WONDUNARWNPR PPR NRO CONTENTS . AIM OF THE PROJECT. . INTRODUCTION. . TYPES OF DIABETES. . SIGNS AND SYMPTOMS. CAUSES. . DIAGNOSIS. . PREVENTION. . MANAGEMENT. . VISITING A DOCTOR. . YOGA CURES DIABETES. . CONCLUSION: CARE AND PREVENTION . BIBLOGRAPHY.Aim of the project To study about DIABETES and suggest ways to fight it. BLUE RING THE UNIVERSAL SYMBOL OF DIABETES.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 disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes. Specialty - Endocrinology Symptoms - Frequent urination, increased thirst, increased hunger Complications - Diabetic ketoacidosis , nonketotic hyperosmolar coma, heart disease, stroke, chronic kidney failure, foot ulcers Diagnostic method - High blood sugar Treatment - Healthy diet, physical exercise Medication - Insulin, metformin 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 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 at onset Mostly in children Mostly in adults Body size Thin or normal Often obese Ketoacidosis Common Rare Autoantibodies Usually present Absent Endogenous Low or absent Normal, decreased Insulin Or increased Concordance 50% 90% In identical twins Prevalence ~10% ~90%Main symptoms of Diabetes blue = more common In Type 1 yes - Blurred vision Stupor i Breath systemic ‘Smell of acetone Weightloss Gastric . ~ Nausea = Kussmaul = Vomiting breathing ie Abdominal (nyper- ventilation) 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.POTN CRD a hy 12. Weight Less Extreme —_rereasect Excessive Frequent Fivednese Pumger Thirst rtnation a es 1p Uh ¢ ‘Tingling and Blurvedt Unneated ene Vision Wound Urine Attracting Ants 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 1 diabetes is of the immune-mediated nature, in which aT cellmediated 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 DMis 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 Pima 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 2 11.1 mmol/l (200 mg/dl) two hours after a 75 g oral glucose load as in a glucose tolerance test * Symptoms of high blood sugar and casual plasma glucose 2 11.1 mmol/I(200 mg/dl) © Glycated hemoglobin (HbA1C) 2 48 mmol/mol (2 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 ona different day. It is preferable to measure a fasting glucose level because of the ease of measurement and the considerable time commitment of formal 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 126 mg/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 90 minutes per day) reduce the risk of diabetes by 28%.Dietary changes 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 policy environment. MANAGEMENT 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 metformin, 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 ina team approach. Home telehealth support can be an effective management technique. YOGA CURES DIABETES Yoga Asana useful for Diabetes cure are those which bring about a stretch and twist in lower thoracic and upper lumbar region, where pancreas is located. These yoga asana are believed to increase the blood supply, massage the organs, activate its cells and thereby cause an increase in secretion of insulin; reducing high blood sugar. Yoga asana regenerates/rejuvenates pancreatic cells by abdominal stretching; also by enhancing enzymatic process it may increase utilization and metabolism of glucose in peripheral tissues. * Yoga Asana can cause muscular relaxation, enhance muscular development and improve circulation to muscles; all of these might enhance insulin receptor expression on muscles and causes increase in glucose uptake by muscles and thus reducing blood sugar.