Biology investigatory project class12 on diabetes mellitus

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NAME :YASHIKA BHOURIWAL
CLASS : 12-B
ROLL NO:

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LIST OF CONTENTS
AIM
INTRODUCTION
CAUSES
SIGNS AND SYMPTOMS
DIAGNOSIS
PREVENTION
CARE AND TREATMENT

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ACKNOWLEDGEMENT
I am overwhelmed in all humbleness and gratefulness to acknowledge
my depth to all those who have helped me to put these ideas, well above
the level of simplicity and into something concrete.
I would like to express my special thanks of gratitude to my teacher
Ms.Ajanta as well as our principal who gave me the golden opportunity
to do this wonderful project on the topic "DIABETES MELLITUS" which
also helped me in doing a lot of Research and i came to know about so
many new things. I am really thankful to them.
Any attempt at any level can 't be satifactorily completed without the
support and guidance of MY parents and friends.
I would like to thank my parents who helped me a lot in gathering different
information, collecting data and guiding me from time to time in making
this project , despite of their busy schedules ,they gave me different ideas
in making this project unique.
Thanking you,
Yashika Bhouriwal

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AIM
To study about diabetes mellitus.
INTRODUCTION
What is diabetes mellitus?
Diabetes mellitus (DM),commonly referred to as diabetes,is a group
of metabolic diseases in which there are high blood sugar levels over a

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prolonged period. Diabetes mellitus (or diabetes) is a chronic, lifelong condition
that affects our body's ability to use the energy found in food. our body breaks
down the sugars and carbohydrates we eat into a special sugar called glucose.
Glucose fuels the cells in your body. But the cells need insulin, a hormone, in
your bloodstream in order to take in the glucose and use it for energy. With
diabetes mellitus, either our body doesn't make enough insulin, it can't use
the insulin it does produce, or a combination of both.
Since the cells can't take in the glucose, it builds up in our blood. High levels
of blood glucose can damage the tiny blood vessels in our kidneys, heart, eyes,
or nervous system. That's why diabetes -- especially if left untreated -- can
eventually cause heart disease, stroke ,kidney disease, blindness, and nerve
damage to nerves in the feet.
COMMON TYPES OF DIABETES
Thereare threemain types of diabetes mellitus:

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 Type 1 DM results from thepancreas' failureto produce enough insulin. This formwas
previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile
diabetes". The causeis unknown.
 Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to
insulin properly. As the disease progresses a lack of insulin may also develop. This form
was previously referred to as "adult-onset diabetes". Theprimary causeis excessive body
weight and not enough exercise.
 Gestationaldiabetes, is the third main form and occurs when pregnantwomen without
a previous history of diabetes develop a high blood sugar level.
Generally, type2 diabetes is more common in people over age 40 who are overweight.
However, the prevalenceof obesity among people in North America has increased the
number of people under age40 who are diagnosed with type 2 diabetes. Nine out of 10
people with diabetes havetype 2.
Type 1
Type 1 diabetes mellitus is characterized by insulin deficiency. This type can be further classified as
immune-mediated The majority of type 1 diabetes is of the immune-mediated nature leads to the loss of
beta cells and thus insulin.[26]
It causes approximately 10% of diabetes mellitus cases in North America and
Europe. Most affected people are otherwise healthy and of a healthy weight when onset occurs. Sensitivity
and responsiveness to insulin are usually normal, especially in the early stages. Type 1 diabetes can affect
children or adults, but was traditionally termed "juvenile diabetes" because a majority of these diabetes
cases were in children.
Type 1 diabetes is partly inherited, with multiple genes, including certain HLA genotypes, known to
influence the risk of diabetes. In genetically susceptible people, the onset of diabetes can be triggered by
one or more
environmental
factors, such as a
viral infection or
diet.

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Type 2
Type 2 diabetes mellitus is characterized by insulin resistance, which may be
combined with relatively reduced insulin secretion.[5]
The defective
responsiveness of body tissues to insulin is believed to involve the insulin
receptor. However, the specific defects are not know
Diabetes mellitus cases due to a known defect are classified separately. Type 2
diabetes is the most common type.In the early stage of type 2, the predominant
abnormality is reduced insulin sensitivity. It is due primarily to lifestyle factors
and genetics.
Gestational diabetes
Gestational diabetes mellitus (GDM) resembles type 2 diabetes occurs in about
2–10% of all pregnancies and may improve or disappear after delivery.
However, after pregnancy approximately 5–10% of women with gestational

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diabetes are found to have diabetes mellitus, most commonly type 2. Gestational
diabetes is fully treatable, but requires careful medical supervision throughout
the pregnancy. Management may include dietary changes, blood glucose
monitoring, and in some cases insulin may be required.
Though it may be transient, untreated gestational diabetes can damage the
health of the fetus or mother. Risks to the baby and skeletal muscle
malformations. Increased fetal insulin may inhibit fetal surfactant production
and cause respiratory distress syndrome. n severe cases, perinatal death may
occur, most commonly as a result of poor placental perfusion due to vascular
impairment Labor induction may be indicated with decreased placental
function.
Other forms of diabetes mellitus include congenital diabetes, which is due
to genetic defects of insulin secretion,

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Causes
Health careproviders do not yet know what causes diabetes. Thefollowing factors may
increaseyour chanceof getting diabetes:
 Family history of diabetes or inherited tendency
 Being overweight (20 percent or more over your desired body weight)
 Physicalstress (such as surgery or illness)
 Use of certain medications,including steroid and blood pressuremedications
 Injury topancreas (such as infection, tumor, surgeryor accident)
 Autoimmunedisease
 High blood pressure
 Abnormalblood cholesterolor triglyceridelevels
 Age (risk increases with age)
 Alcohol (risk increases with years of heavy alcohol use)
 Smoking
It is important tonote that sugar itself does not causediabetes. Eating a lot of sugar can lead
to tooth decay, but it does not causediabetes.
The following is a comprehensivelist of other causes of diabetes:[36]

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 Genetic defects of β-cell function
 Genetic defects in insulin processingor insulin
action
 Insulin genemutations
 Insulin receptor mutations
 Exocrinepancreaticdefects
 Infections
 Drugs
Who gets diabetes?
Diabetes can occur in anyone. However, people who have close relatives with the disease are somewhat
more likely to develop it. Other risk factors include obesity, high cholesterol, high blood pressure, and
physical inactivity. The risk of developing diabetes also increases as people grow older. People who are
over 40 and overweight are more likely to develop diabetes, although the incidence of type 2 diabetes in
adolescents is growing. Diabetes is more common among Native Americans, African Americans, Hispanic
Americans and Asian Americans/Pacific Islanders. Also, people who develop diabetes while pregnant (a
condition called gestational diabetes) are more likely to develop full-blown diabetes later in life.
What other problems can diabetes cause?
Your healthcare team will encourage you to follow your meal plan and exercise program, use your
medications and monitor your blood glucose regularly to keep your blood glucose in as normal a range as
possible as much of the time as possible. Why is this so important? Because poorly managed diabetes can
lead to a host of long-term complications — among these are heart attacks, strokes, blindness, kidney
failure, and blood vessel disease that may require an amputation, nerve damage, and impotence in men.

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SIGNS AND SYMPTOMS
The classic symptoms of untreated diabetes are weight loss, polyuria (increased
urination), polydipsia (increased thirst), and polyphagia(increased hunger). Symptoms may develop
rapidly (weeks or months) in type 1 diabetes, while they usually develop much more slowly and may be
subtle or absent in type 2 diabetes.
Several other signs and symptoms can mark the onset of diabetes, although they are not specific to the
disease. In addition to the known ones above, they include blurry vision, headache, fatigue, slow healing of
cuts, and itchy skin. Prolonged high blood glucose can cause glucose absorption in the lens of the eye,
which leads to changes in its shape, resulting in vision changes. A number of skin rashes that can occur in
diabetes are collectively known as diabetic dermadromesPeople with diabetes frequently experience
certain symptoms. These include:
 being very thirsty
 frequent urination
 weight loss
 increased hunger
 blurry vision
 irritability
 tingling or numbness in the hands or feet
 frequent skin, bladder or gum infections
 wounds that don't heal
 extreme unexplained fatigue

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In some cases, there are no symptoms — this happens at times with type 2 diabetes. In this case, people can
live for months, even years without knowing they have the disease. This form of diabetes comes on so
gradually that symptoms may not even be recognized.
DIAGNOSIS
The preferred method of diagnosing diabetes is the fasting plasma glucose test (FPG). The FPG measures
your blood glucose level after you have fasted (not eaten anything) for 10 to 12 hours.
Normal fasting blood glucose is between 70 and 100 mg/dl for people who do not have diabetes. The
standard diagnoses of diabetes is made when:
 A patient has a fasting blood glucose level of 126 mg/dl or higher on two separate occasions; or
 A patient has a random blood glucose level of 200 mg/dl or greater and has common symptoms of
diabetes, such as:
o Increased thirst
o Frequent urination
o Increased hunger
o Fatigue
o Blurred vision
o Weight loss
On occasion, an oral glucose tolerance test may aid in the diagnosis of diabetes or an earlier
abnormality that may become diabetes - called impaired glucose tolerance.
Another test, the A1C test, measures your average percentage of glycated hemoglobin, or HbA1c, in the
blood. This test tells you about your blood glucose control for the past 2 to 3 months. It gives you an idea of
how your treatment plan is coming along but does not replace daily testing.

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long-term complications of diabetes
Heart attacks, strokes, blindness, kidney failure, and blood vessel disease that
may require an amputation, nerve damage, and impotence in men.Retinopathy
(eye disease),Nephropathy (kidney disease),Neuropathy (nerve disease).
-Other long-term may complications include:
 Eye problems including glaucoma and cataracts
 Dental problems
 High blood pressure
 Heart disease

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PREVENTION
There is no cure for diabetes, but it can be treated and controlled. The goals of managing diabetes are to:
1. Keep your blood glucose levels as near to normal as possible by balancing food intake with medication
and activity.
2. Maintain your blood cholesterol and triglyceride (lipid) levels as near the normal ranges as possible by
decreasing the total amount of fat to 30% or less of your total daily calories and by reducing saturated
fat and cholesterol.
3. Control your blood pressure. (Your blood pressure should not go over 130/80.)
4. Decrease or possibly prevent the development of diabetes-related health problems.
You hold the keys to managing your diabetes by:
 Planning what you eat and following a balanced meal plan
 Exercising regularly
 Taking medication, if prescribed, and closely following the guidelines on how and when to take it
 Monitoring your blood glucose and blood pressure levels at home
 Keeping your appointments with your health care providers and having laboratory tests completed as
ordered by your doctor.
What you do at home every day affects your blood glucose more than what your doctor can do every few
months during your check-ups.
Management

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Diabetes mellitus is a chronic disease, for which there is no known cure except in very specific
situations.Management concentrates on keeping blood sugar levels as close to normal, without causing low
blood sugar. This can usually be accomplished with a healthy diet, exercise, weight loss, and use of
appropriate medications (insulin in the case of type 1 diabetes; oral medications, as well as possibly insulin,
in type 2 diabetes).
Learning about the disease and actively participating in the treatment is important, since complications are
far less common and less severe in people who have well-managed blood sugar levels.[53][54]
Attention is
also paid to other health problems that may accelerate the negative effects of diabetes. These
include smoking, elevated cholesterol levels, obesity, high blood pressure, and lack of regular exercise.
Lifestyle
People with diabetes can benefit from education about the disease and treatment, good nutrition to achieve
a normal body weight, and exercise, with the goal of keeping both short-term and long-term blood
glucose levels within acceptable bounds. In addition, given the associated higher risks of cardiovascular
disease, lifestyle modifications are recommended to control blood pressure.
Medications

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Medications used to treat diabetes do so by lowering blood sugar levels. There are a
number of different classes of anti-diabetic medications. Some are available by
mouth, such asmetformin, while others are only available by injection like insulin.
Type 1 diabetes can only be treated with insulin,Severalother groups of drugs,
mostly given by mouth, may also decrease blood sugar in type II DM.
Since cardiovascular disease is a serious complication associatedwith diabetes, some
recommendblood pressure levels below 120/80 mmHg Aspirin is also
recommendedfor patient with cardiovascular problems, however routine use of
aspirin has not been found to improve outcomes in uncomplicateddiabetes.
Surgery
A pancreas transplant is occasionally considered for people with type 1 diabetes
who have severe complications of their disease, including end stage kidney
disease requiring kidney transplantation.[67]
Weight loss surgery in those with obesity and type two diabetes is often an
effective measure. Many are able to maintain normal blood sugar levels with
little or no medications following surgery[]
and long-term mortality is
decreased. There however is some short-term mortality risk of less than 1%
from the surgery. The body mass index cutoffs for when surgery is appropriate
are not yet clear. It is recommended that this option be considered in those who
are unable to get both their weight and blood sugar under control.

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Conclusion: care and
treatment
Here is a summary of the guidelines that will help you manage your diabetes for a lifetime of
good health

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1. Plan what you eat and follow a balancedmeal plan. See your dietitian at least once
a year.
2. Exercise at least five times a week for 30 minutes each session. Talk to your doctor
before starting any exercise program. Tell your doctor what kind of exercise you
want to do so adjustments can be made to your medicine schedule or meal plan, if
necessary.
3. Follow your medicine schedule as prescribedby your doctor.
4. Know what medicines (brandand generic names) you are taking and how they
work. Keep a list of your medicines with you at all times.
5. Test your blood glucose regularly, as recommendedby your health care provider.
Test your blood glucose more often when you're sick.
6. Try to continuouslykeep your blood glucose level at the recommended range. If
your blood glucose is less than 70 mg/dl and you have more than one
unexplainedlow blood glucose reaction a week, call your doctor. If your blood
glucose is greater than 160 mg/dl for more than a week or if you have two

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consecutive readings greater than 300 mg/dl, call your doctor.
7. Contact your doctor when your blood glucose is over 300 mg/dl. Test your urine
for ketones if recommendedby your doctor.
8. Record your blood glucose and urine ketone test results in a record keeping log.
Bringyour log book with you to all of your doctor's visits.
9. Keep your scheduledappointments with your health care providers. See your
doctor at least every three to four months for regular check-ups if you are treated
with insulin. See your doctor every four to six months if you are treated with other
diabetes medicines or if you are managingdiabetes with diet and exercise alone.
More frequent visits might be necessaryif your blood glucose is not controlledor
if complications of diabetes are progressing. Make sure your health care provider
checks your blood pressure and weight, and examines your feet and insulin
injection sites.
10. Have a glycosylated hemoglobin test (HbA1c) at least two times a year or more
frequentlyas recommendedby your doctor.
11. Have an eye exam (includinga retinopathyscreeningtest) and urinalysis test
once a year, or as recommendedby your doctor. (Your doctor might request that
you have these tests more frequently.)
12. Have your cholesterol andtriglyceride levels checked (lipidprofile test) once a
year.
13. Have a dental exam every six months.
14. If you have any signs of infection, call your doctor or health care provider.

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15. Practice good foot and skin care.
16. DO NOT SMOKE.
17. Try to manage stress as best as you can. You might think about attending a
stress management workshop to help you learn better coping methods.
18. Discuss your travel plans with your doctor. Make sure to bringenough
medicine and supplies with you on your trip. Keep medicines, syringes, and blood
glucose testing supplies in your carry-on bag. Do not check these supplies in case
your luggage is lost.
19. Continue learningaboutyour diabetes to maintain and improve your health.
Attend a diabetes class or schedule visits with your diabetes educator at least once
a year.