Diabetes : What is Diabetes

-

INTRODUCTION

Diabeties

 * Diabetes mellitus (DM), is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period.

 * Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger.

 * If left untreated, diabetes can cause many complication

Long-Term Complications

  •   Heart Disease Heart Attack
  •   Stroke
  •   Chronic Kidney Failure
  •   Foot Ulcer Infection & Gangrene
  •   Eye Damage Diabetic Retinopathy

Severe Diabetes Complications

  •  Ketoacidosis (DKA) High Blood Sugar Ketones in Urine
  •  Nonketotic Hyperosmolar Coma Extremely High Blood Sugar Severe Dehydration
  •  Death



  1.   The number of people living with diabetes rose from 200 million in 1990 to 830 million in 2022. Prevalence has been rising more rapidly in low- and middle-income countries
  2.  In 2021, diabetes and kidney disease due to diabetes caused over 2 million deaths.
  3.   In addition, around 11% of cardiovascular deaths were caused by high blood glucose

TYPES OF DIABETES

  1.  Type 1 Diabetes Mellitus (Insulin dependent)
  2.  Type 2 Diabetes Mellitus (Insulin resistance)
  3.  Gestational Diabetes Mellitus
 Other specific types (genetic, pancreatic, drug-induced)

 Type 1 Diabetes Mellitus (Insulin dependent)

   * Results from the pancreas'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 Diabetes Mellitus (Insulin resistance)

   * Begins with insulin resistance, a condition in which cells fail to respond to insulin properly

   * 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 in pregnant women without a previous history of diabetes

 * Diabetes is due to either the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced.

WHAT IS INSULIN?

 * Insulin is a hormone produced by the pancreas

 * It has a function to control the amount of blood sugar

 * It works by attaching to the insulin receptor in cell to influence the Glut-4 to transport glucose

 

PATHOPHYSIOLOGY


PATHOPHYSIOLOGY Type 1 DM

  •  INSULIN RESISTANCE
  •  RELATIVE INSULIN DEFICIENCY
  •  HIGH BLOOD GLUCOSE LEVELS
  •  Trigger pancreas to produce insulin
  •  TARGET TISSUES RECEPTORS (MUSCLE, FAT, LIVER) RESPOND POORLY TO INSULIN.
  •  GLUT-4 ACTIVITY DECREASES.
  •  INITIALLY, PANCREAS COMPENSATES BY PRODUCING MORE INSULIN.
  •  OVER TIME, B-CELLS BECOME EXHAUSTED
  •  INSULIN SECRETION DECLINES
  •  INSULIN RESISTANCE + B-CELL DYSFUNCTION
  •  WHEN THE GLUCOSE CONCENTRATION IN THE BLOOD REMAINS HIGH OVER TIME, THE KIDNEYS WILL REACH A THRESHOLD OF REABSORPTION ------> GLYCOSURIA
  •  THIS INCREASES THE OSMOTIC PRESSURE OF THE URINE POLYURIA
  •  INCREASED FLUID LOSS
  •  LOST BLOOD VOLUME WILL BE REPLACED OSMOTICALLY FROM WATER HELD IN BODY CELLS AND OTHER BODY COMPARTMENTSINSULIN SECRETION DECLINES
  •  DEHYDRATION ---------> POLYDIPSIA


WHAT CAUSES DIABETES?

 * Diabetes causes vary depending on your genetic makeup, family history, ethnicity, health and environmental factors.

 * There is no defined diabetes cause because the causes of diabetes vary depending on the individual and the type.

RISK FACTORS

  •  Risk of diabetes typically increase when you are:
  •  Older age (45 years or older)
  •   Less active (sedentary life)
  •   Overweight or obese
  •   Family history of diabetes
  •   Pacific Islander, Asian, African, Hispanic, Native American ancestry
  •   Pre-diabetes
  •   High blood pressure
  •   High lipids (triglycerides and low HDL)
  •   Diabetes during pregnancy or baby >9 lbs.

Symptoms

DIABETES COMPLICATIONS

  •  Stroke
  •  High Blood Pressure
  •  Diabetic Retinopathy
  •  Diabetic Nephropathy
  •  Diabetic Neuropathy
  •  Eye Complications
  •  Poor Wound Healing
  •  Cardiovascular Disease
  •  Diabetic Foot ulcers
  •  Cognitive Deficit

HOW ARE DIABETES AND PRE-DIABETES DIAGNOSED?

 * Blood tests are used to diagnosis diabetes and pre-diabetes.

 * Lab analysis of blood is needed to ensure test results are accurate.

 * Glucose measuring devices used in a health care provider's office, such as finger-stick devices, are not accurate enough for diagnosis but may be used as a quick indicator of high blood glucose.

Diagnosis

 * Estimation of blood glucose by glucometer

 * Diabetes diagnosis is confirmed through blood tests that measure glucose levels along with symptoms

Diagnosis

  •  HbA1c Test (A1C): Measures average blood sugar over 2-3 months. Diabetes is \ge6.5\%; prediabetes is 5.7%-6.4%.
  •  Fasting Plasma Glucose (FPG): Requires 8+ hours of fasting. \ge126~mg/dL indicates diabetes; 100-125 mg/dL indicates prediabetes.
  •  Oral Glucose Tolerance Test (OGTT): Measures response to a sugary drink after fasting. \ge200~mg/dL after 2 hours indicates diabetes.
  •  Random Plasma Glucose Test: A reading of ≥ 200~mg/dL at any time, combined with symptoms, indicates diabetes.

Medications

 * Type 1: Essential daily insulin injections or insulin pumps.

 * Type 2: Metformin is commonly the first-line medication to reduce liver glucose production.

 * Other options include Sulfonylureas, SGLT-2 inhibitors, and GLP-1 receptor agonists.

MANAGEMENT OF DIABETES MELLITUS

  •  DIETARY MANAGEMENT
  •   Balanced diet
  •   Low calorie intake
  •   low saturated fat intake
  •   Low carbohydrate/complex sugars/starch
  •   High protein diet
  •   Fiber rich food
  •   Supplementation of minerals/vitamins
  •  EXERCISE →
  •  HYPOGLYCEMIC DRUGS
  •  INSULIN SHORT ACTING -6hrs unmodified
  •    LONG ACTING-several hours modified absorbed on protamine
  •   Genetic engineering


NATIONAL DIABETES CONTROLLING PROGRAM

VISION OF THE PROGRAM

  • Reduce diabetes incidence
  • Prevent complications
  • Promote healthy lifestyles
  • Strengthen primary healthcare system

  • NDCP START 1987 (NATIONAL DAIBETES CONTROLLING PROGRAM)

INDIAN SCENARIO

INDIA HAS 6.51 CRORE DIABETES CASES WHICH IS SECOND HIGHEST NUMBER OF DIABETICS IN THE WORLD

THE PREVALENCE OF DIABETES IN THE COUNTRY IS 9%.

NON-COMMUNICABLE DISEASES ACCOUNTS FOR OVER 60% OF MORTALITY IN THE COUNTRY.

CONTRIBUTION OF DIABETES IS 2% IN THIS 60%.

YEAR WISE STRATEGY'S

The National Diabetes Control Programme was launched during the Seventh Five-Year Plan on a pilot basis in a few districts (e.g., Salem, South Arcot in Tamil Nadu; Jammu & Kashmir) to develop a model for diabetes care at the district level.

Focus:

  •  * Health education and early prevention
  •  * Early diagnosis and treatment
  •  * Prevention of acute and chronic complications
  •  * Rehabilitation for people with diabetes.

   


Target Population

Adults aged 30 years and above

High-risk individuals

Pregnant women

Urban and rural populations

How to Manage Diabetes during Pregnancy?

OBJECTIVE

objective of developing an appropriate model for care and contral of diabetes at the district level so that other states could follow

SCREENING FOR DIABETES

  • Urine examination
  • HbA1c (glycaged hemoglobin)
  • Fasting blood sugar
  • Lipid profile test
  • Kidney function tests

PREVANTION OF DIABETES

  1. PRIMARY PREVANTION
  2. SECONDARY PREVANTION

PRIMARY PREVENTION

  • Nurtritional habit
  • low amount of suger
  • REDUCE SWEETS
  • low colestrol diet
  • low fat diet
  • MAINATIN BODY WEIGHT
  • Physical exercise
  • Avoid sweet food
  • Avoid over nutrition & obsesity

SECONDARY PREVANTION

  • PROPER MANAGMENT
  • SELF CARE
  • HOME GLUCOSE MONITORING
  • TAKE SAMLL AMOUNT OF DIET & IN SMALL INTERVAL

Treatment: diabetes 1

Insulin therapy (required for life)

insulin pump

Continuous Glucose Monitoring (CGM) devices

Healthy diet & carbohydrate counting

Type 2 Diabetes

1 Oral Medications

Metformin (most common first medication)

SGLT2 inhibitors

DPP-4 inhibitors

Sulfonylureas

2 Injectable Medications

GLP-1 receptor agonists

Example: products from Eli Lilly and Company

Insulin (if needed)

Gestational Diabetes

Occurs during pregnancy.

Treatment:

Blood sugar monitoring

Special meal planning

Exercise

Insulin (if required)

New & Advanced Treatments

  • Hybrid closed-loop insulin pumps
  • continuous glucose monitors (CGM)
  • Research into pancreatic cell transplants
  • Artificial pancreas systems








Comments

Post a Comment

Popular posts from this blog

Gunja (Abrus precatorius): The Beautiful Poison

-
Image
  Gunja (Abrus precatorius): The Beautiful Poison – An Ayurvedic and Modern Perspective Category: Agadtantra (Toxicology) Bams 2 nd year In the world of Agadtantra (Ayurvedic Toxicology), few plants are as visually striking and paradoxically dangerous as Gunja. With its vibrant red seeds tipped with black, it resembles a jewel, leading to its use in beads and ornaments. However,  this is beautiful exterior lies a potent poison known as Sthavar Visha Today, we dive deep into the properties, toxicity, and medicinal transformation of Gunja, based on classical Ayurvedic and modern prospective  Introduction Latin name: Abrus precatorius . English - Rosary pea, indian liquorice root. Sanskrit - Raktika, kaakananti,tamrika. Family - Leguminaceae Utpattisthana - Everywhere in india   External Features Characterized by Shrub like climbers with many branches. Leaves - Like tamarind tree, (2-3 inches long) flowers - Small yellowish green Odour - Odourless Rasa Panc...
Read more

Ahiphena (Opium): Bridging Ayurvedic Wisdom and Modern Toxicology

-
Image
 Ahiphena (Opium): Bridging Ayurvedic Wisdom and Modern Toxicology Category: Agadtantra (Toxicology) Bams 2 nd year In the world of Agadtantra (Ayurvedic Toxicology) and modern forensic medicine, few substances are as fascinating—and dangerous—as Ahiphena, commonly known as Opium or the Poppy plant. Known for its potent medicinal properties and high potential for abuse, understanding Ahiphena requires a look at both its traditional Ayurvedic classification and its modern pharmacological profile. Introduction Latin Name : Papaver Somniferum. Family : Papaveraceae. Vernacular Names   Sanskrit : Aaphuk, Ahiphen, Naagphen,   Niphen, Amal. Marathi : Aphu Hindi : Afim English : Opium, Poppy plant . Classification: According to Ayurved - Sthavara vegetative poison Upavisha (Bhavaprakash & Rasatarangini) According to Modern science - Neurotic Cerebral Somniferous Properties   Guna : Laghu, Ruksha,Sukshma, Vyavayee, Vikasee. Rasa : Tikta. Vipaka : Katu. Veerya : ...
Read more

The Suicide Tree : Unveiling the Secrets of Cerbera odollam

-
Image
  The Suicide Tree: Unveiling the Secrets of Cerbera odollam Category: Agadtantra (Toxicology) Bams 2 nd year Nature is full of contradictions.  the most beautiful flora harbors the deadliest secrets . A prime example of this paradox is Cerbera odollam, a plant known by the ominous moniker  " The Suicide Tree " . Native to South India and Southeast Asia, this plant is a subject of significant interest in both Ayurveda and modern toxicology . Let’s dive deep into the morphology , toxicity , and medicolegal importance of this deadly beauty of Cerbera Odollam. Cerbera Odollam    Name of Poison: Cerbera Odollam   Botanical Name: Cerbera odollam   English Names: Suicide Tree, Pong-pong tree   Sanskrit Names : Auddalalka, Svanamara   Family : Apocynaceae Classification   Ayurveda : Plant poison (Sthavara Visha)   Modern : Cardiac poison (affects the heart) Description  Origin: Native to South India and Southeast Asia  Habitat: ...
Read more

आरोग्यवर्धिनी वटी: रसरत्नसमुच्चयांतर्गत एक सर्वांगीण शास्त्रीय व चिकित्सकीय समीक्षा

-
आरोग्यवर्धिनी गुटिका (रसरत्नसमुच्चय... विसर्पादी चिकित्सा) १) घटक द्रव्य द्रव्य — प्रमाण शु. पारद — १ भाग शु. गंधक — १ भाग लोह भस्म — १ भाग ताम्र भस्म — १ भाग अभ्रक भस्म — १ भाग हरितकी — २ भाग } बिभितकी — २ भाग } (त्रिफळा) आमलकी — २ भाग } शु. शिलाजतू — ३ भाग शु. गुग्गुळ — ४ भाग चित्रक — ४ भाग कुटकी (Main) — २२ भाग - यकृत उत्तेजक, तिक्त रसात्मक निम्ब स्वरस / पत्र (भावना देण्यास २ दिवस) २) निर्माण विधी - पारद आणि गंधक कज्जली खल्व मध्ये टाकावी. भस्म घ्यायचा, त्रिफळा घ्यायचा खल्व मध्ये कुटुन घ्यायच (२ दिवस) गुग्गुळ टाकून वटी तयार करायची. वटी सुकवून काचेच्या भरणी मध्ये साठवून ठेवली. निम्ब स्वरस टाकून भावना तयार करायची एकजीव करायच - २ दिवस ३) मात्रा - 250 - 500 mg tablet ४) अनुपान - आर्द्रक स्वरस, मध, जल ५) उपयोग - कुष्ठ कुष्ठ रोग, वातज पित्तज कफज ज्वर, यकृत उत्तेजक, मेदज रोग ६) अशुद्ध असल्यास - रोग अधिकार (१) सर्व प्रकारचे कुष्ठ (२) वातज, पित्तज, कफज कुष्ठ (३) यकृत उत्तेजन (४) मेदज रोग ७) Chemical Composition :-  Mercury (Hg)  Sulphur (S)  Iron (Fe_2So_3) Ferric oxide.  P...
Read more

Spider Poison (लूता विष) : Ayurvedic and modern aspect

-
Image
  Spider Poison (लूता विष) : Ayurvedic and modern aspect  Category: Agadtantra (Toxicology) Bams 2 nd year निसर्गात अनेक जीव आहेत, ज्यांच्यापासून आपल्याला इजा होऊ शकते. आयुर्वेदामध्ये अशा विषारी प्राण्यांचा आणि त्यांच्या विषाचा सखोल अभ्यास 'अगदतन्त्र' या शाखेमध्ये केला जातो. आज आपण अशाच एका विषयावर माहिती घेणार आहोत, तो म्हणजे लूता विष (Spider Poisoning) .  Introduction अगदतन्त्राची व्याख्या: “अगदतन्त्रं नाम सर्पकीट लूता मूषकादि दष्ट विष व्यञ्जनार्थं  विविध विषसंयोगोपर्शमनार्थञ्च | (सु. सु.१/१४)" आयुर्वेदाच्या आठ शाखांपैकी एक असलेल्या अगदतन्त्राचा उद्देश सर्प (साप), कीट (कीटक), लूता (कोळी), मूषक (उंदीर) इत्यादींच्या दंशाचे निदान आणि विविध प्रकारच्या विषांवर उपचार करणे हा आहे.   लूता विष म्हणजे कोळी चावल्यामुळे होणारे विषबाधा.   याचे वर्णन जांगम विष (प्राणीजन्य विष) या अंतर्गत केले जाते. Classification (वर्गीकरण) संख्येनुसार सुश्रुत - १६   वाग्भट - २८   विषाच्या तीव्रतेनुसार  तीक्ष्ण विष लूता : ७ दिवसांच्या आत मृत्यू होतो....
Read more