Diabetes a brief overview for Diabetic patient

1. Diabetes : A brief Overview for
Diabetic patient
Dr J Rangwala
drjoozer@gmail.com

2. What happens when we eat?
After eating most of the food (carbohydrates) is
turned into glucose.
Glucose is the main energy source of the body.

3. Normal Blood Glucose control:
Non Diabetics
In Non diabetics blood glucose stay in healthy
range :
Because:
Insulin is released at right times and in right amount
from Pancreas
Insulin helps glucose to enter cells.
Glucose entered in the cells is consumed as energy
source.
Thus there is lowering of blood sugars in the desired
healthy range after meals.

4. Hyperglycemia: Diabetics
In diabetics blood glucose level builds up leading
to hyperglycemia due to several possible causes:
Reasons are:
Too little insulin is made my pancreas
Cells are not able to use insulin well
Liver releases too much of glucose, due to lack / no
insulin

5. Symptoms of Hyperglycemia:
Increase urination
Increase thirst
Increase crave to eat
Feeling tired
Weight loss
Blurry vision
More prone to infections
Slow healing of cuts or wounds
Nausea and vomitting etc

6. What if persistent Hyperglycemia?
Hyperglycemia can cause serious long term
problems: chronic complications of Diabetes:
Blindness
Kidney disease
Nerve damage
Heart problems
Stroke
Foot problems
Amputations

7. Types of DM: Two main type:
Type 1 DM:
Pancreas makes too little or no insulin
Type 2 DM:
Cells do not use insulin well ( Insulin Resistance)
Ability for pancreas to make insulin decreases over
period of time.

8. Type 1 DM
1 in 20 Diabetics have Type 1 DM
Most are under 20 years of age when diagnosed
Body can no longer make insulin (absolute insulin
deficiency)
Exogenous Insulin is always required for
treatment.
No Oral antidiabetic medications do not work and
are of NO use.

9. Symptoms of Type 1 DM:
Sudden onset of symptoms
Weight loss
Loss of energy...fatiguness
Increased thirst
Frequent urination
Increase desire to eat
DKA (Diabetic ketoacidosis) : emergency
condition with nausea, vomiting, dehydration, may
lead to coma, and may be fatal if unattended.

10. How to manage Type 1 DM?
Blood glucose monitoring
Education of patient and family
Healthy food choices and Medical Nutirition
therapy
Adequate permissible physical activity
INSULIN to be given as per required dosage and
frequency.

11. Type 2 DM:
90 % of people have Type 2 DM
Most are over 40 years of age, but recently it
becoming common in teens, youg adults and
children too..!
More likely in people who are:
Are over weight
Are Non Caucasians
Have family history of DM
Have history of higher birth weight

12. Symptoms of Type 2 DM:
Usually No symptoms or subtle symptoms in
early stage.
Symptoms are same as for Type 1 DM but
gradual in onset
Gradual onset : So symptoms may be mistaken
for other problems
1 in 4 with Type 2 DM are undiagnosed and are
unaware.

13. How to manage Type 2 DM?
Always stress on :
Healthy eating
Blood glucose monitoring
Adequate permissible physical activity
Education of patient and family
Medications may change as per bllod sugar
controls:
Oral agents with or without
Insulin

14. Risk factor for Type 2 DM:
Overweight, Obesity
Sedentary lifestyle
Family history of diabetes
History of gestational diabetes
Age
Ethenicity:
African american
Hispanic / latino
Native americans
Asian american
High birth weight child

15. What is Prediabetes?
1 in 4 adult person has Prediabetes
Occurs before Type2 DM
Blood glucose levels are higher than normal but
not yet in diabetic range.
Most of prediabetics are unaware
Early detection and Life style changes is to be
recommended to delay conversion to Type 2 DM
Are at high CV risk

16. What prediabetics and high risk
people should do?
To reduce chances of converting to Type 2 DM
Weight loss
Exercise
Medication : Metformin, AGI

17. How to prevent diabetic
complication?
To reduce chances of developing diabetes
complications through:
Blood glucose control:
Diet
Blood glucose monitoring
Exercise
Medications
Blood pressure control
Lipids control
Regular visit to Health care providers
Early detection and treatment of complications of
diabetes

18. Steps to lower risk of diabetes
complication:
Control HbA1c : 7 %
Blood pressure: <140/80 mm of hg
Lipids level:
LDL: 70 – 100 mg/dL
Non HDL : 100 – 130 mg/dL
HDL : above 40 – 50 mg/dL
TG: less than 150 mg/dL
Quit smoking
Be active and agile
Make healthy food choices
Take proper care of feet
Do recommended screenings and early treatment