5 Diabetes Powerpoint(PPT) presentations

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Diabetes mellitus is a clinical syndrome characterised by hyperglycaemia due to absolute or relative deficiency of insulin. This can arise in many different ways but is most commonly due to autoimmune type 1 diabetes or to adult-onset type 2 diabetes. Lack of insulin affects the metabolism of carbohydrate, protein and fat, and can cause a significant disturbance of water and electrolyte homeostasis. Death may result from acute metabolic decompensation, while long-standing metabolic derangement is frequently associated with functional and structural changes in the cells of the body, with those of the vascular system being particularly susceptible. These changes lead to the development of clinical ‘complications’ of diabetes which characteristically affect the eye, the kidney and the nervous system.

The distribution of blood glucose concentration in populations is unimodal, with no clear division between normal and abnormal values. Hyperglycaemia represents an independent risk factor for the development of disease of both small and large blood vessels. Diagnostic criteria for diabetes have been selected to identify those who have a degree of hyperglycaemia which, if untreated, is associated with a significant risk of microvascular disease, and in particular diabetic retinopathy. Less severe hyperglycaemia is called ‘impaired glucose tolerance’. This is not associated with substantial risk of microvascular disease, but is associated with increased risk of large vessel disease (e.g. atheroma leading to myocardial infarction) and with a greater risk of developing diabetes in future. The implication of these criteria is that there is no such thing as ‘mild’ diabetes not requiring effective treatment.

Diabetes occurs world-wide and the incidences of both type 1 and type 2 diabetes are rising; it is estimated that, in the year 2000, 171 million people had diabetes, and this is expected to double by 2030. This global pandemic principally involves type 2 diabetes, to which several factors contribute, including greater longevity, obesity, unsatisfactory diet, sedentary lifestyle and increasing urbanisation. Many cases of type 2 diabetes remain undetected. However, the prevalence of both types of diabetes varies considerably around the world, and is related to differences in genetic and environmental factors. The prevalence of known diabetes in Britain is around 2-3%, but is higher in the Middle and Far East (e.g. 12% in the Indian subcontinent). A pronounced rise in the prevalence of type 2 diabetes occurs in migrant populations to industrialised countries, as in Asian and Afro-Caribbean immigrants to the UK. Type 2 diabetes is now being observed in children and adolescents, particularly in some ethnic groups, such as Hispanic and Afro-Americans.

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