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Diabetes mellitus

Learn about diabetes mellitus, a chronic condition characterized by high blood glucose levels due to a deficiency of insulin. Explore the symptoms, diagnosis, and management of both type 1 and type 2 diabetes. Understand the potential complications and ways to prevent and manage them.

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Diabetes mellitus

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  1. Diabetes mellitus

  2. An absolute or relative deficiency of insulin • Diabetes mellitus • - a chronic elevation of the blood glucose concentration • due to an absolute or relativedeficiency of insulin • (deficiency of insulin -absolute or a resistance to insulin –relative) • The chronic hyperglycaemia is associated with long term tissue damage, especially the blood vessels, nerves, heart, kidneys and eyes. • http://en.wikipedia.org/wiki/Diabetes • http://www.diabetes.org/home.jsp • http://diabetes.niddk.nih.gov/ • http://www.latrobe.edu.au/podiatry/diabetesresources/diabetes_lecture_1.htm

  3. Type 1 Diabetes -- the body's failure to produce insulin, • auto immune disorder • insulin-producing cells destroyed • daily insulin replacement necessary • most prevalent type of diabetes in children and adolescents

  4. 90% Type 1 diabetes • Absolute insulin deficiency • Auto-immune process • Pancreatic beta-cell destruction

  5. Ketoacidosis (key-toe-ass-i-DOE-sis) is a serious condition that can lead to diabetic coma or even death. Ketoacidosis may happen to people with type 1 diabetes. Ketoacidosis occurs rarely in people with type 2 diabetes. Early diagnosis • Diagnosis: • fasting blood-glucose concentration > 7.7 mmol/l • random blood-glucose concentration > 11 mmol/l • glucosuria • ketonuria • Ketoacidosis (酮酸中毒) The newly diagnosed child

  6. Type2 Diabetes-- insulin resistance (the body fails to use insulin properly) • Most common in adults • Increasingly common in children • Overweight • inactivity

  7. Normal blood glucose levelsNormal homeostatic mechanisms maintain blood glucose levels within a narrow range of 3.5-6.5 mmol/l

  8. Actions of insulin Effect of insulin on glucose uptake and metabolism. Insulin binds to its receptor (1) on the cell membrane which in turn starts many protein activation cascades (2). These include: translocation of Glut-4 transporter to the plasma membrane and influx of glucose (3), glycogen synthesis (4), glycolysis (5) and fatty acid synthesis (6).

  9. Insulin acts through receptors on cell membrane -Insulin receptors are found on most mammalian cells – action of insulin is mediated through these receptors.- Impaired action of insulin can result from defects in the receptors or defects in post-receptor events – insulin resistance / insensitiveness

  10. Adipose tissue Free Fatty acids liver insulin Ketone bodies pancreas Normal prevention of ketosis and events leading to ketosis Insulin deficiency Mobilize free fatty acids from adipose Increased fats to liver Increased uptake and oxidation of fats Increased production of ketone bodies

  11. ketone bodies

  12. hypoglycaemia = lowsugarin the blood 7 mmol/l 4 mmol/l With insulin it may happen that your blood sugar falls below the lower limit of 4 mmol/l (72 mg/dl), a condition known as hypoglycaemia = lowsugarin the blood.

  13. Irritability Sweating Dizziness Handshaking It is a condition your body sound alarm that it is short of fuel. sweaty, hungry, dizzy, nervous, lose concentration, with shaking hands or blurred vision…

  14. … and you have immediately to take sugar (3-4 lumps or 3 teaspoons) or a glass of coke or juice. If after 15 minutes you feel that your blood sugar is still low, take extra sugar. Always carry sugar with you.

  15. Take extra carbohydrate (2 buiscuits, a sandwich, minimars bar) when you will have moderate or heavy exercise.

  16. Diabetes related complications

  17. Diabetes related complications

  18. Fungal infection between the toes

  19. Inflamed toe

  20. Oral Hypoglycemics--MOA

  21. Diabetes is Managed,But it Does Not Go Away. GOAL: To maintain target blood glucose

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