CLINICAL FEATURES OF DIABETES.pptx

1. CLINICAL FEATURES
OF DIABETES
• Hyperglycemia
• Dehydration
• Loss of weight
• Poor resistance to infections due to protein depletion .
• Glycosuria
• Polyuria
• Polydipsia
• Polyphagia

2. Tests for type 1 and type 2 diabetes
and prediabetes
• Glycated hemoglobin (A1C) test.
• Random blood sugar test.
• Fasting blood sugar test
• Oral glucose tolerance test
Tests for Gestational diabetes
• Initial glucose challenge test
• Follow-up glucose tolerance testing

3. Management of Diabetes
Over 40 medications have been approved by the Food and
Drug Administration for the treatment of Diabetes
Diabetes medication drug classes include:
1. Sulfonylureas - glimepiride , glipizide and glyburide .
2. Glinides (also called meglitinides) - epaglinide and
nateglinide .
3. Biguanides - Metformin
4. Alpha-glucosidase inhibitors- acarbose
5. Thiazolidinediones - ioglitazone and rosiglitazone
6. GLP-1 analogs - exenatide , liraglutide , albiglutide ,
semaglutide and dulaglutide
7. DPP-4 inhibitors – alogliptin , sitagliptin , saxagliptin and
linagliptin
8. SGLT2 inhibitors - canagliflozin , dapagliflozin and
empagliflozin
9. Bile acid sequestrants – colestipol , cholestyramine and
colesevelam

4. Primary prevention
Two strategies for primary prevention have been suggested:
• POPULATION STRATEGY - prevention of the emergence of
risk factors in countries in which they have not yet done .The
preventive measures comprise maintenance of normal body
weight through adoption of healthy nutritional habits and
physical exercise . The nutritional habits include an adequate
protein intake, ahigh intake of dietary fibre and avoidance of
sweet foods. Elimination of other less well defined factors
such as protein deficiency and food toxins may be considered
in some populations. These measures should be fully
integrated into other community-based programmes for the
prevention of non-communicable diseases (e.g., coronary
heart disease).
• HIGH-RISK STRATEGY -Subjects at risk should avoid
diabetogenic drugs oral contraceptives. It is wise to reduce
factors that cause atherosclerosis, e.g., smoking, high blood
pressure, cholesterol and high triglyceride levels.
Secondary prevention
When diabetes is detected, it must be
adequately treated The aims of treatment are
• to maintain blood glucose levels as close
within the normal limits
• to maintain ideal body weight. Treatment is
based on-
(a) diet alone- small balanced meals more
frequently
(b) diet and oral antidiabetic drugs,
(c) diet and insulin.
Good control of blood glucose protects against
the development of complications.
Tertiary prevention
• objective at the tertiary level is to
organize specialized clinics (Diabetic
clinics) and units capable of providing
diagnostic and management skills of a
high order.
• tertiary level should also be involved
in basic, clinical and epidemiological
research.