Diabetes Mellitus Diabetes Mellitus Global and national prevalence of Global and national prevalence of diabetes diabetes Types of diabetes Types of diabetes Pathogenesis of diabetes Pathogenesis of diabetes Classification and criteria for lab Classification and criteria for lab diagnosis of diabetes diagnosis of diabetes Lab investigations for a patient of Lab investigations for a patient of diabetes diabetes MCQ’s MCQ’s
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Diabetes Mellitus Global and national prevalence of diabetes Global and national prevalence of diabetes Types of diabetes Types of diabetes Pathogenesis.
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Diabetes MellitusDiabetes Mellitus
Global and national prevalence of Global and national prevalence of diabetesdiabetes
Types of diabetesTypes of diabetes Pathogenesis of diabetesPathogenesis of diabetes Classification and criteria for lab Classification and criteria for lab
diagnosis of diabetesdiagnosis of diabetes Lab investigations for a patient of Lab investigations for a patient of
diabetesdiabetes MCQ’sMCQ’s
Patient J.L., December 15, 1922
February 15, 1923
The Miracle of The Miracle of InsulinInsulin
Diabetes MellitusDiabetes Mellitus
““Diabetes is a dreadful Diabetes is a dreadful
affliction,---------”. affliction,---------”.
Areteus of Cappadosia in 2Areteus of Cappadosia in 2ndnd Century. Century.
It continues to be a sinister disease, if It continues to be a sinister disease, if
not taken care of.not taken care of.
Sheikh M.Z, Diabetes Mellitus: The Continuing Challenge,
JCPSP 2004 Vol.14(2), 63-64
Diabetes a Diabetes a globalglobal epidemic epidemic
> 40 Years> 40 Years Months to yearsMonths to years RareRare Independent *Independent * NoNo YesYes Normal or high *Normal or high * Normal / ExhaustionNormal / Exhaustion ComplicationsComplications
Late and vascular. Late and vascular.
I. CLASSIFICATION AND I. CLASSIFICATION AND DIAGNOSIS OF DIABETESDIAGNOSIS OF DIABETES
Classification of DiabetesClassification of Diabetes
Type 1 diabetesType 1 diabetes ββ-cell destruction-cell destruction
Other specific types of diabetesOther specific types of diabetes Genetic defects in Genetic defects in ββ-cell function, insulin action-cell function, insulin action
Diseases of the exocrine pancreasDiseases of the exocrine pancreas
Drug- or chemical-inducedDrug- or chemical-induced
2-h plasma glucose in the 75-g OGTT2-h plasma glucose in the 75-g OGTT140-199 mg/dl (7.8-11.0 mmol/l): IGT140-199 mg/dl (7.8-11.0 mmol/l): IGT
oror
A1C 5.7-6.4%A1C 5.7-6.4%
*For all three tests, risk is continuous, extending below the lower limit of a range and becoming disproportionately greater at higher ends of the range.
ADA. I. Classification and Diagnosis. Diabetes Care 2011;34(suppl 1):S13. Table 3.
Recommendations:Recommendations:Detection and Diagnosis of GDMDetection and Diagnosis of GDM
ScreeningScreening use use plasma glucose fasting plasma glucose fasting and 2 hours after breakfast,and 2 hours after breakfast, if abnormal go for 50 gram oral glucose if abnormal go for 50 gram oral glucose
challenge test.challenge test.
In pregnant women previously known to have diabetes, In pregnant women previously known to have diabetes, and and screening test abnormal go for screening test abnormal go for confirmatory test for diagnosis of GDM at 24-28 weeks gestation, using a 100 gram glucose- OGTT