INTRODUCTION TO MANAGEMENT OF DIABETES MELLITUS

Introduction of Management of Diabetes Mellitus

1. RECENT advance in MANAGEMENT OF DIABETES MELLITUS 1

2. CONTENT INTRODUCTION HISTORY OF DIABETES TYPES OF DIABETES COMPLICATION IN DIABETES MANAGEMENT OF DIABETES CONCLUSION REFERENCE 2

3. INTRODUCTION Diabetes Mellitus (DM) is a metabolic disorder characterized by the presence of chronic hyperglycaemia accompanied by greater or lesser Impairment in the metabolism of carbohydrates, lipids and proteins. Type 1 diabetes (which is immune-mediated or idiopathic) Type 2 DM (formerly known as non-insulin dependent DM) is the most common form of DM characterized by hyperglycaemia, insulin resistance, and relative insulin deficiency. 3

4. HISTORY OF DIABETES Ancient time Greek & Roman physicians concluded that on their observation “diabetes” as a large urine volume. Thereafter, this statement is reconstituted by Thomas Willis (1674) and added the adjective that is, mellitus (means Honey). But this statement which was claimed by this scientist for which he took a reference of Ayurveda system in those Charkas stated that “The diabetes is a disease flow of urine”. Nowadays, after various researches WHO declared that diabetes mellitus is characterised by chronic hyperglycaemia which results into disturbed metabolism cycle of carbohydrate, fats and protein due to improper secretion of insulin or insulin action or both. 4

5. TYPES OF DIABETES Type 1 Diabetes Mellitus Type 2 Diabetes Mellitus Gestational Diabetes Other types: LADA ( latent Autoimmune Diabetes in Adult) MODY (maturity-onset diabetes of youth) 5

6. COMPLICATION IN DIABETES 1) ACUTE: Diabetic ketoacidosis. Hyperglycaemia hyperosmolar state. Hypoglycaemia. Diabetic coma . Erectile disinfectant. Respiratory infection. Periodontal disease. 2) CHRONIC: Macro vascular. Micro vascular. Neuropathy. Infections. 6

7. MANAGEMENT OF DIABETES : 1) Self-administration : Insulin delivering devices : Insulin pen Prefilled syringe Insulin Pumps Jet injector Oral hypoglycaemic agents : Sulphonyl Ureas Derivatives. Bigaunide. Thiazolidinediones. DPP4 Inhibitor. SGLT2 Inhibitor . Insulin pen Jet injector Prefilled syringe 2) Artificial pancreas system : 7

8. 3) Regular glucose level checking : 4) Diet regimen : 5) Regular exercise : 8

9. CONLUSION: Diabetes is characterised by chronic hyperglycemia which occurs due to disturbed metabolism cycle of carbohydrates, fats and proteins because of improper insulin secretion, insulin action or both. The present review is an attempt to focus on types, physiological aspects of diabetes and its complication, goals of management & synthetic treatment of diabetes. The main goal of diabetes management is to restore carbohydrate, fat & protein metabolism to normal state. For this purpose individuals with an absolute deficiency of insulin are treated through injection & tablets containing hypoglycemic agents. The purpose of this review is giving information about how to improve the patient’s routine life by dietary modification, regular exercise and by proper medication. For he /she can enjoy life joyfully by keeping the sugar level in control. 9

10. REFERENCE : Gyle square Edinburgh A national clinical guideline, Scotland, SEPT 13;EH:12 9,FEB National diabetes facts sheet 2003, Department of human service centre of disease and control. World Health Organisation :Definition, Diagnosis, classification of diabetes, Report of WHO. Mohommad ashraf gennie, Suman Kotwal JISMA JULY-SEPT.,2012; VOL.25.NO.3 International Diabetes Federation (IDF)SIXTH EDITION 2013. Kamlesh P. Patel, et.al, NHL journal of medical science / 2013 JAN/ VOL: 2/issue 01. Howord Fishbein,Dr.PH&PJ.PLumbo,MP( Myoclinic pro-55-88.1980) Updated JUNE2014; Stacy Griffin, Laura, Hieronymus. (Ref,MARCH,31,2008)   10