ACKNOWLEDGEMENT

I would like to express my sincere gratitude to all these

individuals for mentioning and supporting me in
completing this project.
My biology teacher Manisha Patra, for providing me
with invaluable insights and directions.
Our esteemed principal Bidhan Kanti Biswas, for
fostering an environment of learning and creativity
within our school.
To my parents, their constant encouragement,
patience, and understanding have been the pillars of
my success.
I am grateful to my friends who contributed ideas and
perspective that enriched the project. Thank you
everyone for shaping this project and enhancing my
learning experience.
Thank you all,
With warm regards.

Aritrika Pandey
INDEX
Seria Title Page no.
l no.

01. Objective of the project 03

02. Introduction 04

03. Types of diabetes 05-06

04. Comparison of Type 1 And 07

Type 2 diabetes

05. Signs and symptoms 08

06. Causes 09-10

07. Diagnosis 11

08. Prevention 12

09. Management 13-15

10. Case Study 16-23

11. Conclusion 24

12. Bibliography 25
OBJECTIVE OF THE PROJECT :
To study about Diabetes mellitus
 Diabetes mellitus is a disease, in which the body’s
ability to produce or respond to the hormone
insulin is impaired, resulting in abnormal
metabolism of carbohydrates and elevated levels
of glucose in the blood.
 INTRODUCTION :

Diabetes mellitus (DM), commonly referred to as

diabetes, is a group of metabolic disorders in which
there are high blood sugar levels over a prolonged
period.
Symptoms of high blood sugar include frequent
urination, increased thirst, and increased hunger.
If left untreated, diabetes can cause many
complications. Acute complications can include
diabetic ketoacidosis, hyperosmolar hyperglycemic
state or death.
Serious long-term complications include cardiovascular
diseases, foot ulcers, and damages to the eyes.
 Specialty : Endocrinology
 Symptoms: Frequent urination, increased thirst,
increased hunger.
 Complications : Diabetic ketoacidosis, nonketotic
hyperosmolar coma, heart diseases, stroke, chronic
kidney failure, foot ulcers.
 Diagnostic method : High blood sugar
 Treatment : Healthy diet, physical exercise
 Medication : Insulin, Methformin
  Frequency : 415 million (8.5%)
 Deaths : 1.5 – 5.0 million per year.

TYPES OF DIABETES:

Diabetes is due to either the pancreas not producing

enough insulin or the cells of the body not responding
properly to the insulin produced.

There are three main types of diabetes mellitus:

 Type 1 DM : Results from the pancreas's failure
to produce enough insulin . This form was
previously referred to as "insulin-dependent
diabetes mellitus" (IDDM) or "juvenile diabetes".
The cause is 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 "non insulin-dependent diabetes
mellitus" (NIDDM)or "adult-onset diabetes". The
most common cause is excessive body weight and
not enough exercise.

 Gestational diabetes : It is the third main form

and occurs when pregnant women without a
previous history of diabetes develop high blood
sugar levels
 Comparison of Type 1 and Type 2
diabetes:
Feature Type 1 diabetes Type 2 diabetes
Onset Sudden Gradual
Age of onset Mostly in children Mostly in adults
Body size Thin or normal Obese
Ketoacidosis Common Rare
Autoantibodies Usually present Absent
Endogenous Low or absent Normal,
insulin increased,
decreased
Concordance 50% 90%`
in identical twins
Prevalence ~10% ~90%
 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 DM, while they usually develop much more
slowly and may be subtle or absent in type 2 DM.

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
dermadromes.

CAUSES :

 Type 1 : Type 1 diabetes mellitus is characterized

by loss of the insulin-producing beta cells of the
pancreatic islets, leading to insulin deficiency. This
type can be further classified as immune-mediated
or idiopathic. The majority of type 1diabetes is of
the immune-mediated nature, in which a T cell
mediated autoimmune attack leads to the loss of
beta cells and thus insulin. 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 2 : Type 2 DM is primarily due to lifestyle

factors and genetics. A number of lifestyle factors
 are known to be important to the development of

type 2 DM including obesity (defined by a body

mass index of greater than 30), lack of physical
activity, poor diet, stress, and urbanization. Excess
body fat is associated with 30% of cases in those of
Chinese and Japanese descent, 60 - 80% of cases
in those of European and African descent, and
100% of Indians and Pacific Islanders. Even those
who are not obese often have a high waist-hip
ratio.

 Gestational diabetes : Gestational diabetes

mellitus (GDM) resembles type 2 DM in several
respects, involving a combination of relatively
inadequate insulin secretion and responsiveness. It
occurs in about 2-10% of all pregnancies and may
improve or disappear after delivery.
 DIAGNOSIS :

Diabetes mellitus is characterized by recurrent or

persistent high blood sugar, and is diagnosed by
demonstrating any one of the following:

 Fasting plasma glucose level ≥ 7.0 mmol/l (126

mg/dl)
 Plasma glucose ≥ 11.1 mmol/l (200 mg/dl) two
hours after a 75 goral glucose load as in a glucose
tolerance test.
 Symptoms of high blood sugar and casual plasma
glucose ≥ 11.1mmol/l(200 mg/dl)
 Glycated hemoglobin (HbA1C) ≥ 48 mmol/mol (≥
6.5 DCCT %).

A positive result, in the absence of unequivocal high

blood sugar, should be confirmed by a repeat of any of
the above methods on a different day. It is preferable
to measure a fasting glucose level because of the ease
of measurement and the considerable time
commitment off normal glucose tolerance testing,
which takes two hours to complete and offers no
prognostic advantage over the fasting test. According
to the current definition, two fasting glucose
measurements above 126mg/dl (7.0 mmol /l) is
considered diagnostic for diabetes mellitus.
PREVENTION :
There is no known preventive measure for type 1
diabetes. Type 2 diabetes which accounts for 85-90%
of all cases can often be prevented or delayed by
maintaining a normal body weight, engaging in
physical activity, and consuming a healthful diet.
Higher levels of physical activity (more than 90minutes
per day) reduce the risk of diabetes by
28%.Dietarychanges known to be effective in helping
to prevent diabetes include maintaining a diet rich in
whole grains and fiber, and choosing good fats, such as
the polyunsaturated fats found in nuts, vegetable oils,
and fish. Limiting sugary beverages and eating less red
meat and other sources of saturated fat can also help
prevent diabetes. Tobacco smoking is also associated
with an increased risk of diabetes and its
complications, so smoking cessation can be an
important preventive measure as well. The relationship
between type 2 diabetes and the main modifiable risk
factors (excess weight, unhealthy diet, physical
inactivity and tobacco use) is similar in all regions of
the world. There is growing evidence that the
underlying determinants of diabetes are a reflection of
the major forces driving social, economic and cultural
change: globalization, urbanization, population aging,
and the general health.
 MANAGEMENT :

 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.

 MEDICATIONS : 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 as methformin, while others are only
available by injection such as GLP-1 agonists. Type
1 diabetes can only be treated with insulin,
typically with a combination of regular and NPH
insulin, or synthetic insulin analogs.

 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.
 SUPPORT : In countries using a general
practitioner system, such as the United Kingdom,
care may take place mainly outside hospitals, with
hospital-based specialist care used only in case of
complications, difficult blood sugar control, or
research projects. In other circumstances, general
practitioners and specialists share care in a team
approach. Home telehealth support can be an
effective management technique. It has been seen
that various yoga postures can improve sensitivity
of b-cells of the pancreas to glucose signal and also
improve insulin sensitivity. This can result in better
glucose uptake and reduction of blood sugar.
Certain Yoga Asana can directly stimulate pancreas
by enhancing circulation in the meridian of
pancreas and rejuvenates its capacity to produce
insulin. Evidence suggests that regular yoga
practice can significant reduce body weight, which
is particularly important to keep diabetes under
check. Symptoms of diabetes can be worsened by
increase in blood pressure. Yoga Asana like corpse
pose, bridge pose child pose and yoga nidra has
been seen beneficial in controlling hypertension.
 CASE STUDY

Requirements: Two patients

  PATIENT no. 1:
 Name : Mira Sarkar
 Gender : Female
 Date of Birth : 19/07/70
 PID (Pelvic inflammatory disease) : None
 Local Address: Prantik, Ichapur, North 24
Parganas, PO:Nawabganj, pin: 743144
 Phone: +91 9123632234
 Email : mirasarkardp@gmail.com

Questionaire :
1. When were you first diagnosed with diabetes?
2. Year : 2015 Age: 45 years
3. Please list all medication(s) you take, including
dosage
Ans: metformin (Glumetza, Riomet, Riomet ER)
4. Where do you give your injection?
Ans: The upper arm.
5. Do you rotate sites with each injection?
Ans: No.

6. Any problems with sites (lumping, pitting, etc.)?

Ans: No.
7. Do you exercise regularly?
Ans: Yes.
8. About how many times a week?
Ans: 5 days a week.
9. Types of exercise?
Ans: aerobic exercise, resistance training and
flexibility and balance exercise.
10. Usual time of day and length of time?
Ans: In the morning. About 45 minutes.
11. Problems with exercise-related low blood
sugar reactions?
Ans: Yes.
12. Any complications of diabetes? Ans: Not yet.
  PATIENT NO. 2 :
 Name : Swapna Sarkar
 Gender : Female
 Date of Birth : 27/07/83
 PID (Pelvic inflammatory disease) : None
 Local Address: Maniktala, North 24 Parganas,
PO:Nawabganj, pin: 743144
 Phone: +91 7003452314
 Email : sarkarswapna27@gmail.com

 Questionaire :
1.Why do you eat to avoid low blood sugar reactions?
Ans.: I avoid carbohydrates in the morning.
 2.What is the most challenging aspect of nutrition for
you?
Ans.: I think, avoiding sugar.
3.Have you ever attended sessions with a registered
dietitian?
Ans. : Yes
4.Regarding diabetes, have you recently felt angry,
sad, scared, stressed?
Ans.: Yes
5.Do you rotate sites with each injection?
Ans: No.
6. Any problems with sites (lumping, pitting, etc.)?
Ans: No.
7.Do you exercise regularly?
Ans: Yes.
8.About how many times a week?
Ans: 5 days a week.
9. Types of exercise?
Ans: aerobic exercise, resistance training and
flexibility and balance exercise.
10. Usual time of day and length of time?
Ans: In the morning. About 45 minutes.
11. Problems with exercise-related low blood
sugar reactions?
Ans: Yes.
12. Any complications of diabetes?
Ans: Not yet.
 Few words from expert :

“If you have diabetes, your body doesn’t make enough

or any—insulin, or doesn’t use insulin properly. Glucose
then stays in your blood and doesn’t reach your cells.
Diabetes raises the risk for damage to the eyes,
kidneys, nerves, and heart. Diabetes is also linked to
some types of cancer. Taking steps to prevent or
manage diabetes may lower your risk of developing
diabetes health problems.”

[Designation of Dr.]
 Conclusion :
Diabetes mellitus is growing to epidemic proportions,
leading to devastating complications if not treated
well. There are many challenges in the successful
treatment of diabetes mellitus because of personal and
economic costs incurred in diabetes therapy.
 BIBLOGRAPHY :

 N.C.E.R.T. CLASS XII BIOLOGY textbook.

 https://en.wikipedia.orgwiki/
Diabetes_mellitushttps://

 www.mokshamantra.com/yoga-fordiabetes-high-
blood-sugarhttp://

 www.alamy.com/stock-photo-diabetesmellitus