diabetesmellitusdisorder.blogspot

All abOut Diabetes Melitus

Diabetes Treatment

Treatment

The goal of diabetes management is to keep blood glucose levels as close to normal as safely possible. Since diabetes may greatly increase risk for heart disease and peripheral artery disease, measures to control blood pressure and cholesterol levels are an essential part of diabetes treatment as well.

People with diabetes must take responsibility for their day-to-day care. This includes monitoring blood glucose levels, dietary management, maintaining physical activity, keeping weight and stress under control, monitoring oral medications and, if required, insulin use via injections or pump. To help patients achieve this, UCSF's Diabetes Teaching Center offers self-management educational programs that emphasize individualized diabetes care. The program enables patients to make more consistent and appropriate adjustments in their therapy and lifestyle.

Dietary Management and Physical Activity

Modifying eating habits and increasing physical activity are typically the first steps toward reducing blood sugar levels. At UCSF Medical Center, all patients work with their doctor and certified dietician to develop a dietary plan. Our Teaching Center conducts workshops that provide patients with information on food nutrient content, healthy cooking and exercise.

Insulin Therapy

People with type 1 diabetes require multiple insulin injections each day to maintain safe insulin levels. Insulin is often required to treat type 2 diabetes too. Using an insulin pump is an alternative to injections. The pump is about the size of a pager and is usually worn on your belt. Insulin is delivered through a small tube (catheter) that is placed under the skin (usually in the abdomen).

There are four major types of insulin:

• Rapid-acting
• Short-acting
• Intermediate-acting
• Long-acting

Your doctor will determine your dose and how often you need to take insulin. There is no standard insulin dose as it depends on factors such as your body weight, when you eat, how often you exercise and how much insulin your body produces.

Oral Medications

Sometimes blood sugar levels remain high in people with type 2 diabetes even though they eat in a healthy manner and exercise. When this happens, medications taken in pill form may be prescribed. The medications work in several different ways. These include improve the effectiveness of the body's natural insulin, reduce blood sugar production, increase insulin production and inhibit blood sugar absorption. Oral diabetes medications are sometimes taken in combination with insulin.

Diabetes ManifestatiOns~ signs&symptOms~

The classical symptoms of diabetes are polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). Symptoms may develop rapidly (weeks or months) in type 1 diabetes while in type 2 diabetes they usually develop much more slowly or maybe absent.

Prolonged high blood glucose causes glucose absorption, which leads to changes in the shape of the lenses of the eyes, resulting in vision changes; sustained sensible glucose control usually returns the lens to its original shape. People (usually with type 1 diabetes) may also present with diabetic ketoacidosis, a state of metabolic dysregulation characterized by the smell of acetone; a rapid, deep breathing known as Kussmaul breathing; nausea; vomiting and abdominal pain; and an altered states of consciousness.

Weight loss happened due to burning of fat to produce and also provide energy to the body cells because diabetic patients cannot produce insulin to convert glucose to glucagon and provide energy to the body cells. So , diabetic patients will experience weight loss.

Disease Complication

Stroke/ heart attack happened


when the blood high with glucose,it will slow down the blood flow (sticky blood).build up sticky plaque and worsen the stenosis (if any) and can lead to TIA/stroke/atherosclerosis,PAD and so on.

Eye damage : Diabetes retinopathy 

high blood glucose sugar will damage the tiny blood vessels in the retina while the proliferative retinopathy is new blood vessels grow along the retina, and without treatment-bleed,blurr vission-lead to blindness.

Kidney damage 

 When blood high with glucose, the excessive material will be passing-out through the kidney. So, when it is too sticky,it will depress the nephrons which functions to filtrit the excessive material and can cause the kidney damage/impotence.

Numbness and reduce blood supply

Hyperglycemia(high glucose level in blood) will lower the blood flow especially to the peripheral vessels. This can lead to numbness and nerve damage.

Pheripheral Vascular Disease

 Blood vessel damage in the feet may cause tissue damage. High glucose level will disturb the healing process  infections,foot ulcers,foot gangrene.

gross anatOmy Of pancreas!

normal pancreas

RISKS FACTOR OF DIABETES

• A member of a high-risk groups (Native Americans, Latinos, Asian-Americans, and African-Americans),
• Lack of activity – being obese – resistance to insulin
• Disturbance of normal physiologic function of the body - hormones
• genetic defects in the human sixth chromosome abnormalities on HLA
• Older people experience degenerative of the organ including pancreas – less production of insulin can lead to DM 

Types of Diabetes

TYPE OF DIABETES :

TYPE 1

•       In type 1 diabetes mellitus,characterised by the insulin-producing beta cells of the islets of Langerhans in the pancreas leading to insulin deficiency is loss. The majority of type 1 diabetes is of the immune-mediated nature, where beta cell loss is a T-cell mediated autoimmune attack by the body itself, and is rendered incapable of making insulin.

•       The patient with type 1 diabetes must rely on exogenously administered insulin for         survival.

•        Patients with type 1 diabetes in the blood can be found a variety of autoimmune antibodies, such as glutamic acid decarboxylase antibody (GAD antibodies), islet cell antibody (ICA antibodies) and so on. These abnormal antibodies can damage the body's own insulin secretion of insulin B cells, so that should not normally secrete insulin. This phenomenon happened because the GAD antibodies or ICA antibodies have the similarities with the protein bacterial that will provoc autoimmune attack to the beta cells. The pancreas will damage and no insulin can be produce. So,diabetes type 1 occur.

TYPE 2

·         Type 2 diabetes is the most common type and usually occur to obese people.

·         Type 2 diabetes mellitus is characterized by insulin resistance which may be combined with relatively reduced insulin secretion. The defective responsiveness of body tissues to insulin is believed to involve the insulin receptor.

·         In the early stage of type 2 diabetes, the predominant abnormality is reduced insulin sensitivity. At this stage hyperglycemia can be reversed by a variety of measures and medications that improve insulin sensitivity or reduce glucose production by the liver. As the disease progresses, the impairment of insulin secretion occurs, and therapeutic replacement of insulin may sometimes become necessary in certain patients.

GESTATIONAL DIABETES MELLITUS (GDM)

·         Gestational diabetes is a type of diabetes that occurs in non-diabetic women during pregnancy.

·         It is any degree of glucose intolerance with its onset during pregnancy or late in pregnancy. This form of diabetes usually disappears after the birth of the baby.

·         GDM occur because the placenta will produce a wide range of fetal growth for growth hormones, these hormones on the healthy growth of the fetus is very important, but it can block the body's insulin-mother role, so trigger diabetes. Some of the mother did not get the gestational diabetes because the fetus helps to produce an extra insulin so that the glucose can be convert to glucagon.

Disease classification

DISEASE CLASSIFICATION 

·         Metabolic disease --> Disturbance of normal physiologic function of the body

characterized by high blood glucose levels – Hyperglycaemia. Their immune system defects because patients with type 1 diabetes in the blood can be found a variety of autoimmune antibodies, such as glutamic acid decarboxylase antibody (GAD antibodies), islet cell antibody (ICA antibodies) and so on. These abnormal antibodies can damage the body's own insulin secretion of insulin B cells, so that should not normally secrete insulin.

·         Hereditary disease ---> genetic defects in the human sixth chromosome abnormalities on HLA.Genetic defects prompted the current study is the incidence of type 1 diabetes foundation, the performance of such genetic defects in the human sixth chromosome abnormalities on HLA antigen. Prompted scientists: I have diabetes onset familial characteristics.

Critical condition of Diabetes Melitus

This video shows the critical of  Diabetes Melitus

pathophysiology

• ·         Diabetes mellitus is all about the pancreas.
• ·          Pancreas consists of Beta cells that important for insulin productions.
• ·         Insulin function to convert glucose in the blood stream to glucagon. Glucagon then will impairs with the cells in the body and provide energy to the cells for their functions.

What is diabetes melitus?

•       Diabetes  derived from the Greek meaning   “siphon” or “pass-through”.

•       DM also can be consider as a condition in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced.

•       In 5^th-6^th century – indian physician recognised sweet,honey-like taste (polyuric patient) that attract the ants and insects.

•       Hyperglycemia lead to spillage of glucose into the urine, hence the term Diabetes-sweet urine.

•       Diabetes mellitus is a group of metabolic diseases characterized by high blood glucose levels – Hyperglycaemia.This results from defects in insulin secretion, or action, or both.

•       Hyperglycemia lead to spillage of glucose into the urine, hence the term Diabetes - sweet urine.