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DIABETES And Its Types

HUMAN PHYSIOLOGY
Dr. Maryam Zafar
Program: (BS-MLT)
Section: (A) RIMSHA JALIL
L1S22BSML0016
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TABLE OF CONTENT

Diabetes………………………………………………………………………………1

Definition……………………………………………………………………1.1
Symptoms…………………………...………………………………………1.2
Diagnosis…………………………………………………………………….1.3
Types………………………………………………………………………...1.4

Diabetes Mellitus…………………………………………………………………..…2
Effects………………………………………………………………………...2.1
Types of MD……………………………………………………………….....2.2

Diabetes Insipidus………………………………………………………………….…3
Symptoms……………….……………………………………………………3.1
Causes………………………………………………………………………...3.2
Types of DI………………………………………………………………...…3.3

Difference b/w diabetes mellitus and insipidus………...………………………………4

Gestational Diabetes……………………………………………………………….….5
Symptoms………….………………………………………………………….5.1
Causes………………………………………………………………………….5.2
Treatment of diabetes………………………………………………………………….6
Table of drugs that induce diabetes………………………………………………,..…7
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1.DIABETES AND ITS TYPES

1.1 Definition:

Diabetes is a metabolic disorder in which there are high levels of sugar in the blood,
a condition called Hyperglycemia. Under normal conditions, food is broken down to glucose
which then enters the bloodstream and acts as fuel for the body. The pancreas produces a
hormone called insulin which helps to carry glucose from the bloodstream into muscle, fat and
liver where it can be used as fuel.
Diabetics are not able to move this sugar out of the bloodstream because of two primary reasons:
1. Their pancreas does not produce enough insulin
2. Their cells do not respond normally to insulin, a condition called insulin resistance. This
is why people with diabetes have high blood sugar levels

1.2 Symptoms of diabetes:

The symptoms of diabetes are as follows:

 Urinate a lot, often at night.

 Are very thirsty.
 Lose weight without trying.
 Are very hungry.
 Have blurry vision.
 Have numb or tingling hands or feet.
 Feel very tired.
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 Have very dry skin.

1.3 How diabetes can be diagnosed?

Diabetes is diagnosed and managed by checking glucose level in a blood test. There are three
tests that can measure your blood glucose level:
1) Fasting glucose test
2) Random glucose test
3) A1c test
4) Oral glucose tolerance test

Fasting plasma glucose test: 

This test is best done in the morning after an eight hour fast (nothing to eat or drink
except sips of water).

Random plasma glucose test: 

This test can be done any time without the need to fast.

A1c test:

 This test, also called HbA1C or glycated hemoglobin test, provides your average blood
glucose level over the past two to three months. This test measures the amount of glucose
attached to hemoglobin, the protein in your red blood cells that carries oxygen. You don’t
need to fast before this test.

Oral glucose tolerance test:

 In this test, blood glucose level is first measured after an overnight fast. Then you drink a sugary
drink. Your blood glucose level is then checked at hours one, two and three.
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Normal Prediabetes Diabetes

Type of test
(mg/dL) (mg/dL) (mg/dL)

Less than 100

Fasting
100-125 126 or higher
glucose test

Less than 140

Random (anytime)
140-199 200 or higher
glucose test

Less than 5.7%

A1c test 5.7 - 6.4% 6.5% or higher

Oral glucose
Less than 140 140-199 200 or higher
tolerance test

1.4 Types of diabetes:

There are three types of diabetes:

 Diabetes mellitus
 Diabetes insipidus
 Gestational diabetes

2.Diabetes mellitus:
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Diabetes is a heterogeneous group of disorders which are characterized by rise in blood

sugar level. It is a hereditary disease. Diabetics are unable to metabolize blood sugar in
their body and pass glucose in their urine

2.1 Effects of diabetes mellitus:

Harmful effects of diabetes mellitus:

 Kidney failure
 Adult blindness
 Heart disease
 Lower limb ampulation

2.2 Types of diabetes mellitus:

There are two types of diabetes mellitus:

 Type I (insulin dependent diabetes mellitus)

 Type II non-insulin dependent diabetes mellitus)

Type I or IDDM:

Type I or insulin dependent diabetes mellitus usually occurs in early age before 40.It is
also called juvenile diabetes.

Causes of IDDM:

 It is caused due to deficiency of pancreatic h0rmone insulin this insulin. This

insulin normally routes blood glucose to cells for use.
 Type I is an auto immune disorder. This immune system synthesized auto
antibodies against body’s own cell.
 Sometimes, specific viral infections activate auto immune response.
 T-cells of immune system attack pancreas and destroy insulin producing B-cells
thus pancreas does not produce insulin.
 Diabetics of type I must receive exogenous insulin to survive.
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Genetic basis of IDDM:

 The genetic basis of this disease are well understood now the insulin gene is
located on short arm of chromosome 11.
 Polymorphism and genetic variations within this locus can cause diabetes type i .
But it is only caused by a recessive single gene trait. Rather it is a multifactorial
inheritance.it is associated with several alleles

Type II or NIDDM:

Diabetes mellitus type II is non insulin dependent. 90% of diabetes patient are effected by
type II.

Causes of NIDDM:

 The persons produce some endogenous insulin themselves.

 But their body cells gradually lose response to insulin so these cells cannot take
up glucose from blood they develop a sort of insulin resistance.
 It occurs among people over the age of 40. It is more common among the obese.
 Obesity increase insulin resistance exercise reduces obesity. so it indirectly
increase insulin sensitivity and improves glucose tolerance.

Genetic basis of type II:

 Certain genetic factor exists which develop diabetes under certain environmental
conditions.
 About 2%-5% of the type II diabetes get the disease early in life before 25 years
of age it is called maturity onset of diabetes of the young (MODY)

Treatment of diabetes mellitus:

 Type 1 diabetes: If you have this type, you must take insulin every day. Your
pancreas no longer makes insulin.
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 Type 2 diabetes: If you have this type, your treatments can include medications (both for
diabetes and for conditions that are risk factors for diabetes), insulin and lifestyle changes
such as losing weight, making healthy food choices and being more physically active

Comparison between type I and type II

3.Diabetes insipidus:
Diabetes insipidus (DI) is a rare disease that causes frequent urination. The large volume of
urine is diluted, mostly water.
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3.1 Symptoms:

The main symptoms of diabetes insipidus are:

 Excessive thirst (polydipsia), which can cause an uncontrollable craving for water.
 Excessive urine volume, which can cause you to wet the bed or to get up during the
night to urinate frequently.
Possible symptoms in infants and young children include:
 Excessive thirst
 Unusually wet diapers, bedwetting, or excessive urine output
 Fussiness and irritability
 Dehydration
 High fever
 Dry skin
 Delayed growth
Adults can experience some of the above symptoms, plus:
 Confusion
 Dizziness
 Sluggishness
Diabetes insipidus can also cause severe dehydration, which can lead to seizures, brain
damage, and even death if left untreated.

3.2 Diabetes insipidus causes:

 Diabetes insipidus can occur when any part of the system that regulates fluid in your
body breaks down. It’s closely associated with low levels of antidiuretic hormone

 (ADH), also known as vasopressin. ADH levels affect how well your kidneys conserve
water.
 To understand diabetes insipidus, it helps to understand how your body normally uses
and regulates fluids.
 Fluids make up around 50 to 60 percent of an adult’s overall body mass and around 75
percent of an infants.
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 Maintaining the proper amount of fluid in your body is key to your overall health.
Consuming water and food throughout the day helps provide fluid to your body.
Urinating, breathing, and sweating help eliminate fluid from your body.
 Your body uses a system of organs and hormone signals to regulate body fluids. It makes
less urine when you need to replace fluid lost to sweating and makes more urine when
there’s too much fluid in your body.
 In addition The kidneys play an important role in fluid regulation by removing extra fluid
from your bloodstream.
 The bladder stores the fluid waste until you urinate it out.
 The brain produces ADH, which is stored in the pituitary gland after production.
 The hypothalamus is the specific area of the brain where ADH is made. The
hypothalamus regulates thirst.
 When your body needs to retain water, the pituitary gland will release ADH into the
bloodstream.
 When you need to get rid of water, ADH is either released in smaller amounts or not
released at all, and you’ll urinate more often.

3.3 Types of insipidus disease:

Here are Two types of diabetes insipidus:

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 Central diabetes insipidus

 Nephrogenic diabetes insipidus

Central diabetes insipidus:

It is the most common type of diabetes insipidus. It’s caused by damage to the
pituitary gland or hypothalamus. This damage means ADH cannot be produced,
stored, or released normally. Without ADH, large amounts of fluid are released into
the urine.

Causes of central diabetes insipidus:

Central diabetes insipidus is often the result of:

 Head trauma
 Conditions that cause brain swelling
 brain tumors
 surgery affecting the pituitary gland or hypothalamus
 Loss of blood supply to the pituitary gland
 Rare genetic conditions

Central diabetes insipidus treatment:

 Desmopressin is an artificial hormone that’s often used to treat central diabetes insipidus.
 It’s a synthetic form of ADH. It’s available as a pill, a nasal spray, or an injection. While
taking this medication, it’s important to regulate your water intake and drink only when
you’re thirsty.
 If your diabetes insipidus is caused by another condition such as a tumor or an issue with
the pituitary gland, your doctor will treat that condition first and then determine if the
diabetes insipidus still needs to be treated.

Nephrogenic diabetes insipidus:

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Nephrogenic diabetes insipidus can be genetic or acquired. Certain genetic mutations

can damage the kidneys, leaving them unable to respond to ADH.

Causes of nephrogenic diabetes insipidus:

Other possible causes of the kidney damage — and nephrogenic diabetes insipidus — include:
 medications, such as lithium or tetracycline
 blockage of the urinary tract, which includes obstruction of the ureters (which carry urine
from the kidney to the bladder)
 electrolyte imbalances, such as too much calcium or not enough potassium
 chronic kidney disease, on rare occasions

Nephrogenic diabetes insipidus treatment:

 In nephrogenic diabetes insipidus, addressing the underlying cause may cure the problem.

 Other treatments include:

 High doses of desmopressin
 Diuretics, which can be taken along with either aspirin or ibuprofen (Advil, Motrin

 Other nonsteroidal anti-inflammatory drugs (NSAIDs), such as indomethacin

4.DIFFERENCE BETWEEN DIABETES MELLITUS AND INSIPIDUS:

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5. Gestational diabetes:

Gestational diabetes is a condition in which your blood sugar levels become high

during pregnancy. It affects up to 10% of women who are pregnant. Gestational diabetes
goes away after you give birth. But it can affect your baby’s health, and it raises your risk
of getting type 2 diabetes later in life.

5.1 Symptoms:

Women with gestational diabetes usually don’t have symptoms or may chalk them up to
pregnancy. Most find out that they have it during a routine screening

 Thirstier than usual

 Hungrier and eat more than usual

 Pee more than usual

5.2 Causes of gestational diabetes:

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During pregnancy, your placenta makes hormones that cause glucose to build up in

your blood. Usually, your pancreas can send out enough insulin to handle it. But if your
body can’t make enough insulin or stops using insulin as it should, your blood sugar

levels rise, and you get gestational diabetes.

6.COMMON TREATMENT OF DIABETES:

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7. DRUGS THAT INDUCES DIABETES:

Glucocorticoid
Thyroid hormone
Thiazides
Alpha-adrenergic agonists
Beta-adrenergic agonists
Dilantin
Pentamidine
Nicotinic acid
pyrinuron
Others
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 ^ "Causes of Diabetes". National Institute of Diabetes and Digestive and Kidney Christ-
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