Diabetes

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What is Diabetes?

Diabetes is a metabolic and vascular disorder characterized by chronic hyperglycemia, along with disturbances in the metabolism of carbohydrates, fats, and proteins. This occurs due to defects in insulin secretion, insulin action, or both.

India: The Diabetes Capital of the World

The pancreas releases insulin through β-cells in the islets of Langerhans.

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Types of Diabetes
Type 1 Diabetes Mellitus (DM)
  • No insulin present or
  • β Cell destruction
  • Therefore most commonly seen in childhood
  • Younger than 20 years of age
    Type 2 Diabetes Mellitus (DM)
  • Insulin may be present but body might be
  • Resistant to insulin
  • Impaired secretion through pancreas
  • Increased glucose production.
TYPE 1 DM
CAUSES
  • 1. Autoimmune Disease
  • 2. Genetic Factors
  • 3. Environmental Factors - Viral Infections may tigger islet cell destruction.
    SIGNS & SYMPTOMS
  • 1. Poluria - Excessive Urination
  • 2. Polydipsia - Excessive Thirst
  • 3. Polyphagia - Excessive Hunger
TYPE 2 DM
CAUSES
  • 1. Increasing age.
  • 2. Obesity ( dietary habits).
  • 3. Family history.
  • 4. Sedentary life style.
  • 5. Genetic factor- Risk of T2DM in offspring is more than double if both parent are diabetic.
    SIGNS & SYMPTOMS
  • 1.Blurred Vision
  • 2. Frequent Infection
  • 3. Slow Wound Healing
  • 4. Poluria - Excessive Urination
  • 5. Polydipsia - Excessive Thirst
  • 6. Polyphagia - Excessive Hunger
Diagnosis
Diagnosis Fasting (mg/dl) PP (mg/dl)
Normal 90-100 70-140
Pre-Diabetic 110-126 140-200
Diabetic > 126 > 200
HBA1C CRITERIA
NORMAL < 5.6
PRE - DIABETIC 5.9 - 6.5
DIABETIC > 6.5

Uncontrolled Diabetes I.E Uncontrolled Sugar levels can lead to

DKA (Diabetic keto-acidosis)

Where blood glucose level is >250mg/dl. Along with other diagnosing criteria.Usually occur in typ 1 but may occur in typ 2 in later stages. It can be lead to.

  • 1. Nausea, vomiting
  • 2. Abdominal pain
  • 3. Dehydration - causing dry skin
  • 4. Cold extremities like palms & soles
  • 5. Depressed mental function

    • Altered sensorium, seizures, headache uncontrolled bowel/ bladder function.

  • 1. Rapid & Deep Breathing (Kussmaul Breathing)
  • 2. Low body temperature
  • 3. Fruity smell from patients breath

    • It`s an emergency condition patient can even end up into coma Rush to hospital immediately.

Hypoglycaemia

when blood sugar level is < 90 mg/dL. Sweating, palpitation, tingling/ numbness in the lips or tongue.

  • Headache
  • Giddiness
  • Weakness
  • Blurred/ impaired vision
  • Unconsciousness
  • Extreme cases can lead to come.

Chronic complications of diabetes

EYE - Diabetic retinopathy
  • Loss of vision
  • Blurred vision
  • Seeing spots
  • Distorted vision
  • Seeing floaters - finally blindness
  • Extreme cases can lead to come.

Kindey - Diabetic nephropathy

It can lead to renal failure Recurrent UTI - burning micturition Swelling over hands, feels and ankles.

Nerves/Diabetic Neuropathy

  • Loss of vibration sense from palm & soles
  • Pain in feet, shins & anterior thigh loss of balance
  • Patient complains of feeling of walking on cotton wool
  • Unrecognised trauma can causes blisters, which finally leave to ULCERS

Heart & Vessels

Coronary artery disease

Angina

MI - Myocardial ischemia

Cerebrovascular Disease

Stroke

Transient ischemic attack

Dermatological Complilaions

  • Vaginal candidiasis
  • Diabetic ulcers
  • Intertigo - inflammation of skin folds
  • Carbuncles & furuncles
  • Balanoposthitis : infection & inflammation of penis
  • Acanthosis nigricans - patches of thick dark velvety skin Over Body Folds & Creases
  • Necrobiosis lipoidica (NLD)- collagen degenerating disorder along with skin lesions
  • Xanthelasma - yellow bumps / patches over the under eye or under the eye brow
  • Psoriasis- discolored patches of skin which may be itchy & scaly Musculoskeletal complication
  • Painful muscle swelling
  • carpal tunnel syndrome, dupuytren's contracture, flexor tenosynovitis, diabetic sclerodactyly