[1]

TOPIC; DIABETES MELLETUS

NAME; CHETAN RATHI
CLASS; 12(A)
 [2]

LIST OF CONTENTS
AIM

INTRODUCTION

CAUSES

SIGNS AND SYMPTOMS

DIAGNOSIS

PREVENTION

CARE AND TREATMENT

 [3]

ACKNOWLEDGEMENT

I am overwhelmed in all humbleness and gratefulness to

acknowledge my depth to all those who have helped me to
put these ideas, well above the level of simplicity and into
something concrete.
I would like to express my special thanks of gratitude to my
teacher Ms. Chayya bhatnagar who helped me a lot
gathering information, collecting data and guiding me from
time to time in making this project , despite of her busy
schedules ,they gave me different ideas in making this
project unique as well as our laboratery teacher mr.ved
prakash who gave me the helped me to do this wonderful
project on the topic "DIABETES MELLITUS" which also
helped me in doing a lot of Research and i came to know
about so many new things. I am really thankful to them.
Any attempt at any level can 't be satifactorily completed
without the support and guidance of my parents and
friends.
I would like to thank my parents who helped me a lot in
gathering different.

Thanking you

Chetan rathi
 [4]

AIM
To study about diabetes mellitus.
 [5]

INTRODUCTION
What is diabetes mellitus?

Diabetes mellitus (DM), commonly referred to as diabetes, is a group

of metabolic diseases in which there are high blood sugar levels over a
prolonged period. Diabetes mellitus (or diabetes) is a chronic, lifelong condition
that affects our body's ability to use the energy found in food. our body breaks
down the sugars and carbohydrates we eat into a special sugar called glucose.
Glucose fuels the cells in your body. But the cells need insulin, a hormone, in
your bloodstream in order to take in the glucose and use it for energy. With
diabetes mellitus, either our body doesn't make enough insulin, it can't use
the insulin it does produce, or a combination of both.
Since the cells can't take in the glucose, it builds up in our blood. High levels
of blood glucose can damage the tiny blood vessels in our kidneys, heart, eyes,
or nervous system. That's why diabetes -- especially if left untreated -- can
 [6]

eventually cause heart disease, stroke ,kidney disease, blindness, and nerve
damage to nerves in the feet.

COMMON TYPES OF DIABETES

There are three main types of diabetes mellitus:

Type 1 DM results from the pancreas' failure to produce enough insulin. This form was
previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile
diabetes". The cause is unknown.

Type 2 DM begins with insulin resistance, a condition in which cells fail to respond
to insulin properly. As the disease progresses a lack of insulin may also develop. This
form was previously referred to as "adult-onset diabetes". The primary cause is excessive
body weight and not enough exercise.
 [7]

Gestational diabetes, is the third main form and occurs when pregnant women
without a previous history of diabetes develop a high blood sugar level.
Generally, type 2 diabetes is more common in people over age 40 who are overweight.
However, the prevalence of obesity among people in North America has increased the
number of people under age 40 who are diagnosed with type 2 diabetes. Nine out of 10
people with diabetes have type 2.

Type 1
Type 1 diabetes mellitus is characterized by insulin deficiency. This type can be further classified as
immune-mediated The majority of type 1 diabetes is of the immune-mediated nature leads to the loss of
beta cells and thus insulin.[26] It causes approximately 10% of diabetes mellitus cases in North America and
Europe. Most affected people are otherwise healthy and of a healthy weight when onset occurs. Sensitivity
and responsiveness to insulin are usually normal, especially in the early stages. Type 1 diabetes can affect
children or adults, but was traditionally termed "juvenile diabetes" because a majority of these diabetes
cases were in children.

Type 1 diabetes is partly inherited, with multiple genes, including certain HLA genotypes, known to
influence the risk of diabetes. In genetically susceptible people, the onset of diabetes can be triggered by
one or more environmental factors, such as a viral infection or diet.

Type 2
 [8]

Type 2 diabetes mellitus is characterized by insulin resistance, which may be

combined with relatively reduced insulin secretion.[5] The defective
responsiveness of body tissues to insulin is believed to involve the insulin
receptor. However, the specific defects are not known.

Diabetes mellitus cases due to a known defect are classified separately. Type 2
diabetes is the most common type.In the early stage of type 2, the predominant
abnormality is reduced insulin sensitivity. It is due primarily to lifestyle factors
and genetics.

Gestational diabetes
Gestational diabetes mellitus (GDM) resembles type 2 diabetes occurs in about
210% of all pregnancies and may improve or disappear after delivery.
However, after pregnancy approximately 510% of women with gestational
 [9]

diabetes are found to have diabetes mellitus, most commonly type 2. Gestational
diabetes is fully treatable, but requires careful medical supervision throughout
the pregnancy. Management may include dietary changes, blood glucose
monitoring, and in some cases insulin may be required.
Though it may be transient, untreated gestational diabetes can damage the
health of the fetus or mother. Risks to the baby and skeletal muscle
malformations. Increased fetal insulin may inhibit fetal surfactant production
and cause respiratory distress syndrome. n severe cases, perinatal death may
occur, most commonly as a result of poor placental perfusion due to vascular
impairment Labor induction may be indicated with decreased placental
function.

Other forms of diabetes mellitus include congenital diabetes, which is due

to genetic defects of insulin secretion,

Causes
 [10]

Health care providers do not yet know what causes diabetes. The following factors may
increase your chance of getting diabetes:

Family history of diabetes or inherited tendency

Being overweight (20 percent or more over your desired body weight)

Physical stress (such as surgery or illness)

Use of certain medications, including steroid and blood pressure medications

Injury to pancreas (such as infection, tumor, surgery or accident)

Autoimmune disease

High blood pressure

Abnormal blood cholesterol or triglyceride levels

Age (risk increases with age)

Alcohol (risk increases with years of heavy alcohol use)

 [11]

It is important to note that sugar itself does not cause diabetes. Eating a lot of sugar can lead
to tooth decay, but it does not cause diabetes.

The following is a comprehensive list of other causes of diabetes: [36]

Genetic defects of -cell function

Genetic defects in insulin processing or insulin

action

Insulin gene mutations

Insulin receptor mutations

Exocrine pancreatic defects

Infections

Drugs

WHO GETS DIABETES?

 [12]

Diabetes can occur in anyone. However, people who have close relatives with the disease
are somewhat more likely to develop it. Other risk factors include obesity, high cholesterol,
high blood pressure, and physical inactivity. The risk of developing diabetes also increases
as people grow older. People who are over 40 and overweight are more likely to develop
diabetes, although the incidence of type 2 diabetes in adolescents is growing. Diabetes is
more common among Native Americans, African Americans, Hispanic Americans and
Asian Americans/Pacific Islanders. Also, people who develop diabetes while pregnant (a
condition called gestational diabetes) are more likely to develop full-blown diabetes later in
life.

WHAT OTHER PROBLEMS CAN DIABETES CAUSE?

Your healthcare team will encourage you to follow your meal plan and exercise program,
use your medications and monitor your blood glucose regularly to keep your blood glucose
in as normal a range as possible as much of the time as possible. Why is this so important?
Because poorly managed diabetes can lead to a host of long-term complications among
these are heart attacks, strokes, blindness, kidney failure, and blood vessel disease
that may require an amputation, nerve damage, and impotence in men.
 [13]

SIGNS AND SYMPTOMS

The classic symptoms of untreated diabetes are weight loss, polyuria (increased
urination), polydipsia (increased thirst), and polyphagia(increased hunger). Symptoms may
develop rapidly (weeks or months) in type 1 diabetes, while they usually develop much
more slowly and may be subtle or absent in type 2 diabetes.
Several other signs and symptoms can mark the onset of diabetes, although they are not
specific to the disease. In addition to the known ones above, they include blurry vision,
headache, fatigue, slow healing of cuts, and itchy skin. Prolonged high blood glucose can
cause glucose absorption in the lens of the eye, which leads to changes in its shape,
resulting in vision changes. A number of skin rashes that can occur in diabetes are
collectively known as diabetic dermadromesPeople with diabetes frequently experience
certain symptoms. These include:

being very thirsty

frequent urination

weight loss

increased hunger
 [14]

blurry vision

irritability

tingling or numbness in the hands or feet

frequent skin, bladder or gum infections

wounds that don't heal

extreme unexplained fatigue

In some cases, there are no symptoms this happens at times with type 2 diabetes. In this case, people can
live for months, even years without knowing they have the disease. This form of diabetes comes on so
gradually that symptoms may not even be recognized.

DIAGNOSIS

preferred method of diagnosing diabetes is the fasting plasma glucose test (FPG). The FPG
measures your blood glucose level after you have fasted (not eaten anything) for 10 to 12
hours.

Normal The fasting blood glucose is between 70 and 100 mg/dl for people who do not have
diabetes. The standard diagnoses of diabetes is made when:

A patient has a fasting blood glucose level of 126 mg/dl or higher on two separate
occasions; or

A patient has a random blood glucose level of 200 mg/dl or greater and has common
symptoms of diabetes, such as:

o Increased thirst

o Frequent urination

o Increased hunger

o Fatigue

o Blurred vision
 [15]

o Weight loss

On occasion, an oral glucose tolerance test may aid in the diagnosis of diabetes or an
earlier abnormality that may become diabetes - called impaired glucose tolerance.

Another test, the A1C test, measures your average percentage of glycated hemoglobin, or
HbA1c, in the blood. This test tells you about your blood glucose control for the past 2 to
3 months. It gives you an idea of how your treatment plan is coming along but does not
replace daily testing.

long-term complications of
diabetes

Heart attacks, strokes, blindness, kidney

failure, and blood vessel disease that may
require an amputation, nerve damage, and
impotence in men.Retinopathy (eye
disease),Nephropathy (kidney
disease),Neuropathy (nerve disease).

-Other long-term may complications include:

Eye problems including glaucoma and cataracts

Dental problems
 [16]

High blood pressure

Heart disease

PREVENTION
There is no cure for diabetes, but it can be treated and controlled. The goals of managing diabetes are to:

1. Keep your blood glucose levels as near to normal as possible by balancing food intake with
medication and activity.
 [17]

2. Maintain your blood cholesterol and triglyceride (lipid) levels as near the normal ranges as possible
by decreasing the total amount of fat to 30% or less of your total daily calories and by reducing

saturated fat and cholesterol.

3. Control your blood pressure. (Your blood pressure should not go over 130/80.)

4. Decrease or possibly prevent the development of diabetes-related health problems.

You hold the keys to managing your diabetes by:

Planning what you eat and following a balanced meal plan

Exercising regularly

Taking medication, if prescribed, and closely following the guidelines on how and when to take it

Monitoring your blood glucose and blood pressure levels at home

Keeping your appointments with your health care providers and having laboratory tests completed
as ordered by your doctor.

What you do at home every day affects your blood glucose more than what your doctor can do every few
months during your check-ups.

Management
 [18]

Diabetes mellitus is a chronic disease, for which there is no known cure except in very
specific situations.Management concentrates on keeping blood sugar levels as close to
normal, without causing low blood sugar. This can usually be accomplished with a healthy
diet, exercise, weight loss, and use of appropriate medications (insulin in the case of type 1
diabetes; oral medications, as well as possibly insulin, in type 2 diabetes).
Learning about the disease and actively participating in the treatment is important, since
complications are far less common and less severe in people who have well-managed blood
sugar levels.[53][54] Attention is also paid to other health problems that may accelerate the
negative effects of diabetes. These include smoking, elevated cholesterol levels, obesity, high
blood pressure, and lack of regular exercise.

LIFESTYLE
 [19]

People with diabetes can benefit from education about the disease and treatment, good nutrition to achieve
a normal body weight, and exercise, with the goal of keeping both short-term and long-term blood
glucose levels within acceptable bounds. In addition, given the associated higher risks of cardiovascular
disease, lifestyle modifications are recommended to control blood pressure.

MEDICATIONS

Medications used to treat diabetes do so by lowering blood sugar levels. There are a
number of different classes of anti-diabetic medications. Some are available by
mouth, such asmetformin, while others are only available by injection like insulin.
Type 1 diabetes can only be treated with insulin,Several other groups of drugs,
mostly given by mouth, may also decrease blood sugar in type II DM.
Since cardiovascular disease is a serious complication associated with diabetes, some
recommend blood pressure levels below 120/80 mmHg Aspirin is also
recommended for patient with cardiovascular problems, however routine use of
aspirin has not been found to improve outcomes in uncomplicated diabetes.

SURGERY
 [20]

A pancreas transplant is occasionally considered for people with type 1 diabetes

who have severe complications of their disease, including end stage kidney
disease requiring kidney transplantation.[67]
Weight loss surgery in those with obesity and type two diabetes is often an
effective measure. Many are able to maintain normal blood sugar levels with
little or no medications following surgery[] and long-term mortality is
decreased. There however is some short-term mortality risk of less than 1%
from the surgery. The body mass index cutoffs for when surgery is appropriate
are not yet clear. It is recommended that this option be considered in those who
are unable to get both their weight and blood sugar under control.

Conclusion: care and

treatment
 [21]

Here is a summary of the guidelines that will help you manage your diabetes
for a lifetime of good health

1. Plan what you eat and follow a balanced meal plan. See your
dietitian at least once a year.
2. Exercise at least five times a week for 30 minutes each session. Talk
to your doctor before starting any exercise program. Tell your doctor
what kind of exercise you want to do so adjustments can be made to
your medicine schedule or meal plan, if necessary.
 [22]

3. Follow your medicine schedule as prescribed by your doctor.

4. Know what medicines (brand and generic names) you are taking and
how they work. Keep a list of your medicines with you at all times.
5. Test your blood glucose regularly, as recommended by your health
care provider. Test your blood glucose more often when you're sick.
6. Try to continuously keep your blood glucose level at the
recommended range. If your blood glucose is less than 70 mg/dl and
you have more than one unexplained low blood glucose reaction a
week, call your doctor. If your blood glucose is greater than 160 mg/dl
for more than a week or if you have two consecutive readings greater
than 300 mg/dl, call your doctor.

7. Contact your doctor when your blood glucose is over 300 mg/dl. Test
your urine for ketones if recommended by your doctor.
8. Record your blood glucose and urine ketone test results in a record
keeping log. Bring your log book with you to all of your doctor's visits.
9. Keep your scheduled appointments with your health care providers.
See your doctor at least every three to four months for regular check-
ups if you are treated with insulin. See your doctor every four to six
months if you are treated with other diabetes medicines or if you are
managing diabetes with diet and exercise alone. More frequent visits
might be necessary if your blood glucose is not controlled or if
 [23]

complications of diabetes are progressing. Make sure your health care

provider checks your blood pressure and weight, and examines your
feet and insulin injection sites.
10. Have a glycosylated hemoglobin test (HbA1c) at least two times a
year or more frequently as recommended by your doctor.
11. Have an eye exam (including a retinopathy screening test) and
urinalysis test once a year, or as recommended by your doctor. (Your
doctor might request that you have these tests more frequently.)
12. Have your cholesterol and triglyceride levels checked (lipid profile
test) once a year.
13. Have a dental exam every six months.
14. If you have any signs of infection, call your doctor or health care
provider.
15. Practice good foot and skin care.

16. DO NOT SMOKE.

17. Try to manage stress as best as you can. You might think about
attending a stress management workshop to help you learn better
coping methods.
18. Discuss your travel plans with your doctor. Make sure to bring
enough medicine and supplies with you on your trip. Keep medicines,
syringes, and blood glucose testing supplies in your carry-on bag. Do
not check these supplies in case your luggage is lost.
19. Continue learning about your diabetes to maintain and improve your
health. Attend a diabetes class or schedule visits with your diabetes
educator at least once a year.
 [24]

BIBLIOGRAPHY ..
NCERT Class 12 Lab Manual
htps://en.wikipedia.org
htps://www.google.co.in
htps://www.scribd.com
htps://www.slideshare.com
Class 12 NCERT Textbook
Reference artcles from various blogs.