Diabetes mellitus B.Pharm 2nd sem pathophysiology

1. DIABETES MELLITUS

2.  Diabetes mellitus is a group of metabolic disorder
characterised by hyperglycemia resulting from defects in
insulin secretion, insulin action, or both.
TYPES OF DIABETES
Type 1 DM (Juvenile or Insulin dependant diabetes)
 Here pancreas produce little or no insulin.
 Severe form of diabetes.
 Occurs in childhood.
 Symptoms appear in initial stage.

3. Type 2 DM (Adult onset or Insulin independent diabetes)
 Here the pancreas usually produces some insulin. But either the
amount produced is not enough for the body's needs, or the body's
cells are resistant to it.
 Mildest form of diabetes and accounts for about 95% of diabetes
cases in adults.
 Occurs in adult and symptoms appear in later stages.
Gestational diabetes
 Diabetes that's triggered by pregnancy is called gestational
diabetes.
 Because high blood sugar levels in a mother are circulated through
the placenta to the baby, gestational diabetes must be controlled to
protect the baby's growth and development.

4. ETIOLOGY
GENETIC FACTORS ENVIRONMENTAL
FACTORS
FACTORS WITHIN
INDIVIDUAL
•Genetic mutation of β-cells
•Mutation in mitochondrial
DNA
•Genetic defects in insulin
action
• Obesity
•Lifestyle changes
•Lack of physical activity
TYPE 1 DM
•Production of
autoantibodies to destroy
β- cells
•Deficiency in insulin
secretion
TYPE 2 DM
•Insulin resistance

5. SIGNS AND SYMPTOMS
 Ketoacidosis
 Ketonuria
 Glycosuria (presence of glucose in urine)
 Polydypsia (increased thirst)
 Polyuria (increased frequency of urination)
 Polyphagia (extreme hunger)
 Weight loss
 Fatigue and headache
 Blurred vision
 Frequent infections
Ketones are by-products of muscle and
fat breakdown when there is no enough
insulin

6. PATHOGENESIS OF TYPE 1 DM
Viral infection
Molecular mimicry
And/or
Damage to beta cells
Immune response against normal
beta cells
And/or
Immune response against altered
beta cells
Genetic predisposition
Beta cell destruction
TType 1 DM

7. Environmental factorsInsufficient insulin production or
insulin resistance
Genetic predisposition
Persistently high levels of blood
glucose
TType 2 DM
Increase in glucose synthesis
PATHOGENESIS OF TYPE 2 DM

8. COMPLICATIONS
SHORT TERM LONG TERM
• Ketoacidosis
•Non ketotic coma (severe
dehydration due to continuous
loss of glucose in urine)
•Hypoglycemia (reduced
glucose level in blood)
MACROVASCULAR
•Atherosclerosis
•Diabetic microangiopathy
(thickening of basement membrane
of blood vessels)
MICROVASCULAR
•Diabetic nephropathy (damage to
kidneys)
•Diabetic neuropathy (damage to
nerves)
•Diabetic retinopathy (damage to
retina)