AN OVER VIEW OF

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AN OVER VIEW OF

• DIABETES MELLITUS
• DR J DAS

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Epidemiology

• Indian settled abroad develop diabetes more than
  their local inhabitants.
• It has been proved in Java, Fiji, Trinidad, South
  Africa Singapore, Maldives, Canada, U K USA.

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National scenario of Diabetes

• Year Urban Rural
• 1970 2.3 1.3
• 91-92 8.7 2.4
• 1995 11.8 2.4
• 2000 14.7 2.4
• 2002 16.5 2.5
• 2004 18.1 2.8
• 2005 18.7 3.0
• 2008 20 3.5

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In modern India.

• Every fifth family of urban society there is one
  diabetes.
• More than 18 of adult population of urban
  society is diabetes.
• 60 million of people will have diabetes by 2025

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What is Diabetes?

• Diabetes Mellitus is a metabolic disorder
  characterized by rise of glucose level in blood
  due to real or apparent deficiency of insulin
  hormone.

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How diabetes develop?

• DIABETES OCCURS DUE TO DEFICIENCY OR INEFFICIENCY
  OF INSULIN.

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Why ?

• Hereditary factor.
• Environmental factor.

Multiple infection
Over eating
G
e n e
Over weight
Multiple surgery.
Advanced age
t I c
Multiple pregnancy
Lack of physical activity
Stress Strain
DIABETES

MELLITUS
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Hereditary influence on development of diabetes

• Both parent- 99.
• One parent and one grand parent-70.
• One parent and other parent from diabetic
  family-50.
• Only one parent-40.
• One parent from diabetic family-20

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Evolution of diabetes
CDM
DM
PPBS more than 140mg more than twice.
IGT
E G I
PPBS more than 140mg in one Occasion. FBS normal.
Repeat test shows normal PPBS.
Normal blood sugar
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Diagnostic criteria

• Normal FBS- lt110mg
• PPBS lt 140mg
• IFG _gt110mg
  to lt126mg
• IGT- FBSlt126mg
• PPgt_140 but lt200
• DM-FBSgt_126mg
• PPBS 200mg
  
  
  

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TYPES OF DIBETES

• Type 1 DM.
• Type 2 DM.
• Other specific type.

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Disaster

• Nerve.
• Eyes.
• Kidney.
• Heart.

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WHY COMPLICATION?

• Thickening of the internal wall of the artery.
• Advanced glycosylated end product.

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Neuropathy

• Burning sensation of feet or hands.
• Tingling numbness.
• Severe pain in the leg or feet.
• Weakness of group of muscle.

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Eyes (Retinopathy)

• Frequent change of vision.
• Cataract in early age.
• Retinopathy-Bleeding in retina.
• Vitreous hemorrhage.
• Retinal detachment.
• Blindness.

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Kidney.

• Microalbuminurea.
• Albuminurea.
• Nephropathy
• Renal failure.

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Heart Cardiovascular

• Peripheral Vascular Disease.
• Coronary Artery disease.
• Disease of heart.

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Treatment
Complication free Diabetes

• Education Awareness.
• Exercise.
• Diet.
• Drugs

Awareness
Aw
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Exercise.

• Treatment is incomplete without exercise even
  when blood sugar is controlled.
• Regular exercise for minimum five days in a week.
• Walking is the best exercise

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Diet.

• Diet prescribed as per requirement of the body.
• 3 major 4 minor food planning is to avoid
  hypoglycemia.
• Diet during long drive, shift duty, fasting,
  Ramzan should very clear.
• Fruits as per advise.

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Drugs

• Prescription of Doctor.
• Non conventional medicine should not be continued
  without monitoring the result.
• Non conventional medicine strictly prohibited in
  complication.

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Living with Diabetes.

• Every days blood sugar is important.
• Protocol of the treatment program should be clear
  to all.
• Aim is to live peacefully with Diabetes without
  developing complication

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Protocol of treatment program

• Urine sugar daily.
• Blood sugar monthly.
• Glycosylated hemoglobin 3 monthly.
• Plasmafructosamine in pregnancy.
• Routine urine examination to see albumin.
• Micro albumin yearly.
• Eye, Kidney and Heart checkup yearly.

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Hypoglycemia.

• Good control of Diabetes may produce
  hypoglycemia.
• All Diabetic must know about Hypo and its
  prevention.
• Dose of the drug must be reduced immediately.

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Challenge of Diabetic.

• Hundreds year ago Diabetes was a death sentence,
  but it is not so presently.
• Though, complications are still very high it can
  be minimised drastically.

• It can be achieved only when living with Diabetes
  is clearly understood.
• Peaceful co existence will preserve happiness
  of life and productivity of individual.

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