1. Diabetes Mellitus … Commonly known “phenomenon” of production of sugary urine “ Diabetes” means “to run through” “ Diabetes” means “to run through” “Mellitus” means “sweet or with a taste of honey” “Mellitus” means “sweet or with a taste of honey” Characterized by Characterized by High blood sugar High blood sugar a tendency to develop acute/chronic complications a tendency to develop acute/chronic complications

4. Diagnosis of Diabetes Fasting blood sugar >125 mg/dl, Fasting blood sugar >125 mg/dl, Random blood sugar >199 mg/dl, Random blood sugar >199 mg/dl, Glucose tolerance test (GTT). Glucose tolerance test (GTT). Urine sugar is not for DIAGNOSIS

5. Type I

7. F Leading cause of blindness, 25 times more prone to retinopathy, F 6 times higher risk for stroke, F 6 times higher risk for heart attack F 6 times higher risk for heart attack, F 20 times more prone to lower limb amputation, F 5 times more prone to renal disease. T 2 DM: A Serious Disease

8. 1995 India19.4 China16.0 U.S. 13.9 Russian Fed.8.9 Japan6.3 Brazil4.9 Indonesia4.5 Pakistan4.3 Mexico3.8 Ukraine3.6 All others49.7 Total135.3 1995 India19.4 China16.0 U.S. 13.9 Russian Fed.8.9 Japan6.3 Brazil4.9 Indonesia4.5 Pakistan4.3 Mexico3.8 Ukraine3.6 All others49.7 Total135.3 2025 India57.2 China37.6 U.S.21.9 Pakistan14.5 Indonesia12.4 Russian Fed.12.2 Mexico11.7 Brazil11.6 Egypt8.8 Japan8.5 All others103.6 Total300.0 2025 India57.2 China37.6 U.S.21.9 Pakistan14.5 Indonesia12.4 Russian Fed.12.2 Mexico11.7 Brazil11.6 Egypt8.8 Japan8.5 All others103.6 Total300.0 King H, Diabetes Care, 1998. Top 10 List: Worldwide Epidemic of Diabetes: (Millions of Adults)

9. Why to diagnose early? Diabetes is a progressive disease, it worsens with time, Diabetes is a progressive disease, it worsens with time, Early treatment is rewarding, Early treatment is rewarding, Once complications set in, they are not reversible. Once complications set in, they are not reversible.

10. Step care approach of type 2 DM Insulin ± oral agents Oral combination Oral monotherapy Diet & exercise

11. MANAGING DIABETES : 4 Cardinal Rules for the Patient 1. Follow a healthy meal plan 2. Regular exercise 3. Take your medication 4. Test your blood glucose regularly

12. The ABC of Diabetes Management Effective management of diabetes requires Effective management of diabetes requires A – Control of A1c A – Control of A1c B – Control of Blood pressure B – Control of Blood pressure C – Control of Cholesterol C – Control of Cholesterol Education and Life-style changes like Healthy eating, regular exercise, drinking In moderation and stopping smoking.