This presentation talks about Diabetes, its types and treatment.

1. Diabetes
• ‘Diabetes mellitus’ occurs when the
level of glucose (sugar) in the blood
becomes higher than normal
• Two main types of diabetes
Type 1 diabetes
Type 2 diabetes

2. Type 1 Diabetes
• Pancreas stops making insulin
• Symptoms develop in days or weeks
• Insulin in the blood is very low
• Also called: Juvenile, Early onset,
Insulin-dependent
• Children or young adults usually
affected although adults can also be
affected
• Treated with Insulin injections and diet

3. Type 2 Diabetes
• Symptoms develop gradually compared with
Type 1 Diabetes
• Pancreas still secreting Insulin unlike Type 1
Diabetes, but not sufficient to meet body needs
• Adults usually affected (and children these
days!!)
• Develop Diabetes because:
not make enough Insulin for body's needs
cells in body unable to use Insulin properly,
called ‘Insulin Resistance'

4. Type 2 Diabetes
• Tends to run in families
• More common in South Asians
• Risk factors:
a first-degree relative with Type 2 diabetes
overweight or obese
waist circumference more than 80cm in women,
85cm in men
Impaired Glucose Tolerance: Blood glucose in
between ‘normal’ and ‘Diabetes range’
Gestational Diabetes
Old age

5. OBESITY
DIABETES MELLITUS
INSULIN RESISTANCE
INSULIN SECRETION
DEFECT
GENETIC
PREDISPOSITION
ENVIRONMENTAL
FACTORS
GLUCO-
AND
LIPO-
TOXICITY
Low physical activity
High energy intake
Genes
Vicious
circle
IGT
FFA
TNF-a, resistin,
leptin, adiponectin …
Liver Muscles

6. Symptoms of Type 2
Diabetes
• Vague at first
• Often come on gradually
• Have Diabetes for long time pre-diagnosis
• Common symptoms:
excessively thirsty
passing large amounts of urine
waking frequently at night to pass urine
tiredness
weight loss
blurred vision
frequent infections such as Candida

7. How is Diabetes diagnosed?
• Blood tests for glucose- fasting, Oral
Glucose Tolerance Test
• A routine medical
or
when tests are done for unrelated
medical condition

8. Why treat Diabetes?
• To treat symptoms
• Needs treatment even if no symptoms
to prevent complications

9. Possible complications of
Diabetes
• Short-term complication - a very high blood glucose level can
sometimes lead to Coma
• Long-term complications
 Hardening of the arteries :angina, heart attacks, stroke
 Poor circulation
 Kidney damage
 Eye problems
 Nerve damage
 Foot problems
 Impotence
• Complications of treatment- Hypoglycaemia i.e., ‘low blood
sugar level’

10. Aims of Diabetes Treatment
• Maintain blood glucose level as near
normal as possible
• ↓ other 'risk factors' that ↑risk of
developing complications- BP,
cholesterol, smoking cessation
• Detect complications as early as
possible- heart, eyes, feet, liver, kidneys

11. How to Treat Diabetes
• Lifestyle changes:
 Exercise
 Dietary changes
• Medications:
 Oral medications
 Insulin injections and other injectable
medications that reduce blood glucose

12. Monitoring in Diabetes
• Blood tests:
 HbA1c blood test 3-4 monthly for monitoring the last 3
months blood glucose average
 Creatinine to monitor kidney function
 Liver enzymes to screen for Fatty Liver
 Lipid profile to assess fat content in blood
• Urine Tests: Albumin-Creatinine Ratio to detect any
damage to kidneys due to high Sugar levels and high
blood pressure
• BP monitoring
• Foot Screen: To assess nerve damage and
decreased blood circulation
• Eye Screen: To screen for damage to Retina,
Cataracts, Glaucoma
• ECG to screen for underlying heart problems