BY ROSEMARY C.

AGBO

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 INTRODUCTIONS

WHAT IS DIABETES?
 Diabetes Mellitus is a chronic metabolic disorder
characterized by defective insulin secretion or
activity resulting in high blood glucose level.

 Normal Blood Glucose Level is 4.2-6.1mmol/l .

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 INTRODUCTIONS CONTD.

TYPES OF DIABETES MELLITUS

They are three common forms of Diabetes Mellitus encountered in
practice, namely:

 Type 1 (Insulin Dependent Diabetes Mellitus IDDM or juvenile

onset diabetes)

 Type 2 (Non-insulin dependent Diabetes Mellitus or maturity onset

diabetes)

 Gestational Diabetes: It develops during pregnancy in non-diabetic

individuals, i.e. it is pregnancy induced diabetes.
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 AETIOLOGY
The following aetiological factors predisposes
one to DM:
 A defect in the action or secretion of insulin
 Environmental factors e.g. excessive calorie
intake and lack of physical activity
 Genetic factors.

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 PUBLIC HEALTH IMPORTANCE
 415 million people have diabetes globally and more than
14 million people in African region.
 There were 266,200 cases of diabetes in Ghana in 2015.
 A prevalence of 1.9% in Ghana as at 2015.
 Total adult population of 20-79yrs with diabetes approx.
266,200.
 Number of deaths in adults due to diabetes approx.
4,790.
 Cost per person with diabetes; 720ghc.
 Number of cases of diabetes in adults that are
undiagnosed 189,900.
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 RISK FACTORS

 Hereditary
 Obesity
 Hypertension
 Lack of physical activity
 Drugs: steroids
 Pancreatic diseases

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PATHOGENESIS

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 SYMPTOMS
No recognizable symptoms in many individual and most
diagnosis are made by chance. In some cases the
following symptoms may present:

 Passage of large amount of urine (polyuria)

 Thirst and excessive drinking of water
 Excessive eating/huge appetite (polyphagia)
 Unexplained weight loss
 Blurred vision
 Recurrent boils
 Recurrent itching of the vulva.
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 SIGNS

The following signs may be deduced by the

clinician:
 Lack of sensation in the feet or hands
 Impaired vision acuity
 Cataracts
 Retinal changes
 Pedal edema
 Foot gangrene

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EFFECTS

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 DIAGNOSIS

Diagnosis is made through:

 History of Signs and Symptoms

 Fasting/Random Blood Sugar and Urine Sugar
 Oral Glucose Tolerance Test (OGTT)
 2-Hour post prandial Test

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 MANAGEMENT
 Objective: the main objective of Diabetes
management is to bring the sugar level to
normal. Thus alleviating the signs and
symptoms and to prevent complications

 Treatment of diabetes must be individualized

and treatment goals set for each patient.

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The control for various types of diabetes includes:
 Type 1 –IDDM
Control is by Insulin, Diet, Exercise, and monitoring
 Type 2- NIDD
 Oral hypoglycemic agent, diet, exercises, and
monitoring.
 Gestational
 This could be controlled by DIET alone initially
depending on ones blood Glucose level but as
pregnancy progresses, Insulin may be given. Oral
hypoglycemic agent should NOT be used in
pregnancy.

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 REFERENCES
 National Diabetes Fact Sheet 2003, DEPARTMENT OF HEALTH
AND HUMAN SERVICES Centres for Disease Control and Prevention
 World Health Organization. Definition, Diagnosis and Classification of
Diabetes Mellitus and its Complications. Report of WHO. Department
of Non-communicable Disease Surveillance. Geneva 1999
 Academy of Medicine. Clinical Practice Guidelines. Management of type
2 diabetes mellitus. MOH/P/PAK/87.04(GU), 2004
 NHS. Diabetes - insulin initiation - University Hospitals of Leicester
NHS Trust Working in partnership with PCTs across Leicestershire and
Rutland, May 2008.
 Standard treatment guidelines
 Slideshare.com

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