diabetis mellitis

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Diabetes mellitus
Defintion: Syndrome of disorderd metabolism result in high blood
sugar( hyperglycemia).
Types:
1- Type 1: Due to loss of insulin producing cells ( beta cells ) in
the pancreas leading to insulin deficiency.
2-Type 2 : Due to reduced insulin secretion or insulin
resistance.
Signs and Symptoms:
1 – The triad of polyurea, polydepsia and polyphagia.
2 – Visual changes and blurred vision.
3 – Smell of acetone in patient breath.
4 – Nausea, Vomiting and abdominal pain.
5 – Unexplained weight loss.
Investigations:
1 – Urine analysis: Kidney excrete sugar in urine when blood sugar is
150 mg/ dl.
2 – Blood analysis:
a- Normal fating venous blood sugar: 120 mg/dl.
b- Random venous blood sugar: 200 mg/dl.
c- Post prandial blood sugar: 200 mg/dl.
1
Measures higher than that measures indicate Diabetes mellitus.
Diagnosis:
Depends mainly on the investigations
Treatment:
Depends on the measures.
By Trial and error.
1- Insulin and used in type 1 and complicated type 2. It is of
many types.
2 - agents that increase the amount of insulin secreted by
the pancreas as Sulfonylurease.
3 - agents that increase the sensitivity of target organs to
insulin as Metformin.
4 - agents that decrease the rate at which glucose is
absorbed from the gastrointestinal tract as Acarbose.
5 - Special diet regime.
6 – Exercise.
7 - Weight loss.
8 – Self home glucose monitor: with educated patients.
9 – Combination of drugs are used and to reach to ideal
blood glucose level depends on the cooperation of the
patient ,experience of the doctor and mainly on trial and
error.
2
Case no.1:
A patient complain from weight loss.
When discussed by the doctor find that he complain also from
polyurea, polydepsia and polyphagia.
The doctor discovered that he have blurring of vision and smell
aceton in his breath.
1- What you suspect?
2- What investigations you do?
3- What is the treatment?
3
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