A Comprehensive Study on Diabetes

Mellitus – Type 1 and Type 2

NAME : HARSHIT.B.P
CLASS : XII A
SUBJECT : BIOLOGY

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ACKNOWLEDGEMNET

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CERTIFICATE PAGE

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INDEX

SL TOPIC PAGE
NO. NO.
1. Introduction to Diabetes 5
2. Types of Diabetes Mellitus 6
3. Type 1 Diabetes – Causes, 7
Symptoms, Diagnosis, Treatment
4. Type 2 Diabetes – Causes, Risk 11
Factors, Diagnosis, Treatment
5. Symptoms & Diagnosis of Diabetes 14
6. Treatment & Management 16
7. Complications of Uncontrolled 19
Diabetes
8. Prevention of Type 2 Diabetes 20
9. Recent Research & Innovations 20
10. Case Study / Real-Life Example 21
11. Role of WHO and India’s National 22
Programs
12. Conclusion 23
13. Bibliography 24

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1. Introduction to Diabetes
A. What is Diabetes?
Diabetes mellitus is a chronic health condition characterized by elevated levels of
blood glucose, commonly known as blood sugar. Glucose serves as the primary
energy source for the body's cells and is derived from the food we consume. The
hormone insulin, produced by the pancreas, facilitates the entry of glucose into
cells to be utilized for energy. In individuals with diabetes, the body either does not
produce sufficient insulin or cannot effectively use the insulin it produces. This
inefficiency leads to an accumulation of glucose in the bloodstream, resulting in
high blood sugar levels.

There are several types of diabetes, with the most prevalent being:

 Type 1 Diabetes: An autoimmune condition where the body's immune

system attacks and destroys insulin-producing beta cells in the pancreas,
leading to little or no insulin production.
 Type 2 Diabetes: A metabolic disorder where the body becomes resistant to
insulin or doesn't produce enough insulin, often associated with lifestyle
factors.
 Gestational Diabetes: A form of diabetes that develops during pregnancy
and usually resolves after childbirth but increases the risk of developing type
2 diabetes later in life.

B. Why is it Important to Study Diabetes?

Understanding diabetes is crucial due to its widespread impact on global health.

According to the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), prolonged high blood glucose levels can lead to serious health
complications, including heart disease, kidney failure, nerve damage, and vision
problems.

Moreover, diabetes education plays a vital role in improving the quality of life for
individuals with the condition. Effective diabetes education can lead to better self-
management, reducing the risk of complications such as diabetic foot ulcers and
amputations, which are both physically and financially burdensome.

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Studying diabetes also contributes to the development of new treatments and
management strategies. Clinical research allows for the testing of new medications
and therapies, aiming to enhance the effectiveness of diabetes care and ultimately
find a cure.

2. Types of Diabetes Mellitus

Diabetes Mellitus is broadly classified into several types based on the cause and
mechanism of the disease. The most common forms are Type 1, Type 2, and
Gestational Diabetes.

A. Type 1 Diabetes

Type 1 Diabetes is an autoimmune disorder in which the immune system

mistakenly attacks and destroys the insulin-producing beta cells of the pancreas.
As a result, the body is unable to produce insulin, a hormone essential for glucose
absorption by cells.

 Usually diagnosed in children and young adults

 Requires daily insulin injections or an insulin pump
 Not preventable
 Symptoms include excessive thirst, frequent urination, weight loss, fatigue,
and blurred vision

According to the American Diabetes Association (ADA), Type 1 diabetes accounts

for about 5–10% of all diabetes cases

B. Type 2 Diabetes

Type 2 Diabetes is the most common form, making up about 90–95% of cases. It is
primarily caused by insulin resistance, where the body’s cells do not respond
properly to insulin, and relative insulin deficiency.

 More common in adults but increasingly seen in children due to rising

obesity

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  Strongly linked to lifestyle factors: poor diet, lack of exercise, and obesity
 Often manageable through diet, exercise, and oral medications
 May require insulin in advanced stages

As per the Centers for Disease Control and Prevention (CDC), lifestyle changes
can help prevent or delay Type 2 diabetes in many at-risk individuals.

C. Gestational Diabetes (GDM)

Gestational Diabetes occurs during pregnancy when the body cannot produce
enough insulin to meet the extra needs.

 Affects 2%–10% of pregnancies in India and worldwide

 Typically resolves after delivery, but increases the risk of Type 2 Diabetes
later in life for both mother and child
 Managed through diet, exercise, and sometimes insulin

According to the World Health Organization, early screening and care during
pregnancy are crucial for managing GDM and ensuring a healthy birth outcome.

3. Type 1 Diabetes
A. What is Type 1 Diabetes?
Type 1 Diabetes Mellitus (T1DM) is a chronic autoimmune disease where the
body’s own immune system attacks and destroys the beta (β) cells of the pancreas
that produce insulin—a hormone crucial for controlling blood sugar levels.
Without insulin, glucose cannot enter the cells and remains in the bloodstream,
leading to hyperglycemia (high blood sugar).

"Type 1 diabetes accounts for about 5-10% of all diagnosed diabetes cases and is
not preventable."

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Cause: Autoimmune Destruction of β-cells

In Type 1 diabetes, T-cells, a type of immune cell, mistakenly target and destroy
pancreatic β-cells located in the islets of Langerhans. This immune response may
be triggered by:

 Genetic predisposition (HLA genes)

 Environmental factors (e.g., viral infections like Coxsackievirus)
 Family history of autoimmune diseases

As β-cells are destroyed, insulin levels fall drastically, and blood sugar rises.

Scientific Note: Antibodies like GAD65, ICA, and insulin autoantibodies (IAA)
are often found in individuals developing T1DM.

Age of Onset

 Most commonly diagnosed in children, adolescents, and young adults

 Peak age: Between 4–14 years
 However, it can occur at any age, even in adulthood (called LADA – Latent
Autoimmune Diabetes in Adults)

According to the International Diabetes Federation (IDF), India is among the top
countries with rising childhood Type 1 diabetes rates.

B. Symptoms

Type 1 diabetes symptoms usually appear suddenly and may include:

 Polyuria: Frequent urination

 Polydipsia: Increased thirst
 Polyphagia: Increased hunger
 Unexplained weight loss
 Extreme fatigue
 Blurred vision
 Fruity-smelling breath (due to ketones)
 In severe cases: Diabetic Ketoacidosis (DKA), a life-threatening emergency

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C. Diagnosis

Diagnosis of Type 1 diabetes involves several tests:

1. Fasting Blood Glucose ≥ 126 mg/dL

2. HbA1c Test ≥ 6.5% (average blood sugar over 3 months)
3. Oral Glucose Tolerance Test (OGTT)
4. Random Blood Glucose Test ≥ 200 mg/dL
5. Autoantibody Testing (to confirm autoimmune cause)
6. C-peptide test (low levels indicate lack of insulin production)

D. Treatment: Insulin Therapy

Since Type 1 diabetes results in little or no insulin production, insulin therapy is
essential for survival.

Types of Insulin:

 Rapid-acting (e.g., Lispro)

 Short-acting (e.g., Regular insulin)
 Intermediate-acting (e.g., NPH)
 Long-acting (e.g., Glargine, Detemir)

Methods of Insulin Delivery:

 Insulin syringes
 Insulin pens
 Insulin pumps
 Continuous Glucose Monitoring (CGM) combined with pumps for precision

Patients must balance insulin doses with food intake and physical activity.

Daily Life and Precautions

Living with Type 1 diabetes requires careful day-to-day management. Here are key
aspects:

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1. Blood Glucose Monitoring

 4–8 times daily or via CGM

 Target range: 80–130 mg/dL (fasting)

2. Dietary Control

 Balanced diet with controlled carbohydrate intake

 Prefer low-glycemic index foods
 Frequent, smaller meals

3. Physical Activity

 Regular exercise helps insulin sensitivity

 Must monitor sugar before and after activity to prevent hypoglycemia

4. Hypoglycemia Management

 Symptoms: Shaking, sweating, confusion

 Immediate intake of sugar (glucose tablets, juice)
 Carry snacks/glucose sources at all times

5. Long-term Complication Prevention

 Regular eye check-ups (retinopathy)

 Kidney function tests
 Nerve exams (neuropathy)
 Foot care

6. Mental and Emotional Wellbeing

 Diabetes distress is common

 Support groups, counseling, or therapy can help

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4. Type 2 Diabetes
A. What is Type 2 Diabetes?

Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder where the body
either becomes resistant to insulin or doesn't produce enough insulin to maintain
normal blood sugar levels. Unlike Type 1, the pancreas still produces insulin in
Type 2—but the body's cells don’t respond effectively to it.

“Type 2 diabetes accounts for 90–95% of all diabetes cases globally.” — CDC

Cause: Insulin Resistance + Lifestyle

In Type 2 diabetes:

 The body’s cells become resistant to insulin, so glucose is not absorbed

properly.
 The pancreas compensates by producing more insulin, but over time, the β-
cells get exhausted, leading to relative insulin deficiency.

Causes include:

 Obesity and excess fat, especially abdominal fat

 Sedentary lifestyle
 Unhealthy diet (high sugar, processed foods)
 Genetic predisposition
 Hormonal imbalances (like PCOS, stress hormones)

Scientific Note: Obesity leads to chronic low-grade inflammation, which

interferes with insulin signaling in muscle and liver cells.

Age of Onset

 Commonly develops in adults over the age of 40

 Increasingly seen in teenagers and children due to poor lifestyle habits

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  Onset is gradual and often goes undiagnosed for years

B. Symptoms of Type 2 Diabetes

Symptoms are often mild at first but worsen with time:

 Frequent urination (polyuria)

 Excessive thirst (polydipsia)
 Unexplained weight changes
 Fatigue
 Slow-healing wounds
 Blurry vision
 Numbness or tingling in hands and feet (due to neuropathy)
 Recurring infections (skin, gums, bladder)

Risk Factors

Many risk factors increase the chances of developing Type 2 diabetes:

1. Obesity

 Particularly abdominal or visceral fat

 Increases insulin resistance

2. Genetics

 Family history of Type 2 diabetes increases risk

 Certain ethnicities (South Asians, African Americans) are more prone

3. Lifestyle Factors

 Sedentary behavior
 Poor diet (high sugar, fried foods)
 Smoking and alcohol use
 Stress and poor sleep

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4. Other Conditions

 High blood pressure

 High cholesterol
 Polycystic Ovary Syndrome (PCOS)
 Gestational diabetes history

"Over 77 million people in India are estimated to have Type 2 diabetes as of 2021."
— International Diabetes Federation (IDF)

C. Diagnosis
Diagnosis is often done during routine screening or when symptoms appear.

1. Fasting Blood Sugar ≥ 126 mg/dL

2. HbA1c Test ≥ 6.5%
3. Random Blood Glucose Test ≥ 200 mg/dL
4. Oral Glucose Tolerance Test (OGTT) ≥ 200 mg/dL after 2 hours
5. Urine test (checks for glucose and ketones)

D. Treatment

1. Medications

 Metformin: Most commonly prescribed to reduce glucose production in the

liver
 Sulfonylureas: Stimulate insulin release
 SGLT2 Inhibitors: Help kidneys remove excess glucose
 GLP-1 Agonists: Improve insulin release and reduce appetite
 Insulin injections: Used if oral medications fail

2. Lifestyle Modifications

 Weight loss (5–10% can make a big difference)

 30 minutes of daily exercise (walking, swimming, yoga)
 Low-glycemic diet

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  Quitting smoking and limiting alcohol
 Stress management (yoga, meditation)

Daily Life and Diet

Living with Type 2 diabetes means building daily routines that support stable
blood sugar levels.

Daily Routine Tips:

 Monitor blood glucose regularly

 Take medications on time
 Schedule meals and snacks
 Stay hydrated

5. Symptoms & Diagnosis of Diabetes

A. Common Symptoms of Diabetes (Both Type 1 & Type 2)
While the onset and severity of symptoms can differ between Type 1 and Type 2
diabetes, many warning signs are common across both types. Recognizing these
symptoms early is key to timely diagnosis and prevention of complications.

Frequent Symptoms:

 Increased urination (Polyuria): The kidneys work harder to eliminate excess

glucose, resulting in more frequent urination.
 Excessive thirst (Polydipsia): Due to frequent urination, the body becomes
dehydrated, increasing thirst.
 Unexplained weight loss: Especially common in Type 1 diabetes, due to the
body burning fat and muscle for energy.
 Increased hunger (Polyphagia): Despite eating enough, glucose isn’t being
utilized properly, triggering hunger.
 Extreme fatigue: Lack of glucose in the cells leads to low energy levels.
 Blurred vision: High sugar levels pull fluid from the eyes, affecting focus.

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  Slow-healing wounds and infections: High blood sugar impairs the immune
system and damages blood vessels.
 Tingling or numbness in hands and feet: Due to nerve damage (diabetic
neuropathy).
 Dark skin patches (Acanthosis Nigricans): Often seen in Type 2 diabetes,
especially around the neck or armpits.

Note: In Type 1 diabetes, symptoms often appear suddenly and severely. In Type
2, they develop gradually and may go unnoticed for years.

B. Diagnostic Tests for Diabetes

Early diagnosis is essential to avoid complications like nerve damage, kidney

disease, heart problems, and vision loss. Several simple blood tests are used to
detect diabetes:

1. Fasting Blood Sugar (FBS) Test

 What it is: Measures blood glucose after 8–12 hours of fasting.

 Normal: Below 100 mg/dL
 Pre-diabetic: 100–125 mg/dL
 Diabetic: 126 mg/dL or above on two separate tests

Common first-line test for diabetes.

2. HbA1c (Glycated Hemoglobin) Test

 What it is: Measures the average blood sugar over the past 2–3 months.
 Normal: Below 5.7%
 Pre-diabetic: 5.7% – 6.4%
 Diabetic: 6.5% or above

3. Oral Glucose Tolerance Test (OGTT)

 What it is: Blood sugar is tested before and 2 hours after drinking a glucose-
rich solution (75g glucose).
 Normal (after 2 hrs): Less than 140 mg/dL
 Pre-diabetic: 140–199 mg/dL
 Diabetic: 200 mg/dL or above
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4. Random Blood Sugar Test

 What it is: Blood sugar tested at any time of the day.

 Diabetes: ≥ 200 mg/dL (with symptoms)

6. Treatment & Management of Diabetes

Managing diabetes is a lifelong process that involves a combination of medication,
lifestyle changes, dietary control, and constant monitoring. Effective management
not only controls blood glucose levels but also prevents long-term complications
like heart disease, kidney failure, and vision loss.

1. Medicines

 For Type 1 Diabetes:

 No oral medications are effective. Insulin therapy is essential.

 For Type 2 Diabetes:

A variety of oral and injectable drugs are available to improve insulin sensitivity
and reduce glucose production.
Medication Class Example Function
Reduces glucose production in the
Biguanides Metformin
liver
Stimulates the pancreas to
Sulfonylureas Glimepiride
release insulin
Increases insulin release after
DPP-4 inhibitors Sitagliptin
meals
Dapaglifloz Helps kidneys remove sugar
SGLT2 inhibitors
in through urine
GLP-1 receptor Slows digestion and reduces
Liraglutide
agonists sugar spikes

2. Insulin Therapy

Insulin is essential for people with Type 1 diabetes and sometimes for advanced
Type 2 diabetes.

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  Types of Insulin:
o Rapid-acting: Acts within minutes (e.g., Lispro)
o Short-acting: Takes 30–60 mins (e.g., Regular insulin)
o Intermediate-acting: Lasts 12–18 hours (e.g., NPH)
o Long-acting: Controls sugar levels all day (e.g., Glargine)
 Modes of Delivery:
o Syringe or pen
o Insulin pump
o Inhaled insulin (rare)

3. Lifestyle and Diet Management

A balanced, low-sugar, and high-fiber diet is crucial for diabetic patients.

 Foods to Prefer:
o Whole grains (brown rice, oats)
o Leafy vegetables
o Lentils, beans
o Lean proteins (eggs, tofu, fish)
o Fruits with low glycemic index (berries, apple, guava)
 Foods to Avoid:
o Sugary drinks and sweets
o Processed/junk food
o White bread and rice
o Excess red meat
 Recommended Practices:
o Eat small, frequent meals
o Avoid skipping meals
o Drink plenty of water

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4. Exercise

Regular physical activity helps improve insulin sensitivity and reduces blood sugar
levels naturally.

 Recommended: 30 minutes/day, 5 days/week

 Examples:
o Walking or jogging
o Yoga and stretching
o Cycling or swimming
o Light weight training

5. Monitoring Blood Sugar Levels

Self-monitoring is critical for adjusting medications, diet, and activity levels.

 Tools Used:
o Glucometer (for daily readings)
o Continuous Glucose Monitor (CGM)
o HbA1c test (every 3 months)

Monitoring
Ideal Frequency
Schedule
Type 1 Diabetes 4–10 times/day
1–2 times/day (or as
Type 2 Diabetes
advised)

Record Keeping:
 Patients are advised to maintain a blood sugar logbook and share it with
doctors during check-ups.
 Consistent monitoring helps prevent dangerous highs (hyperglycemia) and
lows (hypoglycemia).

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7. Complications of Uncontrolled Diabetes
When diabetes is not properly managed, persistently high blood sugar levels can
lead to serious and sometimes life-threatening complications:

1. Kidney Damage (Diabetic Nephropathy)

 The kidneys’ filtering system becomes damaged over time.

 May lead to protein leakage into urine and eventually kidney failure.
 Diabetes is the leading cause of end-stage renal disease (ESRD) worldwide.

2. Eye Damage (Diabetic Retinopathy)

 High glucose damages the blood vessels in the retina.

 Can cause blurred vision, cataracts, glaucoma, and even blindness.
 Regular eye check-ups are crucial for early detection.

3. Nerve Problems (Diabetic Neuropathy)

 Leads to numbness, tingling, or pain in hands and feet.

 Can impair digestion and sexual function.
 In extreme cases, untreated foot injuries can lead to amputation.

4. Cardiovascular Risks

 Diabetics have 2–4 times higher risk of heart attacks and strokes.
 Leads to atherosclerosis, high blood pressure, and heart failure.
 Maintaining sugar, cholesterol, and blood pressure is essential.

8. Prevention of Type 2 Diabetes

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While Type 1 is not preventable, Type 2 diabetes is largely avoidable with healthy
lifestyle choices:

Healthy Eating

 Reduce sugar and refined carbs.

 Increase fiber, whole grains, and lean proteins.
 Avoid processed and junk food.

Regular Exercise

 At least 150 minutes of moderate activity per week.

 Helps with weight control and insulin sensitivity.

Avoiding Obesity

 Obesity is the most significant risk factor.

 Maintain BMI between 18.5 and 24.9.
 Avoid sedentary behavior (like long hours of screen time).

Early Screenings

 Regular blood sugar tests (especially for those with family history).
 Annual HbA1c and fasting glucose tests can detect prediabetes early.

9. Recent Research & Innovations

1. Artificial Pancreas

 Combines a continuous glucose monitor (CGM) with an insulin pump.

 Automatically regulates insulin delivery in real-time.
 A major advancement for Type 1 diabetes management.

2. Islet Cell Transplant

 Transplanting insulin-producing β-cells from a donor pancreas.

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  Still experimental but shows promise in reducing insulin dependence.
 Challenges include immune rejection and short lifespan of transplanted cells.

3. Gene Therapy

 Focuses on correcting defective insulin genes.

 Researchers are exploring CRISPR-based editing to reverse Type 1 diabetes.
 Still in pre-clinical trials.

4. New Drug Developments

 Smart insulins that activate only when needed.

 Dual agonist drugs (e.g., tirzepatide) that control both sugar and weight.
 Oral insulin capsules are being tested for better compliance.

10. Case Study / Real-Life Example

Nick Jonas – A Celebrity with Type 1 Diabetes

 The popular American singer was diagnosed with Type 1 diabetes at age 13.
 Initially hospitalized with a blood sugar level over 700 mg/dL.
 Uses an insulin pump and CGM to manage his condition.
 He advocates for diabetes awareness through his foundation Beyond Type 1.
 Nick Jonas is proof that with proper care and attitude, diabetes can’t stop
you from achieving greatness.

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11. Role of WHO & India’s National Programs
World Health Organization (WHO):

 Launched the Global Diabetes Compact (2021) to reduce premature deaths.

 Aims to ensure access to affordable insulin and monitoring devices.
 Works with nations to promote health education and healthy lifestyles.

🇮🇳 India’s National Efforts:

 NPCDCS (National Programme for Prevention & Control of Cancer,

Diabetes, Cardiovascular Diseases and Stroke):
o Set up to provide screening, diagnosis, and treatment at grassroots
levels.
o Health camps, mobile units, and awareness drives organized.
 Ayushman Bharat Program offers free treatment at government hospitals.
 Promotion of yoga and traditional diets under Fit India Movement.

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12. CONCLUSION
Working on this project has been a truly enlightening experience. Before starting, I
had a basic idea of what diabetes was, but I didn’t fully understand how deeply it
affects millions of people around the world—both physically and emotionally.
Through detailed research and analysis, I now understand that diabetes is not just a
disease of high blood sugar, but a chronic condition that demands constant
management, awareness, and support.

I explored the three main types of diabetes—Type 1, Type 2, and Gestational

Diabetes. Learning about Type 1 diabetes showed me how an autoimmune disorder
can lead to the complete destruction of insulin-producing cells, making people
dependent on insulin for the rest of their lives. I was especially moved by the fact
that many of these cases are diagnosed in children and teenagers, which means that
they have to deal with this condition from a very young age. This made me
appreciate the mental strength and discipline that these individuals must have.

Type 2 diabetes, which is the most common form, gave me a new perspective on
how lifestyle choices such as diet, exercise, and weight management play a crucial
role in preventing or delaying the disease. It was surprising to learn that while
genetics play a role, a large number of cases could be prevented with healthier
habits. This information encouraged me to reflect on my own eating habits and
physical activity, and inspired me to be more conscious about my health moving
forward.

This project has not only increased my knowledge of diabetes as a medical

condition but also taught me valuable life lessons about responsibility, discipline,
and the importance of a healthy lifestyle. It has inspired me to spread awareness
among friends and family and encouraged me to adopt better habits in my own life.
As a student, I feel more informed and empowered to contribute positively to the
health of my community.

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BIBLIOGRAPHY

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