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Diabetes Mellitus šš°šÆ (Type1 (Symptoms (tiredness and listlessness,ā¦
Diabetes Mellitus
šš°šÆ
Type1
Risk factors
Environmental factors
particular infections
geographiclocation
the disease is more common between boys and men
Family history
family members having diabetes
seasonal and birth months
being born in spring
age
mainly children and adolescent
Causes
Cellular mediated destruction of B cells
Autoimmune disease
The rate of cell destruction
Slow mainly in: adults
Rapid in ; infants and children
Symptoms
tiredness and listlessness
Nausea
Extreme thirst
Dizziness
Frequent urination
At severe hyperglycemia : coma may occur
hyper tension
abnormal lipoprotien metabolism
weight losss
Without the Treatment
(complications)
Kidney damage
nerve damage
Retinopathy
the blood vessels become damaged
ketoacidosis
unconsciousness
coma and death
mental confusion
cerebral edema
Treatment (to prevent the complications)
exercise and healthy diet
Taking insulin
Monitor blood sugar levels
Other Forms
idiopathic type 1 or type 1B diabetes
not associated with autoantibodies
insulin is required for survival
less common
70%-90% with type 1D have T1A the rest with T1B
Prevention
Secondary
aims to stop the progress ion to type1 diabetes in autoantibody- positive subjects
Primary
in genetically predisposed individuals
is initiated before diabetes associated auto anti-bodies occur
prevalence
most common in
finland
sardinia
uncommon in
china
india
venezuela
Diagnosis
random plasma glucose more than200mg\dl
HbA1c more than 5.6%
fasting plasma glucose more than 126 mg\dL
Type 2
Causes
Insulin resistance
Genes
overweight
Bad communication between cells
Insulin deficiency due to autoimmune destruction of beta cells
symptoms
thirst
polyuria
tirdness
wounds that do not heal
tingling and numbness in hands and feet
frequent infections
complications
Hearing impairment
sleep apnea
Alzheimer's disease
prevalence
Europeans
Caribbeans
Pakistanis
West Africans
Risk factors
Factors can be controlled
Age 45 or older
Family member with diabetes ( a parent or a sibling )
Ethnicity (African Americans are more likely to get diabetes)
Factors can't be controlled
Pre diabetic
With cardiovascular disease
With high blood pressure
Polycystic ovary syndrome
Treatment
If diabetic ketoacidosis
Insulin with healthy diet and more exercise
If not ketoacidosis
Metformin
If asymptomatic (without ketoacidosis )
Healthy diet and exercise
Hypertension &Microalbuminuria
By ACE inhibitors
Diagnosis
Fasting glucose (more than 7 mmol/L)
Random glucose level (more than 11.1 mmol/L)
HbA1c (more than 6.5%)
Notes
It used to be adult DM but now children get it due to obesity especially girls 2:1 ratio .
In a 24-years study conducted on 7461 patients with new onset type 2 diabetes in Sweden,it was found that patients with diabetes have excess mortality 47% compared to matched population controls .However,this percentage decreased by 2% per increasing calendar year of diagnosis .A possible explanation is early detection of diabetes.
Gestational diabetes
Causes
During pregnancy the placenta produces hormones that lead to abulid up of glucose in your blood
the mother's beta cells can't produce enough insulin to overcome that increased blood sugar level
Complications
Risk for type 2 diabetes
Problems to the baby
Increased fetal size
hypoglycemia in the baby
complicated delivery
Symptoms
Hyperglycemia
Sleep disorder breathing
Overweight
Thirsty
Feeling more eating
High blood sugar
Risk factos
Age greater than 25
Excess weight
genetic factors
Prevalence
Native Americans, Asians, Hispanics, and African-American women are at higher risk for GDM than non-Hispanic white women
GDM prevalence was also higher in Aboriginal women than in non-Aboriginal women
A high prevalence of GDM is among the Asian population
Diagnosis
after a 75 g oral glucose tolerance test (OGTT
Fasting test(ā„ 92, 180 and 153 mg/dl, one-hour and two-hour plasma glucose concentration respectively)
Note
GDM can disappear within hours of giving birth depending on individual factors
Treatment
Eat healthy diet
Make exercise
Examine how much weight you gain
Take insulin if necessary