Diagnosis and Classification of Diabetes Mellitus

Diagnosis and Classification of Diabetes Mellitus 2014

“Group of metabolic disorders which is characterized by hyperglycaemia and abnormalities in carbohydrate, lipid and protein metabolism”
Diabetes is a chronic disease. Now-a-days it is one of the most common diseases in our country. Some of important points regarding Diagnosis and Classification of Diabetes Mellitus 2014 are discussed below.
Types:
There are two major types of diabetes
a) Type1(Insulin dependent)
It is characterized by loss of beta islets of Langerhans in the pancreas resulting in absolute deficiency of insulin.
b) Type2 (Non-insulin dependent)
It is characterized by insulin resistance.
Signs and symptoms:
Following are the major signs and symptoms of diabetes mellitus
 Hyperglycemia
 Polyuria
 Polydipsia
 Glycosuria
 Blurred vision
 Fatigue and headache
 Dehydration etc.
Complications:
a)Macrovascular complications
 Hypertension
 Myocardial infarction
 Brain haemorrhage
 Dry gangrene
b) Microvascular complications
 Retinopathy
 Nephropathy
 Neuropathy
 Diabetic foot
Diagnosis:
Diabetes mellitus is diagnosed by following tests
 Fasting blood glucose level
 Random blood glucose level
 Oral glucose tolerance test
 Urine analysis
Management:
a)Life style modifications
 Reduce weight
 Do exercise daily
 Avoid smoking
 Avoid alcohol consumption
 Increase dietary fibre
Wherever possible choose high fibre food e.g. wholemeal bread and whole meal cereals etc.
 Reduce carbohydrate diet.
 Try to reduce fat particularly saturated fat. Monounsaturated fats such as olive oil are preferred. Choose grill, steam or oven baked food instead of frying or cooking with oils.
 Try to eat at least five portions of fruit and vegetables every day.
 Use less salt as high intake can raise blood pressure
Treatment:
During the therapy following tests must be performed
 Daily glucose measurement
 Blood pressure measurement
 lipid profile
 Foot examination
 Eye examination
 Dental examination
Treatment of Type1:
Insulin is used in this type of diabetes.
Following types of insulin are used
 Ultra short acting insulin
 Short acting insulin
 Intermediate acting insulin
 Long acting insulin
Storage of insulin:
 Protect insulin formulations from light
 Do not freeze
Adverse reactions of insulin:
 Hypoglycaemia is the most common and dangerous complication. It may be due to delay in taking food, too much physical activity or excess dose of insulin.
Symptoms of hypoglycaemia are sweating, tremor, palpitation, anxiety, tachycardia, headache, blurred vision, confusion and loss of consciousness. Hypoglycaemia is treated by the administration of glucose.
 Allergic reactions
 Insulin resistance
 Oedema due to salt and water retention
Treatment of Type 2:
Following different classes of drugs are used.
a)Sulfonylureas
 Chlorpropamide
 Tolbuamide
 Glimipride
 Glipizide
Adverse effects of sulfonylureas are hypoglycaemia, nausea, vomiting, metallic taste and weight gain.
b) Biguanides
 Metformin
Adverse effects are anorexia, diarrhoea, metallic taste and loss of weight.
c)Thiazolidinediones
 Rosiglitazone
 Pioglitazone
Adverse effects are anaemia, weight gain and fluid retention.
d)Meglitinides
 Repaglinide
e)alpha glucosidase inhibitor
 Acarbose
f)DPP-4 Inhibitors or glipitins
 Sitaglipitin
 Saxaglipitin
g) Glucagon like peptide -1 agonist
 Exenatide
h) Amylin agonist
 Pramlintide

Diagnosis and Classification of Diabetes Mellitus 2014

Diagnosis and Classification of Diabetes Mellitus 2014

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