Medical Lecture Notes
Understanding Diabetes Mellitus
By Dr. Rashed | June 10, 2025
📘 Diabetes Mellitus: A Comprehensive Guide to Management and Prevention
Empowering you with knowledge to live well with diabetes!
🔍 What is Diabetes Mellitus?
Diabetes Mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels due to insulin deficiency, insulin resistance, or both. Left unmanaged, it can lead to serious complications affecting the heart, kidneys, eyes, and nerves.
📌 Key Facts:
- Type 1 Diabetes: Autoimmune destruction of pancreatic beta cells; insulin-dependent.
- Type 2 Diabetes: Insulin resistance with relative insulin deficiency; most common (90–95% of cases).
- Gestational Diabetes: Occurs during pregnancy; increases future risk of Type 2 diabetes.
- Normal fasting glucose: <100 mg/dL
- Prediabetes: 100–125 mg/dL (fasting) or 140–199 mg/dL (2-hour postprandial)
- Diabetes: ≥126 mg/dL (fasting) or ≥200 mg/dL (2-hour postprandial) on two separate tests
🌍 Epidemiology
- Affects ~537 million adults globally (IDF, 2023)
- Expected to rise to 643 million by 2030
- Higher prevalence in urban areas and among adults >40 years
- Type 2 accounts for the majority of cases, linked to obesity
🧬 Pathophysiology
- Type 1: Autoimmune beta-cell destruction → absolute insulin deficiency
- Type 2: Peripheral insulin resistance + beta-cell dysfunction
- Others: Incretin dysfunction, hepatic glucose overproduction, chronic inflammation
- Genetics: Family history increases risk 2–6 times
⚠️ Risk Factors
Modifiable:
- Obesity (BMI ≥30)
- Physical inactivity
- High-sugar, high-fat diet
- Smoking
- Excessive alcohol intake
Non-Modifiable:
- Age >45 years
- Family history of diabetes
- Ethnicity (higher in South Asian, African, Hispanic populations)
- History of gestational diabetes
🩺 Clinical Manifestations
Early symptoms (especially in Type 2) may be subtle:
- Polyuria (frequent urination)
- Polydipsia (excessive thirst)
- Polyphagia (increased hunger)
- Fatigue, weight loss (more in Type 1)
- Blurred vision
- Slow-healing wounds
Complications:
- Cardiovascular: Heart attack, stroke
- Nephropathy: Chronic kidney disease
- Retinopathy: Vision loss
- Neuropathy: Numbness, tingling, amputations
- Diabetic foot: Ulcers and infections
🧪 Diagnosis
- Fasting Plasma Glucose (FPG): ≥126 mg/dL
- Oral Glucose Tolerance Test (OGTT): ≥200 mg/dL after 2 hours
- HbA1c: ≥6.5%
- Random Plasma Glucose: ≥200 mg/dL + symptoms
- Additional Tests: C-peptide, autoantibodies, lipid profile, kidney function
💊 Management
Lifestyle Modifications (essential for Type 2):
- Diet: Low glycemic foods, avoid sugar/fat, portion control
- Exercise: 150–300 min/week aerobic + resistance training
- Weight Loss: 5–10% body weight loss improves glucose levels
- Quit Smoking: Lowers heart and kidney risks
- Manage Stress: Mindfulness and counseling reduce cortisol
Pharmacotherapy:
- Type 1: Insulin therapy (basal-bolus or pump)
- Type 2:
- First-line: Metformin
- Additional: Sulfonylureas, DPP-4 inhibitors, GLP-1 agonists, SGLT2 inhibitors
- Insulin if HbA1c remains high (>7%)
- Monitoring: HbA1c every 3–6 months (target <7%)
👶 Special Populations
- Children: Insulin + diet + education (Type 1)
- Pregnancy: Tight glucose control (HbA1c <6%), insulin is preferred
- Elderly: Simplified regimens, avoid hypoglycemia
🚨 Emergencies
- Hypoglycemia: Glucose <70 mg/dL → Treat with 15g sugar (juice, glucose tablets)
- DKA (Type 1): Acidosis, dehydration → IV fluids + insulin
- HHS (Type 2): Severe dehydration, glucose >600 mg/dL → urgent care
🛡️ Prevention
- Screen adults ≥45 or high-risk individuals every 3 years
- Maintain healthy body weight and exercise regularly
- Avoid sugary drinks and processed foods
- Manage prediabetes early to prevent progression
📝 Key Takeaways
- Diabetes is manageable with proper diagnosis and consistent care
- Lifestyle modification is the foundation of Type 2 diabetes treatment
- Teamwork between patient and healthcare provider ensures long-term success
Stay Healthy, Stay Empowered!
Share this guide to raise awareness about diabetes prevention and management. Together, we can take control!
Follow for more premium medical insights!
Diabetes | HealthyLiving | MedicalEducation
Post a Comment