This document provides an overview of pathophysiology of diabetes mellitus. It defines diabetes as a metabolic disease involving elevated blood glucose levels due to problems with insulin production or insulin resistance. The main types of diabetes are described as type 1, type 2, and gestational diabetes. Type 1 results from failure of insulin production and type 2 from insulin resistance. Signs and symptoms include increased thirst, frequent urination, weight loss and fatigue. Treatment involves lifestyle changes like diet and exercise as well as medications to improve insulin availability or overcome insulin resistance.

1. PATHO PHYSIOLOGY
B.Pharm 2nd semester
PPT By
Arun Kumar Dutta
Student of GIST,Gunupur

2. CONTENTS
• Definition
• Types
• Etiology
• Pathogenesis
• Sign and symptoms
• Complications
• Diagnosis
• Plan of treatment

3. DEFINITION
• Diabetes mellitus (DM) is a metabolic disease, involving
inappropriately elevated blood glucose levels.
• Too much sugar in the blood caused by problems with insulin
production .
• This include type-I diabetes (deficiency of insulin) and type-II
diabetes(initially excessive , then deficiency).

4. TYPES
• There are three main types of DM
1. Type-1 DM
2. Type-2 DM
3. Gestational diabetes

5. TYPES
• Type-1 DM:- It results from the body’s failure of insulin production by β-cells of the
islets of Langerhans in the Pancreas , leading to insulin deficiency .Only about
10% of all people with diabetes have Type-1 disease. Most people who have Type-1
diabetes develop the disease before age 30 although it can develop later in life
• Type-2 DM:- this form of DM which accounts for 90% of those with diabetes
,encompasses individual who have insulin resistance , diminished tissue
sensitivity to insulin , impaired β-cell function (delayed or inadequate insulin
release)and excessive or inappropriate glycogen secretion. Type-2 diabetes may
occur at any age but more common in people older than the age of 40.
• Gestational diabetes:- Blood sugar elevation during pregnancy is called
Gestational diabetes.

6. ETIOLOGY
• Although the specific etiology is unknown. Autoimmune destruction of
β-cells does not occur but it is attributed to typical genetic makeup,
familial history , obesity and defect in insulin receptor.
• Type-2 diabetes also tends to run in families, obesity, excess
production of growth hormone, high level Corticosteroids.

7. PATHOGENESIS

8. SIGN AND SYMPTOMS
• Ketoacidosis
• Presence of glucose in urine
• Polydipsia(increased thirst)
• Polyuria
• Fatigue and headache
• Blurred vision
• Loss of weight
• Slow healing cuts sores.

9. COMPLICATIONS

10. DIAGNOSIS

11. PLAN OF TREATMENT
• Non pharmacological :- Diet, controlling weight avoid excessive salt in take, avoid
alcohol.
• Pharmacological:-
1. Drugs improving insulin availability
a. Exogenous insulin – Isophane, Protamine
b. Sulfonylureas – Tolbutamide, Glimepiride
2. Drugs over coming insulin resistance
a. Biguanide - Metformin
b. Thiazolidinediones – Rosiglitazone
c. Alpha-glucosidase inhibitors – Miglitol , Acarbose
3. DPP-4 inhibitors – linagliptin , Alogliptin
4. SGLT2 inhibitors – Empagliflozin, Dapagliflozin