DIABETES MELITTUS

-Chronic disease characterized by high levels of sugar in the

blood.
-Normally the body breaks down the sugar and carbohydrates
you eat into a special sugar called glucose.
-Glucose fuels the cell in the body, but the cells need insulin, a
hormone in the blood stream in order to take glucose and use
it for energy.
-With DM either the body doesn’t make enough insulin, it
can’t use the insulin, it doesn’t produce or combination of
both.
 Diabetes is the 6th leading cause of death
among Filipinos based on the data from the 2013
Philippine Health Statistics.
World Diabetes Day- it is officially observed
through the Proclamation No.1942 of 2002,
declaring November 14 as WDD Celebration.
 Types of diabetes melittus:
• Type 1 Diabetes
-also known as insulin dependent diabetes, used to
be called juvenile- onset diabetes because it often begins in
childhood.
-is an autoimmune condition, caused by the body
attacking its own PANCREAS with antibodies.
-in people with Type 1 Diabetes, it damaged pancreas
and doesn’t make insulin.
 Medical Risk associated with type 1 diabetes:
• Damage to the tiny blood vessels in the eyes (diabetic
retinopathy)
• Nerves (diabetic neuropathy)
• Kidney (diabetes nephropathy)
• Increased risk of heart disease and stroke
both types of diabetes have some of the same
warning signs.
COMMON SYMPTOMS:
• Hunger and fatigue
• Peeing more often and being thirstier
OTHER TYPE 1 DIABETES SYMPTOMS:
• Unplanned weight loss
• Nausea and vomiting
TREATMENT:
involves taking insulin, which needs to be injected
through the skin into the fatty tissue.
SIGNIFICANT LIFESTYLE THAT INCLUDES:
– Frequent testing of blood sugar level
– Careful meal planning
– Daily exercise
– Taking insulin and other medications needed.
 Who are at risk?
• Children of diabetics
• Obese people
• People with hypertension
• People with high cholesterol level
• People with sedentary lifestyle
 TYPE 2 DIABETES
-most common form of diabetes
-used to be called adult onset diabetes, but with epidemic
of obese and overweight kids, more teenagers are now
developing type 2 diabetes.
-also called non insulin dependent diabetes.
 Type 2 diabetes is often milder form of diabetes
than type 1. With type 2 diabetes, the pancreas usually
produces some insulin, but either the amount produced
is not enough for the body’s need, or the body cells are
resistant to it. Insulin resistance, or lack of sensitivity to
insulin happens primarily in fat, liver and muscle cells.
There is no cure for diabetes, however can be controlled
with weight management, nutrition and exercise.
Unfortunately, type 2 diabetes tends to progress,
diabetic medications are often needed.
Medical Risk associated with type 2 diabetes:
– Blood vessels
– Kidney
– Nerves
– Eyes
– Risk of heart disease and stroke
 Other type 2 diabetes symptoms:

• Yeast infection-infections can grow in any warm, moist

fold skin, between fingers and toes, under breast in or
around sex organs
• Slow healing sores or cuts
• Dry mouth and itchy skin
• Blurred vision
• Pain or numbness in the feet and legs
 Gestational diabetes

-a type of diabetes that occurs during pregnancy

-any degree of glucose intolerance with onset or first
recognition during pregnancy, whether or not the
condition persisted after pregnancy, and not excluding
the possibility that the unrecognized glucose intolerance
may have antedated or began concomitantly with
pregnancy.
 What is the prevalence of GDM?
• GDM affects up to 15% of pregnant women worldwide
(international diabetes federation)
• GDM affects 14%in 1, 203 Filipino women (DOH)
 During pregnancy, the placenta, which connects
your baby to your blood supply, produces high levels of
various other hormones. Almost all of them impair the
action of insulin in your cells, raising your blood sugar.
As you baby grows, the placenta produces more
and more insulin-blocking hormones. In GDM, the
placenta hormones provoke a rise in blood sugar to a
level that can affect the growth and welfare of the baby.
 Usually there are no symptoms, or the symptoms are mild
and not life threatening to the pregnant women.
Classic symptoms of DM may present rarely, which include:
– Increase thirst
– Increase urination
– Excessive hunger or increased appetite
– Blurred vision
– Fatigue
– Nausea
– Frequent infection
 Possible complications to the mother:
• High risk for operative CS delivery
• Pre eclampsia, eclampsia
• Miscarriage
• Risk for type 2 diabetes
• Recurrent GDM on future pregnancies
 Possible complications to the baby:
• Macrosomia-neonate’s body maybe larger than normal.
• Jaundice- skin turns yellowish, sclera may change color
slightly
• Hypoglycemia-blood sugar is too low
• Congenital and cardiac anomalies
• Congenital malformation
• Possible long term effect- more likely to develop obesity and
type 2 diabetes later in life
 management:
• Regular visit to nutritionist, obstetrician and endocrinologist
are needed to monitor caloric/ nutrients, expected weight
gain, glucose test.
• Should receive nutrition counseling
• Adequate calories and nutrients is very essential to meet the
needs of the pregnancy and should be consistent with
maternal blood glucose goals that have been established.
 TEST CUT OFF DIABETES HOW THE TEST IS
PERFORMED

AC1 >=6.5% No need to fast beforehand.

Provides average blood glucose
level over the past 2 to 3
months.

FASTING PLASMA >=126mg/dL No food or drinks for at

BLOOD GLUCOSE least 8hrs.before the
test. Usually done in the
morning.
ORAL GLUCOSE 2 hours blood glucose Check blood glucose levels in
the fasted state, and after
TOLERANCE TEST >=200 mg/dL
having a special sugar drink to
see how the body processes
the sugar.