The document discusses diabetes mellitus type 2, including its definition as a metabolic disease caused by insulin resistance or deficiency resulting in high blood sugar, common symptoms like those of type 1 diabetes but without ketoacidosis, and management through proper diet, exercise, medication and monitoring of blood sugar and cholesterol levels to control complications affecting eyes, kidneys, nerves, heart and blood vessels.

1. BIOCHEMISTRY ASSIGNMENT
TOPIC-Diabetes Mellitus type -2
Submitted To,
Mr.Shubham Meshram
Department Of Child Health Nursing
Tutor/CI
DMCON
Submitted By,
Purvaja Chapekar
B.S.c Nursing 1st Year2021
Roll No -04
DMCON

2. GENERAL OBJECTIVE
1. Introduction
2. Definition
3. Symptoms
4. Complications
5. Investigation
6. Management

3. Introduction
Diabetes mellitus is a syndrome of impaired
carbohydrates,fat and protein metabolism,caused by
either:-
-Lack of insulin secretion
-Decreased sensitivity of the tissues to insulin
(decrease response to stimuli)

4. Definition
Diabetes mellitus is a metabolic disease
characterized by hyperglycemia,caused by
inherited and acquired defects in insulin
secretion and insulin action.

5. Symptoms
In type -2 diabetes mellitus,the symptoms are
developed gradually which are similar to that
of type 1 expect ketoacidosis.is usually not
present in type 2 diabetes mellitus.

6. Complications
Diabetes complications can be divided as acute and chronic
complications.The complications of diabetes mellitus are less
common and less severe in people who have well-controlled blood
sugar levels.
1.Acute complications
a) Diabetic Ketoacidosis (DKA)is generally seen due to low insulin
levels, which favors lipolysis in adipose tissue. Increased lipolysis
leads to increased mobilization of fatty acids from adipose tissue to
liver,where they are converted to ketone bodies.

7. b)Hyperglycemia-The lack of insulin activity in diabetes
mellitus results in failure of transfer of glucose from the
blood into cells and leads to hyperglycemia.
c) Diabetic Ketoacidotic coma- The combined result of
severe Ketoacidosis, hyperglycemia and hyperosmolarity
and electrolytes , disturbance impaired cerebral function,
producing diabetic Ketoacidotic coma.

8. 2. Chronic Complications
a) Microvascular complications include damage to eyes (
retinopathy)leading to blindness , to kidneys ( nephropathy)
leading to renal failure and to nerves ( neuropathy) leading to
impotence and diabetic foot disorders ( which include several
infections leading to amputation.)
b) Macrovascular complications include cardiovascular diseases such
as heart attacks , strokes and insufficiency in blood flow to legs.

9. Investigation
1.Urine Testing
Urine tests can be used for diagnosing and monitoring diabetes.In
diabetes,urine is tested for the presence of three parameters.
a) Glucose Test-Glucose is not normally found in urine,but it can
pass from the kidneys into the urine in people who have
diabetes.
b) Ketone Test-This test detects the presence of ketones in urine.
Ketones are formed from fatwhen there is insufficient insulin to
allow glucose to be used for fuel.

10. c) Microalbumin test –it is a type of protein in the urine. Protein is
present in the urine when there is a damaged to the kidneys. Since the
damage to blood vessels that occurs as a complication of diabetes.

11. Blood sugar testing with a glucose metre
Glucose metre is a portable electronic device for
determining to approximate concentration of glucose in
the blood.
Glycated hemoglobin estimation
Glycated hemoglobin is the form of hemoglobin that is
bound to glucose. The blood test for HbAlc Level is
routinely performed in people with type 2 diabetes
mellitus. Levels of 6.5 % or higher mean you have diabetes.

12. Glucose tolerance test
The glucose tolerance test is the ability of the body to utilise glucose.
Indicated by type of blood glucose curve after administration of
glucose.
Types of glucose tolerance test
1)Oral GTT (OGTT)
2) Intravenous GTT (IVGTT)
Types of glucose tolerance curve
1. Normal glucose tolerance curve
2. Normal glucose tolerance curve
-diminished glucose tolerance
-increased glucose tolerance

13. Glucose tolerance test performed in specific condition in diabetes
1. Extended GTT
2. Mini GTT
3. GCT( glucose challenge test)

14. Management
There is no cure aur for diabetes , but it can be treated and
controlled. Ideally , the initial management of NIDDM is based
on dietary therapy combined with increased physical activity, if
possible. However oral hypoglycemic drugs or insulin maybe
given in the presence of marked hypoglycinemia.
The goals of managing diabetes are two
1. Keep blood glucose level as near to normal as possible by
proper diet with medication and regular exercise.
2. Maintain blood cholesterol and triglyceride (lipid) levels as
near the normal range as possible.

15. 3.Control blood pressure , blood pressure should not go over 140/90.
4. People with diabetes must take responsibility for their day to day
care. This includes monitoring blood glucose levels, dietary
management, maintaining physical activity, keeping weight and stress
under control, monitoring oral medications.

16. Summary
So, here we discussed about definition ,symptoms,
complication,investigation and management of diabetes mellitus type 2

17. Conclusion
Diabetes is a slow killer with no non curable treatments. However,its
complications can be reduced through proper awareness and timely
treatment.

18. Questions
1. Define diabetes mellitus
2. Enlist symptoms of diabetes mellitus type 2
3. Describe complications of diabetes mellitus
4. ExplainManagement of diabetes mellitus
5. Enumerate investigation’s test

19. Reference
Essentials of biochemistry
Pankaja Niak
Second edition
Jaypee publishers