Diabetes mellitus

INTRODUCTION Diabetes mellitus (DM) is traditionally described as a syndrome of disordered metabolism with hyperglycemia due either to an absolute insulin deficiency or reduction of its biologic effectiveness or both. DM is coming as a global epidemic especially in Asian counties. India is now called as the diabetic capital of the world. CLASSIFICATION NIH Diabetes Data Group, in 1979, traditionally divided diabetes into two main types viz. –...

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Hypertension in Diabetes

Hypertension is a common accompaniment of type 2 diabetes and sets in the course of type 1 diabetes. Hypertension magnifies many fold the damage to the target organs (kidneys, heart, eyes etc) in diabetics and hence needs significant attention. Drug treatment in addition to lifestyle intervention is recommended to reach the prescribed goals by ADA and AHA (BP< 130/85 mm of Hg). Various drug trials on hypertensive diabetics are Appropriate Blood...

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Management approach to a patient wıth dıabetes mellitus

TYPE 1 Diabetes Mellitus All patients with type 1 DM should be exclusively on insulin therapy. The preferred form of therapy is basal bolus therapy which involves one (or more) injections of intermediate acting insulin and premeal bolus of regular insulin. Recently intermediate acting insulin has often been replaced with a long acting analogue (glargine or detemir) and the regular insulin with a short acting analogue (lispro or aspart). There are...

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Insulin

Insulin is the only therapy available for patients with type 1 diabetes.  Insulin is also required in patients with type 2 diabetes who have developed sulfonylurea failure or those who are undergoing an acute infective or operative event, which has destabilized metabolic control. Insulin replacement in patients with type 1 dia­betes has been less than optimal because it is not possible to completely reproduce the normal physio­logic pattern...

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Diagnostic criteria for diabetes

The diagnostic criteria for diabetes mellitus are based on measuring venous plasma glucose in the fasting state and 2 hours after a 75 gram glucose load (recommended by the WHO).  The details of the diagnostic criteria are provided in Table 2. Table 2. Diagnostic criteria for Diagnosis of Diabetes mellitus Category WHO  ADA Impaired fasting glucose (IFG) BGF=100 to < 126 mg/dl BGF=100 to < 126 mg/dl Impaired glucose...

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Laboratory and home based monıtorıng of blood glucose

Blood glucose testing Venous plasma or serum has the advantage over whole blood of providing values for glucose that are independent of hematocrit and reflect levels in the interstitial spaces.  For these reasons and because plasma and serum lend themselves to automated analytic procedures ­they are used in most laboratories. The glucose con­centration is 10-15 % higher in plasma or serum than in whole blood because structural components of...

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