2. Introduction
This presentation will help you
– better understand and manage your diabetes.
– It covers the three main forms of diabetes, type 1 and type
2,.
– how your body metabolizes sugar,
– How to control diabetes
– the fundamentals of nutrition and exercise.
– up-to-date information about recent innovations in
treatment and
– most importantly, you'll see that it's not just possible to
live with diabetes; it's possible to live well.
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3. • Insulin is the principal
hormone in the body
– It plays a key role in all forms
of diabetes mellitus.
– It regulates uptake of glucose
from the bloodstream into
every muscle and all fat cells,
– But not into the cells of the
central nervous system.
• Deficiency of insulin or
insensitivity of its receptors
– Causes Diabetes Miletus
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4. When our body functions normally …
The normal food processing cycle
• food is converted to
glucose before it is used
by the blood and body as
fuel.
• As a result, blood glucose
levels in the body rise.
• In response to this, the
Pancreas release Insulin
into the blood.
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5. When our body functions normally …
The different organs involved in the
normal food processing cycle
• about two-thirds of the
body's cells use Insulin to
• absorb glucose from the
blood
• To use as fuel and
• To convert to other
needed chemicals, or
• for storage.
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6. Normal glucose absorption
Insulin binds to
receptors on the cell
membrane, much as a
key fits into a lock,
signal glucose
transporters
Glucose
transporters move
to the cell
membrane and bind
to glucose.
Glucose enters the
cell.
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7. When the system fails to
absorb glucose….
Type 1 Diabetes Type 2 Diabetes
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An immune system attack
severely limits the ability of
the pancreas to produce
insulin Glucose cannot enter
the cells.
• Cells develop a resistance to
insulin. Glucose builds up in
the bloodstream.

8. When the insulin is high/ low
• Higher insulin levels increase certain
processes, like
– cell growth and duplication,
– protein synthesis, and
– fat storage.
• If the amount of insulin available is
insufficient due to
– insulin insensitivity or resistance - poor
response of the cells
– defective insulin, then glucose will
• neither be absorbed properly by those body cells
that require it
• nor will it be stored appropriately in the liver and
muscles.
• The net effect –
– persistent high levels of blood glucose,
– poor protein synthesis, and
– other metabolic derangements, such as
acidosis.
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9. When the body begins to
malfunction…
• Glucose, after food is absorbed
from the intestines
– and distributed to all the body
cells through the bloodstream.
• The glucose concentration in the
blood
– body keeps constant and avoids
extra glucose right after every
meal
– and starves the body between the
meals and overnight.
The defective food
processing cycle
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10. When the body begins to
malfunction…
• When glucose in the body is excess
– stored in the liver and muscles as
glycogen.
• When glucose is in short supply,
– the body stimulates to eat food
and/or mobilizes the stored glycogen.
• To maintain a constant blood-
glucose level,
– the body relies on pancreas to
produce two hormones insulin and
glucagon
Insulin vs Glucagon
cycle – A comparison10Gokul

11. Diabetes mellitus
Diabetes mellitus (or simply diabetes)
is a condition when:
• the organism begins to malfunction
– metabolic disorder
• levels of the hormone insulin in the
blood become insufficient
• the body cells fail to respond to the
insulin that is produced, or both.
• as a result, blood sugar levels grow
abnormally high (hyperglycaemia)
• This is Diabetes and is not curable.

12. Types of Diabetes
Diabetes mellitus –
Three main forms (WHO):
I. type 1,
II.type 2
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13. SYMPTOMS
• The characteristic symptoms are
• excessive thirst and increased fluid
intake (polydipsia) attempting to
compensate for increased
urination,
• blurred vision due to high blood
glucose effects on the eye's optics,
• unexplained weight loss, and
• lethargy.
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14. CAUSES of Diabetes mellitus
• Type 1 diabetes - when the pancreatic cells are
destroyed due to autoimmune system of the body.
• Type-2 diabetes - when due to high levels of blood
sugar, the body is unable to utilize it’s insulin and
move blood sugar into the cells to produce energy.
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15. Diabetes - a genetic source?
• Partly inheritance - Both type 1 and
type 2 diabetes.
• At least 10 genes found - links to the
causes of Type-2 diabetes.
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16. How genes influence Diabetes?
• Type 1 diabetes is triggered
– by some (mainly viral) infections,
– by stress or environmental exposure (such as exposure
to certain chemicals or drugs).
• Type 2 diabetes - a stronger inheritance pattern.
• If first relatives have type 2 diabetes
• risk of developing type 2 diabetes is much higher.
• This risk increases with increase in number of relatives
with diabetes.
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17. diagnosis
Recurrent or persistent hyperglycaemia during
Diabetes mellitus is diagnosed by any one of
the following methods:
• fasting plasma glucose level
• at or above 126 mg/dL (7.0 mmol/l).
• plasma glucose
• at or above 200 mg/dL (11.1 mmol/l) two hours after a
75 g oral glucose load.
• random plasma glucose
• at or above 200 mg/dL (11.1 mmol/l).
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18. Diabetes screening
• Diabetes screening is recommended
– at various stages of life, and
– For those with any of several risk factors.
• Diabetes screening could be
– a random blood glucose test,
– a fasting blood glucose test,
– a blood glucose test two hours after 75 g of
glucose, or
– a more formal glucose tolerance test.
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19. Incidence of diabetes between men
and women
Relation between BMI and incidence
of diabetes
Prevalence of diabetes between men and
women across age
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20. Impact of Diabetes on other
diseases - complications
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21. Complications from Diabetes
• Careless treatment or its poor
management lead to serious
complications …..
• Diabetes causes:
• Damage to eyes
• heart disease and stroke,
• retinal damage (blindness),
• chronic renal (kidney) failure,
• Poor healing of wounds (gangrene)
• amputations
• Impotence and difficulty passing urine in
adults.
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22. Acute complications from Diabetes
If Diabetes is not
controlled properly,
acute complications
may occur, like
• dehydration
• hypoglycemia,
• ketosis,
• acidosis.
• Coma and
• Even death 22
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23. TREATMENT
• Type 1 diabetes directly treatable
– only with injected insulin
(insufficient or no insulin from pancreas)
– dietary and lifestyle changes
• Type 2 diabetes requires
– dietary treatment together with
• tablets
• injections and,
• frequent insulin supplementation.
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24. Prevention
• Other health problems that
accelerate the toxic effects
of diabetes are
– obesity,
– high blood pressure, and
– lack of regular exercise.
– elevated cholesterol levels,
– smoking,
• Women with high bp must
be careful. They have a
threefold greater risk of
developing diabetes.
• For people with well-
controlled blood sugar
levels, the complications of
diabetes are far less
common and less severe,
• it is vital that for prevention
of diabetes to organize
– Patient education,
– His understanding of the
disease, and
– His participation in
treatment.
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25. Lifestyle changes - Type 1 diabetes
• Make Changes in lifestyle
– take drugs to reduce pressure.
– take an appropriate diet,
– quit smoking,
– Exercise more,
– wear diabetic socks,
• to avoid higher risks of
cardiovascular disease,
• to control blood pressureand
cholesterol
• Combine the use of regular
and/or synthetic insulin for
better results
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26. Lifestyle changes - Type 2 diabetes
• Reduce the risk of long term complications:
This is achievable by combining
– diet,
– exercise and
– weight loss (type 2),
– various oral diabetic drugs (type 2 only), and
– insulin use – when not responding to oral
medications (more for type 2 than type 1).
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27. Conclusion
• Diabetes mellitus is
• a chronic disease,
• without a cure.
• Emphasize on role for
• patient education,
• dietetic support,
• sensible exercise,
• self glucose monitoring (both
short and long term glucose
blood levels within normal
standards).
• avoid short and long-term
diabetes-related problems
• Careful control to reduce the risk
of long term complications.
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28. Some tips for avoiding
complications
• Keep blood sugar levels as close to normal as possible
• Keep blood pressure under 130/80 mm Hg.
• Aim to keep LDL (unhealthy) cholesterol levels under 100
mg/dl,
• Aim to keep HDL (healthy) cholesterol levels over 40 mg/dl,
• Aim to keep triglyceride levels under 150 mg/dl.
• Practice good foot care (see "Damage to the feet and legs").
• Regularly visit your doctor to assess overall health
• Check for ways to reduce your risk and avoid any complications.
• Exercise and walk daily.
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29. Any questions?
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