Dreamline Express/Greater Noida
Diabetes mellitus, or simply diabetes, is a group of metabolic deseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyria (frequent unination), Polydipsia (increased thirst) and polyphagia (increased hunger).There are three main types of deabetes mellitus (DM).
.Type 1 DM result from the body;s failure to produce insulin and currently requires the person to inject insulin or wear an insulin pump. This form was previously referred to as: insulin-independent diabetes mellitus” (IDDM) or “juvenile diabetes:”
.Type 2 DM result from insulin resistance, a condition in which cell fails to use insulin properly, sometimes combined with an absolute insulin deficiency. This form was previously refferred tp as non insulin-dependent diabetes melltius (IDDM) or “adult-onset diabetes”.
.The third main form, gestational diabetes occurs when pregenant women without a previous diagnosis of diabetes develop a high blood glucose level.It may precede development of type 2 DM.
Other form of deabetes mellitus include congenital diabetes, which is due to genetic defects insulin secretion, cystic fibrosis-related diabetes, Steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes.
Untreated, deabetes can cause many camplications. Acute Complications include diabetic ketoacidosis, and nonketotic hyperosmolar coma. Serious long-term camplications include cardiovascular disease chronic renal failure and diabetic retinopathy (retinal damage). Adequate treatment of diabetes is thus important, as well as blood pressure control and lifestyle factors such as stopping smoking and maintaining a healthy body weight.
Gestational diabetes mellitus (GDM) resemb les type 2 diabetes in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness. It occurs in about 2-5 % of all pregnancies and may improave or disappear after delivery. Gestational diabetes is fully treatable, but requires careful medical supervision throuhout the pregenecy. About 20-50 % of affected women develop type 2 diabetes later in life.
Though it my be transient, untreated gestational diabetes can damage the health of the fetus or mother. Risk to the baby include macrosomia (high birth weight). Cogenital cardiac and central nervous system anomalies, and skeletal muscle malformations. Increased fetal insulin may inhibit fetal surfactant production and cause repiratory destress syndrome.
Hyperbilirubinmia may result form red blood cell destruction. In severe cases, prenatal death may occur, most commonly as a result of poor placental perfusion due to vascular impairment. Labour induction may be indicated with decreased placement function. Of injury associated with macrodome, such as shoulder dystocia.
Signs and Symptoms
The classic symptoms of untreated diabetes are loss of weight, polyuria ( frequant urination) , Polydipsia (increase thirst ) and polyphagia (increased hunger) . Symptoms may develop rapidly (weeks or months) slowly and may be subtle or absent.
Progolonged high blood glucose can cause glucose absorption in the lens of the eye, which leads to changes in its shape, result in vision changes. Blurred vision is a comman complaint leading to a diabetes diagnosis. A number of skin rashes that can occure in diabetes are collectively known as diabetic dermatomes.
Complications
Complications of diabetes mellitus
All form of diabetes increase the risk of long-term complication.These typically develop after many years (10-20). But may be the first symptom in those who have otherwise not received a diagnosis before that time. The major long-term complications relate to damage blood vessels.Diabetes doubles the risk of cardiovascular disease. The main “macrovascular” disease (related to atherosclerosis of large arteries) are ischemic heart disease (angina and myocardial infarction), stroke and perpheral vascular disease.
Diabetes also damages the capillaries ( causes microangiopathy). Diabetic retionapathy, which affects blood vessel information in the retina of the eye., can lead to visual symptoms including reduced vision and potentially blindness. Diabetic nephropathy, the impact of diabetes on the kidneys can lead to scarring changes in the kidney tissue, loss of small or progressively large amount of protien in the urine, and eventually chronic kidney disesase requiring dialysis.
Another risk is diabetic neuropathy, the impact of diabetes on the nervous system-most commonly causing numbness, tingling and pain in the feet, and also increasing the risk of skin damage due to altered sensation. Together with vascular disease in the legs neuropathy contributes to the risk of diabetes-related foot problems (Such as diabetic ulcers) that can be difficult to treat and occasionally require amputation. As well, proximal diabetic neuropathy causes painful muscle wasting and weakness.
Management
Diabetes mellitus is a chronis disease, for which there is no know cure execpt in very specific situtations. Management concentrates on keeping blood sugar levels as close to normat(“euglycemia”) as possible, without causing hypoglycemia. This can usually be accomplished with diet exercise, and use of appropriate medication as well as insulin.
Patient education understanding and participation is vital since the complications of diabetes are far less common and less severe in people who have well-managed blood sugar levels.That and May set higher Attention is also paid to other health problems that may accelerate the deleterious effect of diabetes. These include smoking, elevated cholesterol levels, obesity, high blood pressure, and lack of regular exercise. Specialized footwear is widely used to reduce the risk of ulceration, or re-ulceration, in at-risk diabetic feet. Evidence for the efficacy of this remains equivocal,however.
Lifestyle
There are roles for education, dietetic, and sensible exercise, with the goal of keeping both short-term and long-term blood glucose levels within acceptable bounds. In addition, given the associated higher risks of cardiovascular disease, lifestyle modifications are recommended to control blood pressure.
Medications
Metformin is generally recommended as a first line treatment as there is good evidence that it decreases mortality. Diabetes is typically treated with combinations of regular and NPH insulin, or synthtic insulin analogs. When insulin is used in type 2 diabetes, a long-acting formulation is usually added intially, when continuing oral medications. Doses of insulin are then increased to effect.
Support
In countries using a general practitioner system, such as the United Kingdom, care may take place mainly outside hospitals, with hospital-based specialist care used only in case of complications difficult blood sugar control, or research projects. In other cercumstances, general practitioners and specialists share care of in a team approach.
Roshan hospital
Dr. B.N. SACHAN
Diabetes mellitus, or simply diabetes, is a group of metabolic deseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyria (frequent unination), Polydipsia (increased thirst) and polyphagia (increased hunger).There are three main types of deabetes mellitus (DM).
.Type 1 DM result from the body;s failure to produce insulin and currently requires the person to inject insulin or wear an insulin pump. This form was previously referred to as: insulin-independent diabetes mellitus” (IDDM) or “juvenile diabetes:”
.Type 2 DM result from insulin resistance, a condition in which cell fails to use insulin properly, sometimes combined with an absolute insulin deficiency. This form was previously refferred tp as non insulin-dependent diabetes melltius (IDDM) or “adult-onset diabetes”.
.The third main form, gestational diabetes occurs when pregenant women without a previous diagnosis of diabetes develop a high blood glucose level.It may precede development of type 2 DM.
Other form of deabetes mellitus include congenital diabetes, which is due to genetic defects insulin secretion, cystic fibrosis-related diabetes, Steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes.
Untreated, deabetes can cause many camplications. Acute Complications include diabetic ketoacidosis, and nonketotic hyperosmolar coma. Serious long-term camplications include cardiovascular disease chronic renal failure and diabetic retinopathy (retinal damage). Adequate treatment of diabetes is thus important, as well as blood pressure control and lifestyle factors such as stopping smoking and maintaining a healthy body weight.
Gestational diabetes mellitus (GDM) resemb les type 2 diabetes in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness. It occurs in about 2-5 % of all pregnancies and may improave or disappear after delivery. Gestational diabetes is fully treatable, but requires careful medical supervision throuhout the pregenecy. About 20-50 % of affected women develop type 2 diabetes later in life.
Though it my be transient, untreated gestational diabetes can damage the health of the fetus or mother. Risk to the baby include macrosomia (high birth weight). Cogenital cardiac and central nervous system anomalies, and skeletal muscle malformations. Increased fetal insulin may inhibit fetal surfactant production and cause repiratory destress syndrome.
Hyperbilirubinmia may result form red blood cell destruction. In severe cases, prenatal death may occur, most commonly as a result of poor placental perfusion due to vascular impairment. Labour induction may be indicated with decreased placement function. Of injury associated with macrodome, such as shoulder dystocia.
Signs and Symptoms
The classic symptoms of untreated diabetes are loss of weight, polyuria ( frequant urination) , Polydipsia (increase thirst ) and polyphagia (increased hunger) . Symptoms may develop rapidly (weeks or months) slowly and may be subtle or absent.
Progolonged high blood glucose can cause glucose absorption in the lens of the eye, which leads to changes in its shape, result in vision changes. Blurred vision is a comman complaint leading to a diabetes diagnosis. A number of skin rashes that can occure in diabetes are collectively known as diabetic dermatomes.
Complications
Complications of diabetes mellitus
All form of diabetes increase the risk of long-term complication.These typically develop after many years (10-20). But may be the first symptom in those who have otherwise not received a diagnosis before that time. The major long-term complications relate to damage blood vessels.Diabetes doubles the risk of cardiovascular disease. The main “macrovascular” disease (related to atherosclerosis of large arteries) are ischemic heart disease (angina and myocardial infarction), stroke and perpheral vascular disease.
Diabetes also damages the capillaries ( causes microangiopathy). Diabetic retionapathy, which affects blood vessel information in the retina of the eye., can lead to visual symptoms including reduced vision and potentially blindness. Diabetic nephropathy, the impact of diabetes on the kidneys can lead to scarring changes in the kidney tissue, loss of small or progressively large amount of protien in the urine, and eventually chronic kidney disesase requiring dialysis.
Another risk is diabetic neuropathy, the impact of diabetes on the nervous system-most commonly causing numbness, tingling and pain in the feet, and also increasing the risk of skin damage due to altered sensation. Together with vascular disease in the legs neuropathy contributes to the risk of diabetes-related foot problems (Such as diabetic ulcers) that can be difficult to treat and occasionally require amputation. As well, proximal diabetic neuropathy causes painful muscle wasting and weakness.
Management
Diabetes mellitus is a chronis disease, for which there is no know cure execpt in very specific situtations. Management concentrates on keeping blood sugar levels as close to normat(“euglycemia”) as possible, without causing hypoglycemia. This can usually be accomplished with diet exercise, and use of appropriate medication as well as insulin.
Patient education understanding and participation is vital since the complications of diabetes are far less common and less severe in people who have well-managed blood sugar levels.That and May set higher Attention is also paid to other health problems that may accelerate the deleterious effect of diabetes. These include smoking, elevated cholesterol levels, obesity, high blood pressure, and lack of regular exercise. Specialized footwear is widely used to reduce the risk of ulceration, or re-ulceration, in at-risk diabetic feet. Evidence for the efficacy of this remains equivocal,however.
Lifestyle
There are roles for education, dietetic, and sensible exercise, with the goal of keeping both short-term and long-term blood glucose levels within acceptable bounds. In addition, given the associated higher risks of cardiovascular disease, lifestyle modifications are recommended to control blood pressure.
Medications
Metformin is generally recommended as a first line treatment as there is good evidence that it decreases mortality. Diabetes is typically treated with combinations of regular and NPH insulin, or synthtic insulin analogs. When insulin is used in type 2 diabetes, a long-acting formulation is usually added intially, when continuing oral medications. Doses of insulin are then increased to effect.
Support
In countries using a general practitioner system, such as the United Kingdom, care may take place mainly outside hospitals, with hospital-based specialist care used only in case of complications difficult blood sugar control, or research projects. In other cercumstances, general practitioners and specialists share care of in a team approach.
Roshan hospital
Dr. B.N. SACHAN
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