TABLE OF CONTENT
[Link] CONTENT [Link]
4
1 INTRODUCTION
2 SIGNS AND 8
SYMPTOMS
3 COMPLICATION 10
S
16
4 TYPES
5 DIAGNOSIS 17
PREVE 19
6 NTION
AND
7 LIFES 20
TYLE
AND
8 BIBILIOGRAPH 21
Y
INTRODUCTION :
Diabetes mellitus (DM) also known as simply diabetes, is a
group of metabolic diseases in which there are high blood sugar
levels over a prolonged period This high blood sugar produces the
symptoms of frequent urination, increased thirst, and
increased hunger.
Untreated, diabetes can cause many complications. Acute
complications include diabetic ketoacidosis and nonketotic
hyperosmolar coma.
Serious long-term complications include heart disease, stroke,
kidney failure, foot ulcers and damage to the eyes.
Diabetes is due to either the pancreas not producing enough
insulin, or the cells of the body not responding properly to the
insulin produced.
There are three main types of
diabetes mellitus:
Type 1 Diabetes Mellitus
Type 2 Diabetes Mellitus.
Gestational Diabetes.
• Type 1 DM results from the body's failure to produce enough
insulin. This form was previously referred to as "insulin dependent
diabetes mellitus" (IDDM) or "juvenile diabetes". The cause is
unknown.
• Type 2 DM begins with insulin resistance, a condition in which
cells fail to respond to insulin properly.
As the disease progresses a lack of insulin may also develop. This
form was previously referred to as "non insulin-dependent diabetes
mellitus" (NIDDM) or "adult-onset diabetes".
The primary cause is excessive body weight and not enough
exercise.
• Gestational diabetes, is the third main form and occurs when
pregnant women without a previous history of diabetes develop a
high blood glucose level.
Prevention and treatment involves a healthy diet, physical
exercise, not using tobacco, and being a normal body weight.
Blood pressure control and proper foot care are also
important for people with the disease.
Type 1 diabetes must be managed with insulin injections.
Type 2 diabetes may be treated with medications with
or without insulin.
Insulin and some oral medications can cause low blood sugar.
Weight loss surgery in those with obesity is an effective
measure in those with type 2 DM.
Gestational diabetes usually resolves after the birth of the
baby.
SIGNS AND SYMPTOMS :
The classic symptoms of untreated diabetes are weight loss,
polyuria (frequent urination), polydipsia (increased thirst), and
polyphagia (increased hunger).
Symptoms may develop rapidly (weeks or months) in type
usually develop much more slowly and may be subtle or absent in
type 1 Diabetes, while they usually develop much more slowly
and may be subtle or absent in type 2 diabetes.
Several other signs and symptoms can mark the onset of
diabetes, a not specific to the disease.
In addition to the known ones above, they include blurry
vision, headache, fatigue, slow healing of cuts, and itchy skin.
Prolonged high blood glucose can cause glucose absorption in
the lens of the eye, which its shape, resulting in vision changes.
A number of skin rashes that can occur in diabetes
are collectively known as Diabetic dermadromes.
COMPLICATIONS :
All forms of diabetes increase the risk of long develop after
many years(10 – 20) But maybe the first symptom in those who
have otherwise not received a diagnosis before that time.
The major long-term complications relate to damage to blood
vessels.
Diabetes doubles the risk of cardiovascular disease and
about 75% of deaths in diabetics are due to coronary artery
disease.
Other "macrovascular" diseases are stroke, and peripheral
vascular disease.
The primary microvascular complications of diabetes
include damage to the eyes, kidneys, and nerves.
Damage to the eyes, known as diabetic retinopathy, is caused
by damage to the blood vessels in the retina of the eye, and can
result in gradual vision loss and potentially blindness.
Damage to the kidneys, known as diabetic nephropathy, can
lead to tissue scarring, urine protein loss, and eventually chronic
kidney disease, sometimes requiring dialysis or kidney
transplant Damage to the nerves of the body, known as diabetic
neuropathy, is the most common complication of diabetes.
The symptoms can include numbness, tingling, pain, and
altered pain sensation, which can lead to damage to the skin.
TYPES :
Diabetes mellitus is classified into four broad categories:
TYPE 1
DIABETES
TYPE 2
DIABETES
GESTATIONAL
The "other specific types" are a collection of a few dozen
individual causes. The term "diabetes", without qualification,
usually refers to diabetes mellitus.
TYPE 1 DIABETES :
Type 1 diabetes mellitus is characterized by loss of the
insulin the islets of Langerhans in the pancreas, leading to
insulin deficiency.
This type can be further classified as immune diabetes is of
the immune-mediated nature, in which a attack leads to the loss
of beta cells and thus insulin.
It causes approximately 10% of diabetes mellitus cases in
North America and Europe.
Most affected people are otherwise healthy and of a healthy
weight when onset occurs.
Sensitivity and responsiveness to insulin are usually
normal, especially in the early stages.
Type 1 diabetes can affect children or adults, but was
traditionally termed “ juvenile dibetes ” because a majority of
these diabetes cases were in children.
"Brittle" diabetes, also known as unstable diabetes or labile
diabetes, is a term that was traditionally used to describe the
dramatic and recurrent swings in glucose level ,
often occurring for no apparent reason in insulin- dependent
diabetes.
This term, however, has no biologic basis accompanied by
irregular and unpredictable and sometimes with serious
hypoglycemia counterregulatory response to hypoglycemia,
infection, erratic absorption of dietary carbohydrates), and
endocrinopathies (e.g., disease).
These phenomena are believed to occur no more frequently
than in 1% to 2% of persons with type 1 diabetes.
Type 1 diabetes is partly inherited, with multiple
genotypes, known to influence the risk of diabetes.
In genetically susceptible people, the onset of diabetes can be
triggered by one or more environmental factors, such as a viral
infection or diet. There is some evidence that suggests an
association between type 1 diabetes and Coxsackie B4 virus.
Unlike type 2 diabetes, the onset of type 1 diabetes is unrelated to
lifestyle.
TYPE 2 DIABETES :
Type 2 diabetes mellitus is characterized by insulin
resistance, which may be combined with relatively reduced
insulin
secretion.
The defective responsiveness of body tissues to insulin is
believed to involve the insulin receptor. Type 2 diabetes is the
most common type.
In the early stage of type 2, the predominant abnormality is
reduced insulin sensitivity.
At this stage, hyperglycemia can be reversed by a variety of
measures and medications that improve insulin sensitivity or
reduce glucose production by the liver.
Type 2 diabetes is due primarily to lifestyle factors and
genetics, including obesity (defined by a body mass index of
greater than thirty), lack of physical activity, poor diet, stress, and
urbanization.
Those who are not obese often have a high waist–hip
ratio. Dietary factors also influence the risk of developing
type 2 diabetes.
Consumption of sugar-sweetened drinks in excess is
associated with an increased risk.
The type of fats in the diet is also important, with saturated fats
and trans fatty acids increasing the risk and polyunsaturated and
monounsaturated fat decreasing the risk.
Eating lots of white rice appears to also play a role in
increasing risk. A lack of exercise is believed to cause 7% of
cases.
GESTATIONAL DIABETES :
Gestational diabetes mellitus (GDM) resembles type 2
diabetes in several respects, involving a combination of relatively
inadequate insulin secretion and responsiveness.
It occurs in about 2-10% of all pregnancies and may improve
or disappear after delivery.
However, after pregnancy approximately 5-10% of women
with gestational diabetes are found to have diabetes mellitus, most
commonly type 2.
Gestational diabetes is fully treatable, but requires
careful medical supervision throughout the pregnancy.
Management may include dietary changes, blood
glucose monitoring, and in some cases insulin may be
required.
Though it may be transient, untreated gestational diabetes
can damage the health of the fetus or mother.
Risks to the baby include macrosomia (high birth weight),
congenital cardiac and central nervous system anomalies, and
skeletal muscle malformations.
Increased fetal insulin may inhibit fetal surfactant
production and cause respiratory distress syndrome.
Hyperbilirubinemia may result from red blood cell destruction.
In severe cases, perinatal death may occur, most commonly as a
result of poor placental perfusion due to vascular impairment.
Labor induction may be indicated with decreased placental
function.
A Caesarean section may be performed if there is marked
fetal distress or an increased risk of injury associated with
macrosomia, such as shoulder dystocia.
DIAGNOSIS :
Diabetes mellitus is characterized by recurrent or persistent
hyperglycemia, and is diagnosed by demonstrating any one of
the following:
Fasting plasma glucose level ≥ 7.0 mmol/l (126 mg/dl)
Plasma glucose ≥ 11.1 mmol/l (200 mg/dl)
Casual plasma glucose ≥ 11.1 mmol/l (200 mg/dl)
Measurements ≥ 126 mg/dl (7.0 mmol/l)
PREVENTION AND MANAGEMENT :
There is no known preventive measure for type 1 diabetes.
Dietary changes known to be effective in helping to prevent
diabetes include a diet rich in whole grains and fiber, and
choosing good fats, such as polyunsaturated fats found in nuts,
vegetable oils, and fish.
Limiting sugary beverages and eating less red meat and other
sources of saturated fat can also help in the prevention of
diabetes.
Active smoking is also associated with an increased risk of
diabetes, so smoking cessation can be an important preventive
measure as well.
Diabetes mellitus is a chronic disease, for which there is no
known cure except in very specific situations.
Management concentrates on keeping blood sugar levels as
close to normal, without causing hypoglycemia.
This can be accomplished with diet, exercise, and use
of appropriate medications.
Learning about the disease and actively participating in
the treatment is vital for people with diabetes.
Attention is paid to health problems that may accelerate the
deleterious effects of diabetes.
These include smoking, elevated cholesterol levels, obesity,
high blood pressure, and lack of regular exercise.
LIFESTYLE :
People with diabetes can benefit from education about the
disease and treatment, good nutrition to achieve a normal body
weight, and sensible exercise, with the goal of keeping both
short-term and long-term blood glucose levels within acceptable
bounds.
In addition, given the associated higher risks of
cardiovascular disease, lifestyle modifications are recommended
to control blood pressure.
MEDICATIONS :
Metformin is generally recommended as a first line
treatment for type 2 diabetes, as there is good evidence that it
decreases mortality.
Routine use of aspirin has not been found to improve outcomes
in uncomplicated diabetes.
Angiotensin converting enzyme inhibitors (ACEIs)
improve outcomes in those with DM while the similar
medications angiotensin receptor blockers (ARBs) do not.
Type 1 diabetes is typically treated with a combinations
of regular and NPH insulin, or synthetic analogs.
When insulin is used in type 2 insulin diabetes, a long-
acting formulation is usually added initially, while continuing
oral medications.
Doses of insulin are then increased to [Link] those with
diabetes some recommend blood pressure levels below 120/80
mm Hg, But evidence only supports less than OR equal to
somewhere between 140/90 mmHg to 160/100 mmHg.
BIBILIOGRAPGHY:
I would like to mention the sources which proved to be
helpful in making this project.
Some of these sources are :-
1. .
2.. 3. Cbse FND study material