Diabetes mellitus pdf free

Women diagnosed with gestational diabetes mellitus GDM should have lifelong testing at least every three years. For all other patients, testing should begin at age 45 years, and if results are normal, patients should be tested at a minimum of every 3-years.

The same tests are used to both screen for and diagnose diabetes. These tests also detect individuals with prediabetes. Diabetes can be diagnosed either by the hemoglobin A1C criteria or plasma glucose concentration fasting or 2-hour plasma glucose. A blood sample is taken after an 8 hour overnight fast. In this test, the plasma glucose level is measured before and 2 hours after the ingestion of 75 gm of glucose.

It is also a standard test but is inconvenient and more costly than FPG and has major variability issues. Patients need to consume a diet with at least g per day of carbohydrates for 3 to 5 days and not take any medications that can impact glucose tolerance, such as steroids and thiazide diuretics. This test gives an average of blood glucose over the last 2 to 3 months. Patients with a Hb A1C greater than 6.

Hb A1C is a convenient, rapid, standardized test and shows less variation due to pre-analytical variables. It is not much affected by acute illness or stress. Hb A1C is costly and has many issues, as discussed below, including lower sensitivity. It is affected by numerous conditions such as sickle cell disease, pregnancy, hemodialysis, blood loss or transfusion, or erythropoietin therapy.

It has not been well validated in non-white populations. Anemia due to deficiency of iron or vitamin B12 leads to spurious elevation of Hb A1C, limiting its use in countries with a high prevalence of anemia. For all of the above tests, if the person is asymptomatic, testing should be repeated later to make a diagnosis of diabetes mellitus. There is no concordance between the results of these tests.

Pregnant women not previously known to have diabetes should be tested for GDM at 24 to 28 weeks of gestation. Blood samples are collected at fasting for 1 hour and 2 hours. A diet low in saturated fat, refined carbohydrates, high fructose corn syrup, and high in fiber and monounsaturated fats needs to be encouraged. Aerobic exercise for a duration of 90 to minutes per week is also beneficial. The major target in T2DM patients, who are obese, is weight loss. If adequate glycemia cannot be achieved, metformin is the first-line therapy.

Following metformin, many other therapies such as oral sulfonylureas, dipeptidyl peptidase-4 DPP-4 inhibitors. Glucagon-like peptide-1 GLP-I receptor agonists, Sodium-glucose co-transporter-2 SGLT2 inhibitors, pioglitazone, especially if the patient has fatty liver disease, alpha-glucosidase inhibitors, and insulin, are available.

Hence, in patients with CV disease, these drugs should be considered next. For patients with T1DM, a regime of basal-bolus insulin is the mainstay of therapy. Also, insulin pump therapy is a reasonable choice. Since hypoglycemia portends increased mortality, preference should be given to therapies that do not induce hypoglycemia, for example, DPP-4 Inhibitors, SGLT-2 inhibitors, GLP-I receptor agonists, and pioglitazone with metformin.

Fundal exams should be undertaken as proposed by guidelines and urine albumin excretion at least twice a year. The drug of choice is a statin since these drugs reduce CV events and CV mortality. Since the different complications and therapies have been detailed in other StatPearls review articles, we have outlined only the principles of therapy.

The list of differential diagnosis of diabetes mellitus consists of various conditions that would exhibit similar signs and symptoms: [16] [17]. DM is associated with increased atherosclerotic cardiovascular disease ASCVD and treating blood pressure, statin use, regular exercise, and smoking cessation are of great importance in ameliorating risk.

The prevalence of vision-threatening diabetic retinopathy in the United States is about 4. Persistent hyperglycemia in uncontrolled diabetes mellitus can cause several complications, both acute and chronic. Diabetes mellitus is one of the leading causes of cardiovascular disease CVD , blindness, kidney failure, and amputation of lower limbs. Acute complications include hypoglycemia, diabetic ketoacidosis, hyperglycemic hyperosmolar state, and hyperglycaemic diabetic coma. Chronic microvascular complications are nephropathy, neuropathy, and retinopathy, whereas chronic macrovascular complications are coronary artery disease CAD , peripheral artery disease PAD , and cerebrovascular disease.

It is estimated that every year 1. Patients must be educated about the importance of blood glucose management to avoid complications associated with DM. Stress must be given on lifestyle management, including diet control and physical exercise. Self-monitoring of blood glucose is an important means for patients to take responsibility for their diabetes management. Regular estimation of glucose, glycated hemoglobin, and lipid levels is necessary.

Healthcare professionals should educate patients about the symptoms of hypoglycemia such as tachycardia, sweating, confusion and required action ingestion of 15 to 20 gm of carbohydrate. Patients should be motivated to stop smoking. Emphasis is required on regular eye check-ups and foot care.

The diagnosis and management of type 2 diabetes mellitus are with an interprofessional team. These patients need an appropriate referral to the ophthalmologist, nephrologist, cardiologist, and vascular surgeon.

Also, patients need to be educated about lifestyle changes that can help lower blood glucose. All obese patients should be encouraged to lose weight, exercise, and eat a healthy diet. The primary care provider and the diabetic nurse must encourage all people with diabetes to stop smoking and abstain from drinking alcohol. The complications of diabetes mellitus are limb and life-threatening and seriously diminish the quality of life.

This book is distributed under the terms of the Creative Commons Attribution 4. Turn recording back on. National Center for Biotechnology Information , U. StatPearls [Internet]. Search term. Continuing Education Activity Diabetes mellitus DM is a chronic metabolic disorder characterized by persistent hyperglycemia.

Introduction Diabetes mellitus DM is a chronic metabolic disorder characterized by persistent hyperglycemia. Etiology DM is broadly classified into three types by etiology and clinical presentation, type 1 diabetes, type 2 diabetes, and gestational diabetes GDM. Gestational Diabetes Mellitus Hyperglycaemia, which is first detected during pregnancy, is classified as gestational diabetes mellitus GDM , also known as hyperglycemia in pregnancy.

Monogenic Diabetes A single genetic mutation in an autosomal dominant gene causes this type of diabetes. Secondary Diabetes Secondary diabetes is caused due to the complication of other diseases affecting the pancreas for example, pancreatitis , hormone disturbances for example, Cushing disease , or drugs for example, corticosteroids. Epidemiology Diabetes is a worldwide epidemic. Pathophysiology In T1DM, there is cellular-mediated, autoimmune destruction of pancreatic beta cells.

History and Physical Patients with diabetes mellitus most commonly present with increased thirst, increased urination, lack of energy and fatigue, bacterial and fungal infections, and delayed wound healing. Ekinci, Erosha Premaratne, Scott T. Baker, Sianna Panagiotopoulos and Richard J. MacIsaac 63 Pathology of human diabetic neuropathy, M.

Mojaddidi, A. Sharma and Rayaz A. Malik 64 Autonomic neuropathy, Chinmay S. Rosenbloom 66 The diabetic foot, Frank L. Bowling and Andrew J.

Boulton 67 Erectile dysfunction in diabetes mellitus, Michael H. Borgnakke and Robert J. Barengo and Karl Matz 70 Atherogenesis, coronary heart disease and insulin resistance syndrome in diabetes, Barak Zafrir and Jorge Plutzky 71 Endothelial function and metabolic syndrome, Xinpu Chen and Sridevi Devaraj 72 Hemostatic abnormalities in diabetes mellitus, R.

Ajjan and Peter J. Grant 73 Clinical features and treatment of coronary heart disease in diabetes, Eberhard Standl, Michael Erbach, Markolf Hanefeld, Oliver Schnell, Bernd Stratmann and Diethelm Tschoepe 74 Arterial hypertension in diabetes: etiology and treatment, Colleen Flynn and George Bakris 75 Peripheral vascular and cerebrovascular disease in diabetes mellitus, Debabrata Mukherjee Section XIII: Diabetes and public health 76 The diabetes challenge: from human and social rights to the empowerment of people with diabetes, C.

Di Iorio, Fabrizio Carinci and M. Massi Benedetti 77 The economics of diabetes care: a global perspective, Rhys Willi. And If the owner of the book gives a complaint about the pdf copy then we are bound to remove the copy from our site! To file a complaint, email us—. Or you can provide your email to the comment section, and we will send you the pdf copy through your email! And also, please must share your experience with this book.

We will publish your comment though you add a relevant link about this content! Save my name, email, and website in this browser for the next time I comment. Notify me of follow-up comments by email. Notify me of new posts by email. Check price on Amazon. Like this: Like Loading Related Articles.

Loading Comments Email Required Name Required Website. Two categories were defined on Grade Merchant 31 Daily laborer 22 5. Data Quality Control Measures House wife 48 Completion, 3.

Ethical Consideration accuracy, and clarity of the collected data were checked carefullyon aregularly basis. Ethical approval and clearance was obtained from Institutional Review Board of University of Gondar prior to enrolment.

Data was kept confidential renal diseases. Majority Three hundred five 4. Results See table 2. Socio Demographic Characteristics of Study Subjects 4.

Two More than half The mean hundred four More than three The diabetes. Regarding the ethnic profile of study definition of diabetes. Concerning the educational status of study smoking. One participants consider orally taken tablets and injection hundred thirty six See participants knew about exercise and dietary management table 1.

The correct responses on complication of DM like hypoglycemia, nephropathy, Table 2: Health profile of participant,FHH, retinopathy, and neurologic were They reported that 2 0. More than three fourth Two hundred seventy two No Type II No Source of Information and Appraisal of Treating 4.

The remaining Concerning the type of medication they were taking, more participants sited friends and relatives,and media with than three fourth One hundred sixty two Source of information Diabetes is a raised blood Medical staff 85 Media 25 6 sugar only Diabetes is a disease which Identify risk factor for DM Five minutes 58 Over eating No response 7 1.

Orally taken tablets Excess thirst Identify health risk factors for DM Among respondents Obesity 23 5. Age, educational status, duration No response 13 3. Yes The likelihood of good knowledge among individuals unable to read and write. Six month ago 10 2. Within one month 64 Within one month 78 Within one month 12 2.

The likelihood of good practice among female 3. One hundred fifty four The likelihood practice regarding diabetes. Two hundred thirty Participants in grade were 3. Among respondents 12 2. The 4. Age, sex, marital status, educational status, 2. Birr 0. Birr 1 1 Duration of DM 43 This indicated that a lot should be 5. Discussion done for involvement of Medias in diabetes education. The study showed that the mean participant. The difference with Gujarat knowledge regarding diabetes.

The patients due to the rush in the out-patient department and prevalence of knowledge was lower compared to studies negligence. This difference might be due to high 3. This finding was lower education facilities and less participation of media and compared to study conducted in Saudi 9. This difference NGO in awareness creation about diabetes in our setting. This study was like constrain of time and facilities focus on acute rather supported by similar study in Pakistan and India which than preventive care and competing care demands Similarly, passing lots of urine pressure within one months or less were This study which was reported as the most common diabetes symptom was different from study conducted in Nepal which was by This could be due to poor experience in the patient conducted in Indian However done in Nepal which was Only This could be due to inadequate supported by study in jimma university 17 , However it level of information given by the physicians on risk factors was less compared to study conducted in India which and their consequences.

A study done in Saudi to assess complications related to DM. Poor state of were 9. However, this level of inadequate Among respondents This could be due to low are high economic burden for the country in the knowledge about the importance of managing their weight management of complication which comes due to in in reduction of complication and less dietary management adequate precaution for the complication.