DIABETES MALLITUS

2. PRESENTED TO: DR. AQEELA MALIK
PRESENTED BY: SHANZA TANVEER
Roll No: Fa-17/BS BCH/010
CLINICAL BIOCHEMISTRY

3.  Diabetes mellitus, commonly known
as diabetes, is a metabolic disease that
causes high blood sugar ( hyperglycemia).
 The hormone insulin moves sugar from the
blood into your cells to be stored or used for
energy.
 With diabetes, your body either doesn't make
enough insulin or can't effectively use the
insulin it does make.

4.  It is caused due to the deficiency of insulin or
insulin resistance or both.
 The pancreas (an organ behind your stomach)
produces little insulin or no insulin at all.
Insulin is a naturally occurring hormone,
produced by the beta cells of the pancreas,
which helps the body use sugar for energy.
Or
 The pancreas makes insulin, but the insulin
made doesn't work as it should. This
condition is called insulin resistance.

5.  Increased thirst
 Frequent urination
 Unexpected weight loss
 Increased fatigue
 Blurred vision
 Irritability
 Skin itchy
 Red, swollen and tender gums
 Slow healing sores

6. There are two main types of diabetes:
 Type 1
 Type 2

7.  Type 1 diabetes is also called insulin-dependent
diabetes
 Type 1 diabetes occurs because the insulin-
producing cells of the pancreas (beta cells) are
damaged.
 The pancreas makes little or no insulin, so sugar
can’t get into the body's cells for use as energy.
 Type 1 is the most common form of diabetes in
people who are under age 30, but it can occur at
any age.
 Ten percent of people with diabetes are
diagnosed with Type 1.

8.  Type 1 diabetes is an autoimmune condition. It
happens when your body attacks
your pancreas with antibodies. The organ is
damaged and doesn't make insulin.
 Your genes might cause this type of diabetes. It
could also happen because of problems with cells
in your pancreas that make insulin.
 Many of the health problems that can come with
type 1 happen because of damage to tiny blood
vessels in your eyes (called diabetic retinopathy),
nerves (diabetic neuropathy),
and kidneys (diabetic nephropathy).
 People with type 1 also have a higher risk
of heart disease and stroke.

9.  It is also called non-insulin diabetes mellitus.
 In Type 2 diabetes (adult onset diabetes), the
pancreas makes insulin, but it either doesn't
produce enough, or the insulin doesn't work
properly.
 Nine out of 10 people with diabetes have
Type 2.
 This type occurs most often in people who
are over 40 years old but can occur even in
childhood if there are risk factors present.

10.  In the case of insulin resistance, the body is
producing the insulin, but insulin sensitivity
is reduced and it does not do the job as well
as it should do.
 The glucose is not entering the body’s cells
properly, causing two problems;
 A buildup of glucose in the blood
 The cells are not getting the glucose they
need for energy and growth.

11. Tests for type 1 and type 2:
Glycated hemoglobin (A1C) test:
 This blood test, which doesn’t require fasting, indicates your
average blood sugar level for the past two to three months. It
measures the percentage of blood sugar attached to
hemoglobin, the oxygen carrying protein in RBC’s.
 The higher your blood sugar levels, the more hemoglobin you’ll
have with sugar attached.
 An A1C level of 6.5% or higher on two separate tests indicates
that you have diabetes.
 An A1C between 5.7 and 6.4 % indicates prediabetes (A condition
in which blood sugar is high but not high enough to be type 2
diabetes)
 Below 5.7 is considered normal.

12.  If the A1C test results aren’t consistent, the test
isn’t available, or you have certain conditions that
can make the A1C test is inaccurate- such as if
you are pregnant or have an uncommon form of
hemoglobin- you doctor may use the following
tests to diagnose diabetes:
RANDOM BLOOD SUGAR TEST:
A blood sample will be taken at a random time.
Regardless of when you last ate, a random blood
sugar level of 200 mg/dL-11.1mm/L or higher
suggests diabetes.

13. Oral glucose tolerance test:
For this test, you fast overnight and the fasting
blood sugar level is measured. Then you
drink a sugary liquid, and blood sugar levels
are tested periodically for the next 2 hours.
A blood sugar level less than 140 mg/dL is
normal.
A reading of more than 200 mg/dL after 2
hours indicates diabetes.
A reading 140 -199mg/dL indicates
prediabetes.

14. People with type 1 diabetes need insulin therapy
to survive.
Treatment for type 1 diabetes, involves injecting
insulin into the fatty tissue just under your skin.
You might use:
 Syringes
 Insulin pens that use prefilled cartridges and a
thin needle
 Jet injectors that use high-pressure air to send a
spray of insulin through your skin
 Pumps that send insulin through a tube to a
catheter under the skin of your belly

15.  It helps in the transportation of glucose
across the cell membrane.
 Insulin activate the GLUT-4 (transporter of
glucose) as a result of that glucose
transportation occur across the cell.
 It helps in the formation of glucose.
 Insulin inhibit the phosphorylase enzyme
which convert the glycogen into glucose

16. Involves keeping a healthy weight, eating right, and
exercising. Some people need medication, too.
 Oral diabetes medications are used in the treatment
for TYPE 2 diabetes. Medicine within this category fall
within one of several classes, including;
Enhance insulin secretions:
 Sulfonylureas (KATP channel blocker), TOLBUTAMIDE
etc.
 Glucagon like peptide-1 (GLP1) Receptor agonist
(injectable drug) , EXACENATIDE .
Overcome insulin resistence:
 Beguanide (Ampk activator), METOPHORMIN