1. Diabetes mellitus “ Basic approach” Dr Sajith.V.S MBBS,MD (Gen Med )

2. Diabetes Diabetes affect nearly every organ system in the body. affect nearly every organ system in the body. It has been projected that 300 million individuals would be affected with diabetes by the year 2025. It has been projected that 300 million individuals would be affected with diabetes by the year 2025. In India it is estimated that presently 19.4 million individuals are affected by this deadly disease, which is likely to go up to 57.2 million by the year 2025. In India it is estimated that presently 19.4 million individuals are affected by this deadly disease, which is likely to go up to 57.2 million by the year 2025.

3. reasons changes in lifestyle, changes in lifestyle, people living longer than before (ageing) people living longer than before (ageing) low birth weight could lead to diabetes during adulthood. low birth weight could lead to diabetes during adulthood.

4. Sugar

5. Provides energy to all cells in the body Provides energy to all cells in the body Brain depends glucose as fuel Brain depends glucose as fuel

6. Insulin Insulin

8. Diabetes related complications are Diabetes related complications are coronary artery disease, coronary artery disease, peripheral vascular disease, peripheral vascular disease, neuropathy, neuropathy, retinopathy, retinopathy, nephropathy, nephropathy, People with diabetes are People with diabetes are 25 times more likely to develop blindness, 25 times more likely to develop blindness, 17 times more likely to develop kidney disease, 17 times more likely to develop kidney disease, 30-40 times more likely to undergo amputation, 30-40 times more likely to undergo amputation, two to four times more likely to develop myocardial infarction and twice as likely to suffer a stroke than non-diabetics. two to four times more likely to develop myocardial infarction and twice as likely to suffer a stroke than non-diabetics.

10. Types of diabetes Type 1 Type 1 ( 5-10% ( 5-10% of all diabetes mellitus cases) X X

11. Type 2 ( Type 2 (90% to 95% of all diabetes mellitus cases ) X ↓ ↓ ↓

12. Gestational diabetes Gestational diabetes Other causes Other causes

14. Risk Factors for Prediabetes and Diabetes Mellitus Family history of diabetes Cardiovascular disease Overweight or obese state Sedentary lifestyle impaired glucose tolerance or impaired fasting glucose Hypertension Increased levels of triglycerides, low concentrations of high- density lipoprotein cholesterol, or both History of gestational diabetes History of delivery of an infant with a birth weight >9 pounds Polycystic ovary syndrome Psychiatric illness

15. Criteria for the diagnosis of diabetes mellitus Symptoms of diabetes polyuria, polydipsia, and unexplained weight loss + casual plasma glucose concentration >200 mg/dl. OR FPG >126 mg/dl. OR 2-hour postload glucose >200 mg/dl during an OGTT (75 g anhydrous glucose dissolved in water).

16. “pre-diabetes” FPG 100 mg/dl =normal ● FPG 100–125 mg/dl =IFG (impaired fasting glucose high risk for development of diabetes in these patient

17. PREVENTION OF TYPE 2 DIABETES MELLITUS Perform screening with either the 2-hour oral glucose tolerance test or fasting plasma glucose test to establish a diagnosis of diabetes mellitus or to identify prediabetes mellitus Initiate interventions that include lifestyle modifications Weight reduction goal: 5% to10% of total body weight Nutrition goals: reduce fat intake to less than 30% of total energy intake; reduce saturated fat intake to less than 10% of total energy intake; and increase fiber intake to 15 g/1000 kcal or more Prescribe regular physical activity (approximately 150 minutes per week) Treat hypertension and dyslipidemia aggressively;

28. Basic foods