3. DEFINITION
• DM is a metabolic disease in which there is high blood glucose levels over a
prolonged period.
TYPES
DM is classified into four broad categories
• Type 1
• Type 2
• Gestational diabetes
• “Other specific types”
4. CAUSES
• Type 1- loss of insulin producing beta cells of the islet of pancreas, leading
to insulin deficiency. ( idiopathic/immune-mediated)
• Type 2- loss of function of insulin receptor
• Gestational diabetes- in pregnancy without previous history of diabetes
CLASSICAL SIGNS & SYMPTOMS
• Unexplained weight loss
• Polyuria
• Polydipsia
• Polyphagia
Other S&S may include: Fatigue, Blurred vision, Headaches, Dry mouth etc
5. COMPARISON BTW TYPE 1 & 2 DIABETES
FEATURE TYPE 1 DIABETES TYP 2 DIABETES
Onset Sudden Gradual
Age of onset Mostly in children Mostly in adults
Body size Thin/normal Often obese
ketoacidosis Common Rare
Autoantibodies Usually present Absent
Endogenous insulin Low/absent Normal/decreased/increased
Concordance in identical twins 50% 90%
Prevalence ˷10% ˷90%
6. PATHOPHYSIOLOGY
When there is;
• Insufficient amount of insulin, OR
• Poor response of cells to insulin, OR
• Defect in insulin itself
glucose will not be absorbed properly by the body cells that require it & it will not
be stored appropriately in the liver & muscles. The net effect is persistently high
levels of blood glucose, poor protein synthesis & other metabolic derangements
such as acidosis.
↑ glu conc. over time → excretion of glu in urine → ↑urine osmotic pressure →
inhibition of water reabsorption → polyuria → ↓blood vol. →dehydration &
↑sed thirst (polydipsia)
7. DIAGNOSIS
Criteria: Classical signs and symptoms + hyperglycemia
1. Random plasma glucose concentration ≥11.1 mmol/l.
OR
2. Fasting plasma glucose level ≥ 7.0 mmol/l
OR
3. OGTT ≥11.1mmol/l (75g oral glucose load is given)
OR
4. Glycated hemoglobin ≥6.5%
Fasting glucose level 6.1- 6.9mmol/l---- impaired fasting glucose
Plasma glucose ≥7.8mmol/l but ˂11.1mmol/l after an OGTT----
impaired glucose tolerance. (major risk of CVD)
