DIABETES MELLITUS

DIABETES MELLITUS

India is the capital of DIABETES MELLITUS due to change of life style and western diet.

Diabetes Mellitus refers to hyperglycemia(high blood sugar) include reduced insulin secretion, decreased glucose utilization, and increased glucose production.

Normal glucose level :

Fasting blood sugar=80-110 mg/dL

Impaired glucose tolerance (IGT), characterized by elevations in postprandial glucose(< 126 mg/dL).

Impaired  fasting glucose (IFG) , characterized by elevations in fasting glucose(110–125 mg/dL).

Gestational diabetes occurs during pregnancy

NORMAL PHYSIOLOGY

Glucose — a sugar — is a source of energy for the cells that make up muscles and other tissues.

Glucose comes from two major sources: food and your liver.

Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin.

The pancreas secretes insulin hormone into the bloodstream.

The insulin circulates, enabling glucose to enter your cells.

Insulin lowers the amount of sugar in your bloodstream.

Your liver stores and makes glucose.

When your glucose levels are low, such as when you haven’t eaten in a while, the liver breaks down stored glycogen into glucose to keep your glucose level within a normal range.

TYPE 1 DM

CAUSES

  • Commonly develops before 20 years of age
  • Genetic
  • Environmental toxins
  • Immunologic factors that ultimately lead to immune-mediated destruction of the pancreatic beta cells and insulin deficiency.
  • Autoantibodies against beta cell antigens appear after this triggering event, followed by progressive loss of insulin secretion.
  • Reduced exposure to microorganisms in early childhood limits maturation of the immune system and increases susceptibility to autoimmune disease (the ‘hygiene hypothesis’).
  • Environmental triggers include viruses (coxsackie, rubella, enteroviruses)
  • Bovine milk proteins- major constituent of cow’s milk, has been implicated, since children who are given cow’s milk early in infancy are more likely to develop type 1 diabetes than those who are breastfed
  • Nitrosourea compounds
  • Vitamin d deficiency
  • Stress may precipitate type 1 diabetes by stimulating the secretion of counter- regulatory hormones
  • Use of INSECTICIDE,PESTICIDE,RODENTICIDE,WEEDICIDE in agricultureOrganophosphorus  Poison(Op Poison)-Malathoin, Tetron, Parathion,Chlorthoin,Diazion(Tik 20)Organo Chlorines-Ddt,Aldrin,Endrin,Endosulfan,Benzene Hexa Chloride

    Paraquat(Weedol)

    Flourides(Sodium Flourides)

    Zinc Phosphide

    Aluminum Phosphide

TYPE 2 DM

Pathophysiology

Type 2 DM is characterized by impaired insulin secretion, insulin resistance, excessive hepatic glucose production, abnormal fat metabolism, and systemic low-grade inflammation.

Increased hepatic glucose output predominantly accounts for increased Fasting blood Glucose levels, whereas decreased peripheral glucose utilization results in postprandial hyperglycemia.

CAUSES of Type 2 DM

  • Obesity
  • Sedentary work
  • Lack of physical exercise
  • High calorie intake
  • High fat intake
  • Lack of fiber
  • High carbohydrate diet
  • Familial
  • Children of pregnancies complicated by gestational hyperglycemia also exhibit an increased risk of type 2 DM.
  • Polycystic ovary syndrome(PCOS)
  • High blood pressure
  • Low levels of high-density lipoprotein (HDL), or “good,” cholesterol
  • High triglycerides
  • Stress
  • Depression
  • Smoking
  • Alcohol
  • Pancreatitis
  • Cancer of pancreas

SYMPTOMS

  • Increased thirst
  • Frequent urination
  • Extreme hunger
  • Unexplained weight loss
  • Fatigue
  • Irritability
  • Blurred vision
  • Slow-healing sores
  • Frequent infections, such as gums or skin infections and vaginal infections
  • Mood change, irritability, difficulty in concentrating, apathy
  • Loss of libido
  • Impotence
  • UTI

COMPLICATIONS

Cardiovascular disease

  • Coronary artery disease with chest pain (angina),
  • Heart attack
  • Atherosclerosis

Kidney damage (nephropathy)

  • Renal failure
  • Glomerular disease

Peripheral arterial disease

  • Sensory loss
  • Pain
  • Motor weakness
  • Claudication
  • Ischaemia

Cerebrovascular disease

  • Transient ischaemic attack
  • Stroke

Cataracts

Glaucoma

Retinopathy

Periodontal disease

Hearing loss

Fatty liver disease

Diabetic ketoacidosis

Foot Ulceration

PREVENTION AND CONTROL

1.Get more physical activity

There are many benefits to regular physical activity. Exercise can help you:

  • Lose weight
  • Lower your blood sugar
  • Boost your sensitivity to insulin — which helps keep your blood sugar within a normal range
  1. Get plenty of fiber

Fiber may help you:

  •  Reduce your risk of diabetes by improving your blood sugar control
  • Lower your risk of heart disease
  • Promote weight loss by helping you feel full
  • Foods high in fiber include fruits, vegetables, beans, whole grains and nuts.
  • High intake of millet.

3.Don’t smoke

4.To prevent foot problems:

  • Wash your feet daily in lukewarm water.
  • Dry your feet gently, especially between the toes.
  • Moisturize your feet and ankles with lotion or petroleum jelly.
  • Check your feet daily for calluses, blisters, sores, redness or swelling.

5.Avoid sugar-sweetened beverages.

  • Avoid biscuit
  • Avoid chocholate
  • Avoid carbonated drinks
  • Avoid cake, confectionary
  • Artificial sweetener
  • Avoid sugar free tablet

6.QUIT Alcohol

7.Reduce your stress

8.Reduce your body weight if your obese

9.Avoid chemical pesticides, chemical fertilizer for farming

10.Avoid herbicides

11.Avoid weedicides

12.Avoid rodenticide

DIAGNOSIS

Blood CBC ,FBS,PPBS,HBA1C, Lipid Profile,Urea,Creatinine,

Urine sugar ,microalbumin,ketone bodies

Treatment

Homeopathy medicine

 

 

 

 

 

 

 

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