Diabetes: A cronic disease that need special attention

     W hat is Diabetes:

Diabetes is a chronic, incurable disease that occurs when the body doesn’t produce any or enough insulin, leading to an excess of sugar in the blood. 

 Three major diabetes types can develop: 

Type 1, 

type 2, and 

gestational diabetes.

        Diagnosis Of Diabetes

> diagnosis of diabetes mellitus is readily entertained when a patient presents with classic symptoms: 

>polyuria, polydipsia, polyphagia, weight loss,  blurred vision, lower extremity paresthesias,  However, many patients with type 2 diabetes are asymptomatic, and their disease remains undiagnosed for many years. Getting diagnosed begins with one of three tests;

>A fasting glucose test, A level of 126 mg/dL or higher may mean diabetes.

 > An oral glucose tolerance test ,  a glucose level of 200 mg/dL or higher at 2 hours, may mean diabetes.

>The HbA1c test , is a simple blood test that shows your average blood sugar levels for the past 2-3 months. An A1c level of 6.5% or higher may mean  diabetes.

        Risk Factors :

(1) Obese/overweight

(2) Family history

(3) Sedentary lifestyle

(4) Age.

 

               Treatments of Diabetes 

Entails ,

(1) Appropriate goal setting 

(2) Medications

(3) Appropriate self-monitoring of blood glucose 

(4) Dietary and exercise modifications 

(5) Regular monitoring for complications 

(6) Laboratory assessment 

  

              Medications

Drug classes used for the treatment of  diabetes include the following;

Biguanides.

Sulfonylureas

Meglitinide derivatives

Alpha-glucosidase inhibitors

Thiazolidinediones (TZDs)

Glucagonlike peptide–1 (GLP-1) agonists

Dipeptidyl peptidase IV (DPP-4) inhibitors

Selective sodium-glucose transporter-2 (SGLT-2) inhibitors

Insulins

Amylinomimetics

Bile acid sequestrants

Dopamine agonists

Management of Glycemia

Monotherapy, dual therapy, triple therapy.

            

              Dietary and exercise modification:

Caloric restriction is of first importance. After that,  Modest restriction of saturated fats and simple sugars is also reasonable.

Weight reduction Modest weight losses of 5-10% have been associated with significant improvements in cardiovascular disease risk factors .

 aerobic exercise of more than 150 minutes per week combined  with dietary modifications is associated with greater HbA1c reduction.

Regular monitoring for complications

Entails yearly eye examination for ophtalmic complications.

Ensuring  blood pressure of not more than 140/90 mmhg  is achieved in hypertension. 

Treatment of dislipidaemia with statins

Use of low dose aspirin or clopidogrel in patients at risk of coronary heart disease.

Protection of the feet by applying lubricating agents (but not between the toes) and wearing appropriate footwear (shoes and socks or stockings) is important in management of neuropathy. Daily inspection of the feet after bathing is mandatory.

Laboratory assessment

In treatment of diabetes with insulin,  hba1c should be checked every 3months, without insulin every 3-6months.

In conclusion,

Diabetes is a chronic disease that requires long term medical attention to limit the development of its devastating complications and to manage them when they occur. 

THANK YOU