Diabetes mellitus is a metabolic disorders yung Metabolic disorders are characterized by the inability to properly utilize or

store energy and Diabetes mellitus is the most common of the endocrine disorders. It is a chronic condition characterised
by hyperglycemia yung hyperglycemia ito yung high levels of sugar, or glucose, in the blood.

A chronic, progressive, systemic disease characterized by dysfunction in metabolism of fats, carbohydrates, protein and
insulin and the function and structure of blood vessels and nerves.

Diabetes cannot be cured but it can be managed ,mamaya po eexplain nila further kung pano iminamanage yung diabetes

In the absence of effective treatment, DM can lead to acute complications such as diabetic ketoacidosis (DKA) yung
diabetic ketoacidosis happens when the signal from insulin in the body is so low mostly eto yung nangyayare sa mga may
diabetes mellitus 1

Here are the reasons

First yung Glucose (blood sugar) can't go into cells to be used as a fuel source.
Second yung liver makes a huge amount of blood sugar.
Third yung Fat is broken down too rapidly for the body to process.
Kapag yung fat is broken down by the liver into a fuel it is called ketones . DIba kase yung Ketones are normally produced
by the liver when the body breaks down fat after nung last meal mo These ketones are normally used by the muscles and
the heart. So kapag yung ketones are produced too quickly and build up in the blood, nagiging toxic na sila by making
the blood acidic. This condition is known as ketoacidosis.

And lasty yung hyperosmolar hyperglycemic syndrome (HHS) ito ay serious complication of diabetes mellitus especially
may diabetes mellitus 2 , it happens when blood sugar levels are very high for a long period of time. Nangyayare to
hyperosmolar hyperglycemic syndrome kapag mataas yung blood sugar ngisang tao. Yung Symptoms of HHS can include
extreme thirst, frequent urination, changes in vision and confusion. HHS is an emergency and you should contact your
healthcare provider immediately if you have these symptoms.

again
Isulat sa ppt
(DKA)- DM 1
(HHS)-DM2
Nangyayare ito kapag hindi kagad sila nag undergo ng treatment

Diabetes mellitus is rapidly increasing worldwide but the greatest increase is expected in developing countries including
the Philippines. It is of public health concern to monitor countrywide prevalence of diabetes as it leads to significant
cardiovascular-related mortality as well as significant complications such end stage renal disease, blindness, lower leg
amputations eto yung pag putol ng paa

SO mostly kase sa philippines ang cause ng diabetes nila ay poor lifestyle , mahihilig po kase yung mga pilipino sa
unlimited rice , date po nablitaan ko na parang ipina pa ban ni cynthia villar yung unli rice kase dapat itrain daw yung
mga pilipino not to eat rice kase nagiging diabetic yung mga tao which is true naman kase excess or sobra sobra sa rice
ay nakakataas ng bloodsugar yung rice kase is a carbohydrates

Diabetes mellitus is a disease of public health concern not only because of the costs involved in the care of
individuals with this disease but because of the expected micro-vascular and macrovascular complications resulting from
poor blood sugar control which impact on quality of life and shorten life span.
Again because of the expected micro-vascular and macrovascular complications resulting from poor
blood sugar control which impact on quality of life and shorten life span Diabetes is a disease that is
strongly associated with both microvascular and macrovascular complications

Yung Microvascular complications of diabetes are those long-term complications that affect small blood
vessels. These typically include retinopathy, nephropathy, and neuropathy

Yung macrovascular complication ayun yung is a disease of any large blood vessels in the body
including the in the brain ,heart and , peripheral vascular disease ayun yung lack of bloodflow in legs

Yung Gangrene eto yung type of tissue death caused by a lack of blood supply.

The vast majority of patients with DM are classified into one of two broad categories: type 1 DM and
type 2 DM. Patients with type 1 DM have an absolute insulin deficiency or walang kakayanan ang
katawanmag produce ng insulin .whil Patients with type 2 DM have varying degrees of β- cell
dysfunction often coupled with insulin resistance. Women who develop diabetes during pregnancy are
classified as having gestational diabetes (GDM).

Less common types of diabetes are caused by genetic defects, pancreatic destruction, endocrine
disorders, and medications.

So eto yung mga other reason na nagkakaroon or induced ng diabetes

 Here are the types of Diabetes: yung most common lang ay yung type 1 and 2 and yung
gestational diabetes

Type 1 Diabetes- insulin deficiency

Type 2 Diabetes -insulin resistance

Type 3 Diabetes- is the title which has been proposed for the Alzheimer’s disease resulting in
resistance to insulin in the brain

Double Diabetes- combination sya ng type 1 and type 2 diabetes. In this disease the person
suffering develops insulin resistance and the key features of type 2 disease. In this case the most
common reason for insulin resistance is obesity.

Gestational Diabetes- eto yung diabetes during pregnancy.it develops during third trimester of
the pregnancy period

Brittle Diabetes-also called labile diabetes, is diabetes that is hard to control. It is characterized
by extreme swings in blood sugar levels, from too high (hyperglycemia) to too low
(hypoglycemia) or vice versa.yung main reason for its occurrence is absorption problems in
intestines

Maturity onset diabetes of youth (MODY) is a group of several conditions characterized by

abnormally high blood sugar levels. These forms of diabetes typically begin before age 30,
although they can occur later in life.

DM1
- Formerly called insulin-dependent diabetes(IDDM) or juvenile-onset diabetes.
-The result of autoimmune destruction of the β-cells of pancreas the only cells in the body that
make the hormone insulin that regulates blood glucose.
-Type 1 diabetes most commonly develops in childhood or young adulthood however, it can
occur at any age.
-Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes.
-Risk factors for type 1 diabetes may include autoimmune, genetic, and environmental factors.

Again yung type 1 diabetes is

the body makes little or no insulin
-people with type 1 diabetes must take insulin everyday
-type 1 is usually diagnosedd more often in children and young adult

Type 2
Noninsulin-dependent diabetes or adult-onset diabetes.
Type 2DM is the result of β-cell dysfunction coupled with some degree of insulin resistance.
Genetics play a critical role in the development of type 2 DM as there is a strong inheritance
pattern.
In patients with type 2 DM, high blood pressure and dyslipidemia, characterized by high-serum
triglycerides and low HDL-cholesterol levels, are very frequent comorbid conditions.

- the body prevents the insulin or insulin resistant

-the body make insulin but not enough
-most people with diabetes about 90percent have type 2
- this kind of diabetes usually happens inpeople na matatanda na r or in those who are
overweight or obese
 These are the classification of diabetes mellitus 2

Age
Family history
High riskrace or ethnicity
Obese
Sedentary lifestyle
Glucose tolerance
Hypertension
Dyslipedemia
History of Gestational Diabetes
History of vascular disease
Prescense of acanthosis nigricans eto po yung example nun yung dicoloration ng skin neck
and armpit
Lastly yung pcos

Pathophysiology

What is insulin?
Insulin is secreted by B-cells of the islets of Langerhans. It lowers blood glucose and
modulates disposition of fats and amino acids as well as carbohydrates. Other function
includes:
a. Promotes the cellular uptake of plasma glucose
b. Stimulates conversion of glucose into energy storage molecules (e.g., glycogen, fat) in the
liver, muscles, and adipose cells
c. Facilitates cellular uptake of amino acids and their incorporation into proteins
d. Inhibits production of glucose from liver, muscle glycogen, or amino acids
e. Decreases the breakdown of fatty acids to ketone bodies

This is the pancreas or sa tagalog ay lapay -

Yung cells of endocrine pancreas are called islets of langerhans nag sesecrete eto ng 2
hormones yung insulin(beta cells) and glucagon(alpha cells)

Yung insulin eto yung peptide hormone na pinuproduce ng bcells which plays a major role in
the regulation of glucose homeotasis
Again if may malfunction or hindi nag proproduce ng insulin and yung glucose level ay mataas
that is excreted throug urine ang tawag don ay diabetes mellitus. DIabetes is identified by the
prescence of sugar in urine kaya yung iba nilalangam yung urine because of glucose
Type 2 diabetes

1st

Eto yung digestive system natin from mouth to anus .

So yung Carbohydrates eto yung substance or food na ginagamit natin for energy like rice sweets

After pumunta sa stomach papunta sya sa intestine dito sa intestine the sugar broken down into single
molecules which is yung glucose

an then Yung glucose ay nag tratravel sa body streams mo

Eto yung bloodstream natin that contains insulin sugar and blood vessels .kapag may type 2 diabates ka
nag iincrease yung glucose mo sa blood so ayan nakikita natin na mas madami yung glucose sa blood ang
tawag dito ay hyperglycemia kaya mostly malapot yung dugo ng mga may diabetes.

Para magamit yung glucose sa body as fuel or energy kailangan ng molecule naito pumunta sa cell

So yung pancreas ma dedetec nya yung high amount of glucosena meron ka sa blood stream so nag
rerelease eto ng hormone na insulin eto ay chemical messenger or tinutulungan nya yung glucose
pumasok from your blood stream into your cell Kase yung insulit nag hehelp sya mag reduce ng amount
of sugar in the blood to the healthy level

Yung insulin parang lock and key sya , insulin sya yung key para pumasok yung glucose sa cell yung insulin
receptor sya yung lock

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In type 2 diabetes the cells become resistanceto insulin and ignore its message to absorb glucose this is
known as insulin resistance bale onti lang yung napasok ng glucose sa cell

In adition the pancrease un able to produce insulin needed or insufficcient insulin production

Eto yung bloodstream natin that contains insulin sugar and blood vessels .kapag may type 2 diabates ka
nag iincrease yung glucose mo sa blood so ayan nakikita natin na mas madami yung glucose sa blood ang
tawag dito ay hyperglycemia kaya mostly malapot yung dugo ng mga may diabetes.

- in addition may hormone pa na sinisecerete yung pancreas which is known as glucagon .yung glucagon
or alpha cells tells the livers to release stored sugar if your blood sugar gets too low for example pag
hindi ka kumain or nalipasan ka na atska yung mga hindi kumakain sa sa gabi

Another hormone that involve in diabetes ayun yung GLP1 or Glucagon-like peptide-1 so yung GLP1 eto
yung nag hehelp sa pancreas na mag produce ng right amount of insulin to move sugar from the blood
into the cells
GLP1 ang primary action nya ay mag stimulate ng beta cells sa pancreas to produce insulin if the blood
sugar is too high nag hehelp rin sya ma lower yung amount ng sugar na galing sa liver
in addition may hormone pa na sinisecerete yung pancreas which is known as glucagon .yung
glucagon or alpha cells tells the livers to release stored sugar if your blood sugar gets too low for
example pag hindi ka kumain or nalipasan ka na atska yung mga hindi kumakain sa sa gabi

Another hormone that involve in diabetes ayun yung GLP1 or Glucagon-like peptide-1 so yung GLP1
eto yung nag hehelp sa pancreas na mag produce ng right amount of insulin to move sugar from the
blood into the cells
GLP1 ang primary action nya ay mag stimulate ng beta cells sa pancreas to produce insulin if the
blood sugar is too high nag hehelp rin sya ma lower yung amount ng sugar na galing sa liver

Normally insulin helps the cell of the body takes sugar out of the blood
Cells use the sugar as fuel