Transcript
CLINICAL FEATURES
and complications
OfDiabetes Mellitus
Vajja Swathi8th Sem
Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia with disturbances in metabolism of
Carbohydrates, Fats ,Proteins
resulting from defects ofInsulin secretion, Insulin action (or)Both
Clinical Definition
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Type I Diabetes:
Have little or no insulin secretory capacity.
Depend on exogenous insulin to prevent metabolic decompensation and death.
Symptoms are ACUTE and appear relatively abruptly (i.e. Over days or Weeks)
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Clinical presentation of Diabetes is heterogeneous ranging from asymptomatic type to life threatening diabetic ketoacidosis.
TYPE I DIABETESOSMOTIC SYMPTOMS :
Thirst and frequent drinking (POLYDIPSIA)
More frequent urination, (POLYURIA)
Excessive hunger (POLYPHAGIA)
Unexplained weight loss
Fatigue and Lassitude
ASSOCIATED SYMPTOMS:Muscular Cramps
Blurred vision
Cutaneous and Oro genital fungal or bacterial infections.
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Insulin
Glucose Utilization +
Glycogenolysis
Hyperglycemia
Glucosuria¯ (osmotic diuresis)
¯ POLYURIA*(and electrolyte imbalance)
POLYDIPSIA*
* Hallmark symptoms of diabetes
Insulin
Protein Catabolism
Gluconeogenesis(amino acids glucose)
Hyperglycemia
WEIGHT LOSS and Fatigue
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Type II Diabetes:Insulin resistance
Body tissues do not respond to insulin Results in hyperglycemia
Decreased (but not absent) endogenous insulin secretory capacity. Not dependent on insulin
for immediate survival
Require insulin therapy for optimal glycemic control over time
Clinical features of type 2 diabetes can be insidious
TYPE II DIABETESASYMPTOMATIC
Undetected hyperglycemia for many years (asymptomatic phase)
OSMOTIC SYMPTOMS :
Classic symptoms may be quite mild
Thirst and frequent drinking (POLYDIPSIA)
More frequent urination (POLYURIA), Nocturia
Excessive hunger (POLYPHAGIA)
Weight Gain
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
ASSOCIATED SYMPTOMS:Nonspecific complaints often dominate
Fatigue and lassitude,
Blurred vision,
Dizziness,
Infections,
Delayed wound healing
Numbness of limbs.
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Presence of Sufficient Endogenous Insulin
NO Protein Catabolism
NO Gluconeogenesis
(amino acids glucose)
NO WEIGHT LOSS
OVER WEIGHT (or) OBESE
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Clinical features at presentation of type 1 and type 2 diabetes
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Develops during pregnancy.
Detected at 24 to 28 weeks of gestation.
Associated with risk for cesarean delivery, perinatal death, and neonatal complications.
Mother suffering from diabetic vascular disease results in IUGR.
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Acute complicationsDiabetic ketoacidosisHyperosmolar diabetic nonketotic coma
Chronic complications: MICROVASCULAR
RetinopathyNephropathyNeuropathy
MACROVASCULARCerbrovascular, Cardiovascular, Peripheral vascular disease
INFECTIONS
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Cerebrovascular diseaseIschemic heart diseasePeripheral vascular disease
Macro-vascular Complications
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Risk:Stroke 2 to 4 times
higherHeart Disease 2 to 4
times higher
~75% of diabetes patients have high blood pressure (hypertension)
~75% of people with diabetes have a dyslipidemia (cholesterol disease)
CARDIOVASCULAR DISEASES
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
CEREBRO VASCULAR DISEASES
Transient ischemic attackCognitive impairmentCerebrovascular accidentsStroke
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Blockage of arteries in legs.Contributing factor to amputations.
PERIPHERAL ARTERIAL DISEASES
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
MICRO-VASCULAR COMPLICATIONS
RetinopathyNephropathyNeuropathy
i
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
MaculopathyRetinopathyProliferative Retinopathy
RETINOPATHY
Normal retina
Non proliferative diabetic retinopathy
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
NEPHROPATHY
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
Clinical Definitio
n
Type 1 diabet
es
Type 2 diabet
es
Gestational
diabetes
Complications
DIABETIC DERMPOATHY
THANK YOU
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