Diabetis sri2


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Diabetis sri2

  1. 1. Guide Srilakshmi M. Pharm Presented by A.Srikanth reddy 07FM1R0013
  2. 2. •DIABETES ( From a Greek word meaning “ siphon “, referring to the increased output of urine) MELLITUS (From a Latin word meaning “sweet“ Diabetes mellitus (DM) is a set of related diseases in which the body Cannot regulate specifically sugar( glucose) in the blood. known also as glycosuria (glucose in urine)
  3. 3. • Figures for the year 2007 show that the 5 countries with the largest amount of people diagnosed with diabetes were • India (40.9 million), • China (38.9 million), • US (19.2 million), • Russia (9.6 million), and • Germany (7.4 million). • Currently, India is the diabetes capital of the world.
  4. 4. • Glucose in the blood gives you energy to perform normal glucose level • daily activities, run for a bus, (100mg/dl) ride your bike, take an aerobic exercise class, glucose is produced in liver. • Gluconeogenesis & glycogenesis
  5. 5.  Insulin is produced by beta cells of langerhans of pancreas  In a healthy person, the blood glucose level is regulated by several hormones, including insulin.  Insulin allows glucose to move from the blood into liver, muscle, and fat cells, where it is used for fuel insulin
  6. 6. • Type 1 diabetes • Type 2 diabetes • Gestational • Pre-diabetes
  7. 7. Type 1 diabetes: •Type 1 diabetes comprises about 10% of total cases of diabetes. The majority of type 1 diabetes is of the immune-mediated nature, where beta cell loss due to T-cell mediated autoimmune attack. There is no known preventive measure against type 1 diabetes •Type 1 diabetes can occur in an older individual due to destruction of pancreas by alcohol, disease, or removal by surgery. It also results from progressive failure of the pancreatic beta cells, which produce insulin •. •People with type 1 diabetes require daily insulin treatment to sustain life
  8. 8. • At least 90% of patients with diabetes have type 2 diabetes. • The pancreas secretes insulin, but the body is partially or completely unable to use the insulin. This is sometimes referred to as insulin resistance. • The body tries to overcome this resistance by secreting more and more insulin (hyper inslunemia)
  9. 9. • It causes Dystocia It is abnormal or difficult child birth. • The Gestational diabetes occurs in about 2%–5% of all pregnancies and may improve or disappear after delivery • Untreated gestational diabetes can damage the health of the fetus or mother. Risks to the baby include macrosomia (high birth weight), • Gestational diabetes is fully treatable but requires careful medical supervision throughout the pregnancy • About 20%–50% of affected women develop type 2 diabetes later in life
  10. 10. • Pre-diabetes is a common condition related  to diabetes. In people with pre-diabetes, the  blood sugar level is higher than normal but  not high enough to be considered diabetic. 
  11. 11. • Polydipsia • • Polyuria • Weight loss • Polyphagia • Poor wound healing: High blood sugar levels prevent white blood cells, which are important in defending the body against bacteria and also in cleaning up dead tissue and cells, from functioning normally. When these cells do not function properly, wounds take much longer to heal and become infected more frequently
  12. 12. • Diabetic retinopathy • Diabetic Neuropathy • Diabetic ketoacidosis • Hyper osmolar hyperglycemic  non ketonic syndrome •  Foot problems • Hypoglycemia  • Diabetic nephropathy  • Atherosclerosis • Infection
  13. 13. • Common complication of  diabetes affecting the blood vessels  in the retina (the thin light-sensitive  membrane that covers the back of the eye).  If untreated, it may lead to blindness  •  Non proliferative: retinopathy is the earlier stage. (bleeding) in the retina  with leakage of blood causing a "wet retina" or protein deposits • Proliferative retinopathy is the second stage. New abnormal vessels  develop in the retina and grow towards the center of the eye. 
  14. 14. • It is the disorder related to nerves    Types • Peripheral: causes pain or loss of feeling in the toes, feet, legs, hands  • Autonomic: Autonomic neuropathy causes changes in digestion, bowel and  bladder function, sexual response, and perspiration (sweating)  • Proximal neuropathy :causes pain in the thighs, hips, or buttocks and  leads to weakness in the legs 
  15. 15. •  With damage to the nervous system,  a person with diabetes may not be  able to feel his or her feet properly (dysesthesia). •  Normal sweat secretion and oil production that lubricates the skin of  the foot is impaired leads to formation of  foot ulcers •  Damage to blood vessels and impairment of the immune system  from diabetes make it difficult to heal these wound  • Amputation of leg is the only treatment
  16. 16. • Hypoglycemia (low blood sugar) is a  commonly perceived problem  Generally, hypoglycemia is defined as  a serum glucose level (the amount of sugar or glucose in your blood) below 70 mg/dL, (normal-100mg/dl) Sypmtoms • Difficult in speech or slurred speech • Confusion, dizziness, Dysphoria, anxiety, moodiness, depression, Fatigue,  weakness, apathy,  lethargy. 
  17. 17. • Diabetic nephropathy typically affects the network  of tiny blood vessels (the microvasculature) in the glomerulus, a key structure in the kidney  composed of capillary blood vessels.  • The glomerulus is critically necessary for the filtration  of the blood. Features of diabetic nephropathy include  the nephrotic syndrome with excessive filtration of protein  into the urine (proteinuria 
  18. 18. • The levels of glucose  causes the accumulation of fat in blood vessels  leading to the hardening of the walls of the vessels which leads  diminished  blood supply cause the atherosclerosis further  leads to heart  attacks
  19. 19. • in diabetic keto acidosis, the body shifts from its normal fed metabolism (using carbohydrates for fuel) to a fasting state (using fat for fuel). The resulting increase in blood sugar occurs • These fatty acids are converted to ketones by a process called oxidation. The body consumes its own muscle, fat, and liver cells symptoms Excessive thirst Frequent urination, Dehydration, Vomiting Loss of appetite, Confusion, Abdominal pain,
  20. 20. • As the body contains high amount of glucose in blood it encourages the growth of bacteria, fungus in infections as we know that glucose serves as the source of energy for microbes
  21. 21. • It is a serious condition in which the blood sugar level gets very high. The body tries to get rid of the excess blood sugar by eliminating it in the urine. This increases the amount of urine significantly and often leads to dehydration so severe that it can cause seizures, coma, and even death
  22. 22. • Finger stick glucose test • Fasting plasma glucose • Glycosylated hemoglobin
  23. 23. • The test involves sticking the patient's finger for a blood sample which is then placed on a strip. The strip goes into a machine that reads the blood sugar level. • Finger stick blood glucose values may be inaccurate at very high or very low levels, so this test is only a preliminary screening study
  24. 24. • The patient will be asked to eat or drink nothing for 8 hours before having blood drawn (usually first thing in the morning). If the blood glucose level is greater than or equal to 126 mg/dL without eating anything, they probably have diabetes.
  25. 25. • This test is a measurement of how high blood sugar levels have been over about the last 120 days (the average life-span of the red blood cells on which the test is based). • Excess blood glucose hooks on to the hemoglobin in red blood cells and stays there for the life of the red blood cell. • The percentage of hemoglobin that has had excess blood sugar attached to it can be measured in the blood
  26. 26. • Diet • Exercise • Medications • Alcohol use • Quit smoking • Self monitored glucose
  27. 27. • A healthy diet is key to controlling blood sugar levels and preventing diabetes complications. • If the patient is obese and has had difficulty losing weight on their own, talk to a healthcare provider. He or she can recommend a dietitian
  28. 28. •  Regular exercise, in any form, can help reduce  the risk of developing diabetes. Activity can also reduce the risk of developing complications  of diabetes such as heart disease, stroke, kidney  failure, blindness, and leg ulcers •  As little as 20 minutes of walking three times  a week has a proven beneficial effect. Any exercise is beneficial; no matter how  light or how long, some exercise is better than no exercise 
  29. 29. • Excessive alcohol use is a known risk  factor for type 2 diabetes. Alcohol consumption can cause low  or high blood sugar levels, increase in triglycerides, which is a  type of fat in our blood.  • Chronic alcohol causes pancreatitis &damage  to beta cells of langerhans
  30. 30. • Smoking:  If the patient has diabetes,  and you smoke cigarettes , they are raising the  risks markedly for nearly all of the complications of diabetes.  • Smoking damages blood vessels and contributes  to heart disease, stroke, and poor circulation in the limbs. If someone needs  help quitting, talk to a healthcare provider. 
  31. 31. •  Check blood sugar levels frequently, at least  before meals and at bedtime, and record the  results in a logbook. 
  32. 32. • Sulfonylureas: These drugs stimulate the pancreas to make more insulin. Ex. Glipizide (Glucotrol) glyburide • Insulin • Biguanides: These agents decrease the amount of glucose produced by  the liver.       Ex-  Metformin, phenformin,butformin • Alpha- glucosidase inhibitors: These agents slow absorption of the  starches one eats. This slows down glucose production. Ex- Miglitol(Glyset), Acarbose(Glucobay) • Meglitinides: These agents stimulate the pancreas to make more insulin. Ex-  Repaglinide(Prandin)                      Nateglinde(Starlix)