AN OVER VIEW OF DIABETES MELLITUS DR J DAS
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.
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%
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
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.
How diabetes develop? • DIABETES OCCURS DUE TO DEFICIENCY OR INEFFICIENCY OF INSULIN.
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
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%
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
Diagnostic criteria Normal – FBS- <110mg PPBS < 140mg IFG _>110mg to <126mg IGT- FBS<126mg PP>_140 but <200 DM-FBS>_126mg PPBS 200mg
TYPES OF DIBETES • Type 1 DM. • Type 2 DM. • Other specific type.
Disaster • Nerve. • Eyes. • Kidney. • Heart.
WHY COMPLICATION? • Thickening of the internal wall of the artery. • Advanced glycosylated end product.
Neuropathy • Burning sensation of feet or hands. • Tingling numbness. • Severe pain in the leg or feet. • Weakness of group of muscle.
Eyes (Retinopathy) • Frequent change of vision. • Cataract in early age. • Retinopathy-Bleeding in retina. • Vitreous hemorrhage. • Retinal detachment. • Blindness.
Kidney. • Microalbuminurea. • Albuminurea. • Nephropathy • Renal failure.
Heart & Cardiovascular • Peripheral Vascular Disease. • Coronary Artery disease. • Disease of heart.
Treatment Complication free Diabetes • Education & Awareness. • Exercise. • Diet. • Drugs Awareness Aw
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
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.
Drugs • Prescription of Doctor. • Non conventional medicine should not be continued without monitoring the result. • Non conventional medicine strictly prohibited in complication.
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
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.
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.
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. Challenge of Diabetic.