Diabetes mellitus is a group of metabolic disorders characterized by high blood glucose levels resulting from defects in insulin secretion or action. There are four main types: type 1 caused by beta cell destruction; type 2 caused by insulin resistance and inadequate insulin secretion; gestational occurring during pregnancy; and prediabetes where blood glucose levels are higher than normal but not high enough for a diabetes diagnosis. Risk factors include family history, obesity, lack of exercise, and certain medical conditions. Management involves monitoring blood glucose, nutritional and lifestyle changes, exercise, diabetes education, and pharmacological treatments like insulin, oral medications, and management of complications.

1. DIABETES
MELLITUS AND ITS
MANAGEMENT
Sreyoshi Majumder

2. D E F I N I T I O N
1 CLINICAL MANIFESTATIONS
2
T Y P E S
3 PATHOPHYSIOLOGY
4
R I S K F A C T O R
5 M A N A G E M E N T
6
CONTENTS

3. 01
DEFINITION
Diabetes mellitus is a group of
metabolic and heterogeneous
disorders characterized by high
level of blood glucose that result
from defect in insulin secretion or
action or both

5. ANATOMY OF
PANCREAS

7. INSULIN
SECRETION
FROM
PANCREAS

9. • The glucose levels are tightly controlled by insulin
• When blood glucose elevates insulin normalizes the glucose
level.
•INSULIN -hormone produced by pancreas
controls the level of glucose in the body by
regulating production and storage of glucose
produced by beta cells of islet of langerhans of the
pancreas
NORMAL INSULIN
METABOLISM

10. TYPES OF
DIABETES
MELLITUS

11. 1.TYPE I DIABETES (IDDM)
2.TYPE 2 DIABETES (NIDDM)
3.GESTATIONAL DIABETES
4.PRE DIABETES

12. TYPE I DIABETES MELLITUS
• It is caused by destruction of beta cells of the
pancreas
• In this condition the pancreas secrete very little
insulin or completely stop producing insulin.
• This occurs as the body kills its own cell is also
known as autoimmune reaction.
• The exact cause of type 1 diabetes is unknown but
some are family history ,virus that injured
pancreas,alcohol consumption and surgical
removal of pancreas.

13. TYPE 2 DIABETES MELLITUS
•This condition some insulin are still made
by pancreas but inadequate amount as a
result there is an increase in the
production of insulin and this may result in
insufficient level of insulin to control sugar
level.
• INSULIN RESISTANCE -IT IS REFERRED TO THE

15. RISK FACTORS
• HEREDITARY
• OBESITY
• LACK OF EXERCISE
• PHYSICAL INACTIVITY
• FAMILY HISTORY
• HIGH ALCOHOL CONSUMPTION
• HIGH BP
• PCOD
• GESTATIONAL DM
• PRE DIABETES

16. GESTATIONAL DIABETES MELLITUS
It is defined as any degree of
glucose intolerance with its first on
set during pregnancy

17. PRE DIABETES
Pre diabetes is a new term for
impaired fasting glucose or impaired
glucose tolerance .It is characterized
by glucose level that are higher than
normal but not high enough to be
diagnostic of diabetes.

18. DIABETES
ASSOCIATED WITH
OTHER
CONDITIONS
when diabetes is caused as of
another condition is termed as
secondary diabetes it may develop
when the beta cells of pancreas are
destroyed by any disease condition
for example chronic pancreatitis etc.

19. CLINICAL MANIFESTATIONS OF DIABETES MELLITUS
1. POLYUREA
2. POLYDIPSIA
3. POLYPHAGIA
4. GLUCOSE IN URINE
5. PRONE TO INFECTION
6. BLURRED VISSION
7. LATHERGY
8. CONFUSION
9. WEIGHT LOSS
10.POOR WOUND HEALING

21. PATHOPHYSIOLO
GY

23. DIAGNOSTIC EVALUATION
1.FASTING BLOOD GLUCOSE -IS TEST DONE
AFTER NOT EATING FOR 8 TO 12 HOURS A
NORMAL FASTING BLOOD GLUCOSE LEVEL
IS LESS THAN 100 MG PER DL. A FASTING
BLOOD GLUCOSE OF 126 MG FOR DL OR
HIGH INDICATES DIABETES.

24. RANDOM BLOOD GLUCOSE
TEST
Blood can be drawn at any time
throughout the day. A random blood
glucose level of 200 mg per DL or high in
person who have symptoms of high blood
glucose suggest a diagnosis of diabetes.

25. ORAL GLUCOSE TOLERANCE
TEST
Ogtt is most sensitive test for diagnosing
diabetes and prediabetes.
It is not routinely recommended because it is
inconvenient compared to a fasting blood
glucose test.

27. URINE AND SERUM KETONE
TEST
This taste maybe ordered to
monitor patient who are present at
the emergency room with
symptoms suggesting acute
hyperglycemia and to monitor
patient who are being treated with
keto acidosis.

28. COMPLICATION
S

30. MANAGEMENT

31. Exercise
Education
Monitoring
Pharmacological
Management
Nutritional
Management

32. PHARMACOLOGIC
AL MANAGEMENT
INSULIN THERAPY

33. RAPID ACTING
INSULIN
It has an onset of 10 to 15 minutes a
peak action of 1 to 2 hour after injection
and duration 3 hours.
Ex.-HUMALOG,NOVOLOG

34. LONG ACTING INSULIN
Long acting insulin has an onset of 6 to 8
hours peak action of 12 to 16 hours and
duration 22 to 30 hours.
Ex-zinc insulin, lantus

35. SHORT ACTING INSULIN
Short acting insulin has an onset of 30
minutes to 1 hour peak action of 2 to 3
hours and duration 4 to 6
hours.
Ex-regular insulin,lente

37. ORAL ANTIDIABETIC
AGENT
1. SULFONYLUREA DRIG-THESE MEDICATIONS STIMULATE PANCREAS TO PRODUCE
AND RELEASE MORE INSULIN. Ex-glimepiride.
2. MEGLITINIDES-THESE HAVE EFFECT SIMILAR TO SULFONYLUREAS BUT PATIENT
DO NOT LIKELY TO DEVELOP LOW BLOOD SUGAR.
3. BIGUANIDES-INHIBITS PRODUCTION AND RELEASE OF GLUCOSE FROM LIVER
WHICH MEAN PATIENT NEEDS LESS INSULIN.EX- METFORMIN
4. ALPHA GLUCOSIDASE INHIBITOR -BLOCK THE ACTION OF INSULIN IN DIGESTIVE
TRACT THAT BREAKDOWN CARBOHYDRATES. THIS MEANS SUGAR IS ABSORBED
INTO BLOODSTREAM MORE SLOWLY WHICH HELPS EVEN RAPID RISE OF BLOOD
SUGAR.
5. THIAZOLIDINEDIONES-IS DRUGS MAKE BODY TISSUE MORE SENSITIVE TO
INSULIN AND KEEP LIVER FROM OVER PRODUCING GLUCOSE.

38. EXERCISE
1. EXTRA ACTIVE EVERYDAY
2. DO AEROBIC EXERCISE
3. DO STRENGTH TRAINING
4. STRETCHING

39. NUTRITIONAL
MANAGEMENT
1. Helps to keep blood glucose level, blood pressure
and cholesterol within the range set by your
healthcare professional.
2. Helps you reduce weight or maintain a healthy
weight.
3. Can delay or prevent the onset of complications
caused by diabetes.

40. GLYCAEMIC INDEX
Research have created or glycemic index that
ranks food according to the ability to raise blood
sugar.

41. MONITORING BLOOD
GLUCOSE
Self monitoring of blood glucose is an important
component of therapy for diabetes mellitus.
Regularly monitoring that group was helps measure the
effectiveness of meal plans ,physical activity and
medications.

42. EDUCATION
1. Monitor your blood sugar,
2. follow your health care provider's
instructions for managing your blood
sugar level.
3. Take your medications as directed by
your health care provider.
4. Importance of exercise
5. Maintain skin integrity

43. NURSING DIAGNOSIS

44. THANK YOU
FOR
LISTENING