Question

Q1 diagnosis of diabetes :

Q2 treatment for diabetes :

Q3 prevention for diabetes :

Q4 risk factors of diabetes :

Answer 1

Diabetes mellitus: chronic disorder of impaired carbohydrate, protein, and lipid metabolism caused by a deficiency of insulin. Diabetes was classified as either insulin - dependent diabetes mellitus( IDDM) or non-insulin - dependent diabetes mellitus (NIDDM).

Diagnosis of diabetes mellitus :

Physical examination, medical history, and laboratory tests are employed to evaluate clients with diabetes. Clinical manifestations suggest the presence of diabetes, but laboratory tests are needed to make a definitive diagnosis.

Casual blood glucose level; >clients may also be diagnosed with diabetes based on clinical manifestations and a casual blood glucose level greater than 200mg/ dl.

Fasting blood glucose ;> fasting blood glucose level is greater than 126mg/dl.it is defined as no caloric intake for at least 8 hours.

Post load blood glucose ;> postload or postprandial blood glucose samples are drawn 2 hours after a meal. A 2 hour postload glucose level greater than 200mg/dl during an oral glucose tolerance test.

Glycosylated hemoglobin : Glucose normally attaches itself to the hemoglobin molecule on a red blood cell. Once attached, it cannot dissociate. Therefore the higher the blood glucose level, the higher the levels of glycosylated hemoglobin (HbA1c). The term HbA1c is referred to as an A1C. The A1C is an average blood glucose level measured over the previous 3 months. It is stated as a percentage. A1C goals must be individualized, and to avoid diabetes related complication, the ADA recommends keeping the A1C level below 7%.

Treatment of Diabetes

** Oral Anti-diabetes agents :

Five chemical classes of oral Anti-diabetes agents are available.

* Sulfonylureas

* Meglitinides

* Bigunides

* Thiazolidinediones

* Alpha-glucosidase inhibitors

** Insulin Therapy :

Clients with type 1 diabetes do not produce enough insulin to sustain life. They depend on exogenous insulin administration on a daily basis.

Types of Human Insulin :

* Rapid acting - Humalog, Novolog

* Short acting - Humulin R, Novolin R

* Intermediate acting - Humulin N, Humulin L, Humulin 70/30

* Long acting - Humulin U (ultralente), Lantus

The starting dose of insulin is 0.5 unit/kg/day. Two thirds of the dose is commonly given in the morning, and one third is given in the evening.

** Insulin Pump Therapy :

Small portable pumps for the continuous administration of regular insulin are sometimes used. The small pump, worn externally, injects insulin subcutaneously into the abdomen through an indwelling needle site that is usually changed daily.

Prevention for Diabetes :

# Cut sugar and refined carbohydrate from your diet

# Workout regularly

# Drink plenty of water

# Lose weight if you are overweight or obese

# Quit smoking

# Follow a very-low-carb diet

# Avoid sedentary behaviors

# Eat a high fiber diet

# Optimize vitamin D levels - vitamin D is important for blood sugar control

# Minimize your intake of processed foods

Risk Factors :

There are no known health promotion activities to prevent type 1 diabetes mellitus,however, regular exercise and adherence to a prescribed diet may limit the development of complications. In some instances, high risk individuals i. e, first degree relatives of people with type 1 diabetes are screened and appropriate counseling and follow - up are instituted.

Type 2 diabetes mellitus also appears to be a heterogeneous disorder involving both genetic and environmental factors. Heridity plays a major role in the expression of type 2 diabetes. It is more common in identical twins( 58% to 75%) incidence than in general population. Obesity is a major risk factor with 85% of all people with type 2 diabetes being obese.

It is unclear whether impaired tissue (liver and muscle) sensitivity to insulin or impaired insulin secretion is the primary defect in this type of stdiabetes. In addition the prevalence of coronary artery disease in people with type 2 diabetes is twice that in the non-diabetic population,and cardiovascular and total mortality rates are two fold to three- fold greater than in non- diabetic people.