Diabetes Mellitus PPT

1. Diabetes
Mellitus
By –Sakshi Joshi

2. Definition
What is diabetes?
Diabetes is a heterogeneous chronic metabolic
disease characterized by chronic hyperglycemia
due to an absolute or relative lack of insulin or to
a cellular resistance to insulin, which leads over
time to serious damage to the heart, blood
vessels, eyes, kidneys and nerves.

3. Classification
Type 1
• IDDM
• Insulin insufficiency
Type 2
• NIDDM
• Impaired sensitivity to
insulin
Hybrid forms
Ketosis prone type 1
diabetes
(Diabetic ketoacidosis)
• T-cell mediated
autoimmune disease
• Destruction of β-cells

4. Aetiology
Type 1 DM
• The exact cause of type 1 diabetes is unknown. It is
believed that the immune system mistakenly attacks and
destroys insulin-producing beta cells in the pancreas.
• Genes may play a role in some people.
• It’s also possible that a virus sets off the immune system
attack.

5. Aetiology
Type 1 Risk Factors
• Child or teenager
• A parent or sibling with the condition.
• Carry certain genes that are linked to the disease.

6. Aetiology
Type 2 DM
• Type 2 diabetes stems from a combination of genetics and
lifestyle factors. Being overweight or obese increases the risk
as the cells get more resistant to the effects of insulin on blood
sugar.
• Hereditary, family members share genes that make them
more likely to get type 2 diabetes and to be overweight.

7. Aetiology
• Overweight & physically inactive
• Age 45 or older
• A parent or sibling with the condition.
• Have had gestational diabetes or prediabetes
• Have high blood pressure, high cholesterol, or high triglycerides.
• Have African American, Hispanic or Latino American, Alaska
Native, Pacific Islander, American Indian, or Asian American
ancestry.
Type 2 Risk Factors

8. Pathogenesis
Type 1 DM
• It results from the autoimmune destruction of β cells of the
endocrine pancreas and lead to insulin deficiency.
• The process of autoimmune destruction takes place in
genetically susceptible individuals under the triggering effect
of one or more environmental factors and usually progresses
over a period of many months to years, during which period
patients are asymptomatic and euglycemic, but positive for
relevant autoantibodies.
• Symptomatic hyperglycemia and diabetes occur after a long
latency period, which reflects the large percentage of β cells that
destroyed before the onset of diabetes.

9. Pathogenesis
Type 2 DM
• It results with the development of peripheral insulin
resistance associated with compensatory hyperinsulinemia,
followed by progressive β - cell impairment.
• Impaired regulation of hepatic glucose production leads to
declining of β-cell function eventually leading to β -cell failure.
• This results in decreasing insulin secretion & hyperglycemia.

10. Signs & Symptoms
Weight Healthy Exercise
Wounds heal
slowly
Always
thirsty
High blood
sugar
Extreme
fatigue
Unexplained
Weight Loss
Presence of
Ketones in Urine
Frequent
Urination
Blurred Vision
Increased
Hunger
Tingling of
hands or feet

11. Urine test
• Glycosuria
• Ketone bodies
• Microalbuminuria or proteinuria
Oral glucose tolerance test
Pre-diabetes – 140-199mg/dl
Diabetes - ≥ 200mg/dl
Fasting glucose test
Pre-diabetes – 100-125mg/dl
Diabetes - ≥ 126mg/dl
?
Diagnosis
Glycated haemoglobin

12. Management
DASH Diet Control Blood
Pressure
Medications
Antidiabetic drugs
such as Sulfonylureas
(Glimepiride),
Biguanides
(Metformin)
Regularly check
blood glucose
levels
Hydration
Exercise
Insulin
Lose Weight

13. Diabetic Neuropathy Diabetic Retinopathy
Diabetic Nephropathy
The Diabetic Foot
Complications