Diabetes mellitus (Definition, Classification, Clinical features)

Diabetes mellitus (Definition, Classification, Clinical features)

1. DIABETES MELLITUS Definition, Classification, Risk factors & Clinical Features MARYAM JAMILAH BINTI ABDUL HAMID 082013100002 IMS BANGALORE

2. LEARNING OUTCOME Definition Classification Risk factors Clinical features

3. DEFINITION Metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion , insulin action , or both

4. CLASSIFICATION DIABETES MELLITUS Type 1 diabetes Type 2 diabetes Other specific types of diabetes Gestational diabetes mellitus (GDM)

5. TYPE 1 DIABETES Also known as Juvenile Onset Diabetes Complete or near-total insulin deficiency Occurs <14 years old of age Underweight patient

6. Genetic factor Uncommon Develop antibodies against β –cells of islet Develop ketosis; if untreated Insulin secretion Low/absent due to –cell pathology (autoimmune disease) Sensitive to insulin

7. Type 1 diabetes (continuation)

8. Most common >40 years of age Normal or overweight Genetic factor Strongly positive TYPE 2 DIABETES

9. Ketosis with infection (often absent) Insulin secretion Initially normal or but later β -cells are usually normal but disturbance is *less active insulin production *less cellular response to insulin due to deficiency of GLUT 4 in insulin sensitive cells *presence of antibodies against insulin Insulin resistant

10. Genetic defects of β cell function characterized by mutation Genetic defects in insulin action Disease of exocrine pancreas Endocrinopathies Drug-or chemical-induced Infections Uncommon forms of immune-mediated diabetes Other genetic syndromes associated with diabetes OTHER SPECIFIC TYPES OF DIABETES

11. In pregnancy (glucose intolerance) Insulin resistance metabolic changes of late pregnancy Most women revert to normal glucose tolerance post-partum but have substantial risk (30-60%) of developing diabetes mellitus later in life GESTATIONAL DIABETES MELLITUS (GDM)

12. RISK FACTORS Predisposing factors Hereditary Age (increasing age) Obesity BMI Adipose tissues in obese people are more resistant to insulin

13. Lifestyle high fat and cholesterol levels Smoking Sedentary lifestyle

14. CLINICAL FEATURES Hyperglycemia Glycosuria Polyuria Polydipsia Polyphagia Dehydration Loss of weight Poor resistance to infections due to protein depletion

15. REFERENCES AK JAIN, Volume II , 3 rd edition Harrison’s Internal Medicine, Volume II, 17 th edition http://care.diabetesjournals.org/content/27/suppl_1/s5.full