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DIABETES MELLITUS

Type 1: Caused due to autoimmune (self) destruction of the beta cells in the pancreas. Beta cells of pancreas produce insulin which decreases blood glucose level. Absence of beta cells or destruction of pancreas results in increase in blood glucose level. Common in age group 30-40

Type 2: Consist of spectrum of destructions characterized by hyperglycemia (increased blood glucose level) resulting from combination of resistance to insulin action, decreased insulin secretion and excessive or inappropriate glucagon (hormone that increases glucose) secretion. 

Symptoms

  • Increased urination (polyuria), excessive thirst (polydipsia), excessive eating (polyphagia) and weight loss.
  • Blurred Vision
  • Decreased sensation of lower extremities
  • Tiredness, fatigue, lethargy

 

Diagnosis

  1. A fasting blood glucose level of 126mg/dl or higher, or
  2. A 2-hr blood glucose level of 200mg/dl or higher, or
  3. A random blood glucose level of 200mg/dl or higher in patients with classical symptoms of hyperglycemia

Preventions

  1. HbA1c level every 3-6 months.
  2. Regular use of medications oral or subcutaneous insulin (to control blood glucose level).
  3. Proper diet and regular exercise.
  4. Yearly Eye checkup for diabetic retinopathy.
  5. Foot examination for prevention of diabetic foot (ulcer).
  6. Blood pressure <103/80 mmHg, even lower in Diabetic Nephropathy.
  7. Use of lipid lowering drugs.

 

 

Risk Factors

  • Family history of diabetes.
  • Overweight.
  • Unhealthy diet.
  • Physical inactivity.
  • Increasing age.
  • High blood pressure.

 

Treatment

To prevent target organ damage

  1. Eye and Kidney disease (Micro vascular)  risk reduction through the control of blood glucose level and blood pressure
  2. Macro vascular (vessels of Heart, brain and peripheral vessels) risk reduction through control of lipids (fat) and high blood pressure (hypertension), smoking cessation.
  3.  Neurological and Metabolic risk reduction via control of glycemia (blood glucose).