Diabetes psm presentation.pptx

psm ppt of diabetes

1. DIABETES MELLITUS Presenters: 1. Akanksha Jha-09 2. Anshumita P. Mahanta-18 3. Ameera Ah ma d-13 4. Aman-12 5. Amritash Amrit-14 6. Bikramjit Banerjee-43

2. Introduction and Pathogenesis Classification and Complications Problem Statement Epidemiological Determinants Diagnostic Methods Control and Prevention National Programmes CONTENTS

3. The term Diabetes describes a group of metabolic disorders characterised and identified by the presence of hyperglycemia in the absence of treatment . Heterogeneous etiopathology includes - Defects in insulin secretion Defects in insulin action or both Disturbances of carbohydrate , fat and protein metabolism . Introduction to Diabetes

4. PATHOGENESIS OF DIABETES MELLITUS

5. Classification of Diabetes

6. Complications of Diabetes Mellitus

7. WORLD: Diabetes is an “ iceberg disease”. 422 million diabetes cases were present in 2014, of which more that 90% were type 2 diabetes . The prevalence of Diabetes was highest in Eastern Mediterranean region and the region of the Americas ( 11 % for both sexes ) and lowest in the WHO European and Western Pacific regions ( 9% for both sexes ). Around 1.5 million died as a consequence of high blood sugar in 2019 Prevalence rate in low income countries – 8% high income countries – 10% Problem Statement

8. India : India is home to 77 million diabetics , second only to China in the world . The Government of India and Diabetic retinopathy survey 2019 found 11.8% prevalence of Diabetes in India . Males showed prevalence of 12% and females of 11.7% . majority of the cases are of type 2 diabetes .

9. 1 . AGENT underlying cause of diabetes is insulin deficiency which is absolute in type 1 diabetes and partial in type 2 diabetes Mechanisms a) Pancreatic disorders b) Defect in insulin formation c) Destruction of beta cells d) Reduced insulin sensitivity e) Genetic defect f) Autoimmunity EPIDEMIOLOGICAL DETERMINANTS

10. 2. Host factors Age : Prevalence rises with age Sex : In some countries male to female ratio is equal Genetic factors : In identical twins, concordance of type 2 diabetes was 90% and type diabetes was about 50% Genetic markers : Type 1 – HLA-DR3, HLA-DR4, HLA-B8,HLA-B15 Type 2 – not HLA associated Immune mechanisms : some evidence of both cell mediated and of humoral activity against islet cells Obesity : Risk factor for type 2 diabetes Maternal diabetes : Offsprings of diabetic pregnancies are often large and heavy at birth, tend to develop obesity in childhood and are at a high risk of developing type 2 diabetes

11. 3. Environmental risk factors Sedentary lifestyle Diet Dietary fibre Malnutrition Alcohol Viral infections Chemical agents Stress Other factors – occupation, marital status, religion, economic status, education

12. T Screening for Diabetes URINE EXAMINATION - 1. Urine test for glucose 2 hr after meal 2. Often absent in milder form of diabetes 3. This test yields too many false negative results 4. Not considered appropriate for surveys BLOOD SUGAR TESTING – 1. Standard oral glucose tolerance test rem ain s the cornerstone of diagnosis of diabetes . 2. Glucose measurements of fasting , postprandial or random blood sample are used . 3. 2 hour value after 75gm oral glucose is used .

13. The WHO recommendations for the diagnostic criteria for Diabetes (2019) MEASUREMENTS DIAGNOSTIC CUT-OFF VALUE Fasting venous or capillary plasma glucose >7.0 mmoL /L (126mg/dl) 2hr post load venous plasma glucose >11.1 mol/L (200mg/dl) 2 hr post load capillary plasma glucose >12.2 mmol/L (220 mg/dl) Random plasma glucose >11.1 mmol/L (200 mg/dl) HbA1c 6.5% (48mmol/mol)

14. 1 . Primary Prevention Prevention and Care A . Primordial prevention - i. Prevention of the emergence of risk factors . ii. Preventive measures comprise - maintenance of normal body weight , adoption of healthy nutritional habits , physical exercise . B . High Risk Strategy - i. Correction of sedentary lifestyle , overnutrition and obesity ii. Reduce the risk by avoiding diabetogenic drugs like oral contraceptives iii. Reduce factors that promote atherosclerosis like smoking , high blood pressure , elevated cholesterol and high triglyceride levels .

15. 2.Secondary Prevention A. GLYCATED HAEMOGLOBIN – 1.Estimation of glycated Hb at half yearly intervals 2. The percentage of such glycated Hb reflects the mean blood glucose levels during red cell life time. B) SELF CARE - 1.Stick to diet and drug regimens 2. Examination of own urine and blood glucose monitoring 3. Avoid alcohol 4. Self administration of insulin 5. Maintain optimum weight, attend periodic check ups etc. C) Home blood glucose monitoring.

16. Diabetes is a major of disability through its complications . Eg : blindness , kidney failure , coronary thrombosis , gangrene of the lower extremities . The main objective at the tertiary level is to organize specialised clinics ( diabetic clinics ) and units capable of providing diagnostic and management skills of a high order . 3. Tertiary Prevention

17. NPCDCS- National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Strok e

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