Causes and affects and treatment of diabetes

1. DIABETES MELLITUS
Name:- K. Sai Prasanna
B.Pharmacy IV th year
Vignan Institute of Pharmaceutical Technology

2. DIABETES
 Also known as diabetes mellitus
 It is a metabolic disorder in which there will be a raised level of glucose in
blood.
Ranges:
 Fasting: 70-100 mg/Dl
 After meal: less than 140 mg/dL
 Random: 80-130 mg / dL (before meal).
 More than 125 mg/dL during fasting or > 180 mg/dl – 2 hrs after eating
indicates the diabetic condition.

3. General mechanism:
 Every cell in body requires fuel to perform its works here in the body glucose
acts as the fuel.- Glucose is produced due by the breakdown of food in the
stomach.
 The glucose produced need to be transported to the cell, ६ here blood
vessels acts as transporters for carrying the glucose to cell & this occurs only
in presence of insulin (ie uptake of glucose by cell).
glucose insulin cell
blood vessel

4. Types of diabetes mellitus:
 Based on the amount of insulin produced in body / its effectiveness, diabetes
is classified into 3 types mainly:
1. Type-1:
 It is an Insulin dependent Auto immune disorder (Juvenile)
 Pancreas doesnot secrete insulin in this type.
 Around 10% of people with diabetes suffer from type -1 diabetes mellitus.
2.Type -2:
 It is a Non insulin dependent diabetes mellitus.
 Pancreas secrete low amount of insulin or Body can’t utilise the insulin
produced.
 Around (80-10%) of diabetic people suffer from type-2 diabetes mellitus.

5. 3.Gestational diabetes:
 Occurs in pregnant women due to over weight.
 It is generally reversible diabetes which means the levels of glucose in body
comes to normal range after delivery.
 It occurs during 24th week of pregnancy.
 Sometimes it may leads to Type-2 diabetes.
 Prediabetes is a condition in which the levels of glucose is more than normal
but not offically diagnosied as type 2.

6. Causes:
1.Non-modified: which cannot be changed or altered
Genetics, environmental factors
2.Modified:which can be changed
Obesity, Lack of physical exercise, High BP, stress, Smoking
Symptoms:
 Excess thirst (Polydipsia)
 Hunger
 Excess urination(polyuria)
 Weight loss
 Excess fatigue
 Headache
 Loose stools
 Tingling (Prickling / burning in fingers, hands, feet, arms /legs).

7. Diagnosis:
1) Fasting plasma glucose test:
Done in the morning after 8 hours of fasting (except water)
2) Random plasma glucose test:
Any time with out the need of fasting .
3) A1ctest /Hb A1C / Glycated Hb test:
Determine the average blood sugar levels over post 2-3 months.
-Measures amount of glucose attached to Hb
4) Oral glucose tolerance test:
Blood glucose level is measured first after overnight fasting.
Later the patient is given with sugary liquids and retested the glucose levels by
collecting the blood sample 2 hours after giving the liquids.

8. RESULTS
Test Normal Prediabetes Diabetes
Fasting plasma
glucose test
<100mg/dl 100-125mg/dl >126mg/dl
Random plasma
glucose test
<140mg/dl 140-199mg/dl >200mg/dl
A1c test <5-7%mg/dl 5.7-6.4%mg/dl >6.5%mg/dl
Oral glucose
tolerance test
<140mg/dl 140-199mg/dl >200mg/dl

9. Treatment:
 1.Insulin:
 A .Rapid acting insulin : Taken 15 minutes before the meal,shows its action for
about 3-4 hours.
 Ex : Insulin lipro , Aspart(100U/ml)
 B . Short acting insulin : Taken 30 minutes before the meals, shows its action for
about 2-6 hours.
 Ex : Insulin regular
 C . Intermediate acting insulin : Shows action for 12-18 hours
 Ex : NPH
 D . Long acting insulin :Shows action for >18 hours
 Ex : Insulin Detemir(0.1-0.2u/kg once daily in the morning or in 2 divided doses)

10. Treatment :
2.Sulfonyl ureas :
Glimepride(1-2mg once daily with breakfast)
Glipizide(5mg with breakfast)
3.Glinides(metaglinides):
Repaglinide(0.5mg with 2-4 meals per day)
Nateglinide(60-120mg/day)
4.Biguanides :
Metformin –(1g/day)
5.Alpha glucoside inhibitors:
Acarbose(25mg tid)
6.Thiazolidines:
Pioglitazone (25-30mg once daily)
Rosiglitazone (4mg/day in a single or 2 divided doses)

11. Prevention :
 Medication
 Physical exercises for atleast 30 minutes like walking or swimming.
 Maintaining blood cholesterol levels(hdl,ldl and triglyceride levels).
 Manage your bp nmt 140/90mmHg
 Take a mediterranian or healthy diet(including vegetables,fruits,grains).
 Quitting smoking.