Dr.Shreeram Vaidya

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Dr.Shreeram Vaidya

• Diabetes, Yes We can control

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What is Diabetes Mellitus?

• 1500 BC Ebers Papyrus First Described Diabetes
• Diabetes means to siphon .The most obvious sign
  of diabetes is excessive urination
• Mellitus means sweet like a honey.
• It is a disorder of carbohydrate metabolism.
• In which bodys blood sugar (glucose)
• Level remains too high and causes problems.
• Insulin allows bodys cells to use glucose as a
  fuel .

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400 BC Sushrut

• Diabetes Causes
• Genetical
• Environmental

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In 1889 Minkowski

• In 1889 Minkowski, with the German physiologist
  Joseph von Mering (1849-1908), discovered that
  dogs subjected to removal of their pancreas
  develop the symptoms of diabetes, leading
  Minkowski to postulate that the pancreas is the
  site of secretion of an antidiabetic substance,
  now known to be insulin.

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Noble story of Insulin 1921

• DR Banting DR Best isolated insulin
• From pancreas of dog
• Insulin injected to a diabetic dog showed fall
  in glucose levels

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First insulin use Jan 11 1922

• On January 11, 1922, a 14-year-old with type 1
  diabetes named Leonard Thompson received an
  experimental injection at the Toronto General
  Hospital that would change history. At the time,
  type 1 diabetes was thought to be a death
  sentence. Thompson's life was extended by an
  additional 13 years using insulin.

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Pancreas

• The pancreas has an exocrine portion that
  secretes digestive enzymes that are carried
  through a duct to the duodenum. The endocrine
  portion consists of the pancreatic islets, Paul
  Langerhans 1869 Described clusters of cells
  (islets )
• In the pancreas which secrete Glucagon and
  insulin.

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Types Of Diabetes Mellitus

• Type I DM Insulin Dependent Diabetes
• 5-10 of diabetic patients. Usually affects
• Children.
• In this condition pancreas of the patients
• Produce practically no insulin. The patients
  survival is dependent on external insulin.

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Types of Diabetes cont

• Type II Diabetes Non Insulin Dependent
• Diabetes
• Causes
• Genetically
• Environmental
• Insulin is insufficient or insensitive

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Diabetes in the World
Year2010
millions
Reference Wild S, Roglic G, Green A, Sicree R,
King H. Global prevalence of diabetes. Diabetes
Care. 2004 27(5) 1047-1053.
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Symptoms of DM

• Excessively Thirsty (polydypsia)
• Passing a lot of urine (Polyuria)
• Excessive eating ( Polyphagia)
• Delayed wound healing
• Tiredness leg pains and numbness in the foot.
• Person may not have any symptom
• REGULAR CHECKING IS THE KEY

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Diagnosis

• Fasting Glucose gt126mg
• Post Lunch (2Hrs) gt/ 200mg

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Treatment

• Dietary restrictions
• Exercise Burns fats controls obesity
• Drugs Oral or insulin
• Once diabetic Diet restrictions and exercise
  always required

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Diet for Diabetics

• Avoid ice-creams, barfis,pedas,jams, jellies,
  chocolates ,soft drinks, these items cause a
  sudden rise in blood glucose.
• Avoid also butter ,ghee, cream, paneer, deep
  fried food, coconut.
• Fruits to be avoided mangoes bananas , chickoos.

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Diet cont

• Diet
• Lots of salad Carrots cabbage cucumber
• Chapati Bhakari (Rotala)
• Do not apply ghee or oil over roti
• Vegetables can be had in sufficient quantities

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Sweet story

• For One Jelebi or Gulab Jamun
• Sugar present Approximately 20grams
• Capable of raising blood glucose at least to
  400mgs but Your beta cells produce more insulin
  and solve the problem .
• But once they are sick they stop working and take
  outsiders help i.e. may be insulin inj

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BODY MASS INDEXBMI weight in Kg /HT in Meter
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CLASSIFICATION ASIANS RISK COMORBIDIES
UNDER WT lt18.5 LOW
NORMAL RANGE 18.5-22.9 AVERAGE
OVERWT gt23 INCREASED
OBESE I gt25 MODERATE
OBSE II gt30 SEVERE
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Wrong beliefs

• Diabetes can eat wheat but not rice
• Both wheat and rice raise the blood sugar to
  similar extent .
• It should not matter whether one takes wheat or
  rice , as long as the total quantity
• Is restricted .

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Diabetic complications

• Hypoglycemia Blood glucose lt50mg
• Retinopathy screen of eye gets affected
• Neuropathy Found in 50 diabetic , Tingling
  numbness, burning sensation (Feet)
• Nephropathy Kidney damage
• Heart attacks 2-3 times higher than non
  diabetics
• Hyperglycemia Blood glucose above 140mg

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Hypoglycemia Symptoms

• Increased appetite
• Weakness
• Sweating
• Restlessness
• Palpitation
• Giddiness

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Hypoglycemia

• Predisposing Factors
• 1 Delaying or skipping meals
• Heavy alcohol consumption
• Decreased carbohydrate consumption
• Decreased in Insulin requirements
• (after elimination of stress)

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DIABETIC FOOT

• Make checking your feet part of your daily
  routine ,just like brushing your teeth.
• Watch for red spots swelling ,cuts and calluses.
• Use mirror so that you can see heel ,sole
• Wash your feet with warm water every day .to
  avoid burns test water temp with your elbow.

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DIABETES YES WE CAN CONTROL
HDL Cholesterol (Good Cholesterol) gt45
LDL cholesterol Bad cholesterol) lt100mg
Triglycerides lt150mg
Waist measurement lt90cms for male
lt85cms for females
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DIABETES YES WE CAN CONTROL
Fasting blood glucose 80-120mg
Post lunch (2Hours) lt140mg
HbA1c lt7
BMI 18.5-23
Cholesterol lt200mg
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DIABETES YES WE CAN CONTROL
B.P. lt130/80 mmHg
Smoking Say no as it kills insulin producing cells
alcohol No as it will harm in the control
Say no to papad pickle Helps in controlling DM



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Regular Tests

• Examination of Retina
• Urinary Microalbumin early detection of kidney
  damage
• Lipid profile
• HbA1c Quarterly
• B.P . Feet examination at each Doctor visit