diabetes mellitus

1. ZafranUllahkhan
RollNo:24(E)
FinalProff

2. Contents:
 Definition
 Pathophysiology
 Epidemiology
 Etiology
 Types
 Sign and symptoms
 Complication
 Diagnosis
 Management and treatment

3. Definition:
 DM is a chronic metabolic disorder characterized by
hyperglycemia associated with disturbance in
carbohydrates, lipids and protein metabolism.

4. Pathophysiology:
 Insulin is produced in the beta cell of islet of Langerhans and play an
important role in the uptake of the glucose from the blood in to the most cell
of the body specially liver, muscle and adipose tissue. Insulin play a critical
role in balancing glucose level in the body. Insulin can inhibit the breakdown
of glycogen or the process of gluconeogenesis. It can stimulate the transport
of the glucose in to the fat and muscle cell and it can also stimulate the
storage of glucose in the form of glycogen in the liver.
 If the amount of the insulin is decreased or the cell not properly respond to
the insulin so the glucose level will increased.
 If the glucose level is increased in the blood so they cause glycosuria

5. Epidemiology
 In 2013, 382 million people have diabetic worldwide. In this 90% cases of
type-2 DM having equal ratio of 8.3 % of both genders in adult population.
 In 2012 it is resulted that 1.5 million deaths worldwide making it the 8th
leading cause of death in which more than 80% of the diabetic deaths were
occurring in the low and middle income countries.
 In recent era (2016) 422 million peoples have diabetes worldwide.

6. Types:
 Type-1 DM: it is also called childhood or jevenile DM. it is a progressive
immune disorder in which body own immune system attacks on the beta cell
in the islet cell of Langerhans of the pancreas destroyed them sufficiently to
reduce insulin secretion.
 Type-2 DM: it is also called non insulin dependent or maturity diabetes. It is
metabolic disorder characterized tissue resistance to the insulin combined
with the relative deficiency of the insulin and hyperglycemia.
 Type-3 DM: it is also called gestational DM . It is appeared 2-5% in pregnancy
it is temporary and treatable but if untreated it may cause problem with
pregnancy.

7. Etiology
 Type-1: in this type the body own immune system which normally fight with
harmful bacteria and mistakenly destroy the insulin producing cell in the
pancreases, sometime it is genetically and sometime due to environmental
factor i.e. virus etc.
 Type-2: type 2 DM develop when the body become resistant to insulin or when
pancreas stop producing enough insulin. It may be genetically or
environmental factors i.e. excess weight and contributing factors.
 Tyep-3: during pregnancy the placenta which connect your baby to your blood
supply produce high level of other hormone. almost all of them impair the
action of insulin in your cell and rising your blood sugar level.

8. Sign & symptom
 The classic symptom of D.M
 Weight loss
 Polyuria(frequent urination)
 Polydipsia(increase thirst)
 Polyphagia(increase Hunger)
 Fatigue

9. Complication
 The major long term complication related to damage to blood vessel.
Diabetes double the risk of cardiovascular disease. About 75% of death in
diabetes are due to coronary artery disease.
 The primary microvascular complication of diabetes are.
 Diabetic Retinopathy
 Diabetic Nephropathy
 Diabetic Neuropathy

10. Diagnosis
 Diabetes Mellitus is characterized by recurrent or persistent hyperglycemia &
is diagnosed by demonstrating any one of the following.
 Fasting plasma glucose level = 126 mg/dl
 Random plasma glucose level=200mg/dl
 According to WHO people with fasting glucose level 110___ 125 mg/dl are
considered to have impaired fasting glucose.

11. Management &Treatment
 Management: Diabetes millets is a chronic disease for which there is no known cure except in very
specific situation. Management concentrate on keeping blood sugar level as close to normal as possible
without causing hypoglycemia. This can be usually accomplished with diet, exercise and use of proper
medication.
 Treatment:
 Type-1:
 diet control
 Insulin
 Type-2:
 Diet control
 Oral hypoglycemic agent
 Insulin if required
 Type-3:
 Diet control
 insulin

12. Drugs:
 Insulin secreatagogue
 Ist generation:
tolazamide,
tolbutamide,
chlorpropamide
 2nd generation:
glipizide;
gliclazid,
gliquidone
 Insulin sensitizer:
Metformin,
rosiglitazone
Alpha-glucosidase inhibitor:
Meglital
Acarbase