Diabetes Mellitus

Learning Objectives
At the end of this talk you should
understand:
What diabetes mellitus means
The difference between types-1 and -2 diabetes
How the different types are treated
The reasons for the current epidemic of
diabetes and how it can be prevented
What the complications of diabetes are and how
they can be prevented
 What is Diabetes?

Diabetes Mellitus (sugar diabetes) is a

disease characterized by high levels of
sugar (glucose) in the blood

Fasting glucose 126(mg/dl)

 Blood sugar and health
Sugar (glucose) is
an important source Insulin is produced
of energy by the pancreas when
blood sugar is high

What is eaten is
absorbed into Insulin keeps blood
the blood sugar level within
the normal range
for health
 Diabetes in a nutshell
Insufficient insulin to meet the bodys needs
Either a complete lack (type 1) or relative lack (type 2)
Results in raised blood glucose levels
Untreated diabetes results in short-term symptoms and
serious long-term complications
Treatment aims to keep blood glucose levels as close to the
normal range as safely possible
 Complications of Diabetes
Short term:
Symptoms of diabetes
Dehydration
Diabetic Coma
Infections
Long term:
Kidney
Eye
Heart
Circulation
Amputation
 Symptoms of Diabetes
People with diabetes often have typical complaints
(symptoms):
Thirst and frequent drinking
More frequent urination, particularly at night
Unexplained weight loss
Fatigue
Blurred vision
Frequent infections : skin, genital
 Differences between type-1 and
type-2 Diabetes Mellitus
Type 1 Type 2
Young age Middle aged, elderly
Normal BMI, not obese Usually overweight/obese
No immediate family Family history usual
history Symptoms may be present
Short duration of for months/years
symptoms (weeks) Do not present with
Can present with diabetic diabetic coma
coma (diabetic Insulin not necessarily
ketoacidosis) required
Insulin required Previous diabetes in
pregnancy
These differences are not absolute
 The Miracle of Insulin

Patient J.L., December 15, 1922 February 15, 1923

Treatment of Type-1 Diabetes
Mellitus:

Insulin must be administered

into the subcutaneous pocket
between fat & muscle & avoid
injection into fat or muscle.
Can be administered by
needle and syringe or by pen
device
 Treatment of Type-2 Diabetes

Diet/ Oral Oral Oral

Insulin
exercise monotherapy combination +/- insulin

Diet and exercise my control condition for some time

Variety of tablets available when diet exercise no longer work
Tablets can be used in combination with each other or with
insulin
Insulin can also be used alone
 Prevalence of Diabetes
Diabetes is very common
It is becoming more common
(particularly type-2)
Reason for increasing prevalence
of type-2 diabetes
The disease is reaching epidemic proportions
because:
Rates of overweight/obesity have increased
We have become a physically inactive species
Our diets are increasingly unhealthy
Overweight and obesity are diagnosed by
measuring weight and height (Body Mass
Index (BMI)):
Weight in Kg
BMI =
Height in metres2
Normal = 20-25
Overweight = 25-30
Obese = more than 30

Everyone should know their BMI!

 Can Diabetes be Prevented?

To be able to prevent a disease we need to be able to

indentify people at particular risk of developing it
Risk factors for type 2 diabetes
Certain people are more at risk of diabetes:
Those who are overweight/obese
People with a family history of diabetes
Women who had diabetes during pregnancy or
have had a baby weighing more than 9lbs
Physically inactive people
Certain ethnic groups (african, american indian,
asian)
People who have high blood pressure or high
cholesterol
Age more than 45 years
 Can Diabetes be Prevented?
Risk of Type 2 Diabetes can be reduced:
Losing weight
Taking regular exercise : walking for 30 mins per day
Eating healthier food:
Less fat (burgers, fries, crisps, sweet foods)
More fibre (fruit and vegetables, wholegrain
alternatives for rice, bread)
Cutting down on alcohol consumption

Ultimate aim is to reduce the longterm complications

How to prevent the complications
Factors other than blood sugar increase likelihood of
complications and should be managed
Complications can be delayed/prevented by:
Controlling blood sugars: sticking to diet/exercise
programme, taking medication as prescribed
Controlling blood pressure: diet, salt restriction,
medication
Controlling cholesterol levels: diet, statin tablets
Stopping smoking
Taking aspirin?