DIABETES MELLITUS

   

Symptoms: Frequency of urination (pollakisuria); enuresis, nocturia, persistent thirst; polyuria; fatigue; somnolence; hyperphagia; dark skin rash; bad vision.
Special signs: .Hyperpigmented papules on skin; neurological sensory deficit in foot; hammer toe; visual acuity normal; diabetic retinopathy.
Special investigations:  Random blood sugar ≥11.1 mmols/L; Fasting blood sugar ≥ 7.0mmols/L; Glucose tolerance test shows high glucose levels

SHORT DESCRIPTION:
A disease caused by reduced or absent insulin secretion leading to abnormal metabolism of glucose and carbohydrates. It is divided into two types- Type 1 which is predominantly found in the young and type 2 which affects mainly adults and is less insulin dependent. There are three types of coma - diabetic ketoacidotic; hypoglycemic coma and hyperosmolar non -ketotic coma.

This is a chronic metabolic disease which is caused by the body’s inability to use and synthesize insulin. Insulin assists in the conversion of food to energy which is stored in the body, mainly in the liver in gluconeogenesis. This is impaired in the disease causing all sortsof abnormalities of the blood vessels (microangopathies), nerves , kidneys, heart and the eyes which may lead to blindness. Insulin dependent diabetes mellitus (IDDM1) has several loci of gene affection. It is associated with chromosome 6 which contains one locus. 10 loci have been found to cause or are associated with susceptibility to type 1 diabetes mellitus. There is a gene at locus IDDM2 on chromosome 2 and 11, and also on chromosome 7 containing the gene for glucokinase (GCK) which helps insulin secretion and metabolism of glucose.

 

 

Diabetic gangrene

                                                                                                            Diabetes fundus with hemorrhages

 

 

 

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