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Testing for
Autoantibodies.
TYPE 1 DIABETES TYPE 2 DIABETES
Formerly known
पहले जाना गया
“Juvenile onset” or “insulin-dependent”
diabetes.
"किशोर शुरुआत" या "इंसुकलन पर कनर्भर"
मधुमेह।
“Adult onset” or “non-insulin-dependent
"diabetes.
वयस्क शुरुआत" या "गैर-इंसुकलन-कनर्भर"
मधुमेह।
Who is
Diagnosed
िौन है
कनदान
Children and teens, usually with healthy
body weight, but also diagnosed in
adults.
बच्चे और किशोर, आमतौर पर स्वस्थ
शरीर िा वजन, लेकिन वयस्कों में र्ी कनदान
किया जाता है।
Usually diagnosed in adults who are
overweight or obese but also diagnosed
in children.
आमतौर पर उन वयस्कों में कनदान किया
जाता है जो
अकधि वजन या मोटापे से ग्रस्त लेकिन बच्चों
में र्ी कनदान किया जाता है।
Do other family
members have
diabetes too
These people may be the only ones in
their family with the disease.
ये लोग अपने पररवार में बीमारी वाले अि
े ले
हो सिते हैं।
These people often have first-degree
relatives with diabetes (parents, siblings,
or children).
TYPE 1 DIABETES TYPE 2 DIABETES
What causes it?
इसिा क्या िारण होता है?
The person’s immune system mistakenly
attacks and destroys the insulin-
producing beta) cells of the pancreas.
The pancreas can no longer produce any
insulin, a hormone needed for controlling
blood glucose.
व्यक्ति िी प्रकतरक्षा प्रणाली गलती से
हमला िरता है और इंसुकलन पैदा िरने वाले
िो नष्ट िर देता है
(बीटा) अग्न्याशय िी िोकशिाएं । अग्न्याशय
अब िोई इंसुकलन नहीं बना सिता, रि िो
कनयंकित िरने ि
े कलए आवश्यि हामोन
ग्लूिोज।
These people can generally still produce
insulin, but the body becomes “resistant”
to its effects, and insulin is not able to
work as well.As a result, blood glucose
levels rise.The pancreas tries to produce
more insulin to compensate in the early
stages, but over time the pancreas
“burns out” and eventually stops
producing any insulin at all.
ये लोग आम तौर पर अर्ी र्ी उत्पादन िर
सिते हैं इंसुकलन, लेकिन शरीर इसि
े प्रर्ावों
ि
े कलए "प्रकतरोधी" हो जाता है, और इंसुकलन
र्ी िाम िरने में सक्षम नहीं होता है।
नतीजतन, रि शि
भ रा िा स्तर बढ़ जाता है।
अग्न्याशय प्रारंकर्ि अवस्था में क्षकतपूकतभ िरने
ि
े कलए अकधि इंसुकलन िा उत्पादन िरने
िी िोकशश िरता है, लेकिन समय ि
े साथ
अग्न्याशय "जल जाता है" और अंततः बंद हो
जाता हैकिसी र्ी इंसुकलन िा उत्पादन िरना।
TYPE 1 DIABETES TYPE 2 DIABETES
What are the risk factors.
वह क्या हैं जोक्तिम
Unclear; there may be some
environmental risk factors, but a few
genetic risk factors have also been
identified.
अस्पष्ट; ि
ु छ पयाभवरणीय जोक्तिम िारि हो
सिते हैं, लेकिन ि
ु छ आनुवंकशि जोक्तिम
िारिों िी र्ी पहचान िी गई है।
Multiple risk factors include being
overweight or obese; belonging to an
ethnic minority; history of prediabetes,
high blood pressure, high cholesterol, or
heart disease; history of gestational
diabetes or polycystic ovarian syndrome
in women; family history; physical
inactivity.
िई जोक्तिम वाले िारिों में शाकमल हैं
अकधि वजन या मोटापा; एि जातीय
अल्पसंख्यि से संबंकधत; प्रीडायकबटीज, उच्च
रिचाप, उच्च िोलेस्ट्र ॉल या हृदय रोग िा
इकतहास; मकहलाओं में गर्ाभवकध मधुमेह या
पॉलीकसक्तस्ट्ि कडम्बग्रंकथ कसंड
र ोम िा इकतहास;
पररवार ि
े इकतहास; र्ौकति कनक्तियता।
What are the symptoms.
लक्षण क्या हैं
f1+s1+c1+a2+c17=d6/d8
NAME OF SURGERY HOW IT WORKS POSSIBILITY OF DIABETES
Total
pancreatectomyS1+C1+L1+A3+C17+WE+
F1=D6
ि
ु ल अग्नाशय
The entire pancreas is
removed.
संपूणभ अग्न्याशय है
कनिाला गया।
Certain. Without the pancreas, the body
is unable to
make its own insulin, so the patient will
need
multiple daily injections of insulin.
कनकित। अग्न्याशय ि
े कबना, शरीर िरने में
असमथभ है
अपना िुद िा इंसुकलन बनाएं , इसकलए रोगी
िो इसिी आवश्यिता होगी
इंसुकलन ि
े िई दैकनि इंजेक्शन।
Partial pancreatectomy or
near-total pancreatectomy
आंकशि अग्नाशयशोथ या
कनिट-ि
ु ल पैनकिएक्टोमी
Only part of the pancreas
is removed.
अग्न्याशय िा ि
े वल एि कहस्सा
हटा दी है
When nearly all (about 95%) of the
pancreas is removed, almost all people
will require multiple daily insulin
injections. If a smaller part of the
pancreas is removed, the likelihood of
need in insulin injections is less.
जब लगर्ग सर्ी (लगर्ग 95%) अग्न्याशय
िो हटा कदया जाता है, तो लगर्ग सर्ी लोगों
िो िई दैकनि इंसुकलन इंजेक्शन िी
आवश्यिता होगी। यकद अग्न्याशय िा एि
छोटा कहस्सा हटा कदया जाता है, तो इंसुकलन
इंजेक्शन िी आवश्यिता िी संर्ावना िम
होती है।
Pancreaticoduodenecto
my
(“Whipple”)
पैन्क्रियाटिकोडोडोडेने
क्टोमी
("न्क्िपल")
A small part of the
pancreas known as the
“head” is removed.This is
a very common type of
pancreatic surgery.
का एक छोिा सा टिस्सा
अग्न्याशय क
े रूप में जाना जाता िै
"टसर" ििा टिया जाता िै। ये िै
एक बहुत िी सामान्य प्रकार का
अग्न्याशय की सजजरी।
Up to half of people who didn’t have
diabetes before the surgery will develop
diabetes after the procedure.
सजजरी से पिले टजन लोगोों को मधुमेि निीों था,
उनमें से आधे लोगोों को प्रटिया क
े बाि मधुमेि
िो जाएगा।
Distal pancreatectomy
कडस्ट्ल पैनकिएक्टोमी
A small part of the
pancreas known as the
“tail” is removed. एि छोटा सा कहस्सा
अग्न्याशय ि
े रूप में जाना जाता है
"पूंछ" हटा कदया जाता है।
Up to one-third of people who didn’t have
diabetes before the surgery will develop
diabetes after the procedure.
सजभरी से पहले मधुमेह नहीं होने वाले एि कतहाई
लोगों में प्रकिया ि
े बाद मधुमेह कविकसत होगा।
3. 3.1 Glucose meters are small handheld devices used to test your blood glucose at home. A small blood
sample is obtained, usually from your fingertip. From this blood sample, a blood glucose level can be
determined1 Glucose meters are small handheld devices used to test your blood glucose at home. A small blood
sample is obtained, usually from your fingertip. From this blood sample, a blood glucose level can be
determined
Table 3.1. A1C level and estimated average blood glucose levels
A1C (%) BLOOD GLUCOSE (MG/DL) BLOOD GLUCOSE (MG/DL)
6 126 7.0
7 154 8.6
8 183 10.2
9 212 11.8
10 240 13.4
11 269 14.9
12 289 16.5
3.2 Feeling sweaty, shaky, hungry, weak, or anxious are all possible early signs of hypoglycaemia.Treating a low blood glucose
level at the first sign of symptoms is important to prevent the more severe late effect of hypoglycaemia. © 2018, Johns Hopkins
University,Art as Applied to Medicine.
Drinking alcohol (without food) or having an illness are other situations in which hypoglycaemia is more likely to occur, and
precautions to prevent low blood glucose levels should be taken (see “SpecialConsiderations during Sick Days
Table 3.2. Checklist for routine preventive care in diabetes
PROCEDURE HOW OFTEN TYPICAL GOAL
Hemoglobin
A1C
हीमोग्लोकबन
ए1सी
Every 3 months for most people with
diabetes; health care providers
might space out to every 6 months if results
are at goal.
मधुमेह वाले अकधिांश लोगों ि
े कलए हर 3 महीने
में; स्वास्थ्य रक्षि सुकवधाएं प्रदान िरने वाले
यकद पररणाम लक्ष्य पर हैं तो हर 6 महीने में स्थान
कदया जा सिता है।
Less than 7% (53 mmol/mol) for most nonpregnant
adults; s sometimes higher (less than 8% or 8.5% or
64
to 69 mmol/mol) for people who are older and have
multiple health conditions.
अकधिांश गैर-गर्भवती ि
े कलए 7% से िम (53
mmol/mol)
वयस्क; िर्ी-िर्ी अकधि (8% से िम या 8.5% या 64 .
से िम)
69 mmol/mol) उन लोगों ि
े कलए जो बडे हैं और कजनि
े
पास है
िई स्वास्थ्य क्तस्थकतयां
Blood pressure
Check.
रि चाप
जााँच िरना।
At every appointment
हर मुलािात पर
Less than 140/90 mmHg; sometimes less than
130/80 mmHg for those at high risk of cardiovascular
disease.
Evaluate your
risk of heart
Disease.
अपना मूल्ाोंकन करें
टिल का खतरा
रोग।
At every appointment.
िर मुलाकात पर
Modify lifestyle and other risk factors
to prevent Disease.
रोकने क
े टलए जीवनशैली और अन्य
जोन्क्खम कारकोों को सोंशोटधत करें
रोग
Assessment for symptoms of
depression
ि
े लक्षणों ि
े कलए आिलन
कडप्रेशन
Usually at least yearly
आमतौर पर िम से िम वाकषभि
Identify and treat signs of depression if
presentयकद मौजूद हो तो अवसाद ि
े लक्षणों
िो पहचानें और उनिा इलाज िरें
Dental
cleaningsकचकित्सिीय
सफाई
Twice a yearसाल में दो बार Maintain oral hygiene, prevent cavities,
and identify signs of early dental disease
मौक्तिि स्वच्छता बनाए रिें, गुहाओं िो रोि
ें ,
और प्रारंकर्ि दंत रोग ि
े लक्षणों िी पहचान
िरें
Cholesterol
screenिोलेस्ट्र ॉल
स्क्रीन
Usually at least yearly for people
above the age of 40आम तौर पर लोगों ि
े
कलए िम से िम वाकषभि
40 वषभ िी आयु से ऊपर
Many persons with diabetes benefit from
treatment with statins (especially if
above the age of 40) even without high
cholesterol levels, given additional
cardiovascular protection benefitsउच्च
िोलेस्ट्र ॉल ि
े स्तर ि
े कबना र्ी मधुमेह वाले
Eye examआोंखो की परीक्षा Usually yearly but more
frequent if
signs of eye disease are
present
Identify and treat
diabetic eye disease as
early as
possible
Foot examपैर परीक्षा At every visit look at feet;
a more
detailed foot exam will be
done
yearly
Watch for signs of open
ulcerations or injury

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DIABETES HEAD TO TOE.pptx

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  • 20. TYPE 1 DIABETES TYPE 2 DIABETES Formerly known पहले जाना गया “Juvenile onset” or “insulin-dependent” diabetes. "किशोर शुरुआत" या "इंसुकलन पर कनर्भर" मधुमेह। “Adult onset” or “non-insulin-dependent "diabetes. वयस्क शुरुआत" या "गैर-इंसुकलन-कनर्भर" मधुमेह। Who is Diagnosed िौन है कनदान Children and teens, usually with healthy body weight, but also diagnosed in adults. बच्चे और किशोर, आमतौर पर स्वस्थ शरीर िा वजन, लेकिन वयस्कों में र्ी कनदान किया जाता है। Usually diagnosed in adults who are overweight or obese but also diagnosed in children. आमतौर पर उन वयस्कों में कनदान किया जाता है जो अकधि वजन या मोटापे से ग्रस्त लेकिन बच्चों में र्ी कनदान किया जाता है। Do other family members have diabetes too These people may be the only ones in their family with the disease. ये लोग अपने पररवार में बीमारी वाले अि े ले हो सिते हैं। These people often have first-degree relatives with diabetes (parents, siblings, or children).
  • 21. TYPE 1 DIABETES TYPE 2 DIABETES What causes it? इसिा क्या िारण होता है? The person’s immune system mistakenly attacks and destroys the insulin- producing beta) cells of the pancreas. The pancreas can no longer produce any insulin, a hormone needed for controlling blood glucose. व्यक्ति िी प्रकतरक्षा प्रणाली गलती से हमला िरता है और इंसुकलन पैदा िरने वाले िो नष्ट िर देता है (बीटा) अग्न्याशय िी िोकशिाएं । अग्न्याशय अब िोई इंसुकलन नहीं बना सिता, रि िो कनयंकित िरने ि े कलए आवश्यि हामोन ग्लूिोज। These people can generally still produce insulin, but the body becomes “resistant” to its effects, and insulin is not able to work as well.As a result, blood glucose levels rise.The pancreas tries to produce more insulin to compensate in the early stages, but over time the pancreas “burns out” and eventually stops producing any insulin at all. ये लोग आम तौर पर अर्ी र्ी उत्पादन िर सिते हैं इंसुकलन, लेकिन शरीर इसि े प्रर्ावों ि े कलए "प्रकतरोधी" हो जाता है, और इंसुकलन र्ी िाम िरने में सक्षम नहीं होता है। नतीजतन, रि शि भ रा िा स्तर बढ़ जाता है। अग्न्याशय प्रारंकर्ि अवस्था में क्षकतपूकतभ िरने ि े कलए अकधि इंसुकलन िा उत्पादन िरने िी िोकशश िरता है, लेकिन समय ि े साथ अग्न्याशय "जल जाता है" और अंततः बंद हो जाता हैकिसी र्ी इंसुकलन िा उत्पादन िरना।
  • 22. TYPE 1 DIABETES TYPE 2 DIABETES What are the risk factors. वह क्या हैं जोक्तिम Unclear; there may be some environmental risk factors, but a few genetic risk factors have also been identified. अस्पष्ट; ि ु छ पयाभवरणीय जोक्तिम िारि हो सिते हैं, लेकिन ि ु छ आनुवंकशि जोक्तिम िारिों िी र्ी पहचान िी गई है। Multiple risk factors include being overweight or obese; belonging to an ethnic minority; history of prediabetes, high blood pressure, high cholesterol, or heart disease; history of gestational diabetes or polycystic ovarian syndrome in women; family history; physical inactivity. िई जोक्तिम वाले िारिों में शाकमल हैं अकधि वजन या मोटापा; एि जातीय अल्पसंख्यि से संबंकधत; प्रीडायकबटीज, उच्च रिचाप, उच्च िोलेस्ट्र ॉल या हृदय रोग िा इकतहास; मकहलाओं में गर्ाभवकध मधुमेह या पॉलीकसक्तस्ट्ि कडम्बग्रंकथ कसंड र ोम िा इकतहास; पररवार ि े इकतहास; र्ौकति कनक्तियता। What are the symptoms. लक्षण क्या हैं
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  • 51. NAME OF SURGERY HOW IT WORKS POSSIBILITY OF DIABETES Total pancreatectomyS1+C1+L1+A3+C17+WE+ F1=D6 ि ु ल अग्नाशय The entire pancreas is removed. संपूणभ अग्न्याशय है कनिाला गया। Certain. Without the pancreas, the body is unable to make its own insulin, so the patient will need multiple daily injections of insulin. कनकित। अग्न्याशय ि े कबना, शरीर िरने में असमथभ है अपना िुद िा इंसुकलन बनाएं , इसकलए रोगी िो इसिी आवश्यिता होगी इंसुकलन ि े िई दैकनि इंजेक्शन। Partial pancreatectomy or near-total pancreatectomy आंकशि अग्नाशयशोथ या कनिट-ि ु ल पैनकिएक्टोमी Only part of the pancreas is removed. अग्न्याशय िा ि े वल एि कहस्सा हटा दी है When nearly all (about 95%) of the pancreas is removed, almost all people will require multiple daily insulin injections. If a smaller part of the pancreas is removed, the likelihood of need in insulin injections is less. जब लगर्ग सर्ी (लगर्ग 95%) अग्न्याशय िो हटा कदया जाता है, तो लगर्ग सर्ी लोगों िो िई दैकनि इंसुकलन इंजेक्शन िी आवश्यिता होगी। यकद अग्न्याशय िा एि छोटा कहस्सा हटा कदया जाता है, तो इंसुकलन इंजेक्शन िी आवश्यिता िी संर्ावना िम होती है।
  • 52. Pancreaticoduodenecto my (“Whipple”) पैन्क्रियाटिकोडोडोडेने क्टोमी ("न्क्िपल") A small part of the pancreas known as the “head” is removed.This is a very common type of pancreatic surgery. का एक छोिा सा टिस्सा अग्न्याशय क े रूप में जाना जाता िै "टसर" ििा टिया जाता िै। ये िै एक बहुत िी सामान्य प्रकार का अग्न्याशय की सजजरी। Up to half of people who didn’t have diabetes before the surgery will develop diabetes after the procedure. सजजरी से पिले टजन लोगोों को मधुमेि निीों था, उनमें से आधे लोगोों को प्रटिया क े बाि मधुमेि िो जाएगा। Distal pancreatectomy कडस्ट्ल पैनकिएक्टोमी A small part of the pancreas known as the “tail” is removed. एि छोटा सा कहस्सा अग्न्याशय ि े रूप में जाना जाता है "पूंछ" हटा कदया जाता है। Up to one-third of people who didn’t have diabetes before the surgery will develop diabetes after the procedure. सजभरी से पहले मधुमेह नहीं होने वाले एि कतहाई लोगों में प्रकिया ि े बाद मधुमेह कविकसत होगा।
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  • 67. 3. 3.1 Glucose meters are small handheld devices used to test your blood glucose at home. A small blood sample is obtained, usually from your fingertip. From this blood sample, a blood glucose level can be determined1 Glucose meters are small handheld devices used to test your blood glucose at home. A small blood sample is obtained, usually from your fingertip. From this blood sample, a blood glucose level can be determined
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  • 76. Table 3.1. A1C level and estimated average blood glucose levels A1C (%) BLOOD GLUCOSE (MG/DL) BLOOD GLUCOSE (MG/DL) 6 126 7.0 7 154 8.6 8 183 10.2 9 212 11.8 10 240 13.4 11 269 14.9 12 289 16.5
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  • 92. 3.2 Feeling sweaty, shaky, hungry, weak, or anxious are all possible early signs of hypoglycaemia.Treating a low blood glucose level at the first sign of symptoms is important to prevent the more severe late effect of hypoglycaemia. © 2018, Johns Hopkins University,Art as Applied to Medicine. Drinking alcohol (without food) or having an illness are other situations in which hypoglycaemia is more likely to occur, and precautions to prevent low blood glucose levels should be taken (see “SpecialConsiderations during Sick Days
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  • 108. Table 3.2. Checklist for routine preventive care in diabetes PROCEDURE HOW OFTEN TYPICAL GOAL Hemoglobin A1C हीमोग्लोकबन ए1सी Every 3 months for most people with diabetes; health care providers might space out to every 6 months if results are at goal. मधुमेह वाले अकधिांश लोगों ि े कलए हर 3 महीने में; स्वास्थ्य रक्षि सुकवधाएं प्रदान िरने वाले यकद पररणाम लक्ष्य पर हैं तो हर 6 महीने में स्थान कदया जा सिता है। Less than 7% (53 mmol/mol) for most nonpregnant adults; s sometimes higher (less than 8% or 8.5% or 64 to 69 mmol/mol) for people who are older and have multiple health conditions. अकधिांश गैर-गर्भवती ि े कलए 7% से िम (53 mmol/mol) वयस्क; िर्ी-िर्ी अकधि (8% से िम या 8.5% या 64 . से िम) 69 mmol/mol) उन लोगों ि े कलए जो बडे हैं और कजनि े पास है िई स्वास्थ्य क्तस्थकतयां Blood pressure Check. रि चाप जााँच िरना। At every appointment हर मुलािात पर Less than 140/90 mmHg; sometimes less than 130/80 mmHg for those at high risk of cardiovascular disease.
  • 109. Evaluate your risk of heart Disease. अपना मूल्ाोंकन करें टिल का खतरा रोग। At every appointment. िर मुलाकात पर Modify lifestyle and other risk factors to prevent Disease. रोकने क े टलए जीवनशैली और अन्य जोन्क्खम कारकोों को सोंशोटधत करें रोग Assessment for symptoms of depression ि े लक्षणों ि े कलए आिलन कडप्रेशन Usually at least yearly आमतौर पर िम से िम वाकषभि Identify and treat signs of depression if presentयकद मौजूद हो तो अवसाद ि े लक्षणों िो पहचानें और उनिा इलाज िरें Dental cleaningsकचकित्सिीय सफाई Twice a yearसाल में दो बार Maintain oral hygiene, prevent cavities, and identify signs of early dental disease मौक्तिि स्वच्छता बनाए रिें, गुहाओं िो रोि ें , और प्रारंकर्ि दंत रोग ि े लक्षणों िी पहचान िरें Cholesterol screenिोलेस्ट्र ॉल स्क्रीन Usually at least yearly for people above the age of 40आम तौर पर लोगों ि े कलए िम से िम वाकषभि 40 वषभ िी आयु से ऊपर Many persons with diabetes benefit from treatment with statins (especially if above the age of 40) even without high cholesterol levels, given additional cardiovascular protection benefitsउच्च िोलेस्ट्र ॉल ि े स्तर ि े कबना र्ी मधुमेह वाले
  • 110. Eye examआोंखो की परीक्षा Usually yearly but more frequent if signs of eye disease are present Identify and treat diabetic eye disease as early as possible Foot examपैर परीक्षा At every visit look at feet; a more detailed foot exam will be done yearly Watch for signs of open ulcerations or injury