BIOCHEMICAL PROFILE OF DIABETES MELLITUS by DR MUSTANSAR FJMC LAHORE

2. BIOCHEMICAL
PROFILE OF
DIABETES
MELLITUS
DR MUSTANSAR

3. In 1500 BC
Diabetes First Described In
Writing
• Hindu healers wrote that flies and ants were attracted
to urine of people with a mysterious disease that
caused intense thirst, enormous urine output, and
wasting away of the body
© 2004, John Walsh, P.A., C.D.E.

4. • 250 BC
The Word Diabetes First Used
Apollonius of Memphis coined the name
"diabetes” meaning "to go through" or siphon.
He understood that the disease drained more
fluid than a person could consume.
Gradually the Latin word for honey, "mellitus,"
was added to diabetes because it made the
urine sweet.

5. Definition:-
• Diabetes mellitus is a chronic systemic disease
characterized by either a deficiency of insulin or a
decrease ability of the body to use insulin.

6. What is Diabetes Mellitus?
A chronic syndrome of
• impaired
carbohydrate, protein, an
d fat metabolism owing
to insufficient secretion
of insulin or to target
tissue insulin
resistance, characterized
by polydipsia, polyuria
and polyphagia.

7. A glucose (C6H12O6).

8. Classification of
Diabetes.Mellitus.:-

9. Type-I Diabetes mellitus:-
• In this form of diabetes mellitus the Beta cells of
pancreas that normally produce insulin which are
destroy by an auto-immune response.
• As a result insulin injection are needed to control the
elevated blood sugar level.

10. Before Insulin
JL on 12/15/22 and 2 mos later
Before insulin was discovered in 1921,
everyone with type 1 diabetes died
within weeks to years of its onset
© 2004, John Walsh, P.A., C.D.E.

11. CLASSIFICATION
Type 1 diabetes mellitus is
characterized by loss of the insulin-
producing beta cells of the islets of
Langerhans in the pancreas leading to
insulin deficiency.
Type 1 diabetes can affect children or
adults but was traditionally termed
"juvenile diabetes"
because it represents a majority of the
diabetes cases in children.
• TYPE1 DIABETES

12. Causes:-
• 1) Genetic factors.(HLA)
• 2) Immunological factors.
• 3) Environmental factors.

13. Type-2 Diabetes mellitus:-
• It refers from decreased sensitivity to insulin
or decrease production of insulin.
• This type of patient firstly treated by diet and
exercise and secondary by oral hypoglycemic
drug.

14. TYPE 2 DIABETES
Type 2 diabetes mellitus is
characterized by insulin resistance
which may be combined with relatively
reduced insulin secretion.
At this stage hyperglycemia can be
reversed by a variety of measures &
medications that improve insulin
sensitivity or reduce glucose production
by the liver.

15. Causes:-
• 1) Age- > 40yrs.
• 2) Obesity
• 3) Family history.

16. Gestational D.M. :-
• Onset is during pregnancy
usually 2nd & 3rd trimester.
• It may be due to hormonal
secretion by the placenta
which inhibit the action of
insulin.

17. GESTATIONAL DIABETES
Gestational diabetes mellitus (GDM) resembles type 2
diabetes in several respects, involving a combination of
relatively inadequate insulin secretion and
responsiveness. It occurs in about 2%–5% of all
pregnancies and may improve or disappear after
delivery. This is particularly problematic as diabetes
raises the risk of complications during pregnancy, as well
as increasing the potential that the children of
diabetic mothers will also become diabetic in the future.

22. Clinical Manifestation:-
• Polydypsia.
• Polyphasia.
• Polyuria.
• Hyperglycemia.
• Blurred vision.
• Diabetic ketosis.
• Diabetic ketoacidosis.
• Dry skin.
• Slow healing wound.
• Weakness.

24. DIAGNOSIS
Diabetes mellitus is characterized by recurrent or persistent
hyperglycemia, and is diagnosed by demonstrating any one of the following
–
* Fasting plasma glucose level ≥ 7.0 mmol/L (126 mg/dL).
* Plasma glucose ≥ 11.1 mmol/L (200 mg/dL) two hours after a 75 g oral
glucose load as in a glucose tolerance test.
* Symptoms of hyperglycemia and casual plasma glucose ≥ 11.1 mmol/L
(200 mg/dL)
* Glycated hemoglobin (Hb A1C) ≥ 6.5%.

25. Investigations:- • 1) Fasting blood glucose.
• 2) Random blood glucose.
• 3) Postprandial blood glucose
level.
• 4) Oral glucose tolerance test.
• 5) Urine test for ketonuria.
• 6) Urine test for proteinuria.

27. DIABETES MELLITUS

28. Glycemic Control
A1C% Mean Plasma Glucose (mg/dl)
6 135
7 170
8 205
9 240
10 275
11 310

29. Glycemic Control
• HgA1C < 6% - normal.
• HgA1C < 7% - goal.
• HgA1C 7.0 - 7.5% - good control.
• HgA1C > 7.5% - additional therapy
• Pre-prandial glucose 90-130 mg/dl
• Peak postprandial glucose < 180 mg/dl
• HgA1C every 3 months unless at goal then every 6
months.

30. Management:-
• The main management or goal is to normalise insulin
activity and blood glucose level to reduce the
vascular and nephropathic complications.

31. 5
FIVE
main components of
management of diabetes mellitus
patient’s are:-

32. Cont..
• 1) Diet
• 2) Exercise
• 3) Monitoring
• 4) Education
• 5) Medication

33. MEDICATION
Medication may be 2 types
•
Insulin Oral medications

34. CONCLUSION
• FOODS TO BE TAKEN FOODS NOT TOBE
TAKEN
•Fruits & veg •High in fat
•High in sugar
•Garlic, ginger
•Radish •High in salt
•Spinach •Low starchy
carbohydrate
foods