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Transcript of diabetes mellitus
increased glucose uptake by extra hepatic tissues (adipose tissue and skeletal musle)
when to suspect DM:
Etiology of type 1
what is diabetes mellitus?
metabolic disease characterized by:
insulin deficiency -resistance
hyper glycemia coma
هit is a hormon secreted by bita (B) cells of pencreatic islet of langerhans
help cell in using sugar to produce energy
glycogen storage in liver and muscles through glycogenesis
increased cellular uptake of amino acid and protein synthesis
increased lipogensis and inhibit f lipolysis in liver and adipose tissue
formation of keton bodies
Prof. Hosny Fouad (Ph.D)
individuals most suspectable to DM:
persons with family history
individuals with sedentary life
and finally >>>>>>>>>>>>>> is
Side Effects of DM
undue fatigue (general weakness)
increased hunger (polyphgia)
increased thrist (poly dipsia)
increased urination (poly uria)
dry mouth and loss of weight
slow healing of wounds
numbness in feet and loss of sensation
classification of DM according to who :
Occurs in Children & Adults <30 years.
Characterized by Absolute Insulin Deficiency.
Associated with Keto-acidosis.
Results from Destruction of - cells of Pancreatic Islets.
Can be Controlled by Insulin Replacement Therapy.
1) TYPE 1 DM
Occurs in Adults > 40 years; Usually Obese.
Results from Decreased insulin secretion.
Characterized by Insulin Resistance (I.R).
Hyperglycemic Hyperosmolar Coma (HHC).
Controlled by Oral Hypoglycemic Agents.
2) TYPE 2 DM
(insulin in dependent)
gestational diabetes (GD)
Diabetes that first presents during pregnancy
Occurs in 2-10% of pregnancies
30-60% chance of developing T2 DM
Gestational Diabetes (GD) is associated with:
Increased Neonatal and Maternal Mortality rate.
Decreased Glucose Tolerance.
Macrosomia (Big-sized Fetus).
Respiratory Distress Syndrome (RDS).
3) Gestational DM (GD)
. Hyperglycemia leads to the formation of Advanced Glycosylation Endproducts (AGEs) with various proteins in the body.
2. Glycation causes abnormalities in the walls of small blood vessels and thickening of the basement membrane.
3. Affected retinal vessels may lead to retinopathy & blindness.
4. Affected renal vessels leads to renal failure.
5. Affected nerve blood vessels may lead to impotence, and neuropathic foot ulcers & gangrene, which leads to amputation (foot cut).
Hyperglycemia & Microvascular
Complications of DM
1-Fasting blood glucose (FBG) FBG
>140 mg/dL (> 7. 8 mmol/L)
on two occasions is diagnostic for DM.
2-Hrs Postprandial: >
200mg/dL (>11.1 mmol/L) indicates DM
3-o-Glucose Tolerance Test (oGTT)
: a) FBG > 140 mg/dL (>7.8 mmol/L) b) BG > 200 mg/dL (>11.1 mmol/L) at any 2 times points of the curve.
Laboratory Monitoring & Diagnosis of DM
Most diabetic patients are taught how to monitor their own diabetic control.
Home urine testing is the simplest form of monitoring.
Self-assess blood glucose using blood glucose testing device (finger-prick sample).
1.The presence of glucose (glycosuria) in urine has a limited role in the screening or the diagnosis of diabetes.
2. Glycosuria can be detected by glucose strips
Insulin (Life saving).
Oral Hypoglycemic Agents:
1. Insulin Secretagogues: (Trigger β-cells)
a) Sulphonylureas (1st & 2nd Generations)
b) Non-sulphonylureas (Glinides)
2. Biguanides e.g. Metformin, …
3. -Glucosidase Inhibitors e.g. Acarbose,…
4. Insulin Sensitizers: Thiazolidinediones (e.g. Glitazones, Roziglitazone,...
Treatment of D.M.
How to give insulin
Thank you for your attention
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