This document provides an overview of diabetes mellitus, including its classification into type 1 and type 2 diabetes. It defines each type, describing their pathophysiology, causes, signs and symptoms. Type 1 diabetes results from the body's immune system attacking insulin-producing beta cells in the pancreas. Type 2 involves insulin resistance and reduced insulin secretion. Diagnostic tests and treatment options are also reviewed, along with pancreatic anatomy and the role of insulin in regulating blood sugar levels. Complications of diabetes and collaborative care approaches are briefly mentioned.
this research is made by a dental student (me) under supervision of our oral medicine specialist dr. muhassad almudhafer and this research is collected from several articles hope u like it
this my email if u would like to contact me - mnmmnz4503.mm@gmail.com
In these slides I have discussed about the diabetes mellitus and it's management.
For better understanding preferable pictures are added.
Hope it may help you.
Thank you
Algorithms for Diabetes Management for StudentsUsama Ragab
Algorithms for Diabetes Management for Students
By Usama Ragab Youssif
Lecturer of Medicine - Zagazig University
Agenda
Type 2 Diabetes 101
Incretin based therapy
Algorithms of management
Email: usamaragab@medicine.zu.edu.eg, usama.ragab.zu@gmail.com
SlideShare: https://www.slideshare.net/dr4spring/
Facebook: https://www.facebook.com/doc.usama
Facebook Clinic: https://www.facebook.com/usamaclinic
Mobile: 00201000035863
MODY is the name given to a collection of different types of inherited forms of diabetes that usually develop in adolescence or early adulthood.
MODY stands for “Maturity-onset diabetes of the young” and was given that name in the past because it acted more like the adult type of diabetes (Type 2 Diabetes) but was found in young people.
MODY limits the body’s ability to produce insulin, but is different than the juvenile type of diabetes (Type 1 Diabetes).
When our bodies don’t produce enough insulin, it can increase blood glucose levels. High blood glucose levels lead to diabetes.
summary of factors contributing to the pathogeesis of SLE and the events that lead to its associated tissue damage, from genetic and immunologic point of view
Pathophysiology of Diabetes Mellitus (Harrison’s Principles of Internal Medic...Batoul Ghosn
This presentation talks about the Pathophysiology part of Diabetes Mellitus I & II as well as Diabetic Ketoacidosis & Hyperglycemic Hyperosmolar State and Finally with Medical Nutrition Therapy in DIabetes Mellitus. It is made entirely from the Harrsion's Book 19th edition.
Diabetes mellitus (DM) has routinely been described as a metabolic disorder characterized by hyperglycemia that develops as a consequence of defects in insulin secretion, insulin action, or both.
Such a deficiency results in increased concentrations of glucose in the blood, which in turn damage many of the body's systems, in particular the blood vessels and nerves.
1. Microvascular (due to damage to small blood vessels).
2. Macrovascular (due to damage to larger blood vessels).
this research is made by a dental student (me) under supervision of our oral medicine specialist dr. muhassad almudhafer and this research is collected from several articles hope u like it
this my email if u would like to contact me - mnmmnz4503.mm@gmail.com
In these slides I have discussed about the diabetes mellitus and it's management.
For better understanding preferable pictures are added.
Hope it may help you.
Thank you
Algorithms for Diabetes Management for StudentsUsama Ragab
Algorithms for Diabetes Management for Students
By Usama Ragab Youssif
Lecturer of Medicine - Zagazig University
Agenda
Type 2 Diabetes 101
Incretin based therapy
Algorithms of management
Email: usamaragab@medicine.zu.edu.eg, usama.ragab.zu@gmail.com
SlideShare: https://www.slideshare.net/dr4spring/
Facebook: https://www.facebook.com/doc.usama
Facebook Clinic: https://www.facebook.com/usamaclinic
Mobile: 00201000035863
MODY is the name given to a collection of different types of inherited forms of diabetes that usually develop in adolescence or early adulthood.
MODY stands for “Maturity-onset diabetes of the young” and was given that name in the past because it acted more like the adult type of diabetes (Type 2 Diabetes) but was found in young people.
MODY limits the body’s ability to produce insulin, but is different than the juvenile type of diabetes (Type 1 Diabetes).
When our bodies don’t produce enough insulin, it can increase blood glucose levels. High blood glucose levels lead to diabetes.
summary of factors contributing to the pathogeesis of SLE and the events that lead to its associated tissue damage, from genetic and immunologic point of view
Pathophysiology of Diabetes Mellitus (Harrison’s Principles of Internal Medic...Batoul Ghosn
This presentation talks about the Pathophysiology part of Diabetes Mellitus I & II as well as Diabetic Ketoacidosis & Hyperglycemic Hyperosmolar State and Finally with Medical Nutrition Therapy in DIabetes Mellitus. It is made entirely from the Harrsion's Book 19th edition.
Diabetes mellitus (DM) has routinely been described as a metabolic disorder characterized by hyperglycemia that develops as a consequence of defects in insulin secretion, insulin action, or both.
Such a deficiency results in increased concentrations of glucose in the blood, which in turn damage many of the body's systems, in particular the blood vessels and nerves.
1. Microvascular (due to damage to small blood vessels).
2. Macrovascular (due to damage to larger blood vessels).
Learn everything you need to know about diabetes mellitus and diabetes of all types as well as its causes, symptoms, and risks. Additionally, you'll learn how to diagnose it, how to prevent it from diabetes
Diabetes is a disease that affects your body's ability to produce or use insulin. Insulin is a hormone. When your body turns the food you eat into energy (also called sugar or glucose), insulin is released to help transport this energy to the cells. ... There are two main types of diabetes: Type 1 and Type 2 .
Includes Information about Pharmacotherapeutic of Diabetes Mellitus, all details about etiology, Pathophysiology, pharmacology, treatment, current clinical trials on DM etc.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
2. Review the anatomy & Physiology of pancreas.
Define Diabetes Mellitus
Define classification of Diabetes.
Briefly explain Type 1 diabetes, its pathophysiology, causes and sign
and symptoms.
Briefly explain Type 2 diabetes, its pathophysiology, causes and sign
and symptoms.
Explain diagnostic test to detect Diabetes.
Describe treatment of Diabetes.
List down complications of Diabetes.
Describe collaborative care of Diabetes.
Insulin (Structure , Function & Types)
Objectives
3. Pancreatic Anatomy
Gland with both exocrine and endocrine functions
15-25 cm long
60-100 g
Location: retro-peritoneum, 2nd lumbar vertebral level
Extends in an oblique, transverse position
Parts of pancreas: head, neck, body and tail
5. Production of Pancreatic Hormones by Three Cell Types
Alpha cells produce glucagon.
Beta cells produce insulin.
Delta cells produce somatostatin.
6. Islet of Langerhans Cross-section
Three cell types are present, A
(glucagon secretion), B (Insulin
secretion) and D (Somatostatin
secretion)
A and D cells are located around the
perimeter while B cells are located in
the interior
Venous return containing insulin flows
by the A cells on its way out of the
islets
7. Definition:-
Diabetes mellitus is a group of metabolic disease characterized by
elevated levels of glucose in the blood(hyperglycemia)resulting
from defects in insulin secretion ,insulin action or both.
Diabetes mellitus is a chronic ,lifelong condition that affects your
body’s ability to use the energy found in the food.
9. Type 1 Diabetes Mellitus
Type 1 diabetes also called insulin-
dependent diabetes.
This type of diabetes is characterized by loss
of insulin-producing beta cells in islets of the
Langerhans in the pancreas.
It used to be called juvenile-onset diabetes,
because it often begins in childhood.
It may be caused by a genetic predisposition.
It could also be the result of faulty beta cells
in the pancreas that normally produce
insulin.
10. Pathophysiology
Type 1 diabetes occurs as a result of the body's immune system
attacking the insulin producing beta cells of the pancreas,
although it is not clear why this happens. A lack of insulin in
the blood means inadequate amounts of glucose are taken up
by cells of the body to provide energy for cellular functions.
Consequently, glucose remains in the blood leading to a high
blood sugar level.
11. What is insulin and how does it work?
Insulin is the principal hormone that regulates uptake of glucose
from the blood into most cells (primarily muscle and fat cells, but
not central nervous system cells).
Therefore deficiency of insulin or the insensitivity of its receptors
plays a central role in all forms of diabetes mellitus.
Most of the carbohydrates in food are converted within a few hours
to the monosaccharide glucose, the principal carbohydrate found in
blood and used by the body as fuel.
Insulin is released into the blood by beta cells (β-cells), found in the
Islets of Langerhans in the pancreas, in response to rising levels of
blood glucose, typically after eating.
12. Cont.….
Insulin is used by about two-thirds of the body's cells to absorb
glucose from the blood for use as fuel, for conversion to other needed
molecules, or for storage.
Insulin is also the principal control signal for conversion of glucose to
glycogen for internal storage in liver and muscle cells.
Lowered glucose levels result both in the reduced release of insulin
from the beta cells.
If the amount of insulin available is insufficient, if cells respond
poorly to the effects of insulin (insulin insensitivity or resistance),
there can be persistent high levels of blood glucose, poor protein
synthesis, and other metabolic derangements, such as acidosis.
13. Causes
Viral infection - Some research has suggested that the immune
system is activated in response to viral infection. As the immune cells
are activated against the virus particles, they are also activated against
the beta cells of the pancreas. Viruses that have been implicated in the
causation of type 1 diabetes include rubella viruses.
Genetic tendency - Type 1 diabetes seems to run in families which
suggests a genetic basis to the pathology of the condition. Some HLA
(Human Leukocyte antigen) genotypes are known to raise the risk of
developing type 1 diabetes.
Lack of vitamin D:-There is thought that lack of vitamin D in the
first year of a child's life may raise the risk of type 1 diabetes
developing.
14. Cont.…..
Development of antibodies - Some researchers have suggested that
the development of antibodies against proteins in cow's milk may
also lead to the development of antibodies that attack the beta cells of
the pancreas. The presence of antibodies against pancreatic beta cells
is seen in a subtype of type 1 diabetes mellitus.
Certain drugs and chemicals may also play a role in
the development of type 1 diabetes by destroying the pancreatic beta
cells. These include chemicals such as pyrinuron (Vacor, N-3-
pyridylmethyl-N'-p-nitrophenyl urea) which is used as a rat poison
and is no longer used in the USA. An anticancer and antibiotic agent
called streptozotocin used to treat pancreatic cancer also destroys the
pancreatic beta cells.
16. Type 2 Diabetes Mellitus
By far the most common form of diabetes is type 2 diabetes,
accounting for 95% of diabetes cases in adults.
It used to be called as adult onset diabetes or non-insulin
dependent diabetes.
17. Pathophysiology:-
DM 2 is due to insulin resistance or reduce insulin sensitivity,
combined with relatively reduced insulin secretion, which in cases
become absolute. The defective responsiveness of body to insulin
almost certainly involves in the insulin receptor in cell membrane.
The pancreas usually produce some insulin.
Type 2 diabetes is caused by either inadequate production of the
hormone insulin or a lack of response to insulin by various cells of
the body.
18. Insulin resistance refers to when cells of the body such as the
muscle, liver and fat cells fail to respond to insulin, even when
levels are high. In fat cells, triglycerides are instead broken down to
produce free fatty acids for energy; muscle cells are deprived of an
energy source and liver cells fail to build up glycogen stores.
This also leads to an overall rise in the level of glucose in the blood.
Glycogen stores become markedly reduced and there is less glucose
available for release when it may be needed. Obesity and lack of
physical activity are thought to be major causes of insulin resistance.
19. Normal regulation of blood sugar
Glucose is an important source of energy in the body. It is mainly
obtained from carbohydrates in the diet which are broken down into
glucose for the various cells of the body to utilize. The liver is also
able to manufacture glucose from its glycogen stores.
In a healthy person, a rise in blood sugar after a meal triggers the
pancreatic beta cells to release the hormone insulin. Insulin, in turn,
stimulates cells to take up the glucose from the blood. When blood
glucose levels fall, during exercise for example, insulin levels also
decline.
20. As well as insulin stimulating the uptake of glucose from the
blood by body cells, it also induces the:
Conversion of glucose to pyruvate (glycolysis) to release free
energy.
Conversion of excess glucose to glycogen for storage in the liver
(glycogenesis).
Uptake and synthesis of amino acids, proteins, and fat
21. Causes
Weight
Fat distribution
Sedentary life styles
Race
Family history
Age(more than 45)
Pre diabetes
Polycystic ovary syndrome
Body mass index higher than 25
Removal of pancreas
22. Sign and symptoms
Initial symptoms:-
Polyuria
Polydipsia
Polyphagia
Unintended weight loss
Irritability and other mood changes
Fatigue and weakness
23. Blurred vision
Vaginal yeast infection in female/Balanitis(inflammation of penis)
Tingling or numbness in hands or feet
Fatigue
Nausea vomiting
24. Later sign symptoms
Perspiration
Irritability
Wound not heal easily
Trembling
Confusion
25. Differences between type-1 and type-2 Diabetes
Mellitus
Type 1
Young age
Normal BMI, not obese
No immediate family history
Short duration of symptoms (weeks)
Can present with diabetic coma
(diabetic ketoacidosis)
Insulin required
Type 2
Middle aged, elderly
Usually overweight/obese
Family history usual
Symptoms may be present for
months/years
Do not present with diabetic coma
Insulin not necessarily required
Previous diabetes in pregnancy
26. Diagnosis.
The diagnosis of type 1 diabetes and many cases of type 2, is
usually prompted by recent-onset symptoms of excessive
urination (polyuria) and excessive thirst (polydipsia), and often
accompanied by weight loss.
The diagnosis of other types of diabetes is usually made in other
ways. These include ordinary health screening; detection of
hyperglycemia during other medical investigations;
Diabetes mellitus is characterized by recurrent or persistent
hyperglycemia, and is diagnosed by demonstrating any one of the
following
27. Diagnostic test
Glycated hemoglobin (A1C) test :-An A1C level of 6.5 percent or
higher on two separate tests indicates that you have diabetes. An A1C
between 5.7 and 6.4 percent indicates prediabetes. Below 5.7 is
considered normal.
Random blood sugar test:-a random blood sugar level of 200
milligrams per deciliter (mg/dL) ,11.1 millimoles per liter (mmol/L) or
higher suggests diabetes.
Fasting blood sugar test:-A fasting blood sugar level from 100 to 125
mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7
mmol/L) or higher on two separate tests, you have diabetes.
Oral glucose tolerance test:-A blood sugar level less than 140 mg/dL
(7.8 mmol/L) is normal. A reading of more than 200 mg/dL (11.1
mmol/L) after two hours indicates diabetes. A reading between 140 and
199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes.
32. Diabetes Mellitus
Goals of diabetes management:
Reduce symptoms
Promote well-being
Prevent acute complications
Delay onset and progression of long-term complications
ay onset and progression of long-term complications
34. Nutritional Therapy
Within the context of an overall healthy eating
plan, a person with diabetes can eat the same
foods as a person without diabetes
Overall goal of nutritional therapy
Assist people to make changes in nutrition
and exercise habits that will lead to
improved metabolic control
Food composition
Meal plan developed with dietitian
Nutritionally balanced
Does not prohibit the consumption of any
one type of food.
35. Exercise
Essential part of diabetes management
Increases insulin sensitivity
Lowers blood glucose levels
Decreases insulin resistance
Take small carbohydrate snacks Q 30 min during exercise to
prevent hypoglycemia
Exercise after meals
Exercise plans should be individualized
Monitor blood glucose levels before, during, and after exercise
36. Monitoring Blood Glucose
Self-monitoring of blood glucose (SMBG)
Allows self-management decisions regarding diet, exercise, and
medication
Important for detecting episodic hyperglycemia and
hypoglycemia
Patient education is crucial
37. Structure of Insulin
Insulin is a polypeptide hormone, composed of two chains (A and B)
BOTH chains are derived from proinsulin, a prohormone.
The two chains are joined by disulfide bonds.
38. Roles of Insulin
Acts on tissues (especially liver, skeletal muscle, adipose) to increase
uptake of glucose and amino acids.
- without insulin, most tissues do not take in glucose and amino
acids well (except brain).
Increases glycogen production (glucose storage) in the liver and
muscle.
Stimulates lipid synthesis from free fatty acids and triglycerides in
adipose tissue.
Also stimulates potassium uptake by cells (role in potassium
homeostasis).
39. The commonly used types of insulin are:
1. Rapid-acting types are presently insulin analogues, such as the insulin
analogues aspart or lispro. these begin to work within 5 to 15 minutes and
are active for 3 to 4 hours
40. 2. Short-acting, such as regular insulin – starts working within 30 minutes
and is active about 5 to 8 hours
A mixture of NPH and regular insulin – starts working in 30 minutes and
is active 16 to 24 hours. There are several variations with different
proportions of the mixed insulins
41. 3. Intermediate-acting, such as NPH (Neutral Protamine Hagedorn) –
starts working in 1 to 3 hours and is active 16 to 24 hours
Insulin glargine and Insulin detemir – both insulin analogues which start
working within 1 to 2 hours and continue to be active, without major
peaks or dips, for about 24 hours, although this varies in many individuals.
42. Long Acting
4. Long-acting, such as ultralente insulin – starts working in 4 to 6 hours,
and is active well beyond 32 hours