KENDRIYA VIDYALAYA
SUNDARGARH
TOPIC : DIABETES MELLITUS
NAME - AMRUTA BHOJWANI
CLASS -XII
ROLL NO -
SUBJECT – F.N.D
TEACHER`S SIGN
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CERTIFICATE
This project is on the topic “DIABETES MELLITUS” and
was completed under the guidance of Ms. Suman and
submitted to AISSCE practical examination 2022-23.
NAME: Amruta Bhojwani
CLASS: XII Commerce
ROLL NO:
SIGNATURE OF INTERNAL EXAMINER:
SIGNATURE OF EXTERNAL EXAMINER:
SIGNATURE OF PRINCIPAL
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ACKNOWLEDGEMENT
I would like to express my special thanks of gratitude to
my teacher Ms. Suman as well as our principal Mr KSP
Rao who gave me the golden opportunity to do this
wonderful project on the topic diabetes mellitus which
also helped me in doing a lot of research and I came to
know about so many new things I am really thankful to
them.
Secondly, I would also like to thank my parents and
friends who helped me a lot in finalizing this project
within the limited time frame.
SIGNATURE OF THE STUDENT
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CONTENTS
SL. NO. TITLE PAGE NO.
1 INTRODUCTION 5
2 SIGNS AND SYMPTOMS 7
3 COMPLICATIONS 8
4 TYPES 10
5 DIAGNOSIS 14
6 PREVENTION AND 15
MANAGEMENT
7 LIFESTYLE AND MEDICATIONS 16
8 BIBLIOGRAPHY 17
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INTRODUCTION
Diabetes mellitus (DM) also known as simply diabetes, is a
group of metabolic diseases in which there are high blood
sugar levels over a prolonged period This high blood sugar
produces the symptoms of frequent urination, increased thirst,
and increased hunger. Untreated, diabetes can cause many
complications. Acute complications include diabetic
ketoacidosis and nonketotic hyperosmolar coma. Serious
long-term complications include heart disease, stroke, kidney
failure, foot ulcers and damage to the eyes.
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 body'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 primary
cause is excessive body weight and not enough exercise.
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• Gestational diabetes, is the third main form and occurs
when pregnant women without a previous history of diabetes
develop a high blood glucose level. Prevention and treatment
involves a healthy diet, physical exercise, not using tobacco,
and being a normal body weight. Blood pressure control and
proper foot care are also important for people with the
disease.
Type 1 diabetes must be managed with insulin injections.
Type 2 diabetes may be treated with medications with or
without insulin.
Insulin and some oral medications can cause low blood sugar.
Weight loss surgery in those with obesity is an effective
measure in those with type 2 DM.
Gestational diabetes usually resolves after the birth of the
baby.
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SIGNS AND SYMPTOMS
The classic symptoms of untreated diabetes are weight loss,
polyuria (frequent urination), polydipsia (increased thirst), and
polyphagia (increased hunger).
Symptoms may develop rapidly (weeks or months) in type
usually develop much more slowly and may be subtle or
absent in type 1 Diabetes, while they usually develop much
more slowly and may be subtle or absent in type 2 diabetes.
Several other signs and symptoms can mark the onset of
diabetes, a 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 its shape, resulting in vision changes.
A number of skin rashes that can occur in diabetes are
collectively known as Diabetic dermadromes.
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COMPLICATIONS
All forms of diabetes increase the risk of long develop after
many years(10 – 20) But maybe the first symptom in those
who have otherwise not received a diagnosis before that time.
The major long-term complications relate to damage to blood
vessels. Diabetes doubles the risk of cardiovascular disease
and about 75% of deaths in diabetics are due to coronary
artery disease.
Other "macrovascular" diseases are stroke, and peripheral
vascular disease.
The primary microvascular complications of diabetes include
damage to the eyes, kidneys, and nerves.
Damage to the eyes, known as diabetic retinopathy, is caused
by damage to the blood vessels in the retina of the eye, and
can result in gradual vision loss and potentially blindness.
Damage to the kidneys, known as diabetic nephropathy, can
lead to tissue scarring, urine protein loss, and eventually
chronic kidney disease, sometimes requiring dialysis or kidney
transplant
Damage to the nerves of the body, known as diabetic
neuropathy, is the most common complication of diabetes.
The symptoms can include numbness, tingling, pain, and
altered pain sensation, which can lead to damage to the skin.
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Diabetes-related foot problems (such as diabetic foot ulcers)
may occur, and can be difficult to treat, occasionally requiring
amputation.
Additionally, proximal diabetic neuropathy causes painful
muscle wasting and weakness.
There is a link between cognitive deficit and diabetes.
Compared to those without diabetes, those with the disease
have a 1.2 to 1.5-fold greater rate of decline in cognitive
function.
DIABETIC EMERGENCIES
People (usually with type 1 diabetes) may also experience
episodes of ketoacidosis, a type of metabolic problems
characterized by nausea, vomitting and abdominal pain, the
smell of acetone on the breathe, deep breathing known as
Kussmaul breathing, and in severe cases a decreased level of
consciousness.
A rare but equally severe possibility is hyperosmolar non-
ketotic state, which is more common in type 2 diabetes and is
mainly the result of dehydration.
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TYPES
Diabetes mellitus is classified into four broad categories:
type 1,
type 2,
gestational diabetes,
and "other specific types".
The "other specific types" are a collection of a few dozen
individual causes. The term "diabetes", without qualification,
usually refers to diabetes mellitus.
Type 1:
Type 1 diabetes mellitus is characterized by loss of the insulin
the islets of Langerhans in the pancreas, leading to insulin
deficiency.
This type can be further classified as immune diabetes is of
the immune-mediated nature, in which a 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.
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Type 1 diabetes can affect children or adults, but was
traditionally termed “ juvenile dibetes ” because a majority of
these diabetes cases were in children.
"Brittle" diabetes, also known as unstable diabetes or labile
diabetes, is a term that was traditionally used to describe the
dramatic and recurrent swings in glucose level , often
occurring for no apparent reason in insulin- dependent
diabetes.
This term, however, has no biologic basis accompanied by
irregular and unpredictable and sometimes with serious
hypoglycemia counterregulatory response to hypoglycemia,
infection, erratic absorption of dietary carbohydrates), and
endocrinopathies (e.g., disease).
These phenomena are believed to occur no more frequently
than in 1% to 2% of persons with type 1 diabetes.
Type 1 diabetes is partly inherited, with multiple genotypes,
known to influence the risk of diabetes.
In genetically susceptible people, the onset of diabetes can be
triggered by one or more environmental factors, such as a viral
infection or diet.
There is some evidence that suggests an association between
type 1 diabetes and Coxsackie B4 virus.
Unlike type 2 diabetes, the onset of type 1 diabetes is
unrelated to lifestyle.
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Type 2:
Type 2 diabetes mellitus is characterized by insulin
resistance, which may be combined with relatively reduced
insulin secretion.
The defective responsiveness of body tissues to insulin is
believed to involve the insulin receptor.
Type 2 diabetes is the most common type.
In the early stage of type 2, the predominant abnormality is
reduced insulin sensitivity.
At this stage, hyperglycemia can be reversed by a variety of
measures and medications that improve insulin sensitivity or
reduce glucose production by the liver.
Type 2 diabetes is due primarily to lifestyle factors and
genetics, including obesity (defined by a body mass index of
greater than thirty), lack of physical activity, poor diet, stress,
and urbanization.
Those who are not obese often have a high waist–hip ratio.
Dietary factors also influence the risk of developing type 2
diabetes.
Consumption of sugar-sweetened drinks in excess is
associated with an increased risk.
The type of fats in the diet is also important, with saturated
fats and trans fatty acids increasing the risk and
polyunsaturated and monounsaturated fat decreasing the
risk.
Eating lots of white rice appears to also play a role in
increasing risk. A lack of exercise is believed to cause 7% of
cases.
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Gestational diabetes:
Gestational diabetes mellitus (GDM) resembles type 2
diabetes 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.
However, after pregnancy approximately 5-10% of women
with gestational diabetes are found to have diabetes
mellitus, most commonly type 2.
Gestational diabetes is fully treatable, but requires careful
medical supervision throughout the pregnancy.
Management may include dietary changes, blood glucose
monitoring, and in some cases insulin may be required.
Though it may be transient, untreated gestational diabetes
can damage the health of the fetus or mother.
Risks to the baby include macrosomia (high birth weight),
congenital cardiac and central nervous system anomalies,
and skeletal muscle malformations. Increased fetal insulin
may inhibit fetal surfactant production and cause respiratory
distress syndrome.
Hyperbilirubinemia may result from red blood cell
destruction. In severe cases, perinatal death may occur, most
commonly as a result of poor placental perfusion due to
vascular impairment.
Labor induction may be indicated with decreased placental
function. A Caesarean section may be performed if there is
marked fetal distress or an increased risk of injury associated
with macrosomia, such as shoulder dystocia.
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Diagnosis:
Diabetes mellitus is characterized by recurrent or persistent
hyperglycemia, and is diagnosed by demonstrating any one
of the following:
Fasting plasma glucose level ≥ 7.0 mmol/l (126 mg/dl)
Plasma glucose ≥ 11.1 mmol/l (200 mg/dl) two hours after a
75 g oral glucose load as in a glucose tolerance test
Symptoms of hyperglycemia and casual plasma glucose ≥
11.1 mmol/l (200 mg/dl)
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.
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Prevention:
There is no known preventive measure for type 1 diabetes.
Dietary changes known to be effective in helping to prevent
diabetes include a diet rich in whole grains and fiber, and
choosing good fats, such as 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 in the prevention of
diabetes.
Active smoking is also associated with an increased risk of
diabetes, so smoking cessation can be an important
preventive measure as well.
Management:
Diabetes mellitus is a chronic disease, for which there is no
known cure except in very specific situations.
Management concentrates on keeping blood sugar levels as
close to normal, without causing hypoglycemia. This can be
accomplished with diet, exercise, and use of appropriate
medications.
Learning about the disease and actively participating in the
treatment is vital for people with diabetes.
Attention is paid to health problems that may accelerate the
deleterious effects of diabetes. These include smoking,
elevated cholesterol levels, obesity, high blood pressure, and
lack of regular exercise.
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Lifestyle:
People with diabetes can benefit from education about the
disease and treatment, good nutrition to achieve a normal
body weight, and sensible exercise, with the goal of keeping
both short-term and long-term blood glucose levels within
acceptable bounds.
In addition, given the associated higher risks of
cardiovascular disease, lifestyle modifications are
recommended to control blood pressure
Medications:
Metformin is generally recommended as a first line
treatment for type 2 diabetes, as there is good evidence that
it decreases mortality.
Routine use of aspirin has not been found to improve
outcomes in uncomplicated diabetes. Angiotensin converting
enzyme inhibitors (ACEIs) improve outcomes in those with
DM while the similar medications angiotensin receptor
blockers (ARBs) do not.
Type 1 diabetes is typically treated with a combinations of
regular and NPH insulin, or synthetic analogs. When insulin is
used in type 2 insulin diabetes, a long-acting formulation is
usually added initially, while continuing oral medications.
Doses of insulin are then increased to effect.
In those with diabetes some recommend blood pressure
levels below 120/80 mmHg; But evidence only supports less
than or equal to somewhere between 140/90 mmHg to
160/100 mmHg.
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BIBLIOGRAPHY
I would like to mention the sources which proved to be
helpful in making this project .
Some of these sources are :-
1. https://www.slideshare.net>mobile>.
2. https://www.diaebeteshealth.com.
3. Cbse FND study material
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THANK
YOU !
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