Question

Essay Define and describe diabetes in regards to signs, symptoms, and testing to diagnose diabetes. Differentiate between the two different types of diabetes.

Answer 1

# Diabetes mellitus is a group of metabolic disorders characterized by elevated levels of blood glucose resulting from defects in insulin secretion, insulin action or both. It is of two different types :-

- Type I

- Type II

1. Type I = is called insulin dependent diabetes mellitus .

5% to 10% of patients have type 1 diabetes mellitus . It is characterized by destruction of the pancreatic beta -cells due to genetic ,immunologic , environmental factors .

Insulin injections are the main core of treatment needed to control the blood glucose levels.

2. Type II = is called Non insulin dependent diabetes mellitus

About 90% to 95% of patients type 2 diabetes mellitus . It results from a decreased sensitivity to insulin or due to decreased amount of insulin production . It occurs in people who are above 30years and in patients with obesity.

It is first treated with diet and exercise and then oral hypoglycemic agents as needed.

# Clinical manifestations :-

- polyuria

- polydipsia

- polyphagia

- Fatigue

- weakness

- Sudden vision changes

- Tingling or numbness in hands or feet

- Dry skin

- Skin lesion or wounds are slow to heal

- Recurrent infections

# Assessment and diagnostic methods :-

- Fasting plasma glucose levels 126 mg/dl or more

- Random plasma glucose

- 2-hour post load glucose levels more than 200mg/dl

- Evaluation of complications

# Management - five components for management of diabetes are :-

- nutrition

- exercise

- monitoring

- pharmacological therapy

- education

Primary treatment of type 1 diabetes mellitus is insulin

Primary treatment of type 2 diabetes mellitus is diet ,weight reduction , exercise and then with oral hypoglycemic agents if non pharmacological methods does not work.

#Complication of diabetes mellitus :-

- Short term complications are hypoglycemia , diabetic ketoacidosis (DKA) , hyperglycemic hyperosmolar non ketotic syndrome (HHNS) .

- Long term complications include microvascular complications and macrovascular complications .

Microvascular complications - small vessels are affected

- neuropathy

- nephropathy

- retinopathy

Macrovascular complications - large vessel are affected

- Coronary artery disease

- Cerebrovascular disease

- Peripheral vascular disease.