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Diabetes Mellitus Bullets

Diabetes Mellitus Bullets

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Published by: winner gift flowers on Nov 07, 2011
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05/18/2013

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Diabetes Mellitus 
A group of metabolic diseases characterized by elevated levels of glucose inthe blood resulting from defects in insulin secretion, insulin action, insulinreceptors or any combination of conditions.
Diabetes Mellitus
A chronic disorder of impaired glucose metabolism, protein and fat metabolism
BASIC PATHOLOGY : Insulin problem (deficiency or impaired action)
Diabetes Mellitus
Insulin is a hormone secreted by the BETA cells of the pancreas
Stimulus of insulin- HYPERGLYCEMIA
Action of insulin: it promotes entry of Glucose into the body cells by bindingto the insulin receptor in the cell membrane
INSULIN : Physiology
Insulin Metabolic Functions:
1. Transports and metabolizes GLUCOSE
2. Promotes GLYCOGENESIS
3. Promotes GLYCOLYSIS
4. Enhances LIPOGENESIS
5. Accelerates PROTEIN SYNTHESIS
RISK FACTORS for Diabetes Mellitus
1. Family History of diabetes
2. Obesity
3. Race/Ethnicity
RISK FACTORS for Diabetes Mellitus
4. Age of more than 45
5. Previously unidentified IFG/IGT
6. Hypertension
RISK FACTORS for Diabetes Mellitus
7. Hyperlipidemia
8. History of Gestational Diabetes Mellitus
CLASSIFICATION OF DM
Type 1 DM
Insulin dependent Diabetes Mellitus
Type 2 DM
 Non-insulin dependent Diabetes Mellitus
Gestational DM
Diabetes Mellitus diagnosed during pregnancy
DM associated with other conditions or syndromes
 
CLASSIFICATION OF DM
Type 1 DM
Insulin dependent Diabetes Mellitus
CLASSIFICATION OF DM
Type 2 DM
Non-insulin dependent Diabetes Mellitus
CLASSIFICATION OF DM
Gestational DM
Diabetes Mellitus diagnosed during pregnancy
CLASSIFICATION OF DM
DM associated with other conditions or syndromes
Other types of DM
1. Impaired Glucose Tolerance
2. Impaired Fasting Glucose
3. Pre-diabetes
TYPE 1- Diabetes Mellitus
This type of DM is characterized by the destruction of the pancreatic betacells
TYPE 1- Diabetes Mellitus
Etiology:
Genetic susceptibility- HLA DR3 and DR4
Autoimmune response
Toxins, unidentified viruses and environmental factors
TYPE 1- Diabetes Mellitus
PATHOPHYSIOLOGY
Destruction of BETA cells
decreased insulin production
uncontrolledglucose production by the liver
hyperglycemia
signs and symptoms
TYPE 1- Diabetes Mellitus
PATHOPHYSIOLOGY
CLASSIC P’s
Polyuria
Polydipsia
Polyphagia
TYPE 2- Diabetes Mellitus
 A type of DM characterized by insulin resistance and impaired insulin production
TYPE 2- Diabetes Mellitus
Etiology:
Unknown
Probably genetic and obesity
 
TYPE 2- Diabetes Mellitus
PATHOPHYSIOLOGY
Decreased sensitivity of insulin receptor to insulin
less uptake of glucose
HYPERGLYCEMIA
TYPE 2- Diabetes Mellitus
PATHOPHYSIOLOGY
Decreased insulin production
diminished insulin action
hyperglycemia
signs and symptoms
TYPE 2- Diabetes Mellitus
PATHOPHYSIOLOGY
BUT (+) insulin in small amount
prevent breakdown of fats
DKA isunusual
GESTATIONAL Diabetes Mellitus
Any degree of glucose intolerance with its onset during pregnancy
Usually detected between 24-28
th
week gestation
GESTATIONAL Diabetes Mellitus
Blood glucose returns to normal after delivery of the infant
 NEVER administer ORAL HYPOGLYCEMIC AGENTS to PREGNANT  MOTHERS!
ASSESSMENT FINDINGS
1. Classic 3 P’s
2. Fatigue
3. Body weakness
ASSESSMENT FINDINGS
4. Visual changes
5. Slow wound healing
6. Recurrent skin and mucus membrane infections
DIAGNOSTIC TESTS
1. FBS- > 126
2. RBS- >200
3. OGTT- > 200
DIAGNOSTIC TESTS
4. HgbA1- for monitoring!!
5. Urine glucose
6. Urine ketones
DIAGNOSTIC CRITERIA
1. FBS equal to or greater than 126 mg/dL (7.0mmol/L)
(Normal 8 hour FBS- 80-109 mg/dL)
DIAGNOSTIC CRITERIA
2. OGTT value 1 and 2 hours post-prandial equal to or greater than 200mg/dL
Normal OGTT 1 and 2 hours post-prandial- is

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