NATIONAL UNIVERSITY OF SCIE & TECH

ZIMBABWE

DIABETES MELLITUS• Joseph Ndondo N0110859W

• Cain Kaundikiza N0110533W

• Gamuchirai Musunda N0110255A

WHAT IS DIABETES MELLITUS?

• Diabetes mellitus, or simply diabetes, is a chronic disease that occurs when the pancreas is no longer able to make insulin, or when the body cannot make good use of the insulin it produces or both, leading to hyperglycemia (excess of glucose in the blood ≥7,9mmol/L).

• This is why many people refer to diabetes as “sugar.”

GUIDELINES FOR BLOOD GLUCOSE

Before meals 2hrs after meals

Ideal (non-diabetic) 4-6mmol/L Up to 7 mmol/l

Type 1 diabetes 4-7 mmol/L Under 9 mmol/L

Type 2 diabetes 4-7 mmol/L Under 8 mmol/L

Children w/ Type 1 D 4-8 mmol/L Under 10 mmol/L

• Insulin is a hormone made by the pancreas, that acts like a key to let glucose from the food we eat pass from the blood stream into the cells in the body to produce energy.

• Insulin binds to its receptor on the plasma membrane, initiates a signaling cascade that promotes fusion of glucose transporter protein (GLUT4) to the membrane where it can facilitate glucose transport.

MAJOR TYPES OF DIABETES

• There are two major types of this disease

1.Type 1 Diabetes ( insulin-dependent)

2.Type 2 Diabetes (non-insulin dependent)

• Frequent urination• Excessive thirst • Unexplained weight loss • Erectile dysfunction• Rapid weight loss (Type 1 diabetes)• Extreme hunger • Sudden vision changes/blurred vision• Tingling or numbness in hands or feet• Feeling very tired much of the time• Very dry skin • Sores that are slow to heal

GENERAL SYMPTOMS OF GENERAL SYMPTOMS OF DIABETES DIABETES

• In its most severe forms, ketoacidosis may develop and lead to stupor, coma and, in absence of effective treatment, death.

• Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

SYMPTOMS

excessive hunger

headache

profuse sweatingfeeling dizzy/shaking

pins and needles around mouth

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

SYMPTOMS

Lack of concentrationAltered vision

Peculiar behaviour

Loss of consciousness

TYPE 1 DIABETES TYPE 1 DIABETES

• Type 1 is usually caused by an auto-immune reaction where the body’s defense system attacks the cells that produce insulin. The reason this occurs is not fully understood but genetic and environmental factors are involved in the development of this type of diabetes.

• A viral cause like mumps or Coxsackie has been concidered

• Results in very low or absolute lack of endogenous insulin. If people with type 1 diabetes do not have access to insulin, they will die.

• This form of diabetes usually strikes children and young adults, although disease onset can occur at any age.

• Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes.

• In Type 1 diabetes, the pancreas fails to produce insulin. • Without insulin, the body’s cells cannot use glucose

(sugar), which the body needs for energy. It begins to burn its own fats as a substitute.

• Unless treated with daily injections of insulin, a person with type 1 diabetes accumulates in the blood dangerous chemical substances from the burning of fat. This can cause a condition known as ‘keto-acidosis’.

• Keto-acidosis involves accumulation of dangerous chemical substances in the blood called ketones, which also appear in the urine

• It develops gradually over hours or days. It is a sign of insufficient insulin.

SYMPTOMS OF KETO-ACIDOSIS

• High blood glucose level and moderate to heavy ketones in the urine,

• Rapid breathing

• Flushed cheeks

• Abdominal pain

• Sweet acetone smell on the breath

• Vomiting

• Dehydration

TYPE 1 SYMTOMS

• Feeling constantly thirsty

• Passing urine frequently, including bedwetting

• Excessive hunger

• Blurred vision

• Unexplained weakness and fatigue

• Weight loss

• Vaginal discharge or itch in young girls

• Nausea and vomiting

CAUSE OF TYPE 1

•exact cause is not known. •Some people are predisposed to developing type 1 diabetes. In these people, the diabetes is possibly triggered by a virus. •Viral infections provide the stimulus of autoimmune destruction rather than actually initiating diabetes•This destroys the part of the pancreas which

produces insulin.

TREATMENT OF INSULIN• As yet, there is no “cure” for either type of diabetes,

although there are many ways of keeping diabetes under control.

• Treatment aims to do what a normal body does naturally – maintain a proper balance of insulin and glucose.

• Diabetes "control" means keeping the level of glucose in the blood as close to normal as possible. The three elements of "control" for type 1 diabetes are:

• Food, Exercise and Insulin

TYPE 2 DIABETES

•In Type 2 diabetes, the body cells are unable to use insulin properly (insulin resistance). This causes glucose (sugar) to accumulate in the blood stream. It usually begins as insulin resistance.

•a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce insulin. This causes glucose (sugar) to accumulate in the blood stream.

• Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity.

• African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians or Other Pacific Islanders are at particularly high risk for type 2 diabetes.

RELATIONSHIP OF TYPE 11 DIABETES TO NUTRITION

• Sedentary lifestyle and high fat, high- calorie diet

• Abnormal levels of cholesterol, and or triglycerides in the blood

• Excess body fat, particularly around the waist • Low birth weight and/or a mother's

malnutrition in pregnancy may cause metabolic disturbances in a fetus that lead to diabetes later in the child's life

TREATMENT OF TYPE 2

• typically includes diet control, exercise, home blood glucose testing, and in some cases, oral medication and/or insulin.

• healthy eating and regular exercise can control blood glucose levels.

• Because many persons with T2DM are overweight and insulin resistant, medical nutrition therapy should emphasize lifestyle changes that result in reduced energy intake and increased energy expenditure through physical activity

OTHER TYPES

Gestational diabetes •common in pregnant women (mostly obese). •It develops due to the complex hormonal and metabolic changes taking place during pregnancy. •Blood glucose levels unusually return to normal after delivery.

GESTATIONAL DIABETESGESTATIONAL DIABETES

• Gestational Diabetes is a form of diabetes that occurs during pregnancy and usually goes away after the baby is born.

• This common condition refers to a high blood glucose level recognized for the first time during pregnancy.

• It develops towards the middle of the pregnancy as a result of the changes in the mother’s hormones. If this condition is left untreated, it can cause complications for the mother and the baby.

• women with GDM and their children are at an increased risk of developing type 2 diabetes later in life. Approximately half of women with a history of GDM go on to develop type 2 diabetes within five to ten years after delivery.

RISK FACTORSRISK FACTORS

• Women:• over 30 years of age • with a family history of type 2 diabetes • who are overweight • from certain ethnic groups e.g. India, Asia,

Pacific Islands, Middle East

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