis Incontinence of urine Diabetes emaciation and tympanites. Burning in
urethra, with very acid urine.

22. INSULINUM
 The treatment of Diabetes, restoring the lost ability to oxidize carbohydrate and again
storing glycogen in the liver.
 It is indicated, It is persistent case of skin irritation, boils or varicose ulceration with
polyuria.
 Dose: 3x to 30x.
ABROMA AUGUSTA
 It is indicated in diabetic patients who feel more weakness due to losing flesh. It is
helpful for patients having thirst with dryness in the mouth, frequent urination, and
increased appetite. Many Diabetes patients suffer from sleeplessness.

23. CASE OF DIABETES MELLITUS IN A 55
YEARS OLD MAN
 Age : 55
 Height : 5ft. 4 inches.
 Weight : 64 kg.
 Present & Past Occupation : Teacher.
 Married.
 Only son died six years back.
PRESENTING COMPLAINTS:
 Weakness & drowsiness more towards evening, aggravated by
movement, exertion.
 Frequent urination.
 Burning after urination: Urethra feels scalded.
 Disturbed sleep.
 Wormy irritation in anus.
 Headache occasionally in the evening. Shifting, piercing pain.
PHYSICAL GENERAL
 Head : Hot feeling in vertex.
 Mouth : Dryness of mouth.
 Teeth : Swelling of gums.
 Abdomen : Occasional gas & distension of abdomen.
 Stomach : Appetite.
 Sweat : Profuse sweat.
 Urine : Yellowish color.
 Stool : Regular.
 Joints : Painful stiffness of joints was severe during 2019,
a little better after allopathic treatment.
 Occasional weakness & trembling of the lower extremities towards
evening, after a day work stumbles.
 Male Genital Organs : History of masturbation during youth up to
his 30s power deficient since.
 Skin Disease : Dandruff, Barber itch.

24. MENTAL SYMPTOMS:
 Irritable & indifferent attitude depression. Likes to be alone, introverted type. Gradual weakness of
memory. Work slowly, Fear of incurable diseases.
FIRST CAUSE OF BREAKDOWN OF HEALTH:
 Death of his son, 6 years of age: Never been well since (N.B.W.S).
PAST HISTORY:
 History of masturbation during youth 30's. Allopathic medicines used for the last 4 years without
appreciable effect.
 History of measles in childhood; Malaria 2-3 times; Stiff joints, barber itch treatment with cortisone group
of medicines; Diabetes; Diagnosed 4 years previously; Suffered from chicken pox in childhood.
FAMILY HISTORY:
 History of skin disease and pleurisy with father.
CASE ANALYSIS:
 Provisional diagnosis :- Diabetes Mellitus(secondary type).
 Miasm :- Tubercular.
 Selection remedy :- Acid Phosphorus.

25. BIBILLIOGRAPHY
 Davidson Principles and Practice of medicine.
 Harrison Principle of internal medicine.
 PubMed.
 Indian journal of research in Homoeopathy...

26. THAN
K YOU
PRESENTATION BY DIVYA DORA