This document discusses diabetes mellitus and related conditions. It begins by defining diabetes mellitus as a metabolic disorder characterized by high blood glucose levels due to defects in insulin production or insulin action. The document then discusses the signs and symptoms of diabetes, including increased urination, thirst, weight loss, and high blood sugar. It describes the causes of diabetes, types of diabetes (type 1 and type 2), and related conditions like hyperinsulinism and hypoglycemia. Treatment options are provided for managing blood sugar levels and symptoms.

1. BIOCHEMIST
RY
ASSIGNMENT-1
BY HIJAB SIDDIQI

2. DIABETES MELLITUS
A metabolic disorder of multiple
aetiology characterized by chronic
hyperglycaemia with disturbances of
carbohydrate, fat and protein
metabolism resulting from defects in
insulin secretion, insulin action, or
both

3. Signs And Symptoms
The diabetic syndrome is due to insulin deficiency
combined with +ve actions of hormones antagonist
to insulin ( glucagon, GH, adrenal glucocorticoids )
diabetes mellitus is characterized by :
 Polyuria
 Polydipsia
 Weight loss in spite of polyphagia (increased
appetite)
 Hyperglycemia
 Glycosuria
 Ketosis
 Acidosis
 Coma.

4. Fig: Symptoms of Diabetes Mellitus

5. Causes
Lack of insulin due to:
 Destruction of β cells
 Surgical removal of pancreas
 Congenital absence of pancreas
 Genetical cause
 Auto-immune disorder
 Viral infections
 Chemicals and drugs

6. Fig: Causes of Diabetes

7. Types Of Diabetes Mellitus
There are two general types of diabetes mellitus:
 Type I diabetes OR insulin-dependent diabetes
mellitus (IDDM) caused by lack of insulin
secretion.
 Type II diabetes OR non-insulin-dependent
diabetes mellitus (NIDDM) caused by decreased
sensitivity of target tissues to the metabolic effect
of insulin.

8. Type I Diabetes…Facts
 It Is not contagious which means you can not give
it to anyone, nor can it be caught.
 Viruses like the mumps or German measles and
apos may cause type I diabetes.
 Different types of foods such as cow’s milk when
fed early in life to 3 or 4 month olds can cause
diabetes.
 Scientist linked type I diabetes to genetics.
Parents with diabetes that have children are more
likely to develop diabetes then someone without a
family history of diabetes.

9. Type I Diabetes
Signs and symptoms:
 Polydipsia
 Polyphagia
 Polyuria
 Weight loss
 Fatigue
 Blurred vision
Causes:
 Genetics
 Obesity – insulin resistance,
 Sedentary lifestyle
 Age – almost half of new
cases are in people over the
age of 55
Treatment:
 Taking insulin
 Exercising regularly and
maintaining a healthy weight
 Eating healthy foods
 Change unhealthy eating
habits.
 Monitoring blood glucose
levels.

10. Type II Diabetes…Facts
 Most common form of diabetes.
 Most important triggers of diabetes is obesity.
Too much body fat makes it hard for the body to
accommodate insulin resistance.
Body fat promotes insulin resistance.
 Also related to genetics.
Inheritance of certain genes, obesity, age, and
lifestyles.
 The decrease in insulin sensitivity with
menopause suggests that estrogen generally
protects against insulin resistance in women. Loss
of estrogen function, through changes in estrogen
receptor, has been shown to cause insulin
resistance and type 2 diabetes in a male patient.

11. Type II Diabetes
Signs and symptoms :
 Polydipsia
 Polyphagia
 Polyuria
 Fatigue
 Blurred vision
 Achanthosis nigricans –
dark patches on skin
 slow healing of wounds
Treatment
 Blood sugar monitoring
 Healthy eating
 Regular exercise
 Possibly, diabetes
medication or insulin
therapy
 No insulin shots unless
sick or in need of more
insulin.
 Oral medications.
 Change to low-fat diet.
 Loosing weight.

12. Hyperinsulinism (CHI) is characterised
by inappropriate and unregulated insulin
secretion from the beta-cells of the
pancreas.
HYPERINSULINISM

13. Congenital Hyperinsulinism
(CHI)
 In congenital hyperinsulinism the beta-cells
release insulin inappropriately all the time and
insulin secretion is not regulated by the blood
glucose level (as occurs normally).
 The action of insulin causes hyperinsulinaemic
hypoglycaemia. High insulin levels prevent ketone
bodies being made.
 This means that the brain is not only deprived of
its most important fuel (glucose), but also ketone
bodies which are used as alternative fuels.

14. Primary Cause
 At present, there are seven known genetic causes
of CHI, which can be inherited in an autosomal
recessive or dominant manner.
 Abnormalities in the genes ABCC8 and KCNJ11
are the most common cause of severe CHI. Other
rare causes are due to abnormalities in genes
involved in regulating insulin secretion from the
pancreas beta cells.

15. Secondary Causes
Secondary causes of hyperinsulinism can be subdivided
into several categories. These categories can often be
distinguished by the length of treatment required and the
infant’s response to medical management. Transient
hyperinsulinaemic hypoglycaemia means that the
increased insulin production is only present for a short
duration and is found in conditions such as:
 Intrauterine growth retardation
 Infants of diabetic mothers
 Infants with perinatal asphyxia
More research is needed to understand why transient
hyperinsulinism occurs. Some syndromes also present in
the newborn period with hyperinsulinaemic
hypoglycaemia. In infants with beckwith weidermann
syndrome, an overgrowth syndrome, up to 50 per cent

16. Symptoms
As CHI is a congenital condition, a child usually
starts to show symptoms within the first few days
of life, although very occasionally symptoms may
appear later in infancy.
 Symptoms of hypoglycaemia can include
floppiness, shakiness, poor feeding and
sleepiness, all of which are due to the low blood
glucose levels.
 Seizures (fits or convulsions) can also occur,
again due to low blood glucose levels. If the
child’s blood glucose level is not corrected, it can
lead to loss of consciousness and potential brain

17. Treatment
 During the transfer to the specialist centre,
children are monitored closely and regularly to
keep the blood glucose level as near normal as
possible. If the level drops, the nurse and/or
doctor in charge will be able to give glucose,
either as a drip or an injection.
 There are various drugs and each one will be tried
in turn until the one that offers the best result is
found. Drugs used to reduce insulin secretion
include: diazoxide, chlorothiazide, nifedipine (this
is rarely used as it is not as effective as the other
medications), glucagon and octreotide.

18. Hypoglycemia is a condition
characterized by abnormally low
blood glucose (blood sugar) levels.
Hypoglycemia may also be referred to as
an insulin reaction, or insulin shock
HYPOGLYCEMIA

19. Symptoms
 Mild Symptoms
The typical signs of low
sugar levels:
 Trembling/shakiness
 Sweating
 Anxiety
 Irritability
 Pallor (face goes pale)
 Heart palpitations
(unregulated pattern)
 Tingling lips
 Loss of consciousness
(uncommon)
 Severe Symptoms
When the hypoglycemia
is more severe the
following signs or
symptoms are possible:
 Concentration problems
 Confusion
 Irrational and disorderly
behavior (similar to
somebody who is drunk)
 Seizures (uncommon)

20. Symptoms

21. Causes
 Hypoglycemia most commonly happens when a
person with diabetes has taken too much insulin
 Lack of glucagon (hormone that is secreted from
the pancreas that raises blood glucose levels)
 Excessive alcohol consumption: drinking heavily
can block liver from releasing stored glucose
 Tumor of pancreas known as an Insulinoma

22. Treatments
 Check your blood sugar often, if below 70mg/dl
(milligrams per deciliter) stabilize it by eating:
 3-4 glucose tablets
 Half of cup of a non diet soft drink
 1 cup of milk
 5 or 6 pieces of hard candy
 Measurements may vary for children
 Doctor may also have a treatment plan, meal
plan, medications or physical activities

23. Importance Of Physical Therapy In
Treatment Of Diseases
 Exercise - make sure you have eaten some
carbohydrate-rich food before you do any
exercise.

24. References
 Lippincott’s illustrated reviews: Biochemistry. Chapter 25 Diabetes Mellitus
 Kiana Favours secretory at Cleveland Clinic (diabetes article)
 http://www.gosh.nhs.uk/medical-information/search-for-medical-
conditions/hyperinsulinism/hyperinsulinism-information/
 Medical Author: Robert Ferry Jr., MD. Retrieved from
http://ww.emedicinehealth.com/low_blood_sugar_hypoglycemia/article_em.htm
 Mathur , R. M. F., & Schiel Jr., W. C. (2008, 21 10). Medicinenet . Retrieved
from http://www.medicinenet.com/hypoglycemia/article.htm
 Robin, S. R. (1999). Hypoglycemic diabetes . Rydner. DOI: Farver, A. F. (2009,
June 2). Hypoglycemic complications. Retrieved from
http://www.mayoclinic.com/health/diabetic-
 Farver, A. F. (2009, June 2). Hypoglycemic complications . Retrieved from
http://www.mayoclinic.com/health/diabetic-
 Rickers, F. (2008). National diabetes information clearinghouse . Retrieved from
http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/
 Davey, D. P. (16, February 20). Hypoglycemia (low blood glucose) in non-
diabetic people . Retrieved from
http://www.netdoctor.co.uk/diseases/facts/bloodsugarlow.htm

25. THANK YOU
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