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Diabetes Mellitus

    Diabetes is a disease characterized by HYPERGLYCEMIA i.e., very high blood sugar. There are 4 types of DM according to W.H.O classification.

    DIABETUS MELLITUS :

    1. Type I (or) Insulin dependent (or) IDDM
    2. Type II (or) non insulin dependent (or) NIDDM.
    3. MRDM ( Malnutrition related DM)
    4. Secondary due to diseases of pancreas , Harmonic imbalance drug induced , pre genetic. Impaired glucose tolerance (Or) IGT
    5. Pregnancy related DM

    INCIDENCE :-

    world wide nearly 143 million people are affected. India 2.4 % in rural and 4 to 11.6 % in urban areas. In 1997 1,02,000 persons died due DM and its complications. Natural history DM is due to either due to deficiency of insulin hormone essential for sugar utilization or decreased sensitivity of insulin. Disease of pancreas genetic defect and or drug induced. The increased blood sugar levels due to defective insulin causes a lot of complications. Usually the blood vessels, kidneys, eyes and nerves are affected . their life span is reduced.

    ENVIRONMENTAL FACTORS :-

    Diet, high carbohydrates, low fiber, high fat diet may be responsible. Sedentary life, lack of exercises and physical activity leads to obesity, decreased insulin production and decreased insulin sensitivity, malnutrition in childhood may cause damage to insulin recaptors.

    VIRAL INFECTION : -

    May cause damage to beta cells which produce insulin, chemical agents , Ex; Alloxan , Streptozocin and Rodenticide are toxic to beta cells.

    STRESS : -

    May aggravate the disease, screening of DM patients. As patients may not have any symptoms periodic blood sugar monitoring will help in detection of cases. The classical symptoms are increased urination ( Frequency ) , increased thirst , obesity , recurrent infections , defective vision , loss of sensation etc.,

    PRIMARY PREVENTION :-

    Heath education , awareness of the disease . need for life style modification, regular physical exercises, to stop smoking and avoid alcohol. Increased cholesterol and irigly cerides may indirectly increase the risk of DM.

    SECONDARY PREVENTION :-

    Early detection by periodical health check identify, high risk groups to maintain ideal body weight.

    TREATMENT :-

    Life style modification, use of oral drugs or insulin , stop smoking , alcohol . Diet high fibre , low fat diet.

    Ideal blood sugar levels as defined by WHO:-

    FASTING BLOOD SUGAR : - 129 mg% P.P.BLOOD SUGAR : - 160 mg% i.e., 1 hour after food.

     

     
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