diabetes mellitus

ahmad faisal

041303003



CRITERIA FOR DIAGNOSING DIABETES MELLITUS


· Fasting glucoseÃ* venous plasma concentration > 140mg/dL on 2 separates occasion

· Postprandial glucose Ã* venous plasma concentration > 200 mg/dL at 2 hour


CHARACTERISTICS OF TYPE 1 AND 2 DM


Type 1

• Onset < 40 yrs
• Wasting is prominent
• Abrupt onset, rapid progress
• Responsive to insulin
• Diabetic ketoacidosis common
• No family history of diabetes

Type 2

• Onset > 40b yrs
• Obese
• Insidious onset, gradual progress
• Responsive to oral hypoglycemics
• Hyperosmolar hyperglycemics coma
• Family history of diabetes present

SUSPECT DIABETES MELLITUS IN OPD PATIENT

• Classical triad symptoms: polyphagia, polyuria, polydypsia
• Recurrent fungal infections, carbuncles
• Delayed wound healing
• Cataract
• Generalized pruritis
• Fatigue

COMPLICATIONS OF DIABETES MELLITUS

• ACUTE

• • Hypoglycemia
  • Diabetic ketoacidosis
  • Hyperosmolar hyperglycemic coma

• CHRONIC

· Circulatory abnormalities (macro and microangiopathy)
· Retinopathy

• • • Micro aneurysms
    • Venous dilatation
    • Hemorrhages
    • Cotton-wool spots
    • Hard exudates
    • Senile cataract
    • Rubeosis iridis

· Nephropathy
1. Diffuse glomerulosclerosis
2. Nodular glomerulosclerosis
3. Pyelonephritis

· Neuropathy
1. Peripheral neuropathy Ã* mononeuropathy
Ã* mononeuritis multiplex
Ã* radiculopathy
Ã* Distal mixed polyneuropathy
Ã* Proximal mixed polyneuropathy

2. Autonomic neuropathy Ã* tachycardia
Ã* Incontinence
Ã* Diarrhea
Ã* Gustatory sweating
Ã* Impotence
Ã* Decrease libido
· Diabetic foot
· Skin complications