This document discusses diabetes, including the different types of diabetes, causes, symptoms, diagnosis and treatment. It provides details on type 1 and type 2 diabetes, gestational diabetes, and impaired glucose tolerance. Prevention methods like diet, exercise and weight control are covered. The document also discusses diagnosis, drug treatments, hospitals for diabetes treatment in India, World Diabetes Day, and myths about the disease.

1. Lets walk for a CURE
PRESENTED BY:
SMRITI BHARDWAJ
BIOTECHNOLOGY
HINDUSTAN COLLEGE OF
SCIENCE AND
TECHNOLOGY,MATHURA.

2.  Introduction
 Types of Diabetes
 Causes of Diabetes
 Prevention
 Symptoms
 Diagnosis and Treatment
 Drug treatment for Diabetes
 Future Aspects
 Hospitals having best diabetic treatment in India
 WHO response for Diabetes
 World Diabetes Day
 Conclusion

3.  Diabetes is a disease in which your blood glucose, or blood
sugar, levels are too high. Glucose comes from the foods you
eat.
 . Insulin, a hormone made by the pancreas, helps glucose
from food to get into your cells to be used for energy.
Sometimes your body doesn’t make enough—or any—insulin
or doesn’t use insulin well. Glucose then stays in your blood
and doesn’t reach your cells which causes diabetes.

4.  Type 1 diabetes
Type 1 diabetes (previously known as insulin-
dependent, juvenile or childhood-onset) is
characterized by deficient insulin production and
requires daily administration of insulin. The cause of
type 1 diabetes is not known and it is not preventable
with current knowledge.
Symptoms include excessive excretion of urine
(polyuria), thirst (polydipsia), constant hunger, weight
loss, vision changes, and fatigue. These symptoms may
occur suddenly.

6.  Type 2 diabetes (formerly called non-insulin-
dependent, or adult-onset) results from the
body’s ineffective use of insulin. Type 2 diabetes
comprises the majority of people with diabetes
around the world, and is largely the result of
excess body weight and physical inactivity.
 Symptoms may be similar to those of type 1
diabetes, but are often less marked. As a result,
the disease may be diagnosed several years after
onset, once complications have already arisen.
 Until recently, this type of diabetes was seen only
in adults but it is now also occurring increasingly
frequently in children.

8. Gestational diabetes
 Gestational diabetes is hyperglycaemia with blood glucose
values above normal but below those diagnostic of
diabetes, occurring during pregnancy.
 Women with gestational diabetes are at an increased risk
of complications during pregnancy and at delivery. They
and their children are also at increased risk of type 2
diabetes in the future.
 Gestational diabetes is diagnosed through prenatal
screening, rather than through reported symptoms.
Impaired glucose tolerance and impaired
fasting glycaemia
 Impaired glucose tolerance (IGT) and impaired fasting
glycaemia (IFG) are intermediate conditions in the
transition between normality and diabetes. People with IGT
or IFG are at high risk of progressing to type 2 diabetes,
although this is not inevitable.

9.  What causes type 1 diabetes?
Type 1 diabetes occurs when your immune system, the body’s system for
fighting infection, attacks and destroys the insulin-producing beta cells
of the pancreas. Scientists think type 1 diabetes is caused by genes and
environmental factors, such as viruses, that might trigger the disease.
 What causes type 2 diabetes?
1. Insulin resistance :
Type 2 diabetes usually begins with insulin resistance, a condition in
which muscle, liver, and fat cells do not use insulin well. As a result,
your body needs more insulin to help glucose enter cells. At first, the
pancreas makes more insulin to keep up with the added demand. Over
time, the pancreas can’t make enough insulin, and blood glucose levels
rise.

10. 2.Overweight, obesity, and physical inactivity
Extra weight sometimes causes insulin resistance and is
common in people with type 2 diabetes. The location of body
fat also makes a difference. Extra belly fat is linked to insulin
resistance, type 2 diabetes, and heart and blood vessel
disease.
 Other causes of diabetes include hormonal disorders,genetic
mutations, certain drugs such as niacine etc.

11.  The goal of diabetes management is to :
1.People living with diabetes need to know: • That
diabetes is a serious lifelong disease that has no cure,
but can be controlled. •
 That the pillars of management include: - diabetes
education - knowing what foods to eat, how much and
how often to eat, - knowing the importance and
precautions of exercise, - how and when to take
diabetes medications.

12.  2. Healthy diet Eating :a healthy diet and increasing
the level of physical activity should be the first steps
in the management of newly diagnosed people with
diabetes, and have to be maintained.
 3. Physical activity : Regular physical activity helps in;
 Increasing insulin sensitivity thus improving blood
sugar control
 Controlling blood pressure
Improving blood flow in the heart and vessels -
Weight loss and maintenance of healthy body weight,
 Giving one a sense of well-being.

13. Here are some of the warning signs and symptoms of diabetes :
 Excessive thirst and hunger
 Frequent urination (from urinary tract infections or kidney
problems)
 Weight loss or gain
 Fatigue
 Irritability
 Blurred vision
 Slow-healing wounds
 Nausea
 Skin infections
 Darkening of skin in areas of body creases (acanthosis nigricans)
 Breath odor that is fruity, sweet, or an acetone odor
 Tingling or numbness in the hands or feet.

14.  Early diagnosis can be accomplished through relatively inexpensive testing of
blood sugar.
 Treatment of diabetes involves diet and physical activity along with lowering blood
glucose and the levels of other known risk factors that damage blood vessels.
Tobacco use cessation is also important to avoid complications.
Interventions that are both cost-saving and feasible in developing
countries include:
 blood glucose control, particularly in type 1 diabetes.
 People with type 1 diabetes require insulin.
 people with type 2 diabetes can be treated with oral medication, but may also
require insulin;
 blood pressure control; and
 foot care.
Other cost saving interventions include:
 screening and treatment for retinopathy.
 blood lipid control (to regulate cholesterol levels)
 screening for early signs of diabetes-related kidney disease and treatment

15.  In recent years, several new diabetes drugs have been developed. These
include oral drugs as well as injectables.
1.Xigduo XR
 Xigduo XR, which comes as a 24-hour extended-release oral tablet,
was approved for use in 2014. Xigduo XR
combines metformin with dapagliflozin. Metformin helps make body
tissues more sensitive to insulin. Dapagliflozin blocks some of the
glucose in your system from reentering your blood through your
kidneys. It also causes your body to get rid of more glucose through
your urine.
2.Synjardy
 Synjardy, which comes as an oral tablet, was approved for use in
2015. It combines the drugs metformin and empagliflozin.
Empagliflozin works in a similar way to dapagliflozin.
3.Glyxambi
 Glyxambi, which also comes as an oral tablet, was approved for use
in 2015. It combines the drugs linagliptin and empagliflozin.
Linagliptin blocks the breakdown of certain hormones in your body
that tell your pancreas to make and release insulin. It also slows
your digestion, which slows the release of glucose into your blood.

16.  Steglujan
 Steglujan, which comes as an oral tablet, was approved in late 2017.
It combines ertugliflozin and sitagliptin.
 Ertugliflozin works through the same mechanism as empagliflozin.
Sitagliptin blocks the breakdown of certain hormones in your body
that tell your pancreas to make and release insulin. It also slows
your digestion, which slows the absorption of glucose into your
blood.
 Segluromet
 Segluromet, which comes as an oral tablet, was approved in late
2017. It combines ertugliflozin and metformin.
 Steglatro
 Steglatro, which comes as an oral tablet, was approved in late 2017.
It’s a brand-name form of the drug ertugliflozin. It works through
the same mechanism as empagliflozin. Like the combination drugs
in this list, Steglatro is used to treat type 2 diabetes.

17.  Despite the known benefits of a healthy lifestyle, many
individuals find it hard to maintain such a lifestyle in our
modern world, which facilitates sedentary behavior and
overeating. As a consequence, the prevalence of type 2
diabetes mellitus is predicted to increase dramatically over
the coming years.
 The various lines of research can be grouped into three
main categories: technological, biological, and
pharmacological.
 Technological solutions are focused on the delivery of
insulin and glucagon via an artificial pancreas, and
components of the system are already in use, suggesting
this option may well be available within the next 10 years.
 Of the biological solutions, pancreas transplants seem
unlikely to be used widely, and islet cell transplants have
also been hampered by a lack of appropriate donor tissue
and graft survival after transplant.

18.  Additional research suggests manipulating
other cell types to replace beta cells may be a
viable option in the longer term.
 In recent years, research has concentrated on
reducing blood glucose, and the increasing
pace of research has been reflected in a
growing number of antidiabetic agents.

19. List of best hospitals for diabetes treatment in
India:
 Fortis C-DOC Hospital, Delhi
 S. L Raheja Hospital, Mumbai
 Apollo Hospitals, Chennai
 Indraprastha Apollo Hospital, Delhi
 Manipal Hospital, Bangalore
 Global Hospitals, Mumbai
 Max Superspecialty Hospital, Delhi
 Fortis Hospital, Bangalore
 Nanavati Hospital, Mumbai
 Columbia Asia, Bangalore

20. WHO aims to stimulate and support the adoption of effective measures
for the surveillance, prevention and control of diabetes and its
complications, particularly in low and middle-income countries. To this
end, WHO:
 provides scientific guidelines for the prevention of major
noncommunicable diseases including diabetes;
 develops norms and standards for diabetes diagnosis and care;
 builds awareness on the global epidemic of diabetes, marking World
Diabetes Day (14 November); and
 conducts surveillance of diabetes and its risk factors.
The WHO "Global report on diabetes" provides an overview of the
diabetes burden, the interventions available to prevent and manage
diabetes, and recommendations for governments, individuals, the civil
society and the private sector.
The WHO "Global strategy on diet, physical activity and
health" complements WHO's diabetes work by focusing on population-
wide approaches to promote healthy diet and regular physical activity,
thereby reducing the growing global problem of overweight people and
obesity.

21.  World Diabetes Day (WDD) was created in 1991 by IDF
and the World Health Organization in response to
growing concerns about the escalating health threat
posed by diabetes.
 . It is marked every year on 14 November, the
birthday of Sir Frederick Banting, who co-discovered
insulin along with Charles Best in 1922.
 World Diabetes Day is the world’s largest diabetes
awareness campaign reaching a global audience of
over 1 billion people in more than 160 countries. The
campaign draws attention to issues of paramount
importance to the diabetes world and keeps diabetes
firmly in the public and political spotlight.

23. There are a number of myths about diabetes that
are all too commonly reported as facts. These
misrepresentations of diabetes can sometimes be
harmful and lead to an unfair stigma around the
condition.
 MYTH 1: PEOPLE WITH DIABETES CAN’T EAT
SUGAR
This is one of the most common diabetes myths;
that people with the condition have to eat a
sugar-free diet.
People with diabetes need to eat a diet that is
balanced, which can include some sugar in
moderation.

24. MYTH 2: TYPE 2 DIABETES IS MILD
 This diabetes myth is widely repeated, but of course it isn’t true.
 No form of diabetes is mild.
 If type 2 diabetes is poorly managed it can lead to serious (even life-
threatening) complications.
 Good control of diabetes can significantly decrease the risk of
complications but this doesn’t mean the condition itself is not serious.
MYTH 3: TYPE 2 DIABETES ONLY AFFECTS FAT PEOPLE
 Whilst type 2 diabetes is often associated with being overweight and
obese by the media, it is patently untrue that type 2 diabetes only
affects overweight people.
 Around 20% of people with type 2 diabetes are of a normal weight, or
underweight.
MYTH 4: PEOPLE WITH DIABETES GO BLIND AND LOSE THEIR LEGS
 Diabetes is a leading cause of blindness and also causes
many amputations each year. However, those people with diabetes that
control blood pressure, glucose, weight and quit smoking all increase
their chances of remaining complication free.
 Blindness and amputation are therefore preventable and the vast
majority of people with diabetes will avoid blindness and amputatio,
particularly if annual diabetic health checks are attended each year.

25.  The number of people with diabetes has risen from 108 million in 1980
to 422 million in 2014.
 The global prevalence of diabetes* among adults over 18 years of age
has risen from 4.7% in 1980 to 8.5% in 2014 (1).
 Diabetes prevalence has been rising more rapidly in middle- and low-
income countries.
 Diabetes is a major cause of blindness, kidney failure, heart attacks,
stroke and lower limb amputation.
 In 2016, an estimated 1.6 million deaths were directly caused by
diabetes. Another 2.2 million deaths were attributable to high blood
glucose in 2012**.
 Almost half of all deaths attributable to high blood glucose occur before
the age of 70 years. WHO estimates that diabetes was the seventh
leading cause of death in 2016.
 Healthy diet, regular physical activity, maintaining a normal body weight
and avoiding tobacco use are ways to prevent or delay the onset of type
2 diabetes.
 Diabetes can be treated and its consequences avoided or delayed with
diet, physical activity, medication and regular screening and treatment
for complication