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Dr.Shreeram Vaidya :Dr.Shreeram Vaidya Diabetes, Yes We can control
What is Diabetes Mellitus? :What is Diabetes Mellitus? 1500 BC Ebers Papyrus First Described Diabetes
Diabetes means to siphon .The most obvious sign of diabetes is excessive urination
Mellitus means sweet like a honey.
It is a disorder of carbohydrate metabolism.
In which body’s blood sugar (glucose)
Level remains too high and causes problems.
Insulin allows body’s cells to use glucose as a fuel .
400 BC Sushrut :400 BC Sushrut Diabetes Causes
Genetical
Environmental
In 1889 Minkowski :In 1889 Minkowski In 1889 Minkowski, with the German physiologist Joseph von Mering (1849-1908), discovered that dogs subjected to removal of their pancreas develop the symptoms of diabetes, leading Minkowski to postulate that the pancreas is the site of secretion of an «antidiabetic» substance, now known to be insulin.
Noble story of Insulin 1921 :Noble story of Insulin 1921 DR Banting & DR Best isolated insulin
From pancreas of dog
Insulin injected to a diabetic dog showed fall in glucose levels
First insulin use Jan 11 1922 :First insulin use Jan 11 1922 On January 11, 1922, a 14-year-old with type 1 diabetes named Leonard Thompson received an experimental injection at the Toronto General Hospital that would change history. At the time, type 1 diabetes was thought to be a death sentence. Thompson's life was extended by an additional 13 years using insulin.
Pancreas :Pancreas The pancreas has an exocrine portion that secretes digestive enzymes that are carried through a duct to the duodenum. The endocrine portion consists of the pancreatic islets, Paul Langerhans 1869 Described clusters of cells (islets )
In the pancreas which secrete Glucagon and insulin.
Types Of Diabetes Mellitus :Types Of Diabetes Mellitus Type I DM Insulin Dependent Diabetes
5-10% of diabetic patients. Usually affects
Children.
In this condition pancreas of the patients
Produce practically no insulin. The patient’s survival is dependent on external insulin.
Types of Diabetes cont :Types of Diabetes cont Type II Diabetes : Non Insulin Dependent
Diabetes
Causes
Genetically
Environmental
Insulin is insufficient or insensitive
Diabetes in the World :Diabetes in the World millions Year2010 Reference: Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes. Diabetes Care. 2004; 27(5): 1047-1053.
Symptoms of DM :Symptoms of DM Excessively Thirsty (polydypsia)
Passing a lot of urine (Polyuria)
Excessive eating ( Polyphagia)
Delayed wound healing
Tiredness leg pains and numbness in the foot.
Person may not have any symptom
REGULAR CHECKING IS THE KEY
Diagnosis :Diagnosis Fasting Glucose >126mg%
Post Lunch (2Hrs) >/ 200mg%
Treatment :Treatment Dietary restrictions
Exercise: Burns fats controls obesity
Drugs : Oral or insulin
Once diabetic Diet restrictions and exercise always required
Diet for Diabetics :Diet for Diabetics Avoid ice-creams, barfis,pedas,jams, jellies, chocolates ,soft drinks, these items cause a sudden rise in blood glucose.
Avoid also butter ,ghee, cream, paneer, deep fried food, coconut.
Fruits to be avoided mangoes bananas , chickoos.
Diet cont :Diet cont Diet
Lots of salad Carrots cabbage cucumber
Chapati Bhakari (Rotala)
Do not apply ghee or oil over roti
Vegetables can be had in sufficient quantities
Sweet story :Sweet story For One Jelebi or Gulab Jamun
Sugar present Approximately 20grams
Capable of raising blood glucose at least to 400mgs but Your beta cells produce more insulin and solve the problem .
But once they are sick they stop working and take outsider’s help i.e. may be insulin inj
BODY MASS INDEXBMI = weight in Kg /HT in Meter 2 :BODY MASS INDEXBMI = weight in Kg /HT in Meter 2
Wrong beliefs :Wrong beliefs Diabetes can eat wheat but not rice
Both wheat and rice raise the blood sugar to similar extent .
It should not matter whether one takes wheat or rice , as long as the total quantity
Is restricted .
Diabetic complications :Diabetic complications Hypoglycemia Blood glucose <50mg%
Retinopathy : screen of eye gets affected
Neuropathy: Found in 50 % diabetic , Tingling numbness, burning sensation (Feet)
Nephropathy: Kidney damage
Heart attacks : 2-3 times higher than non diabetics
Hyperglycemia: Blood glucose above 140mg%
Hypoglycemia Symptoms :Hypoglycemia Symptoms Increased appetite
Weakness
Sweating
Restlessness
Palpitation
Giddiness
Hypoglycemia :Hypoglycemia Predisposing Factors
1 Delaying or skipping meals
Heavy alcohol consumption
Decreased carbohydrate consumption
Decreased in Insulin requirements
(after elimination of stress)
DIABETIC FOOT :DIABETIC FOOT Make checking your feet part of your daily routine ,just like brushing your teeth.
Watch for red spots swelling ,cuts and calluses.
Use mirror so that you can see heel ,sole
Wash your feet with warm water every day .to avoid burns test water temp with your elbow.
DIABETES YES WE CAN CONTROL :DIABETES YES WE CAN CONTROL
DIABETES YES WE CAN CONTROL :DIABETES YES WE CAN CONTROL
DIABETES YES WE CAN CONTROL :DIABETES YES WE CAN CONTROL
Regular Tests :Regular Tests Examination of Retina
Urinary Microalbumin : early detection of kidney damage
Lipid profile
HbA1c Quarterly
B.P . Feet examination at each Doctor visit