Diabetes Mellitus

OUTLINE
• Overview of Diabetes

• How the body controls sugar levels

• Types of Diabetes

• Risk factors

• Signs and Symptoms

• Complications

• Investigation

• Management

• Prevention

• Myths
 Overview of Diabetes
• Diabetes is a chronic (long-lasting) disease characterized by elevated blood sugar (glucose)
levels

• It is referred to as medically as Diabetes Mellitus as there is another form of diabetes that is

not due to elevated blood sugar levels

• It occurs when the mechanism to control blood sugar is destroyed

• Blood sugar is the main energy source of the body and are not gotten only from sugary foods
but most foods eaten are eventually convereted into glucose eg Fruits, carbohydrates

• The prevalence is rising more rapidly in low and middle income countries in comparison to
high income countries.
 Overview of Diabetes

• Nigeria as at 2020 was reported to have the highest incidence of diabetes in sub-saharan
Africa

• It is the sixth leading cause of death in low and middle income countries

• Diabetes is the number one cause of kidney failure, lower-limb amputations, and adult
blindness.
 How The Body Controls Sugar Levels
• The body breaks down most food eaten into sugar (glucose) and it is released into the blood stream

• This blood sugar is controlled by an hormone called insulin released by the pancreas which is an organ
of the body located in the abdomen.

• When there is high blood glucose, the pancrease secretes insulin which is referred as the key that
allows the body cells to take up the glucose

• Recall the sugar in the blood are needed to produce energy and it has to be taken up the by the cells
for it to be used to produce energy, so insulin serves as the key that opens up the cell “doors” so
glucose can leave blood stream into the body cells

• When bloos sugar becomes normal, insulin production stops until when next food is eaten and glucose
is high

• If blood sugar is noted to be low the pancrease releases a hormone called glucagon which actiavtes the
liver mainly to produce glucose into the blood
Types of Diabetes Mellitus
Types of Diabetes Mellitus
• There are 3 main types of diabetes mellitus and some sub classification

• Type 1: It is also called insulin dependent diabetes, it is said to be due to an autoimmune reactio (The body attacks itself
mistakenly) the bodies antibodies mistakenly destroy the cells to produce insulin. It is often diagnosed in childre, teenagers
and young adults

• Type 2: In this type, the pancrease produces insulin but the body does not respond to the signals by insulin (Insulin
resistance). It is the most predominant form of diabetes seen in 90-95% of people with diabetes. It is insidious and takes
may years to develop and may not have symptoms

• Gestational DM: This is diabetes that is seen in pregnant women who never had diabetes. It icreases risk of complications
in pregnancy and in developing type 2 diabetes later in life. It usually resolves after pregnancy in most cases

• Prediabetes: This type is the stage before Type 2 diabetes. Your blood glucose levels are higher than normal but not high
enough to be officially diagnosed with Type 2 diabetes.
Risk Factors
• Age: from 45 years and above

• Race: commoner amongst Blacks, Hispanics, Latinos, Asian-american

• Family history

• Obesity/overweight

• Sedentary lifestyle

• High cholesterol

• Smoking

• History of Gestational diabetes mellitus or prediabetes

• History of Polycystic ovarian syndrome (PCOS)

Signs and Symptoms

• Increased Thirst

• Increased appetite

• Frequent urination

• Unintentional weight loss

• Slow healing of wounds

• Dry skin
 Signs and Symptoms
• Fatigue

• Frequent unexplained infection

• Blurry vision

• Numb or tingling fingers or feet

• In women: there is frequent Urinary tract infections

• In men: erectlie dysfuction, decreased sexual libido

 Complications

• Hypogylcemia: The commonest complication

• Blindness (Destorys the retina, called retinopathy)

• Nerve damage (Neuropathy)

• Chronic kidney disease

• Chronic ulcers especially foot ulcers

• Cardiovascular disorders; Heart attack, stroke, high blood

pressure, peripheral arterial disease

• Dental problems like loss of teeth, holes in teeth

 Complications

• Complications of Gestational diabetes mellitus

1. They are born as overweight

2. Low blood sugar levels at birth

3. Increased risk of developing type 2 diabetes at adulthood

Investigation
• To diagnose diabetes; blood is usually tested and there are several tests that can
be done one the blood

• Fasting Blood Sugar: This is the most reliable test done to diagnose diabetes, it is
done after 8-16hours of fasting and not more, samples are required to be taken
very early in the morning

• Random Blood sugar: Unlike fasting this can be done at any time of the day

• Haemogblobin A1C test: (HBA1C) This test is done to have an idea of what a
persons blood sugar has been over the past 2-3 months, It measures the
percentage of blood sugar attached to haemoglobin, the oxygen-carrying protein
in red blood cells. It does not require fasting
Investigation

• Oral glucose tolerance test (OGTT): This involves checking

blood sample after an overnight fast, then the individual is
given a glucose drink, after which blood glucose levels are
checked at one, two and three hours. It is mainly used to
diagnose gestational diabetes now, however, can still be
requested for non pregnant people
Management
• It is important to know that diabetes cant be cured but can be very well managed

• Lifestyle Modification: this is the first line management for diabetes, it involves healthy eating and physical activity

1. Healthy eating: There are no specific diabetic diets, focus is to inclde more fruits, vegetables, lean proteins and
reduce fats

2. Physical activity: regular aerobic exercise for 30 minutes daily, this helps to reduce blood sugar levels and increase
body sensitivity to insulin

• Medications:

1. Insulin: This is the main treatment for people with type 1 DM and sometimes those with Type 2. it is inform of
injectables

2. Oral hypoglycemic drugs: There are different classes of these drugs and the physician managing will determine
which fits the patient
Prevention
• Type 1 Diabetes can not be prevented as it is mostly genetic, the healthy lifestyle steps taken to treat diabetes can
also be used to prevent it

• Healthy food choices

• Physical activity: aim for 30 minutes for at least 5 times a week

• Achieve healthy weight

• Stress management

• Limit alcohol intake

• Quit smoking

• Get adequate sleep

Myths
• Diabetes is Caused by Eating Too Much Sweet Food: This is not true, although too much sugary foods can
lead to obesity which then increases the risk but taking sugary foods do not directly cause diabetes

• Type 2 Diabetes can only happen to people who are overweight/obese: although being overweight/obese
increases risk of diabetes it is not an absolute risk factor, there are several factors such as physical inactivity,
genetics that contributes to developing diabetes. Around 20% of people with type 2 diabetes are of a normal
weight, or underweight

• People with diabetes are only to eat special diabetic foods and avoid carbohydrates: There are no special
foods for people with diabetes, all that matters is healthy meal with balance that includes specific portion of
carbohydrates, proteins and fat. This helps to control blood sugar levels and hunger

• Diabetes can be cured: There is no cure for diabetes, however, it can e properly managed to delay or prevent
complications from arising
THANK YOU FOR LISTENING

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