Diabetes Mellitus …Diabetes Mellitus …

Commonly known “phenomenon” of production of Commonly known “phenomenon” of production of

sugary urinesugary urine

““Diabetes” means “to run through”Diabetes” means “to run through” ““Mellitus” means “sweet or with a taste of honey”Mellitus” means “sweet or with a taste of honey”

Characterized by Characterized by High blood sugar High blood sugar a tendency to develop acute/chronic complicationsa tendency to develop acute/chronic complications

Diagnosis of DiabetesDiagnosis of Diabetes

Fasting blood sugar >125 mg/dl,Fasting blood sugar >125 mg/dl,Random blood sugar >199 mg/dl,Random blood sugar >199 mg/dl,Glucose tolerance test (GTT).Glucose tolerance test (GTT).

Urine sugar is not for DIAGNOSIS

Type I

Leading cause of blindness, 25 times more prone

to retinopathy,

6 times higher risk for stroke,

6 times higher risk for heart attack6 times higher risk for heart attack,

20 times more prone to lower limb amputation,

5 times more prone to renal disease.

TT22DM: DM: A Serious DiseaseA Serious Disease

1995India 19.4China 16.0U.S. 13.9Russian Fed. 8.9Japan 6.3Brazil 4.9Indonesia 4.5Pakistan 4.3Mexico 3.8Ukraine 3.6All others 49.7Total 135.3

1995India 19.4China 16.0U.S. 13.9Russian Fed. 8.9Japan 6.3Brazil 4.9Indonesia 4.5Pakistan 4.3Mexico 3.8Ukraine 3.6All others 49.7Total 135.3

2025India 57.2China 37.6U.S. 21.9Pakistan 14.5Indonesia 12.4Russian Fed. 12.2Mexico 11.7Brazil 11.6Egypt 8.8Japan 8.5All others 103.6Total 300.0

2025India 57.2China 37.6U.S. 21.9Pakistan 14.5Indonesia 12.4Russian Fed. 12.2Mexico 11.7Brazil 11.6Egypt 8.8Japan 8.5All others 103.6Total 300.0

King H, Diabetes Care, 1998.

Top 10 List: Top 10 List: Worldwide Epidemic of Diabetes:Worldwide Epidemic of Diabetes:

(Millions of Adults)

Why to diagnose early?Why to diagnose early?

Diabetes is a progressive disease, it Diabetes is a progressive disease, it worsens with time,worsens with time,

Early treatment is rewarding,Early treatment is rewarding, Once complications set in, they are not Once complications set in, they are not

reversible.reversible.

Step care approach of type 2 DMStep care approach of type 2 DM

Insulin ± oral agents

Oral combination

Oral monotherapy

Diet & exercise

MANAGING DIABETES : MANAGING DIABETES : 4 Cardinal Rules for the Patient4 Cardinal Rules for the Patient

1. Follow a healthy meal plan 1. Follow a healthy meal plan 2. Regular exercise2. Regular exercise

3. Take your medication 3. Take your medication 4. Test your blood glucose regularly4. Test your blood glucose regularly

The ABC of Diabetes ManagementThe ABC of Diabetes Management

Effective management of diabetes Effective management of diabetes

requiresrequires A – Control of A1cA – Control of A1c B – Control of Blood pressureB – Control of Blood pressure C – Control of CholesterolC – Control of Cholesterol

Education and Life-style changes like Healthy eating, regular exercise, drinking

In moderation and stopping smoking.