Introduction :
Diabetes means polyuriya and melitus means honey, name diabetes mellitus was coined by Thomas willia, who discovered sweetness of urine from diabetic (1675)
Definition :
Diabetes is a metabolic disorder characterized by high blood glucose levels,in most of the cases diabetes mellitus develops due to deficiency of insulin.
Classification :
Type1
Insulin dependent diabetes mellitus (IDDM)
Causes
1.Degeneration of beta cells in the islets of langerhans of pancreas
2.Destruction of beta cells by viral infection
3.Congenital disorder of beta cells
4.Destruction of beta cells during autoimmune diseases
Type2
non insulin dependent diabetes mellitus (NIDDM)
Failure of insulin receptors to give response to insulin
Causes
1.Genetic disorders
2.Physical inactivity
3.Obesity
4.Lifestyle changes like bad eating habits
Signs and symptoms :
1.Increased blood glucose level (300 to 400mg/dL)
2.Glucosuria ( when glucose level above 180mg/dL in blood glucose appears in urine )
3.Osmotic diuresis
4.Polyuria ( Excess urine formation, increase in the frequency of voiding urine)
5.Polydipsia ( Increase water intake)
6.Polyphagia (Intake excess food)
7.Asthenia ( loss of strength)
8.Acidosis
9.Acetone breathing ( acetone is expired in the expiratory)
10.Kussmaul breathing ( increase in the rate and depth of breathing)
11.Circulatory Shock ( Diuresis leads to dehydration it's causes Circulatory shock)
12.Coma ( Increase in the blood glucose level develops hyperosmolarity of plasma which also leads to coma)
Diagnosis:
1.History collection and physical examination.
2.Fasting blood glucose.
3.Postprandial blood glucose.
4.Glucose tolerance test.
Treatment :
Type1 Diabetes Mellitus :
It's treated by exogenous insulin, insulin is a polypeptide, it is degraded in GI tract if taken orally so, it is generally administered by subcutaneous injection.
Type2 diabetes mellitus :
It is treated by oral hypoglycemic drugs.( Classification of oral Antidiabetic Drugs)
1.Sulphonylureas
First generation : Tolbutamide
Second generation: glipizide
2.Biguanide: metformin
3.Meglitinide analogue : Repaglinide
4.D- Phenylalanine derivative: Nateglinide
5.Thiazolidinediones: pioglitazone
6.Alpha Glucosidaseinhibitor:Acarbose,voglibose
7.DPP-4 inhibitors : sitagliptin
Complications of Diabetes Mellitus :
1.cardio vascular complications
- Hypertension
- myocardial infarction
2.Degenerative changes in retina called diabetic retinopathy
3.Degenerative changes in kidney know as diabetic nephropathy
4.Diabetic neuropathy
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