Diabetes Mellitus (dm)
Diabetes mellitus is a disorder in which blood sugar (glucose) levels are abnormally high because the body does not produce enough insulin to meet its needs. Urination and thirst are increased, and people lose weight when they are not trying to. Diabetes damages blood vessels and increases the risk of heart attack, stroke, chronic kidney disease, and vision loss. People with diabetes need to follow a healthy diet that is low in refined carbohydrates (including sugar), saturated fat, and processed foods. They also need to exercise and usually take drugs to lower blood sugar levels. Diabetes mellitus is a disorder in which the amount of sugar in the blood is elevated. Doctors often use the full name diabetes mellitus, rather than diabetes alone, to distinguish this disorder from diabetes insipidus. Diabetes insipidus is a relatively rare disorder that does not affect blood glucose levels but, just like diabetes mellitus, also causes increased urination. Continue reading >>
Diabetes Mellitus And Pregnancy
Initiate testing early enough to avoid significant stillbirth but not so early that a high rate of false-positive test results is encountered. In patients with poor glycemic control, intrauterine growth restriction, or significant hypertension, begin formal biophysical testing as early as 28 weeks. In patients who are at lower risk, most centers begin formal fetal testing by 34 weeks. Fetal movement counting is performed in all pregnancies from 28 weeks onward. There is no consensus regarding antenatal testing in patients with gestational diabetes that is well controlled with diet. Monitoring fetal growth continues to be a challenging and imprecise process. Although currently available tools (serial plotting of fetal growth parameters based on ultrasonographic measurement) are superior to those used previously for clinical estimations, accuracy is still only within 15%. [ 95 ] In the obese fetus, the inaccuracies are further magnified. In 1992, Bernstein and Catalano reported that significant correlation exists between the degree of error in the ultrasonogram-based estimation of fetal weight and the percentage of body fat on the fetus. [ 96 ] Perhaps this is the reason no single formula has proven to be adequate in identifying a macrosomic fetus with certainty. Despite problems with accuracy, ultrasonogram-based estimations of fetal size have become the standard of care. Estimate fetal size once or twice at least 3 weeks apart in order to establish a trend. Time the last examination to be at 36-37 weeks' gestation or as close to the planned delivery date as possible. Select the timing of delivery to minimize morbidity for the mother and fetus. Delaying delivery to as near as possible to the expected date of confinement helps maximize cervical maturity and improves the Continue reading >>
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
- Diabetes and Pregnancy: Fluctuating Hormones and Glucose Management
- Olive oil in the prevention and management of type 2 diabetes mellitus: a systematic review and meta-analysis of cohort studies and intervention trials
Gestational Diabetes
Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy.[2] Gestational diabetes generally results in few symptoms;[2] however, it does increase the risk of pre-eclampsia, depression, and requiring a Caesarean section.[2] Babies born to mothers with poorly treated gestational diabetes are at increased risk of being too large, having low blood sugar after birth, and jaundice.[2] If untreated, it can also result in a stillbirth.[2] Long term, children are at higher risk of being overweight and developing type 2 diabetes.[2] Gestational diabetes is caused by not enough insulin in the setting of insulin resistance.[2] Risk factors include being overweight, previously having gestational diabetes, a family history of type 2 diabetes, and having polycystic ovarian syndrome.[2] Diagnosis is by blood tests.[2] For those at normal risk screening is recommended between 24 and 28 weeks gestation.[2][3] For those at high risk testing may occur at the first prenatal visit.[2] Prevention is by maintaining a healthy weight and exercising before pregnancy.[2] Gestational diabetes is a treated with a diabetic diet, exercise, and possibly insulin injections.[2] Most women are able to manage their blood sugar with a diet and exercise.[3] Blood sugar testing among those who are affected is often recommended four times a day.[3] Breastfeeding is recommended as soon as possible after birth.[2] Gestational diabetes affects 3–9% of pregnancies, depending on the population studied.[3] It is especially common during the last three months of pregnancy.[2] It affects 1% of those under the age of 20 and 13% of those over the age of 44.[3] A number of ethnic groups including Asians, American Indians, Indigenous Australians, and Pacific Continue reading >>
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
- Leeds diabetes clinical champion raises awareness of gestational diabetes for World Diabetes Day
- Gestational Diabetes: The Overlooked Form of Diabetes
Diagnosis And Classification Of Diabetes Mellitus
Go to: DEFINITION AND DESCRIPTION OF DIABETES MELLITUS Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of differentorgans, especially the eyes, kidneys, nerves, heart, and blood vessels. Several pathogenic processes are involved in the development of diabetes. These range from autoimmune destruction of the β-cells of the pancreas with consequent insulin deficiency to abnormalities that result in resistance to insulin action. The basis of the abnormalities in carbohydrate, fat, and protein metabolism in diabetes is deficient action of insulin on target tissues. Deficient insulin action results from inadequate insulin secretion and/or diminished tissue responses to insulin at one or more points in the complex pathways of hormone action. Impairment of insulin secretion and defects in insulin action frequently coexist in the same patient, and it is often unclear which abnormality, if either alone, is the primary cause of the hyperglycemia. Symptoms of marked hyperglycemia include polyuria, polydipsia, weight loss, sometimes with polyphagia, and blurred vision. Impairment of growth and susceptibility to certain infections may also accompany chronic hyperglycemia. Acute, life-threatening consequences of uncontrolled diabetes are hyperglycemia with ketoacidosis or the nonketotic hyperosmolar syndrome. Long-term complications of diabetes include retinopathy with potential loss of vision; nephropathy leading to renal failure; peripheral neuropathy with risk of foot ulcers, amputations, and Charcot joints; and autonomic neuropathy causing gastrointestinal, genitourinary, and cardiovascul Continue reading >>
- Diagnosis and treatment of diabetes mellitus in chronic pancreatitis
- Complicated urinary tract infections associated with diabetes mellitus: Pathogenesis, diagnosis and management
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
Diabetes Mellitus - An Overview | Sciencedirect Topics
Diabetes mellitus (DM) is best defined as a syndrome characterized by inappropriate fasting or postprandial hyperglycemia, caused by absolute or relative insulin deficiency and its metabolic consequences, which include disturbed metabolism of protein and fat. Stanley F. Malamed DDS, ... Daniel L. Orr DDS, MS (ANES), PHD, JD, MD, in Medical Emergencies in the Dental Office (Seventh Edition) , 2015 Gestational diabetes mellitus is characterized by an abnormal result on the oral glucose tolerance test taken during pregnancy that either reverts back to normal in the postpartum period or remains abnormal.3 The clinical pathogenesis of gestational diabetes mellitus is similar to that of type 2 diabetes mellitus, while the clinical presentation is usually nonketotic hyperglycemia during pregnancy. Undiagnosed and untreated gestational diabetes mellitus carries significant risks of perinatal illness and death in all levels of disease severity, which may not be apparent in nondiabetic patients and those whose gestational diabetes mellitus is diagnosed and treated in a timely and effective manner.49,50 Approximately 18% of pregnancies are affected by gestational diabetes.4 Alan J. Sinclair, Simon C.M. Croxson, in Brocklehurst's Textbook of Geriatric Medicine and Gerontology (Seventh Edition) , 2010 Diabetic patients have a twofold to threefold increase in the rate of cerebrovascular accidents or myocardial infarctions, and have a worse outcome than nondiabetic people from either myocardial infarction or stroke.227 Aspirin should be used as secondary prophylaxis in all diabetic people with evidence of macrovascular disease, and it should be strongly considered as primary prevention in diabetic subjects with other risk factors for macrovascular disease, such as hypertension, cigar Continue reading >>
Diabetes Mellitus
Diabetes mellitus is a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas, or by the ineffectiveness of the insulin produced. Such a deficiency results in increased concentrations of glucose in the blood, which in turn damage many of the body's systems, in particular the blood vessels and nerves. There are two principle forms of diabetes: Type 1 diabetes (formerly known as insulin-dependent) in which the pancreas fails to produce the insulin which is essential for survival. This form develops most frequently in children and adolescents, but is being increasingly noted later in life. Type 2 diabetes (formerly named non-insulin-dependent) which results from the body's inability to respond properly to the action of insulin produced by the pancreas. Type 2 diabetes is much more common and accounts for around 90% of all diabetes cases worldwide. It occurs most frequently in adults, but is being noted increasingly in adolescents as well. Certain genetic markers have been shown to increase the risk of developing Type 1 diabetes. Type 2 diabetes is strongly familial, but it is only recently that some genes have been consistently associated with increased risk for Type 2 diabetes in certain populations. Both types of diabetes are complex diseases caused by mutations in more than one gene, as well as by environmental factors. Diabetes in pregnancy may give rise to several adverse outcomes, including congenital malformations, increased birth weight and an elevated risk of perinatal mortality. Strict metabolic control may reduce these risks to the level of those of non-diabetic expectant mothers. Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) refer to levels of blood glucose concentration above the normal r Continue reading >>
Diabetes Mellitus (dm)
By Erika F. Brutsaert, MD, Assistant Professor, Albert Einstein College of Medicine; Attending Physician, Montefiore Medical Center Diabetes Mellitus and Disorders of Carbohydrate Metabolism Diabetes mellitus (DM) is impaired insulin secretion and variable degrees of peripheral insulin resistance leading to hyperglycemia. Early symptoms are related to hyperglycemia and include polydipsia, polyphagia, polyuria, and blurred vision. Later complications include vascular disease, peripheral neuropathy, nephropathy, and predisposition to infection. Diagnosis is by measuring plasma glucose. Treatment is diet, exercise, and drugs that reduce glucose levels, including insulin and oral antihyperglycemic drugs. Complications can be delayed or prevented with adequate glycemic control; heart disease remains the leading cause of mortality in DM. There are 2 main categories of diabetes mellitustype 1 and type 2, which can be distinguished by a combination of features (see Table: General Characteristics of Types 1 and 2 Diabetes Mellitus ). Terms that describe the age of onset (juvenile or adult) or type of treatment ( insulin- or non insulin-dependent) are no longer accurate because of overlap in age groups and treatments between disease types. Impaired glucose regulation (impaired glucose tolerance, or impaired fasting glucosesee Table: Diagnostic Criteria for Diabetes Mellitus and Impaired Glucose Regulation* ) is an intermediate, possibly transitional, state between normal glucose metabolism and diabetes mellitus that becomes more common with aging. It is a significant risk factor for DM and may be present for many years before onset of DM. It is associated with an increased risk of cardiovascular disease, but typical diabetic microvascular complications are not very common (album Continue reading >>
Preventing Type 2 Diabetes Mellitus: Insights From Genetic Studies
Preventing type 2 diabetes mellitus: Insights from genetic studies Diabetes mellitus in the U.S. causes morbidity and mortality and costs in excess of approximately $170 billion a year. Therefore, identifying ways to prevent diabetes is important. Adrian Vella, M.D. , Endocrinology, Diabetes, Metabolism, and Nutrition, at Mayo Clinic in Rochester, Minnesota, says: "The states of impaired fasting glucose and impaired glucose tolerance are associated with a high rate of progression to type 2 diabetes mellitus. However, the risk is heterogeneous. For example, in Olmsted County, Minnesota, 40 percent of people with a fasting glucose 110 mg/dL progress to overt diabetes within a 10-year period, as opposed to 5 percent of those with a fasting glucose <95 mg/dL. "While environmental factors and obesity play a role in progression from prediabetes to diabetes, genetic factors are indubitably important. To date there are approximately 65 common genetic variants reproducibly associated with type 2 diabetes mellitus. However, the greatest risk is associated with variation in the gene TCF7L2. "The effect size is significant; for example, in the Diabetes Prevention Program, the TT genotype of TCF7L2 at rs7903146 conferred a 2.41-fold increase in risk of type 2 diabetes mellitus compared with the CC genotype. Given the frequency of the diabetes-associated allele T of between 30 and 35 percent in most populations and its effect size, this variant makes a substantial contribution to type 2 diabetes mellitus predisposition in a population." Type 2 diabetes mellitus is characterized by defects in insulin secretion and action, with impaired postprandial suppression of glucagon. Dr. Vella highlights: "It has been reported that diabetes-associated variation in TCF7L2 impairs post-challenge Continue reading >>
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- Relative contribution of type 1 and type 2 diabetes loci to the genetic etiology of adult-onset, non-insulin-requiring autoimmune diabetes
- Influence of uncontrolled diabetes mellitus on periodontal tissues during orthodontic tooth movement: a systematic review of animal studies
Diagnosis And Classification Of Diabetes Mellitus
DEFINITION AND DESCRIPTION OF DIABETES MELLITUS Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of differentorgans, especially the eyes, kidneys, nerves, heart, and blood vessels. Several pathogenic processes are involved in the development of diabetes. These range from autoimmune destruction of the β-cells of the pancreas with consequent insulin deficiency to abnormalities that result in resistance to insulin action. The basis of the abnormalities in carbohydrate, fat, and protein metabolism in diabetes is deficient action of insulin on target tissues. Deficient insulin action results from inadequate insulin secretion and/or diminished tissue responses to insulin at one or more points in the complex pathways of hormone action. Impairment of insulin secretion and defects in insulin action frequently coexist in the same patient, and it is often unclear which abnormality, if either alone, is the primary cause of the hyperglycemia. Symptoms of marked hyperglycemia include polyuria, polydipsia, weight loss, sometimes with polyphagia, and blurred vision. Impairment of growth and susceptibility to certain infections may also accompany chronic hyperglycemia. Acute, life-threatening consequences of uncontrolled diabetes are hyperglycemia with ketoacidosis or the nonketotic hyperosmolar syndrome. Long-term complications of diabetes include retinopathy with potential loss of vision; nephropathy leading to renal failure; peripheral neuropathy with risk of foot ulcers, amputations, and Charcot joints; and autonomic neuropathy causing gastrointestinal, genitourinary, and cardiovascular symp Continue reading >>
- Diagnosis and treatment of diabetes mellitus in chronic pancreatitis
- Complicated urinary tract infections associated with diabetes mellitus: Pathogenesis, diagnosis and management
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
Diabetes Md And Shock
Which hormones are involved in regulation of serum glucose level, and under what physiologic conditions would each be secreted? The ingestion of nutrients stimulates the release of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) from cells in the gut. Both hormones stimulate production and release of insulin and amylin. In the fasting state, the fall in insulin levels and stimulation of glycogenolysis causes the secretion of glucagons, along with other counter-regulatory hormones, such as corticosteroids, growth hormone, and catecholamines (pgs. 817-819). What are the differentiating characteristics of type 1 and type 2 diabetes? The differentiating characteristic in type 1 diabetes is the destruction of the cells of the pancreas that leads to an absolute insulin deficiency. Type 2 diabetes is characterized by a resistance to the action of insulin on peripheral tissues and a relative lack of insulin secondary to -cell dysfunction (pgs. 821-824). How do the pathophysiologic processes differ among the various types of diabetes? In type 1 diabetes mellitus, the production of glucose by the liver is no longer opposed by insulin. Overproduction of glucagon by pancreatic cells stimulates glycogenolysis and gluconeogenesis. Insulin deficiency and other hormonal influences lead to lipolysis resulting in fatty acids, which undergo transformation into ketoacids in the liver. Type 2 diabetes mellitus starts with the development of insulin resistance, which is initially compensated for by increased insulin production and hyperinsulinemia. Decompensation occurs as the impaired cells are unable to produce sufficient insulin to overcome insulin resistance. Insulin levels, however, remain elevated above normal until later in progression of the di Continue reading >>
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Nclex Review - Diabetes Mellitus - Ch. 41
Diabetes mellitus is most accurately defined as a disorder that affects The metabolism of glycogen stores and glucose Diabetes mellitus affects utilization of all energy nutrients. Utilization is only one aspect of the process affected by diabetes mellitus. Although energy requirements are met primarily by glucose, this substance can be derived from glycogen stores and amino acid and lactate substrates. The amount of stored fats in the form of triglyceride is potentiated by the action of insulin. Which characteristic uniquely belongs to Type 2 diabetes mellitus? An absolute absence of insulin production A lower than normal basal insulin secretion An absent first-phase insulin response and diminished second-phase response An absent first-phase insulin response and diminished second-phase response Individuals with type 2 diabetes mellitus ultimately have an absent first-phase insulin response and a diminished second-phase response. The other options can be seen in both types of diabetes. The pathophysiology of gestational diabetes mellitus most closely resembles that of In its pathophysiology, gestational diabetes mellitus closely resembles type 2 diabetes mellitus. Hormones produced during pregnancy precipitate insulin resistance, while insulin demands during pregnancy increase twofold to threefold. Type 1 diabetes does not originate as a result of pregnancy. Genetic defects of -cells result in relatively rare, genetically determined defects of the insulin receptor. Chemical-induced diabetes requires the introduction of a chemical that affects the pancreas's ability to produce insulin. What likelihood is there that gestational diabetes will persist or recur after pregnancy? Gestational diabetes markedly increases the development of type 1 diabetes mellitus. If glucose t Continue reading >>
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Journal Of Diabetes And Metabolic Disorders
RG Journal Impact: 2.90 * *This value is calculated using ResearchGate data and is based on average citation counts from work published in this journal. The data used in the calculation may not be exhaustive. RG Journal impact history 2017 RG Journal impact Available summer 2018 2015 / 2016 RG Journal impact 2.90 2014 RG Journal impact 2.73 2013 RG Journal impact 0.82 RG Journal impact over time Additional details Cited half-life data not available Immediacy index data not available Eigenfactor data not available Article influence data not available Website ISSN 2251-6581 Publisher details Publications in this journal Background Mucopolysaccharidosis type IVA, also known as Morquio A or MPS IV A, is an autosomal recessive disease caused by the deficiency of the lysosomal enzyme N-acetylgalactosamine-6-sulfate sulfatase (GALNS). The loss of GALNS activity leads to the impaired breakdown of glycosaminoglycans (GAGs) keratan sulfate and chondroitin-6-sulfate. The accumulation of GAGs results in multiple organ damage. The accurate and early diagnosis of this disorder helps enhance the effectiveness of the treatment. The present study uses a pre-designed protocol for testing GALNS activity in the leukocytes of Iranian patients with MPS IV A and their parents and compares it with healthy controls. Methods Patients with MPS IVA previously diagnosed through the measurement of enzyme activity or genetic analysis entered the study. Leukocytes were obtained from the heparinized blood of the participants. The GALNS activity was measured by a fluorometric method using 4-methylumbelliferyl-β-D-galactoside-6-sulfate (4MU-G6S) as the substrate and proper buffer solutions and calibrators. Results The GALNS activity (nmol/17 h/mg protein) was reported as 0–7.4 in the MPSIV A patients, Continue reading >>
Hyperglycemia (high Blood Sugar)
Hyperglycemia is a hallmark sign of diabetes (both type 1 diabetes and type 2 diabetes) and prediabetes. Other conditions that can cause hyperglycemia are pancreatitis, Cushing's syndrome, unusual hormone-secreting tumors, pancreatic cancer, certain medications, and severe illnesses. The main symptoms of hyperglycemia are increased thirst and a frequent need to urinate. Severely elevated glucose levels can result in a medical emergency like diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar nonketotic syndrome (HHNS, also referred to as hyperglycemic hyperosmolar state). Insulin is the treatment of choice for people with type 1 diabetes and for life-threatening increases in glucose levels. People with type 2 diabetes may be managed with a combination of different oral and injectable medications. Hyperglycemia due to medical conditions other than diabetes is generally treated by treating the underlying condition responsible for the elevated glucose. Blood Sugar Swings: Tips for Managing Diabetes & Glucose Levels A number of medical conditions can cause hyperglycemia, but the most common by far is diabetes mellitus. Diabetes affects over 8% of the total U.S. population. In diabetes, blood glucose levels rise either because there is an insufficient amount of insulin in the body or the body cannot use insulin well. Normally, the pancreas releases insulin after a meal so that the cells of the body can utilize glucose for fuel. This keeps blood glucose levels in the normal range. Type 1 diabetes is responsible for about 5% of all cases of diabetes and results from damage to the insulin-secreting cells of the pancreas. Type 2 diabetes is far more common and is related to the body's inability to effectively use insulin. In addition to type 1 and type 2, gestational diabe Continue reading >>
The Effects Of Diabetes On Your Body
When you hear the word “diabetes,” your first thought is likely about high blood sugar. Blood sugar is an often-underestimated component of your health. When it’s out of whack over a long period of time, it could develop into diabetes. Diabetes affects your body’s ability to produce or use insulin, a hormone that allows your body to turn glucose (sugar) into energy. Here’s what symptoms may occur to your body when diabetes takes effect. Diabetes can be effectively managed when caught early. However, when left untreated, it can lead to potential complications that include heart disease, stroke, kidney damage, and nerve damage. Normally after you eat or drink, your body will break down sugars from your food and use them for energy in your cells. To accomplish this, your pancreas needs to produce a hormone called insulin. Insulin is what facilitates the process of pulling sugar from the blood and putting it in the cells for use, or energy. If you have diabetes, your pancreas either produces too little insulin or none at all. The insulin can’t be used effectively. This allows blood glucose levels to rise while the rest of your cells are deprived of much-needed energy. This can lead to a wide variety of problems affecting nearly every major body system. The effects of diabetes on your body also depends on the type you have. There are two main types of diabetes: type 1 and type 2. Type 1, also called juvenile diabetes or insulin-dependent diabetes, is an immune system disorder. Your own immune system attacks the insulin-producing cells in the pancreas, destroying your body’s ability to make insulin. With type 1 diabetes, you must take insulin to live. Most people are diagnosed as a child or young adult. Type 2 is related to insulin resistance. It used to occur i Continue reading >>
Shared Flashcard Set
Details Title Chapter 17 Questions Description Emergency Care and Transportation of the Sick and Injured Total Cards 86 Subject Health Care Level Undergraduate 1 Created 03/12/2014 Click here to study/print these flashcards. Create your own flash cards! Sign up here. Additional Health Care Flashcards Cards Term Common signs and symptoms of diabetic coma include all of the following EXCEPT: A. warm, dry skin B. rapid, thready pulse C. cool, clammy skin D. acetone breath odor Definition C. cool, clammy skin Term Diabetes is MOST accurately defined as a/an: A. abnormally high blood glucose level B. disorder of carbohydrates metabolism C. lack of insulin production in the pancreas D. mass excretion of glucose by the kidneys Definition B. disorder of carbohydrates metabolism Term A 28-year old female patient is found to be responsive to verbal stimuli only. her roomate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she: A.has a urinary tract infection B. has low blood glucose level C. has overdosed on her insulin D. is signically hyperglycemic Definition D. is signically hyperglycemic Term The signs and symptoms of insulin shock are the result of: A. prolonged and severe dehydration B. fat metabolism within cells C. increased blood glucose levels D. decreased blood glucose levels Definition D. decreased blood glucose levels Term Kussmaul respirations are an indication that the body is: A. trying to generate energy by breathing deeply B. attempting to eliminate acids from the blood C. compensating for Continue reading >>
