Duhok Polytechnic University

Shekhan Technical Collage

Health .
Department:Public Health
Stage; 2th
Subject: Introduction Public Health

Report about: Diabetes Mellitus

Prepared By :Saad Anter Ahmad Supervisor By :

Kherailah Khodeda
LIST OF CONTENTS
Introduction
Causes
Sing and symptioms
Diagnosis
Care and Treatment
 INTRODUCTION
What is diabetes mellitus?
Diabetes mellitus (DM), commonly referred to as diabetes, is a group of
metabolic diseases in which there are high blood sugar levels over a
[5]prolonged period. Diabetes mellitus (or diabetes) is a chronic, lifelong
condition that affects our body's ability to use the energy found in food. our
body breaks down the sugars and carbohydrates we eat into a special sugar
called glucose. Glucose fuels the cells in your body. But the cells need
insulin, a hormone, in your bloodstream in order to take in the glucose and
use it for energy. With diabetes mellitus, either our body doesn't make
enough insulin, it can't use the insulin it does produce, or a combination of
both.

Since the cells can't take in the glucose, it builds up in our blood. High levels
of blood glucose can damage the tiny blood vessels in our kidneys, heart,
eyes, or nervous system. That's why diabetes -- especially if left untreated --
can eventually cause heart disease, stroke ,kidney disease, blindness, and
nerve damage to nerves in the feet.

COMMON TYPES OF DIABETES

There are three main types of diabetes mellitus:
• Type 1 DM results from the pancreas' 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
"adult-onset diabetes". The primary cause is excessive body weight
and not enough exercise.
• Gestational diabetes, is the third main form and occurs when
pregnant women without a previous history of diabetes develop a high
blood sugar level.Generally, type 2 diabetes is more common in
people over age 40 who are overweight. However, the prevalence of
obesity among people in North America has increased the number of
people under age 40 who are diagnosed with type 2 diabetes. Nine
out of 10 people with diabetes have type 2.

Type 1
Type 1 diabetes mellitus is characterized by insulin deficiency. This
type can be further classified as immune-mediated The majority of
type 1 diabetes is of the immune-mediated nature leads to the loss of
beta cells and thus insulin.[26] 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. Type 1 diabetes can affect children or
adults, but was traditionally termed "juvenile diabetes" because a
majority of these diabetes cases were in children. Type 1 diabetes is
partly inherited, with multiple genes, including certain HLA genotypes,
known to influence the risk of diabetes. In genetically susceptible
people, the onset of diabetes can be triggered byone or more
environmental factors, such as a viral infection or diet.

Type 2
Type 2 diabetes mellitus is characterized by insulin resistance, which
may be combined with relatively reduced insulin secretion.[5] The
defective responsiveness of body tissues to insulin is believed to
involve the insulin receptor. However, the specific defects are not
know

Diabetes mellitus cases due to a known defect are classified

separately. Type 2 diabetes is the most common type.In the early
stage of type 2, the predominant abnormality is reduced insulin
sensitivity. It is due primarily to lifestyle factors and genetics.
Gestational diabetes
Gestational diabetes mellitus (GDM) resembles type 2 diabetes
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 [8]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 and skeletal muscle malformations.
Increased fetal insulin may inhibit fetal surfactant production and
cause respiratory distress syndrome. n severe cases, perinatal
deathmay occur, most commonly as a result of poor placental
perfusion due to vascular impairment Labor induction may be
indicated with decreased placental functi

Causes
Health care providers do not yet know what causes diabetes. The
following factors may increase your chance of getting diabetes:
• Family history of diabetes or inherited tendency
• Being overweight (20 percent or more over your desired body
weight)
• Physical stress (such as surgery or illness)
• Use of certain medications, including steroid and blood pressure
medications
• Injury to pancreas (such as infection, tumor, surgery or
accident)
• Autoimmune disease
• High blood pressure
• Abnormal blood cholesterol or triglyceride levels
• Age (risk increases with age)
• Alcohol (risk increases with years of heavy alcohol use)
• Smoking
It is important to note that sugar itself does not cause diabetes.
Eating a lot of sugar can lead to tooth decay, but it does not
cause diabetes.

The following is a comprehensive list of other causes of diabetes:

• Genetic defects of β-cell function
• Genetic defects in insulin processing or insulin
action
• Insulin gene mutations
•Insulin receptor mutations
• Exocrine pancreatic defects
• Infections
• Drugs

Who gets diabetes?

Diabetes can occur in anyone. However, people who have close
relatives with the disease are somewhat more likely to develop it.
Other risk factors include obesity, high cholesterol, high blood
pressure, and physical inactivity. The risk of developing diabetes also
increases as people grow older. People who are over 40 and
overweight are more likely to develop diabetes, although the incidence
of type 2 diabetes in adolescents is growing. Diabetes is more
common among Native Americans, African Americans, Hispanic
Americans and Asian Americans/Pacific Islanders. Also, people who
develop diabetes while pregnant (a condition called gestational
diabetes) are more likely to develop full-blown diabetes later in life.

What other problems can diabetes cause?

Your healthcare team will encourage you to follow your meal plan and
exercise program, use your medications and monitor your blood
glucose regularly to keep your blood glucose in as normal a range as
possible as much of the time as possible. Why is this so important?
Because poorly managed diabetes can lead to a host of long-term
complications — among these are heart attacks, strokes, blindness,
kidney failure, and blood vessel disease that may require an
amputation, nerve damage, and impotence in men.
SIGNS AND SYMPTOMS
The classic symptoms of untreated diabetes are weight loss, polyuria
(increased urination), polydipsia (increased thirst), and
polyphagia(increased hunger). Symptoms may develop rapidly (weeks
or months) 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, although they
are 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 leads to changes in its shape,
resulting in vision changes. A number of skin rashes that can occur in
diabetes are collectively known as diabetic dermadromesPeople with
diabetes frequently experience certain symptoms.
These include:
• being very thirsty
• frequent urination
• weight loss
• increased hunger
• blurry vision
• irritability
• tingling or numbness in the hands or feet
• frequent skin, bladder or gum infections
• wounds that don't heal
• extreme unexplained fatigue
DIAGNOSIS
The preferred method of diagnosing diabetes is the fasting plasma
glucose test (FPG). The FPG measures your blood glucose level after
you have fasted (not eaten anything) for 10 to 12 hours.Normal fasting
blood glucose is between 70 and 100 mg/dl for people who do not
have diabetes. The standard diagnoses of diabetes is made when:

• A patient has a fasting blood glucose level of 126 mg/dl or higher on

two separate occasions; or

• A patient has a random blood glucose level of 200 mg/dl or greater

and has common symptoms of diabetes, such as:
o Increased thirst
o Frequent urination
o Increased hunger
o Fatigue
o Blurred vision
o Weight loss

On occasion, an oral glucose tolerance test may aid in the diagnosis

of diabetes or an earlier abnormality that may become diabetes -
called impaired glucose tolerance.Another test, the A1C test,
measures your average percentage of glycated hemoglobin, or
HbA1c, in the blood. This test tells you about your blood glucose
control for the past 2 to 3 months. It gives you an idea of how your
treatment plan is coming along but does not replace daily testing.
Conclusion: care and treatment

1. Plan what you eat and follow a balanced meal plan. See your
dietitian at least once a year.
2. Exercise at least five times a week for 30 minutes each
session. Talk to your doctor before starting any exercise program.
Tell your doctor what kind of exercise you want to do so
adjustments can be made to your medicine schedule or meal
plan, if necessary.
3. Follow your medicine schedule as prescribed by your doctor.
4. Know what medicines (brand and generic names) you are
taking and how they work. Keep a list of your medicines with you
at all times.
5. Test your blood glucose regularly, as recommended by your
health care provider. Test your blood glucose more often when
you're sick.
6. Try to continuously keep your blood glucose level at the
recommended range. If your blood glucose is less than 70 mg/dl
and you have more than one unexplained low blood glucose
reaction a week, call your doctor. If your blood glucose is greater
than 160 mg/dl for more than a week or if you have two.
7. Contact your doctor when your blood glucose is over 300
mg/dl. Test your urine for ketones if recommended by your doctor.
8. Record your blood glucose and urine ketone test results in a
record keeping log. Bring your log book with you to all of your
doctor's visits.
9. Keep your scheduled appointments with your health care
providers. See your doctor at least every three to four months for
regular check-ups if you are treated with insulin. See your doctor
every four to six months if you are treated with other diabetes
medicines or if you are managing diabetes with diet and exercise
alone. More frequent visits might be necessary if your blood
glucose is not controlled or if complications of diabetes are
progressing. Make sure your health care provider checks your
blood pressure and weight, and examines your feet and insulin
injection sites.
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