Diabetes Mellitus

NAME-ASHUTOSH TRIPATHY
ROLL NO-26
Diabetes means a ‘siphon’ or ‘running through’ and
earlier it was used to describe the polyuria . Mellitus
means sugar . Therefore , dibetes mellitus is a clinical
state which is associated with flow of sugar in urine
CAUSES
Diabetes mellitus is primarily a disease due to Insulin Deficiency.
It is usually associated with hormones which normally have
antagonistic action to insulin; for example, GH,Glucagon &
catecholamine
PREDISPOSING FACTOR
1.HEREDITARY-The most typical
form of diabetes is hereditary
iodiopathic dibetes mellitus (Evidence :the
very high incidence of the disease
in identical twins and in children of
parents who are both diabetic)
2.AGE- The disease is common with
increasing age.
3.OBESITY- A reliable indicator for
body fat is Body Mass Index.
Individuals with Value of 25-30 are
overweight , and those with values
> 30 are obese. Adipose tissues in
obese persons are more resistance
to insulin action than normal
adipose tissue
 CLINICAL MANIFESTATIONS
1-HYPERGLYCEMIA
- A lot of glucose to be filtered into the kidney tubules
through glomerular filtration
-Kidney tubules cannot reabsorb such amounts of glucose .
Glucose is lost in urine called glycosuria
Glucose is osmotically active
Pulls water with it produces a large amount of urine called
polyuria
-Hyperosmolar blood-Low water and high glucose
Large volume of urine
Causes decrease in blood volume
Glucose blood level remains high
-Hyperosmolar blood stimulates osmoreceptors in the
hypothalamus ,trigger an increase in thirst
2.-DECREASED GLUCOSE UTILIZATION
-leads to decreased ATP production
-The body is forced to use other metabolic sources of fuel
-Lipolysis in the adipose tissue
Breakdown of triglycerides into free fatty acid and
glycerol
-Proteolysis in the muscles
Breakdown of proteins into amino acid
Can be used to make energy
-Increase Lipolysis and Proteolysis leads to explained
weight loss
-Increase caloric consumption
-Increase hunger
-To replenish the calories
The PATHOPHYSIOLOGY of diabetes involves abnormalities in insulin production,,
insulin action,, and glucose metabolism.. Understanding the underlying
mechanisms is crucial for developing effective treatment approaches and
preventive measures..
 DIAGNOSIS
1-BLOOD WORK
-Fasting glucose greater than or equals to
126mg/dl
If the patient hasnot eaten in certain amount
of time , blood glucose is expected to be
lower
-Random glucose greater than equals to
200mg/dl
Regardless of the patient eating or fasting
-2-hour oral glucose tolerance test- glucose
greater than or equals to 200mg/dl.
Glucose is given and is supposed to stimulate
insulin production
Insulin is supposed to push glucose into the
cells
Diabetes donot have the insulin or are insulin
resistant-blood glucose level remains high
Need two test to confirm diabetes
2-ANTIBODIES
-can also be taken in consideration
-Anti-islet cell antibodies
-Anti-glutamic acid antibodies
-Anti-insulin antibodies
Age and risk factors should be taken into
consideration

FASTING GLUCOSE
>=126mg/dl
RANDOM GLUCOSE
>=200mg/dl
2 HOUR ORAL GGT >=200mg/dl
HEMOGLOBIN A-1C >=6.5%
TREATMENT
A-DIABETES TYPE 1
-Treated with insulin

B-DIABETES TYPE 2
- Promotion of weight loss
Through exercise and dietary changes
Diabetes type 2 is cause by metabolic syndrome
The patients are obese with bad diets

- Diabetes medications
Metformin-first-line medication
Other type of medications
(1) GLP-1 agonists
(2) DPP-4 inhibitors
(3) SGLT2 inhibitors
(4) Thiazolidinediones
(5) Sulfonylurea
(6) Glucose inhibitors
(7) Meglitinides

-Sometime insulin is given to type 2 diabetes

If they are on multiple diabetes medications
And their hemoglobin A1c > 7%
 DIFFERENCE BETWEEN TYPE 1 AND TYPE 2 DIABETES
JUVENILEN ONSET (OR TYPE 1) DIABETES
1-It occur before 14 years of age;patients are
usually underweight
2-Family history of diabetes mellitus-uncommon
However a genetic factor may predispose to
development of antibodies against Beta-cells
of islet.
3-Develop ketosis and acidosis , if untreated
4-Insulin secretion:low or absent due to Beta-
cell pathology.Thus producing severe diabetes
5- Patients are sensitive to insulin.
6-Treatment –injection of insulin;therefore,also
called insulin dependent diabetes mellitus
MATURITY ONSET (OR TYPE 2) DIABETES
1-Most common type of diabetes.It occur after
40 years of age;patients are normal/overweight
2-Family history of diabetes mellitus-strongly
positive
3-Ketosis with infection are often absent;onset:slow
4-Initially insulin secretion is normal or increased;
later decreases.Beta-cells are usually normal but
main disturbance is (a) less active insulin
produce
(b) less cellular response to insulin (c) presence
of antibodies against insulin
5-Patients are insulin resistant
6-Diet restriction;oral hypoglycemic agents,insulin
is needed only during infection ,therefore also
called non-insulin dependent diabetes mellitus
Conclusion

In conclusion,, a comprehensive
understanding of the causes,
management,, and preventiion of diabetes
iis essentiial for addressing this prevallent
chroniic condiition.. By implementing
effectiive strategiies and advanciing
research,, we can work towards reduciing
the burden of diabetes and iimproviing the
lliives of those affected..