What is Diabetes Mellitus ?

What is Diabetes?

DIABETES

Greek

To pass water like a siphon Sweet as honey

Diabetes Mellitus

“Sweet Urine”

It is a longstanding disease characterized by high blood sugar levels. Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the urine.

What is glucose?

Glucose is an essential nutrient that provides energy for the proper functioning of the body cells.

FUEL

CAR needs fuel to move MAN needs glucose to work

What is glucose?

“Glucose in digested food is absorbed by the intestines into the blood and carried to all the cells in the body. Glucose needs insulin to enter the cells.”

What is Insulin?

Insulin is produced by the PANCREAS especially during meals. Without insulin, glucose can’t enter the cells and remains in the blood.

Glucose Key = Insulin Keyhole = Insulin Receptor Cell = Powerplant

Keyhole = Insulin Receptor CELL = POWERPLANT Key = Insulin

CELL = POWERPLANT

What causes it?

Insufficient production of insulin or the inability of cells to use insulin (insulin resistance).

Type 1 DM insulin (key) absent Type 2 DM defective insulin receptor (keyhole) with insufficient insulin

Do I have Diabetes?

CRITERIA FOR DIAGNOSIS OF DIABETES

American Diabetes Association

8 hr Fasting Blood Sugar 2 hours after 75g glucose (OGTT)

NORMAL IMPAIRED FASTING GLYCEMIA (IFG) IMPAIRED GLUCOSE TOLERANCE (IGT)

< 100 mg/dL  100 and < 126 mg/dL -- < 140 mg/dL --  140 and < 200 mg/dL

DIABETES MELLITUS



126 mg/dL



200 mg/dL Symptoms of diabetes and Random Blood Sugar of



200 mg/dL

200 mg/dL 130 mg/Dl NORMAL 70-126 mg/dL 70 mg/dL

GLUCOSE REGULATION

GLUCOSE INSULIN

200 mg/dL 130 mg/Dl NORMAL 70-126 mg/dL 70 mg/dL

GLUCOSE REGULATION

GLUCOSE INSULIN

ETIOLOGIC CLASSIFICATION OF DIABETES MELLITUS

1. TYPE 1 DIABETES MELLITUS

•

ß-cell dysfunction leading to absolute insulin deficiency 2. TYPE 2 DIABETES MELLITUS

•

predominant insulin resistance with relative insulin deficiency or

•

predominant secretory defect with insulin resistance 3. OTHER SPECIFIC TYPES 4. GESTATIONAL DIABETES MELLITUS

DM TYPE 1

DM TYPE 2

SYMPTOMS OF DIABETES

Increased thirst Excessive urination Increased appetite

SYMPTOMS OF ELEVATED BLOOD GLUCOSE Excessive Urination Frequent Thirst

POLYURIA -increased amount of daily urine

SYMPTOMS OF ELEVATED BLOOD GLUCOSE POLYPHAGIA ITCHINESS

SYMPTOMS OF DIABETES

Weakness and Fatigue Weight Loss Poor Wound Healing Blurring of Vision

WHO GETS DIABETES MELLITUS?

AGE RACE/ COLOR SEX/ GENDER RELIGION

TRIGGERING MECHANISM

CAUSES OF DIABETES MELLITUS

HEREDITY OLD AGE OBESITY

GENETICS OF DIABETES

PATTERN OF INHERITANCE

DM TYPE 1 DM TYPE 2

CAUSES OF DIABETES MELLITUS

PREGNANCY SURGERY ILLNESS MEDICATIONS

COMPLICATIONS OF DIABETES MICROVASCULAR COMPLICATIONS DIABETIC RETINOAPTHY DIABETIC NEPHROPATHY DIABETIC NEUROPATHY MACROVASCULAR COMPLICATIONS CORONARY ARTERY DISEASE CEREBROVASCULAR DISEASE

DIABETIC RETINOPATHY NORMAL RETINA DM RETINOPATHY

30-40 % DIABETES AND KIDNEY DISEASE 15 % 29 %

PEOPLE WITH KIDNEY DISEASE PEOPLE ON DIALYSIS PEOPLE RECEIVING KIDNEY TRANSPLANTATION

DIABETIC NEUROPATHY

MACROVASCULAR COMPLICATIONS

PEOPLE AFFLICTED WITH DIABETES MELLITUS • 25 times more prone to BLINDNESS • 17 times more prone to KIDNEY DISEASE • 5 times more prone to GANGRENE • 2 times more prone to HEART DISEASE • 90 times more prone to NEUROPATHY

MANAGEMENT OF DIABETES

EDUCATION DIET MEDICATION EXERCISE

MANAGEMENT OF DIABETES

Diet

MANAGEMENT OF DIABETES MELLITUS

Exercise

MANAGEMENT OF DIABETES MELLITUS ORAL HYPOGLYCEMIC DRUGS INSULIN

MANAGEMENT OF DIABETES MELLITUS

Education

The Philippine College of Physicians wishes to acknowledge the following for their invaluable efforts in the preparation of this module

Elaine Matawaran, MD Elaine Cunanan, MD Rosa Allyn G. Sy, MD Committee on Advocacy & Public Relations Philippine Society of Endocrinology and Metabolism