DIABETES AND ITS PREVENTION

DIABETES

Diabetes Mellitus is a chronic condition due to deficient insulin production by the beta cells of the islet of Langerhans of the pancreas or the inability of the body cell receptors to respond to available insulin and is associated with raised blood sugar, glycosuria and multiple end-organ damage.

Diabetes Insipidus is a rare condition due to ADH deficiency or the inability of the kidneys to respond to the ADH

CLASSIFICATIONS / TYPES OF DIABETES

Diabetes is broadly classified into 2

Diabetes Mellitus (DM)

Diabetes Insipidus (DI)

Diabetes Mellitus(DM)= Due to insulin deficiency or non response of the body cells receptors to insulin= There are 4 Subtypes types

Type 1 DM= IDDM OR Juvenile DM. Occurs in 10% of cases

Type 2 DM= NIDDM OR Adult onset DM. Occurs in 80% of cases

Type 3 DM = Malnutrition related DM. Occurs in 5% of cases

Gestation DM= pregnancy induced DM. Occurs in the remaining 5% of cases

Diabetes Insipidus=2 Subtypes=

Central DI due to ADH ( vasopressin) deficiency due to pituitary gland damage

Nephrogenic DI = due to non response of the kidneys to ADH which could be genetic or acquired ( due to kidney diseases like polycystic kidney disease) and drugs ( like lithium)

CAUSES OF DIABETES

Type 1 DM= Genetic = Autoimmune damage of the beta cells of the islet of Langerhans of the pancreas (Triggers of the autoimmune damage are viruses (eg, enterovirus, mumps, rubella, and coxsackievirus ), toxic chemicals, exposure to cow’s milk in infancy especially before 3 months of age).

Type 2 DM =Genetic= Autoimmune damage of the insulin cell receptors. Acquired= excess fat intake, obesity, sedentary life style, excess refined sugar intake

Type 3 DM= Acquired= Malnutrition, Alcohol, Cigarette smoking and pancreatic infections that causes pancreatic fibrosis and pancreatic calcifications

CAUSES OF DIABETES MELLITUS

Gestational DM= Associated with pregnancy in pregnant women without a previous HX of DM and it resolves after birth. Heavy meat eaters, excess refine sugar intake, sedentary life style and obesity during pregnancy. usually manifest after 28wks of pregnancy

Majority of these people are asymptomatic and are only picked during routine investigation

For those who had gestational DM, it becomes recurrent during subsequent pregnancies

CAUSES OF DIABETES INSIPIDUS

Central DI= caused by damage to the pituitary glands

Nephrogenic Di= caused by kidney diseases like polycystic kidney disease and drugs like lithium

SIGNS AND SYMPTOMS OF DIABETES MELLITUS

POLYURIA

POLYDIPSIA

POLYPHAGIA

WEIGHT LOSS IRRESPECTIVE OF INCREASED APPETITE (IN TYPE 1 DM)

OBESITY (IN TYPE 2 DM)

HAIR LOSS

CATARACT

KETON BREATH

HEPATOMEGALY (DUE TO FATTY INFILTRATION OF THE LIVER)

MUSCLE WASTING

NUMBNESS

DIAGNOSIS OF DIABETES MELLITUS

FBS > 7.7MMOL/L (> 140mg/dl)

RBS . 11.1 MOL/L(> 200mg/dl

INVASION OF URINE RECENTLY VOIDED BY ANTS

SIGNS AND SYMPTOMS OF DIABETES INSIPIDUS

POLYURIA

POLYDIPSIA

NON INVASION OF URINE RECENTLY VOIDED BY ANTS

NORMAL FBS AND RBS

COMPLICATIONS OF DIABETES

ON THE CNS

DIABETIC ENCEPHALOPATHY

STROKE

ON THE PERIPHERAL NERVOUS SYSTEM

DIABETIC NEUROPATHY

ON THE EYES

DIABETIC RETINOPATHY

BLURRED VISION

BLINDNESS

ON THE CVS

CARDIAC  DISEASES

VASCULAR DISEASES LIKE CAD AND PAD

ON THE KIDNEYS

RENAL STENOSIS

DIABETIC NEPHROPATHY

RENAL FAILURE

ON THE SKIN

SKIN RASHES (DIABETIC DERMADROMES)

DIABETIC FOOT ULCERS IF NOT TAKEN GOOD CARE OF =>GANGRENOUS FOOT => LEG AMPUTATION

PREVENTION OF DIABETES

TYPE 1 DM WHICH HAS A GENETIC CAUSE IS UNPREVENTABLE

TYPE 2 DM CAUSED BY EXCESS FAT INTAKE, OBESITY, INCREASED REFINE SUGAR INTAKE, SEDENTARY LIFE STYLE

TYPE 3 DM CAUSED BY MALNUTRITION, CIGARETTE SMOKING AND ALCOHOL INTAKE

GESTATIONAL DM CAUSED BY EXCESS FAT INTAKE, ALCOHOL INTAKE, OBESITY, INCREASE REFINE SUGAR INTAKE DURING PREGNANCY

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